Cleanses? Supplements? How to tell fact from fiction with gut health advice
Data shows that cases of inflammatory bowel disease and colon cancer are on the rise. At the same time, social media is inundated with ads and influencers touting products that promise to boost what’s broadly called “gut health.” How do we separate the facts from the fads? Dr. Shazia Siddique, an assistant professor of gastroenterology at the University of Pennsylvania, joins John Yang to discuss.
John Yang:
Go on social media these days and you're bombarded with ads and influencers, touting all sorts of products promising to reduce digestive tract complaints, supplements, juice cleansers diets, all promoting what's broadly called gut health.
And indeed, cases of inflammatory bowel disease and colon cancer are on the rise. And a 2023 survey for a health care company found that two-thirds of those questions said they have symptoms like gas, bloating and abdominal pain on a regular basis. But how do we separate the facts from the fads?
Dr. Shazia Siddique is an assistant professor of gastroenterology at the University of Pennsylvania School of Medicine. She's also on the clinical guidelines committee of the American Gastroenterological Association. Dr. Siddique, why all this attention? Why all this focus on gut health?
Dr. Shazia Siddique, University of Pennsylvania School of Medicine: Well, we're definitely seeing a rise in gastrointestinal diseases globally over the past two decades, from 250 million cases back in 1990, to now more than 440 million cases. And digestive diseases can range from heartburn to hemorrhoids to colon cancer, and especially recently, what we're seeing is an uptick in colorectal cancer, particularly among young individuals, and is the leading cause of cancer death in men under 50.
John Yang:
Is there any explanation for that rise?
Shazia Siddique:
Well, what we're seeing globally is that there are many factors associated with it. One is a Western diet, one that is high and fast food, processed foods, more meat, less diverse vegetables. And then there are other lifestyle factors like alcohol consumption, tobacco use, and to also more sedentary behavior.
John Yang:
And how does gut health affect overall health?
Shazia Siddique:
Well, it is interesting that emerging research on the gut microbiome, which are the microorganisms that live in your gut, show that there is a link between those microorganisms and your immune function, and arguably, also your cardiovascular health, metabolic health and nervous system. So, we know what we eat and what we expose our gut to can have impact on our overall health as well.
John Yang:
What are the biggest misconceptions you hear from patients in your practice? And do they ask you about things and Products and Procedures that, in your view really don't have any use?
Shazia Siddique:
Yes, unfortunately, it's something that's very common. One of the most common things that I'm asked about is about doing colon cleanses, which is this concept that we need to detoxify our body and our gut, using laxatives or other cleansing materials.
But the reality is that colon cleanses are really not necessary. Our liver and our kidneys detoxify our bodies appropriately. And colon cleanses if anything can be harmful in some cases.
John Yang:
Let's start off with what people may be feeling and asking about or wondering about. Are there symptoms that maybe someone can control with over the counter medications? And are there symptoms where they should go see a doctor?
Shazia Siddique:
Yeah, absolutely. So if you're having more severe symptoms, like blood in your stool, severe abdominal pain, weight loss that you can't explain, those are all symptoms, that you should be seeing a doctor much sooner, and likely getting a colonoscopy for colon cancer screening.
Other symptoms that are more mild like bloating, oftentimes, those are things that you can do mild changes in your diet, for example, anything that's swallowing air, so carbonated beverages, drinking out of a straw, gum, chewing, those are very simple things you can do cut out of your diet to see for bloating gets better. But like with any symptom, if it's persistent, you should definitely talk to your doctor.
John Yang:
You said talks about patients who are coming and asking about cleanses and things like that. How should people evaluate the claims and these products that are being advertised or influencers are talking about?
Shazia Siddique:
Well, I think really what we need is to have any sort of data showing that there is a benefit in gut health and overall health and really, that has been borne out at all. If anything, we've seen patients have harms from colon cleanses, like dehydration, electrolyte abnormalities, or an even depending on the type of cleanse some episodes of colitis, which is inflammation in the colon. So the the risks and downsides really don't outweigh the benefits.
John Yang:
Do you see patients who come into with the side effects with things that they might not have had if they hadn't done that?
Shazia Siddique:
I actually had a patient who came in with rectal pain. And as we started to talk about it, I realized that she had actually done a coffee enema, which was something she had learned from TikTok and she ended up having imaging findings of colitis as a result of this enema. So unfortunately, people are influenced by what they see on social on media but it's really not data driven.
John Yang:
So what do you tell your patients how they should maintain their gut health without doing all these other things?
Shazia Siddique:
The most important thing is to have a nutritionally diverse diet, so less red meat, lots of vegetables, fiber, fruits, and really avoiding ultra-processed foods. So going from Whole Foods and fresh foods.
John Yang:
Dr. Shazia Siddique from the University of Pennsylvania Thank you very much.
Shazia Siddique:
Thank you so much.