FAQ: We Answer Your Burning Questions About Gut Health and the Microbiome

9 min read



Ever had a question, simple or complex, about inflammatory bowel disease, irritable bowel syndrome, the gut microbiome, digital health, or diet? Last week we took to Reddit to offer insight and support on these topics by answering questions from the intestinal health community! We were pleasantly surprised by the high volume of amazing, important questions that we received. In fact, there were several questions that were so great, we decided to share them with everyone! Check out some of the most popular questions we received and responded to. To all the redditors who sent in questions, thank you! We’ll be sure to host more AMAs (Ask me Anything) in the future.


Interested in viewing our post? Check it out here.


Q: How many poops a day is too many poops? (r/IpretendIhave****s)


A: This is a very common question! So there actually isn't a specific clinical definition of frequent bowel movements. For a healthy individual a normal number of bowel movements can be anywhere from once every three days to three times daily. Anywhere within this range is considered normal.


That being said, the main thing to be aware of is when your personal pattern changes. For example if you are normally someone who 'goes' once a day, but over the course of a few weeks see your pattern become more or less frequent, this might be something to look into. However, unless you find yourself experiencing very loose stools, pain, or even blood in your stool, it's unlikely the change in pattern is due to an illness. Your lifestyle and diet are most likely to blame.


Q: Is interm[ittent] fasting (only eating every 16 hours) good for your gut/digestive track? (r/brighto187)

A: Very interesting question. In short, I've seen that intermittent fasting can help the gut microbiome by reducing the leakiness of the gut and regulating inflammation, which both have important roles for the microbiota. This is because of reduced meal frequency; eating meals at a consistent time (in your 'normal eating phase') maintains your internal clock, which partly regulates your microbiota.


Q: What is the best way to maintain optimal gut health? (r/StarkJeamland)

A: It's such a complex topic that there is no single perfect way to go about this. It is super important to personalize the approach to gut health, because every person is different and their bodies will react differently. Some main things include eating whole foods (fresh produce, whole grains, nuts and seeds), getting regular exercise, maintaining a consistent and healthy sleep schedule, enjoying fermented foods (the gut microbiome loves this!), and taking care of your mental health (reduce stress, get the support you need for mental health disorders/issues, and practice mindfulness). It all sounds a bit cliche, I know, but it's truly incredible how these simple things can promote gut health.


Q: Are there ways to regain tolerance to lactose once it is already lost? Does exposure therapy work in this case? (r/ArialAllCaps)

A: Great question. I'll share my understanding of the current literature on this topic below :)

In short, lactose intolerance can develop at any age. For some this can be caused be a medical condition, but for many it develops without any specific cause or due to genetics (as unsatisfying of an answer as it is).


That being said, many people with this intolerance are able to find a level of lactose-containing foods that they can consume without discomfort. So although there is currently no 'cure' for regaining total tolerance, there are some great guidelines on how to reintroduce lactose foods in a safe way. I will include some tips from the Cleveland Clinic below!

  • Gradually add small amounts of food and drinks that contain lactose to determine your tolerance level. You may be able to tolerate up to 1/2 cup of milk or the equivalent with each meal.

  • Drink milk in servings of one cup or less.

  • Try hard cheeses that are low in lactose, like cheddar.

  • Drink milk with a meal or with other foods.

  • Try yogurt or Greek yogurt with active cultures. You may be able to digest yogurt better than milk. Your own tolerance may vary depending on the brand. Frozen yogurt may not be tolerated as well as yogurt.

  • Substitute lactose-reduced dairy products and 100 percent lactose-free milk for regular dairy products. These products are located in the dairy section of most supermarkets.

  • The lactase enzyme is also available in liquid, tablet or chewable form. No prescription is needed and it can help you tolerate foods containing lactose. Take the enzyme with the lactose-containing food. Lactase will help you digest the lactose so your body can absorb it. Some over-the-counter enzyme products that are available include Lactaid®, Lactrace®, Dairy Ease®, and Sure-Lac®.

  • Many canned nutritional supplements (such as Ensure®, Boost®) are lactose-free. Product labels should be checked.

https://my.clevelandclinic.org/health/diseases/7317-lactose-intolerance


Q: Do probiotic supplements work after you take antibiotics in terms of restoring the microbiome and how?

What are the top three things anyone can do to enhance their gut health?

What is one cool thing about the gut most people do not know?

(r/Xpat_)

A: That's such a great question, and a difficult one to answer. The benefit of probiotics in this case is still being debated and researched heavily. For example, C. difficile infection, there are a few types of probiotics (Lactobacillus Rhamnosus GG and Saccharomyces boulardii) emerging as potentially useful post-antibiotic treatments, but the evidence for this is not yet overwhelming enough. It also really depends on the person; what works for one may not be what someone else needs, due to the fact that everyone's gut microbiome is different. The general idea behind using probiotics to restore the microbiome is that antibiotics impact the relative abundance and balance of gut bacteria. For this reason, probiotics are sometimes used with the intention of reintroducing or promoting the population of affected bacteria. However, further research is definitely required.


I answered this earlier, but it's really standard! Eat whole foods (whole grains, fresh produce, nuts and seeds, etc), make sure you have a consistent and healthy sleep schedule, and get regular exercise. It's remarkable how much these things can help :)


Oh gosh, there's so much! Something random that most people wouldn't think about is that the colon doesn't feel pain from intense temperatures due to the fact that its pain metric is distension (which is why it hurts to be constipated or be passing a big bowel movement).


Q: What's the latest in FODMAP? (r/hedgehogsinhats)

A: FODMAPs are quite an interesting topic. They are tiny indigestible carbs that when processed can lead to bloating, cramps, and flatulence. That's why the low-FODMAP diet has been supported for people with IBS; these individuals tend to have an overly sensitive gut and possibly even more of the bacteria that eat away at FODMAPs and lead to unpleasant symptoms. Reducing the intake of FODMAPs has been shown to relieve symptoms in 75% of IBS participants, which is quite intriguing. More work certainly needs to be done on this, and it's far from a cure-all, so it's important to be mindful of that. Another thing that's difficult about this diet is that it takes a lot of time and patience, because you have to personalize it to your needs and food reactions; but if it works, it is a great option. I've actually recently written a blog post about the low-FODMAP diet if you'd like to consult that :) Thanks!


Q: An ex of mine once told me that couples end up having the same gut microbiome after spending a good amount of time together. Is there truth to this? (r/ALIEN***L)

A: This is a fun one!

u/Specific_Ingenuity84 said it well that 'you'd expect your microbiomes to become more similar when you live together.'


The main distinction I would make is that the gut microbiome is not nearly as impacted as the skin microbiome. Which again makes sense because your skin is in more direct contact with your environment.


There was a study a few years back where researchers in Canada were able to identify if people were couples with an 86% accuracy by analyzing their skin microbiomes. However there were some interesting findings related to this that I will share below.

https://www.sciencedaily.com/releases/2017/07/170719113300.htm


original study - https://journals.asm.org/doi/10.1128/mSystems.00043-17

"Neufeld says the study is the first to identify regions of skin with the most similar microbiomes between partners. They found the strongest similarities on partners' feet.


"In hindsight, it makes sense," says Neufeld. "You shower and walk on the same floor barefoot. This process likely serves as a form of microbial exchange with your partner, and also with your home itself." As a result, partners end up with the same mix.


The analyses revealed stronger correlations in some sites than in others. For example, microbial communities on the inner thigh were more similar among people of the same biological sex than between cohabiting partners. Computer algorithms could differentiate between men and women with 100 percent accuracy by analyzing inner thigh samples alone, suggesting that a person's biological sex can be determined based on that region, but not others."


So as you can see, while it's interesting to say that couples have similar microbiomes, the true reason for this might simply be due to the environments these couples find themselves in.

Thanks for your question :)


Q: What’s the relation between brain fog and gut health? And how can one fix it? (r/dodo3211)

A: I've recently read an interesting study on this. They found that brain fog and depressive-like symptoms are related to inflammation. How it works (in theory) is that the gut lining is more permeable (known as leaky gut), meaning it can be compromised more easily, resulting in the immune system 'around' the intestines being exposed to triggers such as bacteria and dietary elements. This leads to more immune system activation, which leads to more inflammation, and more symptoms like brain fog and other "sickness behaviors". To fix this, their suggestion was to check for leaky gut through antibody tests (IgM and IgA in case you're curious) and then treat for leaky gut accordingly, which could involve immune modulators including medication and dietary changes!


Be sure to check out our post on r/IAmA to join the discussion and learn more!


Want to get your gut in check? Download our app today on iOS or Android!