Gut Health
Something I noticed working in the emergency department (ED) is that we’ve become accepting of gastrointestinal distress, constipation, and diarrhea. It’s been normalized to go days without a bowel movement (BM), to feel pain with having a BM, or to have runny stool. We expect to feel uncomfortable after eating certain foods… and yet we eat them still. Triage nurses (myself included) in EDs nationwide will ask everyone they see ‘any nausea, vomiting, diarrhea, or constipation?’ It’s a basic question that belies the valuable information in the answer. Unfortunately, in the ED, constipation without pathology is dismissed. Abdominal pain with stool present in the colon on x-ray and no other positive diagnostics is chalked up to constipation and also subsequently dismissed. But these symptoms are not normal. They are not to be avoided or tossed aside. Save the ED visit for a true emergency but do not think for one second that having discomfort in your body doesn’t mean anything.
This is in no way to say that if you feel you need medical care you should not seek it; if you’ve had constant abdominal pain for more than two hours or it's been more than four days since you passed any stool, please be seen. This is to say that your GI system is a finely tuned and intelligent machine designed to keep you healthy if tended and that you are the most powerful agent to address your gastrointestinal health (with help of course).
Dysbiosis or a gut microbiota that is out of balance, impairs epithelial function, causing increased gut permeability or leaky gut, which leads to immune dysregulation and inflammatory diseases. These effects are felt locally in the gut and system-wide as inflammation spreads. Folks with dysbiosis have a higher risk of experiencing diarrhea, constipation, and bloating or developing irritable bowel diseases like Crohn’s and ulcerative colitis as well as gastrointestinal cancers. The chronic systemic inflammation associated with dysbiosis has been linked to celiac disease and autoimmunity, food allergies and sensitivities, asthma, autism, chronic stress, decreased fertility in men, endometriosis, and increased fat storage as well as obesity, type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular diseases. Because of the close ties the gut and brain share, dysbiosis also increases the risk of Alzheimer’s disease and brain fog. Whew. That was a lot.
It’s no mistake that we use ‘gut’ to talk about our entire internal self. It produces more than ninety percent of our body's dopamine and serotonin as well as healthy amounts of GABA and norepinephrine; the hormones that make us feel good, give us motivation, make us happy, help us sleep, and get things done. There are special neurons called neuropods that connect our gut directly to our central nervous system through our gut microbiome. Our gut and its bacteria are truly our second brain but instead of telling us how they’re doing, they give us poop.
People can be shy talking about poop. Not surprising given that as a culture we tend to avoid the realities of the body. This insidious denial places our health at risk. You get used to talking about poop as a nurse. You get used to a lot of things. So I’ll say this; pooping is glorious and is also a valuable metric for how your body is doing! Is your poop hard and painful to pass? Is it runny or off-color? Is it pale or slimy? So many issues can be addressed by starting with your gut. Most in fact.
So when we talk about gut health, we are really talking about whole health. When we choose to focus on healing our gut we are taking powerful steps towards improved general health. And the coolest part is that all that power lies with you. You have the agency to improve your gut which can change your brain chemistry. I think that’s pretty incredible.
My favorite video about poo is The Secret Power of Your Poo and I cannot say enough good things about it!
