Advice On Gut Health
Gastrointestinal problems are unpleasant to discuss and even more unpleasant to suffer. Here, a Monmouth doc explains them.
If your stomach is bloated, burbling and upset, it may be time to grab an antacid or a Pepto—or time to see a gastroenterologist. Wondering when you should opt for the latter? Tina Vazirani, M.D., gastroenterology section chief at CentraState Medical Center in Freehold, offers insight on common GI questions and concerns.
What’s most important to know about gastrointestinal (GI) health? “Digestive issues can always be a sign of a bigger health problem. GI health is linked to the immune system, to hormone regulation, even to mental health. The gut is home to trillions of bacteria, and we don’t know the functions of all the bacteria yet, but they’re all important. If something feels wrong, early intervention is key. If you’re having GI issues, listen to your body and get checked out as soon as possible.”
What lifestyle changes can people make to improve GI health? “Follow a balanced diet, and make sure you’re hitting your fiber goals for the day. [That’s 25 grams a day for women and 48 grams a day for men.] Regular exercise, stress management and staying hydrated are also great steps to good digestive health.”
What should people know about gastroesophageal reflux disease (GERD)? “GERD, or acid reflux, happens when stomach acid flows back into the esophagus. To manage it, lifestyle changes are important. You don’t always have to immediately run to medication. Eat small, frequent meals throughout the day, and make sure you eat three hours before going to bed. Avoiding the midnight snack is key! If that doesn’t alleviate symptoms, medications can help significantly. However, there is an association between osteoporosis and the proton pump inhibitors [the classification of drug in many GERD medications], so we’ll always try to minimize the medications and emphasize lifestyle modification. But if you have long-term reflux, it’s important to get checked because it can lead to Barrett’s esophagus, which is a precancerous condition.”
Have there been advances in treatments for common GI problems? “So many! In the last 10 years there’s been significant growth in treatment options, with the creation of more focused therapy and more effective treatment and medicines, especially in the world of inflammatory bowel disease. Ten years ago, we only had really two medications. Now, we are seeing more focused therapies that home in on the GI tract or decrease inflammation without causing a great drop in the immune system, which used to be a problem.”
What would you tell someone who is putting off seeing a gastroenterologist because of embarrassment or anxiety? “We see a lot, and we’ve probably heard everything before. There’s also a confidential patient-physician relationship, so people shouldn’t be worried. Plenty of GI conditions happen to everybody, so people needn’t feel alone. Symptoms are much more common than people think.”
Is there a myth or misconception you’d like to debunk? “A common one is that you have to have one bowel movement every day. I have couples who come in and the wife will say, “Oh, my God, he goes to the bathroom three times a day. That’s not normal!” And the husband will say, “Well, she doesn’t go to the bathroom for three days, and that’s not normal.” But there really is no exact frequency—whether it’s three times a day or three times a week, that’s all considered normal. Everyone is different, and it’s influenced by a lot of things, including diet, hydration, how active you are and your age. If you do have sudden changes in your bowel movements, then that’s something to go and get checked out, because it could be a symptom of something else.”
Why should people seek to get to the bottom of GI symptoms? “It’s important not to ignore symptoms because they can always be the sign of some more chronic condition, such as inflammatory bowel disease, certain types of food intolerances or even stomach or colon cancer. Get checked out!”
What are the screening guidelines for tests that rule out disease? “Colon cancer is the big one. We now start screening at 45 instead of 50. From then, it depends on whether or not you have polyps [a clump of cells that forms on the lining of the colon and can develop into cancer]. If you have no polyps, then you have a colonoscopy every 10 years. If you have one or two polyps, it’s every five. If you have three or more, you do it in three years. We also look at risk factors for colon cancer, including obesity, a diet low in fiber and high in red meat, a sedentary lifestyle and a family history of polyps.”
