#SunMedHerStories Trusting Your Gut: What Your Digestive System Is Telling You

27 March 2022

Remember how as children, we would be able to eat entire packets of sugar-packed candies and processed snack foods without a care in the world? Or how as teenagers, being able to wolf down fast food and still maintain a healthy physique was something you would claim with pride? The after-work drinks in your 20’s and 30’s became a daily ritual to relieve stress, and to eat a tub of ice-cream to nurse a heartbreak just seemed to be a valid excuse for poor eating habits.

Somewhere along the line, we started to notice that our bodies are now reacting differently to the same foods we used to consume; suddenly, we’re not losing the weight as easily as we used to, or find that it takes a longer time to recover after a few drinks … but why exactly is this happening?

Recognising the Symptoms

So what exactly is the gut?

According to Datin Dr Wendy Lim, gastroenterologist and hepatologist at Sunway Medical Centre,  “The gut is a huge organ. At 32m², that’s about the size of a small apartment” and is extremely important to our bodily functions. Otherwise known as the gastrointestinal tract (GI), our gut really starts at our mouths and, well, all the way to the anus. It comprises all the organs of the digestive system that manages the process of extracting nutrients and expelling waste.

As we grow older, it is normal for our gastrointestinal functions to experience changes in motility, absorption, digestion, and secretions of hormones and enzymes, affecting how efficiently our bodies process what we put into it. “As women especially,  once we reach menopause, the hormones will then slow everything down; from your metabolic rate down to your gut motility,” says Datin Dr Wendy. “It is inevitable.”

Listening to our gut and understanding what is happening with our bodies gives us the opportunity to manage our health better, especially as we approach those later years in life. An unhealthy gut—left unchecked or untreated—could speed up the development of diseases, disorders and potentially cancer.

These symptoms can occur anywhere along the GI tract and can include, but are not limited to;

  • Dry mouth
  • Decreased saliva production
  • Changes in taste sensations
  • Reflux
  • Gastric pains
  • Change in bowel habits, such as constipation and diarrhoea

But some studies suggest that not all symptoms of an unhealthy gut manifest along the GI tract. In recent years, there has been a digestive condition that has been bandied about in some medical circles called the ‘leaky gut syndrome’. While human intestines are naturally permeable—that’s how we absorb nutrients after all— a leaky gut is used to describe when the intestines are too permeable and thus are ‘leaking’ nutrients, bacteria or toxins into the bloodstream, causing a host of problems.

“People have postulated that leaky gut poses inflammatory bowel disease, celiac disease—which is gluten sensitivity, auto-immune diseases such as lupus, rheumatoid arthritis, diabetes, fibromyalgia, acne, asthma, and allergies,” explains Datin Dr Wendy. “However, there is not a lot of scientific evidence behind all that and researchers are trying to make the connection whether it is because of what you eat that you are susceptible to these allergies and conditions.”

Although the medical community is still divided about leaky guts, doctors, however, agree that there is undoubtedly a correlation between a healthy gut and the health of the gut’s microbiome.

A Gut Connection

The key is understanding how our gut microbiome works; a complex ecosystem within our gut that consists of predominantly bacteria, along with viruses and fungi. This robust ecosystem is vital in ensuring good gut health, but it is only natural that the gut microbiome changes and becomes less diverse in composition with time.

It is worth noting that a lot of GI functions can be further affected by coexisting medical problems.  “As one gets older, you tend to be more susceptible to getting chronic medical problems which can also result in the consumption of multiple medications (polypharmacy),” explains Datin Dr Wendy. “This—along with affected mobility, and changes in our diet can also predispose us to getting GI symptoms, which will have a profound impact on the quality of life.”

Medication such as antibiotics, for example, will change the distribution of various types of bacteria, potentially shifting the dominant species in the gut and having a profound effect on the composition of your gut microbiome. “When this becomes imbalanced, it becomes a state of dysbiotic microbiome that can potentially trigger inflammation by activating proinflammatory cytokines,” says Datin  Dr Wendy. “You may end up triggering a low-grade inflammation within the gut.”

While this makes elderly people more susceptible to infections, it is important to note that a reduction in the synthesis of important metabolites, such as short-chain fatty acids that have anti-inflammatory and anti-cancer properties, can also be affected through poor eating habits when younger.

Digesting the Hard Facts

It is clear that maintaining a well-balanced diet is key to having a happy, healthy gut … but at what age should we start eating clean?

“You are what you eat,” advises Datin Dr Wendy. “Changing a lifetime of bad habits is going to be more difficult when you’re older, so we should learn good eating habits from a young age.” She encourages cutting back on processed foods such as processed sugars and soft drinks, avoiding excessive amounts of fatty foods and carbohydrates in your daily food intake, while reducing excessive alcohol consumption and smoking which can lead to an increased risk of cancers.  

As for those who practice a purely plant-based diet packed full of delicious anti-oxidant properties that are good for the bowel, Datin Dr Wendy advises to be cautious that you’re getting enough vitamins and micronutrients. “If you are on a plant-based diet, you might want to start taking essential Vitamins D or B, but do be careful of what supplements you take.”

While there are many shops that promote additional supplements to your diet, such as prebiotics and probiotics, it is crucial to do your research. “If you look at the prebiotics that are available in the shops, there are only a few species available, but they don’t address everything, and we don’t know in detail how these microbiomes interact with each other and which combination of bacteria is going to be good for your gut,” says Datin Dr Wendy, adding rather importantly that there is no strong clinical evidence to promote which particular brands work better.  “I would recommend eating healthy, organic foods that are not processed instead, and at least 20 minutes of exercise daily.”

Prevention Is Better Than Cure

While it may be too late to reverse the cumulative effects of copious amounts of boba tea over the years, the body is a fantastic vessel that works hard to repair itself. What you can do with what you know now is to go for a regular colon or cancer screening as cancers can be stopped with early detection.

The recommended age for a healthy, average person with no family history of cancers in the colon or stomach is 45 years old and upwards. “There are many screening methods, depending on your access or availability; colonoscopy screening, stool testing for blood, CT colonography,” says Datin Dr Wendy. “It is not something you need to do every year, but if anytime between the colonoscopy and the next screening date you do develop red flag symptoms like changing bowel habits, unexplained weight loss, abdominal pain … get yourself screened and checked again.”

Regardless of the outcome, it is important to remember that cancer or any gut-related diseases is not a death sentence. In fact, you could be adding valuable years to your life by getting screened and early detection. The message is clear; it takes guts to make your health a priority.