Do you feel it in your gut?

There’s lots of buzz about gut health and how you can improve it. But it’s important to know probiotics are not likely the cure-all for gastrointestinal (GI) issues, as some would like to believe.

According to Dr. Arthur Yan, a board-certified gastroenterologist with Sharp Community Medical Group, his recommendations for improved gut health are always targeted to a specific problem a person is experiencing.

“I focus on management of the symptoms that prompted a patient to see me,” Dr. Yan says. “For example, I recommend high-fiber foods for patients with symptoms of hemorrhoids or digestive conditions that affect the colon, known as diverticular disease. I recommend hydration and fiber for those with constipation. I counsel patients with reflux symptoms on avoidance of food triggers, such as caffeinated beverages.”

If a person is seeking general advice on how to keep the GI tract healthy, Dr. Yan has a simple formula that applies to overall health. “Eat well, exercise, and avoid tobacco and alcohol,” he says.

Do probiotics improve gut health?

While probiotics are often touted as the go-to remedy for GI issues, Dr. Yan reports there are really only a few conditions for which there is enough evidence to support their use. “Everything else is really anecdotal without consistent, validated clinical trial data,” he says. “Some studies show that probiotics are the same as a placebo.”

However, when patients inquire about using probiotics, he simply asks them whether the probiotics they’re taking help with their symptoms and meet their overall expectations. If they feel they help, and they are happy with the product, he doesn’t oppose their use. If not, he recommends avoiding the added expense.

“I do tell patients that probiotics are generally safe to take but can pose a risk in those who are significantly immunocompromised,” Dr. Yan says. “Another note on probiotics is that most clinical studies for the use of probiotics to treat disease are small. They are also hard to study because the composition of the different probiotic formulations out there are so varied.”

Can foods provide GI pain relief?

Dr. Yan advises taking the same “if it works, don’t fix it” approach with the foods a person eats. If a patient says they eat a particular food that reduces GI symptoms, he generally recommends they continue eating that food. If a patient complains of having pain after eating or drinking a specific item, he advises they try removing it from their diet to see if the condition improves.

For example, if a patient with lactose intolerance drinks milk and gets bloating, diarrhea and pain, Dr. Yan recommends they avoid dairy or take lactase enzyme supplements. If a patient has pain due to constipation, he recommends a high-fiber diet with ample hydration.

When should you talk with your doctor about GI issues?

Unlike other organ systems, the GI tract can be taboo, Dr. Yan says. Few individuals like to talk about their colon and bowel issues. He encourages people to feel comfortable enough to discuss their digestive issues with their doctors in order to identify treatments that can help and address potentially serious concerns.

Symptoms that may indicate more serious GI tract problems include:

• Chronic diarrhea

• Rectal bleeding

• Black, tarry stools

• Unexplained weight loss or rapid weight gain

• Jaundice

• Iron-deficiency anemia

• Severe abdominal pain

“A simple guideline would be to see your doctor if you have new or concerning symptoms,” Dr. Yan says. “And make sure you get GI screening tests done at the appropriate age, such as colon cancer screening at age 45 for those who are at average risk.”

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