By Kristopher Schamber, MD, FACP – Medical Director, SMH Primary Care
Today we will be talking about gut health. The gut, or gastrointestinal (GI) tract, generally refers to the stomach, through the small and large intestines, and out the rectum and anus. I will include some discussion of the upper GI tract, or esophagus, as well.
I think it is important first to review some definitions. The term bowel refers to the intestines below the stomach. A bowel movement = poop. Stool = poop. Constipation, while different for everybody, signifies harder, less frequent bowel movements that require straining. Diarrhea, also different between individuals, signifies looser, more frequent bowel movements, typically very watery.
The perfect poop is soft but formed, comes out easily and does not leave any residue on your bottom or the toilet bowl. This is achieved with a healthy amount of dietary fiber, the type of fiber that does not get absorbed through your gut (like the stringy stuff in celery or the rind on an apple).
Constipation, while generally not severe, can cause significant illness, including severe pain, confusion, and even a ruptured colon, in addition to the more common hemorrhoids and diverticulosis. It may increase the risk of colon cancer as well. There are many different causes, including multiple medications, neurologic conditions, cancer, not drinking enough water, and poor diet. Treatment ideally targets the underlying cause. Increasing fiber intake, ideally with vegetables or using a fiber supplement, and drinking plenty of water (for most people, 64 ounces per day) is a must. Laxatives and stool softeners should only be used under the direction of your medical provider.
Diarrhea is generally less common than constipation and has a number of different causes, including infections, medications, tobacco, caffeine, alcohol and artificial sweeteners (Splenda, sweet and low, etc.). Treatment, as above, targets the underlying cause, and fiber can also help. Over-the-counter anti-diarrheals should be used under the direction of your medical provider.
Acid reflux, also known as GERD, typically causes stomach pain just below the breastbone, a burning sensation in the esophagus just beneath the breastbone, or an acid taste in the mouth with belching. It can rarely cause esophageal cancer. Common causes include a number of different foods: Acidic foods like tomatoes or citrus fruits, tomato-based sauces, and greasy and fatty foods. Coffee, alcohol, and tobacco are also common causes. Occasionally someone’s genetic makeup causes an increase in acid production.
Screening for colon cancer is an important part of GI health. A screening test is used to diagnose disease prior to it causing any symptoms. Colon cancer, if found early, can be cured. The screening begins between ages 45–50 and continues until at least age 75. A colonoscopy is the standard study in this community, though there are other tests as well that require a small stool sample.
Diet is very important to GI health, and as you read above, dietary factors play a role in many GI conditions. Generally speaking, a balanced diet with 25% whole grains, 25% healthy proteins (white meat, fish, legumes, etc.), 40% veggies with some fruit, and 10% healthy fats and oils (olive oil, avocado, etc.) is healthy for the gut, in addition to known benefits with the cardiovascular system, weight, and other benefits. As noted above, certain specific foods or beverages can contribute to constipation, diarrhea, or GERD. Diets heavy in smoked meats are linked to certain types of GI cancer.
Probiotics can also be helpful for gut health. Our intestines have good bacteria that help in digestion and other processes. This is known as the gut microbiome, and there is much ongoing research into various effects of this microbiome on the GI tract and throughout the body. Taking a probiotic daily can benefit your gut and the rest of your body with very little risk.
Learn more about Dr. Kristopher Schamber and Sheridan Memorial Hospital’s Primary Care practice and the professionals caring for patients by visiting the respective links.