The Medical Minute: Small changes make big differences in digestion

The bacteria in your gut do more than simply help digest your food. The microorganisms living in your digestive tract can also influence your overall health, including your mood and susceptibility to illness and disease.

Experts still have a lot to learn about the microbiome – the trillions of bacteria that live in your gut – but there are a few things that have become clear.

“In many ways, we are what we eat,” said Dr. Ann Rogers, director of Penn State Surgical Weight Loss.

Many people know they should be eating more of a plant-based diet, yet that can be difficult in a part of the country where starchy corn and potatoes are the closest some people come to eating vegetables.

“We don’t get nearly enough fiber and complex carbohydrates,” Rogers said.

When your body receives a diet high in sugar and simple-to-absorb calories, the bacteria in your gut don’t have much to digest and can actually begin to digest the gut lining, which can lead to trouble.

“A lot of people are afraid to introduce high-fiber foods because they don’t want to get gassy and crampy,” Rogers said. “But if you are patient, your microbiome will adjust.”

She encourages her patients to avoid antibiotics if possible and says it may be worth paying the extra money for high-quality probiotics, as well as hormone- and antibiotic-free meats and dairy products.

“The food industry has started to modify the food we sell to the point where you think you are eating something healthy – for example, an apple – but it’s not the same apple you’d eat years ago. Because of genetic modifications designed to increase sales, it has more sugar and less fiber,” she said.

Long-term use of antacids can change the pH of the digestive tract and alter the gut’s microbiome, so Rogers advises not using them regularly unless it is medically necessary.

Some research recommends eating fermented vegetables such as sauerkraut or kimchi on a weekly basis to promote gut health. Other studies say a regular probiotic supplement can be helpful to just about anyone looking to improve their gut’s microbiome.

Rogers said the biggest problem she sees is that many patients in the surgical weight loss program don’t know how to cook or shop for food.

“Many patients eat mostly at drive-thrus and convenience stores,” she said. “I told one woman to buy a crock pot, put a chunk of meat and some vegetables in it, and turn it on before she left for work. It was a life-changing conversation for her.”

Basic things such as getting enough exercise and sleep, spending time outdoors and managing stress affect gut health just as they do other conditions.

“Regular exercise promotes the diversity of bacteria in the gut,” Rogers said. “And there is a big relationship between our level of stress and the bacteria that live in our gut.”

Stress can affect movement and contractions of the gastrointestinal (GI) tract, make inflammation worse, or even make people more susceptible to infection. Research suggests that some people with functional GI disorders perceive pain more acutely than other people do because their brains do not properly regulate pain signals from the GI tract. Stress can make the existing pain seem even worse.

The good news is that it’s possible to make changes and improve your microbiome.

Rogers said, “It has been shown that if you make even minor changes to your diet, within 24 hours it will change the makeup of your gut.”

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The Medical Minute is a weekly health news feature produced by Penn State Health Milton S. Hershey Medical Center. Articles feature the expertise of faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

March 7, 2018 Penn State Health News

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