“All disease begins in the gut.”

More than 2,000 years ago Hippocrates famously said those words, and all these years later research continues to confirm that Hippocrates was on to something. 

Yet while all disease doesn’t literally start in the gut, many metabolic, autoimmune, and cognitive diseases do start with gastrointestinal disturbances or imbalances—which highlights the fact that you cannot achieve optimal health without a healthy gut. 

What Do I Mean By the Word ‘Gut’?

The gut, otherwise known as the large intestine, hosts trillions of bacteria, fungi and other organisms. You’ve likely heard of the colony of those gut bugs as being a part of the microbiome. Your gut also houses 70% of your immune system and is involved in the majority of your neurotransmitter production (those chemicals that talk to your brain and impact your mood); it also influences your metabolism, energy, and so much more.

When I talk to my patients about gut health, most incorrectly assume that an absence of GI symptoms equates to a healthy gut. I always hate to break it to them (and now, to you) that that’s simply not true. While digestive symptoms like bloating, gas, constipation, diarrhea, and abdominal pain, are very common and may be a sign your gut health is off kilter, it’s also almost just as common for gut health symptoms to present neurologically. Ever experienced brain fog, poor concentration, poor memory, depression, or anxiety? There’s a good chance these issues surfaced because your gut health is off.

It turns out your gut and your brain are in constant communication with each other. This is what we call the gut-brain axis. And here’s why it’s important: This constant stream of communication between your belly and your brain means poor gut function can lead to poor brain function. That’s not all: Other areas that are closely affected by the gut include the skin, immune system (and risk of autoimmune disease), blood sugar regulation, detoxification, and metabolism.

The beautiful thing about gut health is that it’s very responsive to nutrition and lifestyle interventions. If you’re eating a diet high in processed foods and experiencing high levels of stress, that can work against you. But when you treat your gut well through optimal nutrition tweaks, stress reduction, and the supplements and herbs that work best for YOU, most symptoms (even ones that seem totally unrelated to your gut!) are likely to improve. In fact, one study showed that within 2-3 days of making dietary changes, your gut microbial communities respond. Because all of your body’s systems are interrelated, a holistic approach to restore balance is often required. That’s the goal of functional nutrition: To identify the root cause of disease (which often involves assessing gut health!) and then determining the best action plan.

DIGIN Approach to Gut Health

If only I could tell you to pop a probiotic to solve your gut health woes. It just doesn’t work that way! Yes, the definition of gut health includes the idea of having a diverse and resilient presence of bacteria, and probiotics may help you on that front. But there is more to the gut health story. 

To help you remember the key roles of the gut, I love using the acronym DIGIN, which was created by the Institute for Functional Medicine. Your gut works hard to protect you! This is a great way to learn the basics about what it does, which can help you remember what it needs in order to work optimally for you. 

D is for DIGESTION & ABSORPTION

One of the primary goals of gut flora is to help you digest the food you eat and absorb the nutrients in that food. Before it gets to the gut, the food you eat enters the small intestine, where much of the exciting part of digestion begins. This is also where pancreatic enzymes and bile salts are secreted. 

The intestinal tract is lined with something called microvilli, which are fingerlike species that facilitate the absorption of nutrients from the foods we eat. Think of this lining of microvilli as a shag carpet, with each shag having the responsibility of absorbing nutrients. 

The rest of the magic happens as your food moves down to the large intestine, commonly referred to as the gut microbiome. The large intestine hosts bacteria that are involved in taking fiber and converting it to the primary source of energy for the cells in your colon, otherwise known as short chain fatty acids. The microbiome is also where electrolytes are reabsorbed, water is extracted and nutrients are produced by bacteria such as vitamin K, and B vitamins such as biotin (B7), folate (B9) and cobalamin (B12).

Tip for Supporting Digestion & Absorption: 

Take three deep breaths before your meals to activate your parasympathetic nervous system. Eating when you are in high stress mode leads to lower production of digestive enzymes. 

I is for INTESTINAL PERMEABILITY

A healthy gut lining is just as critical to overall health as a healthy gut microbiome. Intestinal permeability refers to the lining of the gut, which is like a gatekeeper (or the bouncer at the front door of a trendy bar), able to determine whether a microbe, pathogen or even food is a friend and can stay—or a troublemaker and needs to get booted. 

If you want a healthy immune system and a lower risk of developing an autoimmune disease, you need a gut barrier that’s fully intact. A barrier that’s not intact is often referred to as a “leaky gut” and can cause big problems. In fact, research shows that leaky gut occurs when the gut has separations in its tight junctions that decrease the body’s ability to effectively defend against pathogenic microorganisms. Which means that if you have a leaky gut, you’re at an increased risk of food sensitivities, allergies, inflammatory bowel disease (IBD), autoimmune conditions (such as multiple sclerosis, type 1 diabetes and lupus), and inflammation. 

Ideally the lining of the gut should be like a cheese cloth, with nothing passing through. 

Tip for Lowering Intestinal Permeability

Avoid trigger foods and/or potential food sensitivities for a 4-8 week period. Examples of common sensitivities can include gluten, grains, soy, and more. This should be personal to your needs.  

G is for GUT MICROBIOTA

The gut microbiome is related to the balance of bacteria that exists in the large intestine. There are several factors that influence the composition of the bacteria that lives here, including age, hygiene, alcohol use, antibiotic use, probiotic use, smoking, vaginal birth versus c-section, breastfeeding versus bottle feeding, and nutrition. While some of these factors are out of your control, many are things you can change. To wit: Research shows that dietary intake is one of the strongest predictors of a person’s gut bacteria composition.

Research also suggests that these microbes have an ability to affect your biology and health in profound ways. Diets rich in plant-based nutrients that are high in fiber and antioxidants can fuel a healthy, balanced bacterial ecosystem. The opposite is true for diets that are high in processed foods, which feed more pathogenic bacteria and lead to bacterial overgrowth, dysbiosis, and fungal overgrowth (candida). The presence of these gut disturbances often results in bloating, abdominal pain, nausea, heartburn, acne, eczema, Hashimoto’s disease, brain fog, and more.

Tip for Supporting the Gut Microbiota: 

Eat fermented and cultured foods that have healthy live strains of bacteria. Not everyone needs to take a probiotic everyday if you have a healthy gut balance and incorporate a variety of fermented foods and fibers into your diet. 

I is for INFLAMMATION

Another job of the gut is to regulate immune activity that’s happening in the gastrointestinal tract. Lowering inflammation (the body’s primary immune response) when there’s no need for it is one of those very important jobs. 

There are several markers of inflammation in the gut that can be measured by a stool test. These markers include fecal Calprotectin, Eosinophil Protein X (EPX), and Fecal Secretory IgA. When a person is experiencing intestinal inflammation—very common in Inflammatory Bowel Disease (IBD) and some other conditions—you will see some of these markers elevated. 

The most important thing to remember here is to figure out if you have some of these markers of inflammation and if you do, you need to get to the bottom of what’s driving that inflammation. 

Tip for Lowering Inflammation: 

Eat a variety of colorful plants. It’s always a good idea to support lower levels of inflammation by eating a variety of anti-inflammatory foods, such as turmeric root, ginger root, berries, pomegranate seeds (or a 1-2 fl oz daily shot of pomegranate juice), cacao powder, green tea.

N is for NERVOUS SYSTEM

You can think of your nervous system as your second brain—and it is directly impacted by the health of your gut barrier (a.k.a. intestinal permeability). That’s because the lining of your gut contains neurons—yes, the same cells that communicate with your brain! This is why researchers are looking at the gut microbiome’s impact on various Central Nervous System (CNS) diseases, like autism and depression. For many children, autism and GI disturbances go hand and hand, and it’s because of the impact that gut health has on the nervous system. This may also explain why individuals with depression often struggle with GI issues, such as constipation or diarrhea.

Tip for Supporting your Nervous System:

Incorporate at least one yoga session into your weekly workouts. Yoga helps decrease the physiological symptoms of stress that can impact the gut and nervous system. Yoga also helps you focus on breathing, which is one of the most powerful tools for calming the nervous system.

As you can see, gut health is an incredibly complex topic with many intricate aspects that all work together to impact your overall health. But here’s the good news: While the science may sound a little complicated, there are simple, straightforward ways to improve your gut health—starting NOW!