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Getting to the guts of the matter of 'gut health'

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James Joel
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If you watch television, you probably have seen commercials advertising products that claim to help improve your “gut health.” The idea of healthy and unhealthy bacteria in a person’s digestive tract has been around for a while, but researchers are learning more all the time about the connection between gut health and overall health.

This week on “Take Care,” Dr. Rajeev Jain, chief of gastroenterology at Texas Heath Dallas, discusses gut flora and how to maintain good gut health. Jain is also a partner at Texas Digestive Disease Consultants and clinical assistant professor of medicine at University of Texas Southwestern Medical School.

  Two thousand years ago Hippocrates said that all disease begins in the gut. As it turns out, 21st century scientists are finding out that might be true. Jain calls it “absolutely fascinating” what the world of medicine is learning about the gut.

First, though, let’s back up and define what we mean by “gut.” Jain says when gastroenterologists refer to the gut, they mean the entire digestive tract, everything from the mouth through the esophagus, stomach, small intestine and colon.

But the discussion on gut health, usually refers to the bacteria, yeast, viruses and organisms living in the digestive tract. And most of those are in the colon, says Jain.

And Jain says that it’s only in the last 10-plus years that doctors are really beginning to understand the impact the colon can have on a person’s overall health.

“Prior to that, everybody thought the colon only had two functions – one was to store waste and the other was to reabsorb water,” says Jain.

But researchers have learned that the bacterial ecosystem, particularly in the colon, is important to facilitating digestion, absorbing nutrients and is implicitly involved in the immune system.

In addition to the gut affecting overall physical health, there have been some studies that show the microbiome could affect emotional health as well, according to Jain.

“There’s more and more data coming out that you are what you eat, essentially. And that’s what’s driving this gut flora – it’s what we consume, mostly,” says Jain.

One study involved looking at patients’ brain activity through an MRI. “By altering their gut flora they could change their mood and behavior,” said Jain.

And the way those researchers altered gut flora? By giving the patient probiotics.

Which brings us back to those commercials. Whether it’s yogurt or pills – all sorts of companies are claiming that probiotics can help regulate your gut health.

Jain says he has seen probiotics work in certain situations.

“Patients with irritable bowel syndrome, we frequently will give them courses of probiotics. And I can tell you, you can see, anecdotally speaking, improvement in their symptoms. And they feel better,” said Jain. “And that’s the most important thing, they want to have a good quality of life.”

Jain says typically for better digestive health, probiotics that contains bifidobacterium or lactobacillus are probably the better ones.

But prescribing probiotics is nowhere near an exact science.

Jain says there are about 100 trillion bacteria and viruses in your gut and jokes that he thinks there’s that many probiotics on the market.

But he says the knowledge of probiotics is rapidly evolving. And he believes that soon doctors will be able to be a lot more specific in prescribing a probiotic.

“We pick a specific antibiotic to treat a specific disease or disorder. And I think where the future is going to be is that we need to pick the right probiotic for the right problem or condition. And we’re not really there yet to know which is the best one.”

But does everyone need to take probiotics to stay healthy? Jain says he doesn’t recommend it, because there is not enough evidence that it helps.

He says healthy patients should just continue a healthy lifestyle – a good diet, exercising, not smoking and not drinking in excess.

“Eat healthy. Diets that are varied in fruits and vegetables, low in meats, mostly lean meats. Those are the things that are going to keep your gut healthy.”

He says for patients with gastrointestinal issues, he will tell them to try probiotics.

Jain acknowledges that some doctors have not embraced the theory of probiotics, but says that is changing.

“With anything new in the field of medicine, there’s always a healthy dose of skepticism,” says Jain. “I believe firmly this is good science behind it.”