Everyone seems to be talking about gut health these days — and for good reason. The digestive system is essential for breaking down the food we eat and converting it to energy. But in recent years, scientists have uncovered that it plays an important role in so much more, from supporting immunity and mental health to potentially warding off a range of chronic diseases like Alzheimer’s.
So what’s the best way to nourish your GI tract? We’ve been curious ourselves — and so have many of you. Readers of our Body and Soul newsletter flooded our inboxes with gut health questions, and now we’re bringing you some answers. We’ve asked Dr. Will Bulsiewicz (aka Dr. B), the U.S. Medical Director of the nutrition company ZOE, a best-selling author, and social media’s favorite gastroenterologist to break down everything you want to know about supplements, indigestion, IBS, and more.
What can we do daily to improve gut health? – Karen S.
Dr. Will Bulsiewicz: This is one of my favorite questions because daily choices really do add up. My top three tips:
- Eat a wide variety of plants — aim for 30 different types per week.
- Include fermented foods like sauerkraut or kefir to feed your gut with healthy microbes.
- Move your body: Even light exercise helps digestion and supports a healthy gut microbiome.
I’ve had almost chronic constipation since I turned 69. What can I do? – Louise H.
I’d recommend increasing your fiber intake gradually (especially from whole plant foods), staying well-hydrated, and getting outside for a walk everyday. In some cases, supplements are needed, and in this context magnesium (in the form of magnesium oxide, citrate, or sulfate) can be effective and potentially paired with a fiber supplement. Also, don’t underestimate the power of routine. A morning routine that includes hydration, a walk outside, and a fiber-rich breakfast (possibly paired with a cup of coffee) can set the stage for a vigorous, healthy daily bowel movement.
What are the best fiber supplements to take that don’t cause bloating? Psyllium husk makes me bloat up too much. Any recommendations? – Jean P.
Full disclosure: I am the founder of a gut health supplement company called 38TERA that makes a fiber supplement called DMN (Daily Microbiome Nutrition).
It’s important to first mention that you should always strive to get your fiber through plant-based food. Then add in a fiber supplement to help you achieve your health goals.
Psyllium can be a great choice for many, but since it causes bloating for you, you have two choices. You can either reduce the amount of psyllium that you’re taking, and then slowly increase it over time. Make sure to drink plenty of water. Or you can replace it with a low FODMAP alternative, such as partially hydrolyzed guar gum (PHGG), acacia fiber, or 38TERA DMN. They’re often gentler on the gut and less likely to cause gas.
Start low and go slow is always a good idea with fiber supplements. And if you suffer with constipation, be aware that this can make the bloating worse. If there’s constipation, get your poop moving first (you may want to turn to a magnesium oxide supplement) and then add the fiber supplement second.
What are your thoughts on high prebiotic yogurts? – Sally D.
I love seeing gut health go mainstream, and I absolutely would love to see you add more fiber and more fermented food to your diet. That said, whether it’s prebiotic yogurts or prebiotic sodas, the fiber in these products comes from supplements. Often the fiber supplement that’s included is not my preferred choice. So I generally prefer to opt for a cleaner yogurt, ideally organic and with a simple ingredient list and no added sugars. Then add berries to it. Raspberries are a surprisingly great source of fiber.
Why is my stomach bloated but I don’t have indigestion problems? – Mary S.
Bloating can come from a variety of causes, including constipation, food intolerances, gas-producing foods, or bacterial imbalances. It’s not always linked to indigestion. I recommend keeping a food and symptom journal, making sure that you’re having large and complete bowel movements, hydrating with water, walking after meals and trying a low FODMAP diet under the guidance of a dietitian if symptoms persist.
There are so many probiotics on the market and all are unregulated. How do you know which one to take? What ingredients should I look for? – Lori A.
To find the right probiotic, you have to first answer this question: What are you hoping to accomplish? You should have a clear goal. Is it to improve bloating, constipation, or IBS? We want to find the probiotic that has been proven in a human clinical trial to be effective for your goal. There’s no “one size fits all” probiotic. We use specific probiotics for specific issues.
Next, we need to purchase the right probiotic. It should match the strain(s) and dose used in the clinical trial. Stick to what’s proven, and focus on quality. Look for products that are third-party tested and have quality certifications.
Last, give the probiotic up to 60 days to work. After that, if it’s not helping then it’s time to move on. Probiotics can help, but they aren’t a magic fix or the bedrock of gut health. You can’t out-supplement a bad diet. It’s much more important to focus on a fiber-rich, plant-diverse diet that helps your native probiotics — the ones you already have inside of you that are starving and need to be fed — to thrive and grow.
Is apple cider vinegar helpful in digestion and cleaning out your gut? – Mary S.
Apple cider vinegar (ACV) has its place, but it’s not a miracle gut cleanser. If your ACV includes “the mother,” then it does include the live cultures. Some small studies suggest that might help with blood sugar regulation or modest digestion support, but we don’t have strong evidence that it “cleans” the gut or that it’s particularly effective.
I do have concerns about the acidity, however. It can erode the enamel of your teeth or potentially provoke heartburn or other digestive issues. In general, I think vinegar (ACV or otherwise) can be included as a part of a healthy diet, but I wouldn’t recommend taking shots of it. For true gut health, I’d recommend focusing on fiber, fermented foods like yogurt or kimchi, and hydration.
What’s the difference between IBD and IBS? And what are some treatments? – Shawna J.
IBS refers to Irritable Bowel Syndrome, which is what we call a functional gut disorder. This means that there are changes in gut motility and function that result in a change in bowel habits (diarrhea, constipation, or both) and gut discomfort. With IBS, there’s no visible inflammation or damage, so the diagnosis is typically made based upon symptoms.
Alternatively, IBD, or Inflammatory Bowel Disease, is a family of chronic inflammatory gut disorders that include Crohn’s disease and ulcerative colitis. In these diseases, the immune system creates massive inflammation and can cause serious damage to the gut that manifests with diarrhea, blood in the stool, and abdominal pain. Inside the intestines, this inflammation is visible and can often be found during a colonoscopy.
IBS and IBD are not the same, but they do share similarities and in some cases can occur simultaneously. With both it’s ideal to include changes to your diet diet and lifestyle in a treatment plan. Treatment of IBS should start with diet and stress management, with supplements and medicines being used only when necessary. IBD generally requires medical treatment to put out the flare and allow the body to heal. Over the long term, diet, sleep, and exercise are an important part of addressing the root cause of the disease and reducing long-term risks.
This interview has been edited and condensed for clarity.
The information provided in this article isn’t intended as medical advice, and shouldn’t replace professional medical treatment. Consult your doctor with any serious health concerns.
