Is your gut happy or unhealthy?

It’s time for a gut check – literally. “It’s not as easy as one would think to figure out if your gut is healthy or not,” says Kristi King, M.P.H., RDN, spokesperson for the Academy of Nutrition and Dietetics. That’s because, according to Scott Schreiber, D.C., CNS, chiropractic physician and clinical nutritionist, “Signs and symptoms of an unhealthy gut include much more than bloating, constipation or diarrhea.”

The gut is a complex organ. And thanks to recent advances in how we analyze the trillions of bacteria living inside of us (aka the gut microbiome), researchers are starting to understand the extent of its complexity and finding links between gut health and the health of its gracious host (us). Some of the less obvious ones Schreiber notes include food sensitivities, anxiety, autoimmune disease and frequent infections. Is your gut as healthy as it could be? Read on for some surprising signs your gut microbiome is imbalanced – and learn what to do about it.

1. Do You Get Sick Easily?
The digestive system is equipped with the largest and most complex part of the human immune system. Among other things, a balanced gut includes microbes that secrete chemical messengers that let immune cells (T cells) know what to do to protect us from pathogens (bad bugs) and foreign substances. Having plenty of good bacteria also protects us by leaving less real estate for opportunistic pathogens that would overgrow if given the space. King says, “The immune system is largely based in the gut, so if you find yourself getting sick frequently, you may need a few more good bacteria in the gut to help out!”

2. Do Your Joints Hurt?
The cause of rheumatoid arthritis (RA), an autoimmune condition that attacks the joints, is unknown. Researchers think the answer may lie in the gut microbiome, perhaps because the gut is such an important part of the immune system. The idea that the gut microbiome could impact immune responses outside the digestive system is new, but it’s been demonstrated in animal studies, as reported in Nature Reviews Rheumatology. Recent findings show that people with RA have unbalanced microbiomes, and the hypothesis is that the wrong bacterial populations overgrow, leading to inflammation. Furthering the gut-joint connection, King adds that rheumatoid arthritis is often associated with other autoimmune conditions, such as celiac disease or inflammatory bowel disease.

3. Do You Have Food Sensitivities?
Food sensitivities are diverse and have their own world of mysteries. King agrees, saying, “This is always a doozy and may be difficult to pin down without keeping food and symptom records.” She recommends working with a registered dietitian nutritionist (RDN) to help determine which foods might be causing problems. What experts in the field do know is that promoting good bacteria in the gut can help with some food sensitivities, such as lactose intolerance. A paper in the British Journal of Nutrition notes that the use of probiotics has helped those who have trouble absorbing lactose.

4. Do You Feel Anxious?
There is strong evidence that the gut and brain communicate. A recent paper published in the Annals of Gastroenterology concludes that gut microbes regulate brain chemistry in a way that affects how we respond to stress and anxiety. “The gut is the second brain of the body,” says King, “and research is starting to show that people suffering from anxiety and depression have altered gut flora.” The Gastroenterology paper reports that certain probiotics may reduce stress-related cortisol levels and anxious behavior, though King notes that “research is still ongoing to find out what good bacteria would be beneficial for our brains.”

5. Do You Have Diarrhea After Taking Antibiotics?
Antibiotics tend to be blunt instruments, killing off pathogens and beneficial bacteria alike, upsetting the natural balance of good bacteria to bad. Keep in mind that even under normal circumstances, the body houses potentially harmful bacteria, but we just don’t normally notice when the good bacteria outnumber the bad.

Without enough good bacteria, bad bacteria can grow out of control, creating toxins that hurt the gut, trigger inflammation and cause diarrhea. King shares that when taking antibiotics, “many times people find it helpful to either take a probiotic or eat probiotic foods like yogurt to help replenish the good bacteria.” Hopefully, the diarrhea clears up within a week of finishing the antibiotic course, but a review paper published in Expert Review of Anti-Infection Therapy says subtle changes to the microbiome may last much longer, the ultimate impact of which is unknown.

Written by Maggie Moon, MS, RDN for Livestrong.com, January 2, 2016.

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