Show 1395: Gut Check–How Digestive Health Influences Everything

This week, we talk with integrative gastroenterologist Robynne Chutkan about why our digestive health is so important. Of course, our digestion provides us with the nutrients that power our bodies, including our muscles, hearts and brains. There is also crucial two-way communication between the gut and the brain.

Why Should We Care About Digestive Health?

Many traditional medical systems around the world center the importance of good digestion. Even Hippocrates, the father of western medicine, was clear that it is critical. Yet American medicine in the 21st century is rediscovering just how digestive health reverberates throughout our lives.

When we talk about the gut-brain connection, many people visualize the bossy brain telling the gut what to do: be nervous, with butterflies in your stomach. Relax, so you can poop. On the other hand, the vagus nerve that is a big part of this communication runs both ways. Scientists have found that the Lewy bodies associated with Parkinson disease are apparent in the gastrointestinal tract long before people develop typical movement problems. In addition, constipation is often one of the earliest symptoms. Alzheimer disease may also begin in the gut.

Medicines That Interfere with Good Gut Health:

In reviewing sources of GI problems, we need to consider diet first, but the medicine chest should also rank high on the list. Drugs designed to affect the digestive tract can also have significant impacts on a range of other organ systems. Moreover, changing the acid/base balance of the stomach as heartburn medicines like omeprazole can also alter the balance of the microbiota. In some cases, the consequence could be small intestinal bacterial overgrowth, or SIBO. To address the symptoms of SIBO effectively, one must determine if a medication is contributing to the problem.

Other medicines may not target the digestive tract specifically, but they still can have a major effect. GLP-1 agonists for diabetes or weight loss are a perfect example. That term may seem technical (because it is), but you will no doubt recognize the brand names Ozempic, Wegovy, Mounjaro or Zepbound. These drugs can slow the movement of food out of the stomach, which can present hazards if a patient requires surgery. Getting anesthesia when the stomach contains food puts the patient at risk for aspirating stomach contents. This dangerous complication can result in serious lung irritation or pneumonia.

When Could Fecal Transplants Improve Digestive Health?

Traditional Chinese medicine has embraced a form of fecal microbiota transplant (FMT) for more than a thousand years. For American medicine, this is something of an innovation that has only become fairly common in the past few decades. Even now, the FDA has approved it for only one indication: treating serious diarrhea due to C. diff. When Clostridium difficile bacteria take over the digestive tract following a round of antibiotics, the usual treatment is more antibiotic. That doesn’t always work, however, and it doesn’t seem the most rational way to restore digestive health. FMT might be better in this context. Future research may find additional uses as well.

Common Gastrointestinal Complaints:

We asked Dr. Chutkan about the most common digestive complaints. Bloating is one; problems with either constipation or diarrhea is another. We discuss symptoms and solutions for bloating. Dr. Chutkan also describes some of the most effective food choices for digestive health–beans and greens. How can you avoid excess gas if you are following such a diet? The dietary supplement Beano can often be very helpful. A diet heavy in vegetables and fruits is one of the best ways to reduce the risk for gastrointestinal cancers.

This Week's Guest:

Robynne Chutkan, MD, is a board-certified gastroenterologist and a faculty member at Georgetown University Hospital. She is the founder of the Digestive Center for Wellness, an integrative gastroenterology practice located in Washington DC. Dr. Chutkan is the author of the digestive health books Gutbliss, The Microbiome Solution, The Bloat Cure and The Anti-Viral Gut: Tackling Pathogens from the Inside Out. An avid squash player, runner and yogi, Dr. Chutkan is passionate about introducing more dirt, sweat and vegetables into people’s lives.

https://robynnechutkan.com/about/robynne-chutkan-md/

[caption id="attachment_125637" align="alignnone" width="768"] Robynne Chutkan, MD, author of The Anti-Viral Gut: Tackling Pathogens from the Inside Out[/caption]