Hello and welcome to the Gastric Health Show. My name is Dawn Boxell, Registered Dietitian. This week’s topic is a healthy gut begins with avoiding unhealthy habits. So we’re going to just dig a little deeper into truly understanding how to build a healthy gut and the things that can interfere with this process. We’ve talked about your gut health before, but we’re packaging this all together in a way that really just allows you to process and implement and think through some strategies or think through maybe some areas that your weak in and areas that need improvement so that you can start challenging and start working and start figuring out how you’re going to switch from maybe this property or lifestyle habit or medical procedure or medication that you have been taking that maybe is interfering with your ability to maintain a healthy gut. We’re going to hopefully give you some thoughts to ponder and try to build on and just really work on really improving your healthy, improving a healthy gut and changing those unhealthy habits that can affect the long-term outcome of you maintaining a healthy gut.

Why is gut health important? 

(01:47)
So we know that your gut health is super important, impacts your digestion, your immune system, your mental health, but many people kind of struggle with an unhealthy gut without understanding why. There are several factors that can lead to an un unhealthy gut really impairing your body’s ability to absorb nutrients, regulate your blood sugar, and how you store fat can also kind of let toxins in through those intestinal walls that are maybe weak and broken in ways that are allowing things to go through that are creating bigger health challenges. So why is gut health so important? And if you followed me, you’ve probably heard some of these, but number one, digestion and nutrient absorption. So this is where your body absorbs all the nutrients from the foods that you consume is in your small intestines and this your small intestines and your large intestines or your colon is where a lot of things happen and is where the gut microbiome is residing and impacting your health negatively.

Digestion and Nutrient Absorption

(03:16)
So for optimal health overall, you want your digestion and nutrient absorption to be in tip-top shape. So this will allow your body to function appropriately. Having any imbalances with your ability to break down and absorb nutrition really can trickle down and cause other problems long term. Some studies have shown that diverse and balanced gut microbiomes are associated with improved nutrient absorption and overall digestive function. So again, having a diverse gut microbiome is all about a variety of different bacteria, fungi, parasites, all of these should be living harmoniously in your gut.

Immune System Function

(04:13):

Mental Health and Brain Function

(04:47)
So if you have, you want to have a strong immune system so that your body doesn’t react to harmless substances and only reacts to harmful. So that again, is one important reason why having a healthy gut matters. Next, of course, your mental health and your brain function. So you have to think of cognitive function, Alzheimer’s disease, dementia, but then also depression, anxiety, any of those areas of the brain that can truly impact your mood and just your mental stability is all coming through the gut. And several studies have shown gut dysbiosis connected to the anxiety, depression and neurodegenerative diseases like the Alzheimer’s and dementia.

Inflammation and Chronic Diseases

Metabolism and Weight Regulation

Overall Well-being and Quality of Life

(08:00)
So studies have shown that specific gut bacteria can affect energy, balance, appetite, regulation, and the metabolism of dietary compounds underscoring the importance of a healthy gut for weight management. Number six, overall wellbeing and quality of life. And really it just comes down to if your gut is truly in a pretty healthy state, your overall health will probably be the same. Again, I’m not a big per person to believe in perfection and that you don’t ebb and flow in and out of different gut issues depending on maybe the season of life or maybe certain stress levels that you’re experiencing.

Causes of an unhealthy gut

(08:51)
I think you can still have life happen, but yet maintain a pretty healthy gut. In the meantime, there are some studies that indicate gut health is essential for digestion, immunity, mental health, inflammation, regulation, metabolism, and just general good health and nurturing a healthy gut through lifestyle choices that can promote diverse gut microbiome, bacteria, and optimal function can really influence your health and longevity. So those are six great reasons of why you want to maintain a healthy gut, but what are some causes of an unhealthy gut? And this is where we kind of dig into this area of where maybe you might have to reflect on some of your behaviors, some of your choices, maybe your current health state and the list of medications and stuff that you’re currently taking because they all can influence how healthy your gut can be currently, but then also in the future.

What other options do I have?

(10:09)
So if you’re having to take things that are really kind of doing the opposite of what you want for your long-term health, you have to step back and say, what can I do differently? What other options do I have? And it really comes down to you as a person and what your goals in life are and how you perceive success with your health. I think we all have a different answer to this and sometimes life experiences and sometimes even, and sometimes even just how our health has been our entire life really can determine this answer. And some people are truly made to live a long life and live it well and have the mindset and the ability to do so, whereas other people have maybe been in a different position that they never had those experiences or never had that, I guess example in their life that they knew that is a potential and that is something that they would desire.

What am I really hoping to get when I am working on my health?

(11:27)
So I think I want you to, as we go through these things, I want you to reflect and think about what do I really want? What am I really hoping to get when I am working on my health? And what do you have? What’s the end goal? Is it just the number on the scale, which I truly hope not. I truly hope it’s that you are to attain or achieve a certain goal or you have a mission or a passion that you’re excited about and you’re working towards that you’re wanting your health to be in a certain position so that you can do all those things that you align with. So as we go through all these, you know have to think about, okay, maybe I need to have a conversation, maybe I need to change my schedule and my routine so that I have time for this.

Medications and Gut Health

(12:25)
So number one, medications and gut health. So medications are definitely necessary and by no means am I telling any person to ever stop a medication that has been prescribed from your physician. Not a good strategy at all for any of us to just stop taking medications, especially some medications. If you abruptly stop, you are seriously going to have some bad health consequences either in the short term or long term because you didn’t maybe wean off appropriately or maybe you were never supposed to get off of it. So this is not to bash any of these medications, this is to educate you on what these medications can do to your gut health that could be influencing your ability to achieve or maintain the health that you have in mind. And this could be what is causing you to get stuck, and this is what I want you to challenge yourself and explore what are my options and really start challenging your healthcare team and okay, if I have to take this, I have to take this, but what can I do to protect myself better?

• Antibiotics: 

(13:52)
So we know that certain medications do impact your gut health very negatively, and one of these is antibiotics. So antibiotics are super effective and I’ve taken antibiotics. I would guess that most everyone has taken antibiotic at some point in their life, so not a bad thing. They have saved lives and I would use it if I had to today and I would just know what to do to support my body to repair and recover that need for the antibiotic. Because let me tell you, life happens. And if you’ve been on my email list, you read my email hopefully this week and heard that my mom had to go to the hospital and it was quite an ordeal. And you know what? If she had needed antibiotics, then absolutely, that is definitely something I would want. And if I kind of reflect back, my daughter going into labor ended up with a C-section and she had to have a lot of antibiotics.

why am I having sinus infections?

(15:08)
She spiked a temp during labor and got a couple of rounds during labor and then she also got some in her C-section and then spiked a temp after her C-section and had to go on sepsis protocol because she spiked a temp later that night after the C-section, she got more antibiotics. So again, it’s not that you don’t do the antibiotics, you do the antibiotics, but you try to get yourself out of those, the chronic need for them. Think of things like reoccurring ear infections and sinus infections. Try to minimize the use or need for those back up a little further and say, okay, why am I having sinus infections? Do I need to start an allergy pill two months earlier before the allergy season arises? I don’t know. Those are conversations that you got to think about. So it’s not about you don’t ever do these medications, it’s just that you need to understand the risks that can impact your gut health, that then impacts your overall health.

Proton Pump Inhibitors (PPIs)

(16:15)
So the antibiotics re research has shown that prolonged or frequent use of antibiotics, reduced gut micro microbio or the gut bacteria potentially leaving a void or a harmful bacteria to thrive. Again, it kills the good and the bad. So it’s not a respecter of bacteria, it just kills all of the overabundance and we want an abundance of good bacteria, so you have to know how to flip the switch and do something different. The next one is proton pump inhibitors or PPIs. And these are widely used for reflux, heartburn and just stomach problems, indigestion. These are prescribed widely and frequently, and the negative is the long-term use of PPIs can really lower your stomach acid level and facilitate the growth of harmful bacteria. It just creates that environment that bacteria can flourish, so it’s no longer killing off when we’re exposed to it because we don’t have enough stomach acid.

Anticholinergics

(17:27)
So when you suppress the stomach acid so low that you don’t have enough to defend your body, then that’s when problems arise. The next are anticholinergics, and these are used for overactive bladder respiratory disorders and these medications kind of by blocking acetylcholine’s action. And unfortunately, anticholinergics can cause a slowdown in your gut motility and this can lead to constipation in an imbalance in your gut transit time. So these types of medication, although necessary, sometimes if you have an overactive bladder, I could see why you would want that, but can you use it short term and then find alternatives so that you don’t need to have this medication on a regular basis? And if not, then what can I do to help support a healthy gut motility so that it doesn’t mess up and create constipation and small intestinal bacterial overgrowth? I mean, just start one.

Whole digestive tract and now you’re creating that environment for bacteria

(18:47)
It just, it’s like a snowball effect. You slow down your whole digestive tract and now you’re creating that environment for bacteria to flourish because it’s going to sit there and food isn’t going to move and it’s not going to be digested appropriately and you’re going to start having issues with your symptoms. You’re going to have lots of gas and bloating and abdominal pain and the list just goes on. So although beneficial, what are my other options? Do we have any other alternatives? And it’s like, okay, list them out, let me have all the good and the bad, and then I just pick the best of the worst. And it may be that you have to maintain on this and you really have to just work on using a prokinetic and using different types of properties that can help keep that gut flowing. The next are NSAIDs and the non-steroidal anti-inflammatory drugs.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): 

(19:55)
They’re amazing. Everybody has used these Motrin, Aleve, ibuprofen. I mean I’ve used them after, I would say I’m not a big pill popper when it comes to headaches and pains per se, but if it goes on for a few days, I might eventually choose to take an Aleve or a Motrin. I know when we got covid at our house, well we were definitely taking Motrin, the Motrin liquid, those were magic. Those made everything feel better. So again, you have to think of short term, not a problem. Any of these drugs are great short term. It’s just long term is when it can destroy your gut and really influence negatively long term. So the negative with NSAIDs are it irritates that gut lining. And as a bariatric patient, this is definitely something that you would be fully aware of. You’ve been told do not take NSAIDs.

Ulcer from an NSAID after bariatric surgery

(21:04)
And I would say most of our patients are pretty good, but not all of them. And because we’ve had plenty of them that would get ulcers because they were taking an NSAID only a couple of times, and that was always the surgeons, they were very quick to say, it doesn’t take but a few times to get an ulcer from an NSAID after bariatric surgery. When you have a normal anatomy with a football sized belly, you have a little bit further that you can go with it without getting an ulcer, but anybody’s at risk for getting an ulcer from an nsaid. But the negative also not also is it irritates that gut lining, but it also increases your risk for intestinal permeability issues or leaky gut. So this creates more havoc and can cause autoimmune diseases and other issues. The next are laxatives, and of course most people don’t really want to use these anyway, but if you have constipation, then you know what, sometimes you just need a laxative.

Laxatives

(22:12)
Now preferably I like using other things like mag citrate, buffered vitamin C, aloe vera, there’s a whole bunch of other things that can be used that can get the job done it. My favorite is honestly smooth move tea. But again, if you’ve never you, you’ve never offered those options and this is what you were told to take, this is what you took. So the negative is that it, yes, it can relieve constipation, but it can also disrupt your gut motility when you start depending on it. So you have to kind of again, peel back that onion layer and say, okay, why am I having constipation? Why do I need laxatives? And let’s start with that and work our way out of needing laxatives. That’s where I would go before you, your colon gets addicted to it and no longer wants to move and now you’re stuck.

Metformin

(23:11)
Now you need something that can support you on a daily basis. The next is metformin. And this is widely used for type two diabetes, but it can alter your gut microbiome. And studies have found that metformin reduces beneficial gut bacteria that can lead to a gut dysbiosis. So again, you’re kind of lowering the good guys, kind of maybe not the level of antibiotics, but if you are impacting those beneficial gut bacteria, then you need to be doing something to counterbalance that loss. The next one is statins. Statins lower cholesterol and reduce cardiovascular disease risk. Great, if you need it, you need it. And genetically, some people, their cholesterol levels are just super elevated and some physicians really get concerned and the risks of heart disease and heart attacks and heart failure and all that can be increased at really high cholesterol levels. So the negative is with having to take these long term is they have GI side effects, bloating, diarrhea, indigestion, and it can just really disrupt your gut health.

Statins

(24:48)
So again, not a bad thing if you have to have it, you have to have it. But I will say challenge your healthcare team. What are my other options in the natural world? Niacin, red yeast, rice, those are some other things that can help those plant sterol. And then if you go to the food, you want to think about oats, the beta glucans and oatmeal, and those can really help support a healthy cholesterol level. So if you can try some of those. And of course diet wise, there’s a ton of things that you can try. Even the fish oils as well and fatty fish, and I’ve even talked about it in, I think this was on maybe my GLP one post, but it was showing with extra virgin olive oil that it can also help support healthy cholesterol levels. So again, there are things you can do and that’s what I’m trying to open the doors for you of alternatives that you could explore and maybe going down that pathway you can be on maybe a dose that is not as disruptive to your digestion and you don’t have the side effects and then you can easily maintain it because you’re adding some of these other things that can help support a healthy cholesterol level.

Selective Serotonin Reuptake Inhibitors (SSRIs): 

(26:24)
And the last one is SSRIs or selective serotonin and reuptake inhibitors. These are antidepressants and they definitely impact your gut because serotonin regulates gut motility and mood. So SSRIs affect gut function and potentially lead to gut related side effects. So again, if you’re on an SSRI antidepressant one, don’t ever abruptly stop. That’s definitely not a good strategy. You can feel really sick mentally, physically, emotionally by doing that. But understand that by taking an SSRI long term, then it could potentially create some gut problems because serotonin is what regulates your motility. So you could have some motility issues when if you need to stay on these for long term. So again, that forces you to reflect on your life and say, why do I feel like I need an antidepressant? What is happening? What is not happening? Am I not addressing? Am I not confronting?

Menopause is not a meno

(27:48)
Where am I in my relationships, my work, my coworkers? Where am I that I am not maybe having some difficult conversations that I’m relying on this antidepressant to help with? Now I’m going to flip that on its head and it could be menopause and you’re just excessively depressed and you need something. And menopause is not a meno. Menopause is just a life stage and you every female goes through this and sometimes you need an antidepressant to kind of get you through that perimenopausal phase. That is sometimes really awful for some people. So interesting. Some people truly walk through menopause like nothing, like their period stopped and they feel nothing, and they have very few side effects, so it’s no big deal. Whereas other people, it is like life changing and their whole world is turned upside down again. Once you get through that and you get become post menopause, you may find that, Hey, I’m okay.

(29:07)
I don’t have to take an SSRI anymore. I have things kind of balanced out now and I feel better, so I don’t need those. So again, you have to reflect on your life and what you are needing and not be afraid to use it if you need to. That was number one. So we covered the causes of an unhealthy gut medication was all of those.

#2 Gut Imbalances and Dysbiosis

(29:35):

Insufficient Good Bacteria

(30:20)
And not having following more of an ultra processed diet. And ultra processed foods don’t have much fiber at all. They have very little fiber. So if that was your life and you’re trying to change that, so you’re working your way out of that lifestyle, you may not have a lot of good bacteria, so you need to transition into more fiber filled carbohydrates and you’re going to get there over time. It just takes time. But that’s going to grow that good bacteria. But then also you have to think about stress. Stress can destroy beneficial gut bacteria. Then we also have talked about the antibiotics and the other medications that can destroy the beneficial bacteria that our bodies need. So again, it’s a combination of all of those. It can influence it and our diet and lifestyle play a role. So if you can really challenge yourself with fiber filled carbohydrates and really work on stress management, those two things alone can make a huge difference.

Overgrowth of Bad Bacteria or Bacteria in the Wrong Location

(31:32)
And then start working on those medications that are maybe adding to this picture so that you put the odds in your favor. And then if you think about an overgrowth of bad bacteria, so it’s not just that you don’t have enough good bacteria, you could have enough good bacteria. It’s just that now you just have too many of the bad guys and the good guys haven’t taken over and are not maybe strong enough to take over because there’s so many of the bad guys. So again, you could have normal levels of good bacteria, but just in abundance of bad bacteria. So an overgrowth of harmful bacteria that can migrate into incorrect parts of the digestive tract that can lead to an unhealthy gut. For example, an overgrowth of e coli or c diff can disrupt the gut’s delicate balance, and these bacteria can produce toxins and enzymes that actually harm the gut lining cause inflammation and a whole lot of GI symptoms.

Small intestinal bacteria overgrowth or SIBO

(32:43)
So not to mention small intestinal bacteria overgrowth or SIBO as a result of the colon bacteria kind of moving into the small intestines can cause digestive disorders and nutrient malabsorption that lead to other gut problems. So it’s kind of like a vicious cycle. You have to start and fix something somewhere to get out of the loop. And then digestive dysfunction, this is where you don’t have enough stomach acid, pancreatic enzymes, bile, you’re lacking these. You’re lacking the ability to digest and break down food appropriately, which is setting up the environment for kind of an overgrowth, the fermentation of the food that you’re consuming. Maybe you’re eating a fabulously healthy diet full of fiber filled carbohydrates, but yet you feel miserable because your body can’t digest it well. And now you have a lot of gas and bloating and abdominal pain, maybe constipation, diarrhea, maybe both.

Digestive Dysfunction and Bacterial Flourishing

(33:56)
You feel miserable. So it kind of perpetuates you to stay in that poor eating because the healthier stuff make you feel bad because you don’t have the ability to digest food appropriately. Some of that can be driven from stress and having high stress level can be a driver of not enough stomach acid, bile, pancreatic enzymes. So again, really managing your stress level can make a big, big influence of that.

#3 Stress and Gut Health

In bounce off ideas of stress free things

(35:44)
Maybe you are avoiding or waiting, maybe you’re like, I’m going to wait till I retire. I’m going to wait until or it’s going to be easier to do when. And I assure you that there’s no better time than the present. If you truly have something you desire to do, find a way to make it happen because it can totally lower your stress just because you’re doing something that you are excited about doing. So I have no magic when it comes to stress. I, I’m not perfect at this either, but I think the more you can collaborate with people who are truly working towards finding a less stressed life is ideal. So connect with other people. You know that I would say that is my goal with our gastric health membership is to truly have a community of people who we can stress less together. We can do fun things and in bounce off ideas of stress free things, fun things, new things, new hobbies, new things to explore and do and experience.

#4 Exercise and Gut Health

(36:59)
And that alone can be super relieving and make you enjoy your life better. When you have a community of people who are trying to accomplish the same goals. Number four, exercise. And we know exercise is great for us, but how is it that exercise can make our gut unhealthy? And I will tell you, most people are not going to fall in this category. I would say the majority of us are just standard exercisers. Like myself, I’m just a standard person who does basic exercise. I don’t do anything extreme and I don’t do anything long for long times outside of maybe some of our long bike rides. Skiing, I guess maybe, but not that hard of a skier. Maybe back in my twenties I was, but no, I’m not in that type of behavior of being where exercise could really influence my gut poorly making it go the other direction.

Exercise is going to be an amazing way to have a healthy gut

(38:20)
So for most people, exercise is going to be an amazing way to have a healthy gut. For some people think of Iron Man triathlons or you do multiple or you go to the gym and you do a lot of cardio for hours like you do, and you maybe you do long hours of weights, not just short, go in, get it done. You literally are there for hours and it’s not to all the gym buddies, you are literally working out. That could flip to the other side. So think of if you are especially a bariatric patient who is maybe trying to do a marathon or an Iron man or triathlon, you’re training, you’re doing these things, I want you to know there’s nothing wrong with doing that, but I would work with a practi practitioner like myself who can truly help guide you through that process.

#5 Diet and Gut Health

(39:26)
So you do it right, so you fuel your body correctly and add in the right thing so you don’t destroy your gut. This is definitely a big thing. And if that is you then reach out. I would love to help support you in a better way so that you don’t have to struggle and battle with that. So you can put some things into place so that you maybe don’t flip it to a negative. Number five, of course, your diet. So if you follow an ultra processed food diet, which is a low fiber diet, that is what can influence your gut health negatively and create an unhealthy gut. So that’s where fiber filled carbohydrates are so important. Fruits, vegetables, beans, lentils, whole grains, all of these are necessary for you to have a healthy gut. So I know that carbs are so controversial and everyone feels like they should not be eating carbohydrates, but I can assure you, you definitely need carbohydrates.

 Finding the right amount of carbohydrates

(40:42)
It’s just finding the right amount of carbohydrates. The right ones that don’t spike your blood sugar, that can trigger higher insulin. That can trigger higher blood sugars and at a chronic level. And that’s where whole real food really is your best option when it comes to fiber filled carbohydrates and avoiding those packaged processed foods because most of the packaged processed foods, not all of them, but most of them are not going to have adequate fiber for most people. So it depends on what your day is like and what you’re combining working with me and in the gastric health membership that is foundational trainings that I share with my members. Those are things that can help you support a healthy gut so that you don’t flip it to be an unhealthy.

Other Factors Influencing Gut Health

(41:43)
Number six, there are other things. So this is kind of just an others category and you want to think about quality sleep. So we’ve talked several posts about quality sleep and how that impacts the health of your gut. And when you don’t get good deep sleep, it can increase your gut permeability. And lead to hormone imbalances and just really impact your overall health and your gut. The next one is excessive alcohol consumption. And this probably isn’t a surprise, but definitely alcohol disrupts your gut bacteria balance and can increase GI inflammation. It does impact that gut barrier and can increase intestinal permeability or leaky gut. And what’s considered as excessive alcohol consumption is nine alcoholic beverages in a week. So it’s so confusing for people because it gets promoted as a glass of wine a night is helpful to your health. So you start with one and sometimes it turns to two and you do that enough nights. And you’ve easily exceeded the nine drinks a week if you’re doing that on a nightly basis.

How is your relationship with food, with your alcohol and what should you do differently?

(43:14)
So again, you’ve got to learn to one, how is your relationship with food. With your alcohol and what should you do differently? And then what can you do to protect your gut and your liver when you drink alcohol? And those are things again that I talk about with my members. The next one is artificial sweeteners. And although controversial, I want you to understand that artificial sweeteners bind to the gut receptors. Which impacts your migrating motor complex, which is what controls your motility. So if you are consuming tons of artificial sweetener through drink additives, protein shakes, protein bars, sugar free puddings. And jellos, and anything sugar free that has artificial sweeteners in it. And you’re doing that round the clock daily, that’s when I would be concerned. I don’t really care if you have a little bit of a certain artificial sweetener every now and then. But if I have somebody with a lot of digestive issues. I’m going to ask them to remove it completely.

Let’s pull out all the artificial sweeteners

(44:40)
Let’s pull out all the artificial sweeteners. And that also includes your coffees and coffee creamers, pulling it out of all of those foods and beverages. So that we can restore your gut balance because it can really impact your gut health negatively. So evaluate your relationship with artificial sweeteners and. How much you’re actually consuming because some people will be surprised at really. How much they’re taking in and have no concept of it. So really to start maybe jotting down, okay, I had it in my coffee. Oh yeah, I had a crystal light. Oh, I had another crystal light. I had a protein shake and a protein bar, and then at snack I had a pudding or whatever. That’s several opportunities a day that you’re getting exposed that that could be driving some of your gut issues. So the next one is vitamin and mineral deficiencies.

Vitamin and mineral deficiencies

(45:47)
You can actually impact your gut health from having vitamin and mineral deficiencies. Certain vitamins and minerals can influence how your gut functions. So making sure that your vitamin and minerals are on point. And they are in reference range is another area that you have to think about. You have to think about these things that can really influence the health of your gut. So let’s wrap this up. Achieving a healthy gut requires really a comprehensive approach. and in my opinion, a knowledgeable practitioner. That can really help put all of the puzzle pieces together for really the best protocol. So that you can reverse it, rebuild it, and restore your whole gut microbiome. And this is definitely something that if you do it early, it takes less work. If you wait, it takes more time, more healing items to get you better. So I’d love to work with you. If you really are struggling with an unhealthy gut or you just are unsure. If it’s your gut that’s driving some of your health conditions, reach out. I’d love to work with you. I would be happy to chat to see if we’re a good fit. And I would

Highly encourage you to check out the gastric health membership because that’s truly the best value that we have going. And it’s a great way to get information that can help lead you to having a healthy gut long term. I hope you guys have enjoyed this week’s topic, and we will see you next time. Bye-bye.

Listen, Learn, Enjoy…

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