Hippocrates, the father of modern
medicine, wrote over 2,000 years
ago: All disease begins in the
gut. But what does “gut health”
mean? How does it affect other
parts of your body? And what can
you do to improve your gut health
if it’s out of balance?
Recently, we sat down with board-certified
gastroenterologist Dr. Assaad Soweid of
the CalvertHealth Medical Group to get his
take on these questions; how to recognize
when there’s a problem and get some
practical tips for making your gut happier.
Q. Why is good gut health
important?
First of all, the gut is simply not a tube as
we used to study where food goes in, gets
absorbed and is excreted. It’s way beyond
that. It’s a system where a lot of other
functions of the body are affected. Your digestive tract is home
to some 500 different bacteria. This is called “the microbiome”
and it plays an important role in things you wouldn’t imagine
like the immune system, regulation of weight, obesity, skin
diseases, even mood conditions and cancers. So, gut health is
important because it can impact many other systems in the body.
In the gut, there are good bacteria, the beneficial ones and
the not so good kind. If there’s an imbalance in favor of the not
so good, at the expense of the beneficial bacteria, then you have
diseases. Your immune system gets affected and you get lower
immunity, inflammatory conditions and autoimmune diseases. You
can have obesity, impairment in your metabolism and absorption
of nutrients. So, basically bad things can happen.
The good bacteria protect you from a lot of things, help you
digest better, improve your immunity, help you combat depression,
cancers and obesity. This, by and large, depends on the microbiome,
what we eat and drink and how we treat our GI tract.
Q. What are the signs of an unhealthy gut?
With an unhealthy gut, you can have excessive gas, which
denotes maldigestion of foods. You can get bloating, constipation,
diarrhea and heartburn. Obviously, in a healthy gut you are
regular and you don’t have these symptoms.
But again, it’s not only the gut
symptoms. Signs of an unhealthy gut
include other things – like depression,
unintentional weight changes and sleep
disturbances. (More than 90 percent of
serotonin, which is key to regulating
sleep, is produced in the gut.) It
can also show up as chronic fatigue
and eczema. Inflammation in the gut
caused by poor diet or food allergies
may cause increased “leaking” of
certain proteins out into the body,
which in turn can irritate the skin. So,
it’s not only the size of an unhealthy gut
but also a lot of other ailments outside
the GI tract that’s important for people
to understand. Of course, not all sleep
problems are caused by the gut but it’s
definitely contributing to this.
Q. What causes poor gut
health?
While food has a big impact on your
gut health, there are also a number
of lifestyle factors to watch out for.
These include: smoking, frequent
antibiotic use, certain medications
such as laxatives and chronic stress.
I tell all my patients you need to
reduce stress. As a matter of fact, I’ve
done a study that is being published
by one of my fellows looking at the
value of “mindful meditation” in
patients with IBS (irritable bowel
syndrome). It’s a form of breathing
exercises you can do in bed in the
morning and evening for 5-10 minutes
a day. Our preliminary data in a small
randomized study showed that when
people do that, they feel better.
Q. How can I improve
my gut health?
Eating a variety of foods that are
good for gut health is the best way
to ensure our gut bacteria is diverse.
In fact, research has shown that
what you eat can change your gut
microbiome within a week. A healthy
diet should include a wide variety of
fruits and vegetables, whole grains and legumes. Fiber is the main fuel
for good bacteria. Prebiotic foods
such as apples, bananas, asparagus,
artichokes, onions and garlic also
help boost good bacteria. We also
have to eat slowly, because when you
eat slowly, regardless of everything,
you digest better.
You can also look after your gut
by making sure you exercise regularly,
drink plenty of water and get a good
night’s sleep. While many studies have
had positive results on the impact of
probiotic supplements, more research
is still needed. We have seen it can
be helpful in certain diseases like
Crohn’s, ulcerative colitis and C. diff
(Clostridioides difficult) infections, which
is the antibiotic-associated infection that
comes with the use of antibiotics.
Q. When do I need to see a
gastroenterologist?
If you’re having any symptoms that
are outside the norm, especially if
they’re acute (severe and sudden
onset). There are also what we call
“alarm symptoms” that call for prompt
attention. Red flag symptoms include
seeing blood or black color in the stools,
vomiting, severe abdominal pain, fever,
weight loss and difficulty swallowing.
You also need to consider other factors
such as age. For example, if a young
person in his or her 20s, has reflux, then
it’s probably a good idea to make some
changes in diet and lifestyle. But if an
older person has reflux, then it could be
associated with certain diseases, so
they should see a physician.