Dec 4, 2024 Ask the Doctor: Trust Your Gut

Shivaprasad Marulendra, MDYou’ve heard the phrase when it comes to making decisions, but your gut doesn’t just give you intuition for reaching conclusions. It also physically interacts and communicates with the rest of your body in ways that affect your overall well-being. “The gut microbiome is tremendously important for both immunity and metabolism,” says Shivaprasad Marulendra, MD, gastroenterologist at Robert Wood Johnson University Hospital Hamilton (RWJUH Hamilton) and member of RWJBarnabas Health Medical Group. Dr. Marulendra explains why the gut is critical, and how you can help it thrive.

What is the gut microbiome?
Think of it as a tiny universe of microorganisms living inside your body. “There are more microbial species in the gut than human cells,” Dr. Marulendra says. Issues with the gut microbiome are linked to many chronic medical conditions, including diabetes, obesity and cardiovascular disease. Gut health also plays a role in several types of cancer, including colorectal cancers.

How does the microbiome affect digestive health?
The microbiome breaks down foods that we eat, but its organisms can act differently based on the foods they encounter. For example, diets high in fatty, processed foods such as deli meats and bacon are linked to increased numbers of cancer cells in the gastrointestinal (GI) tract. “Processed meats are designated Group 1 [highest-level] carcinogens by the World Health Organization,” Dr. Marulendra notes.

What habits can improve gut health?
Eating a high-fiber diet that includes foods such as berries, whole grains and vegetables like broccoli can promote a range of positive effects. “Fiber acts like a prebiotic in the gut, which brings two benefits,” Dr. Marulendra says. “It stimulates the natural hormone GLP-1, which is essential for weight loss—and obesity is a risk factor in many GI-related cancerous and precancerous conditions, such as Barrett’s esophagus. A high-fiber diet also helps build a strong, thick mucus barrier within the gut, which prevents pathogens from damaging healthy cells.” Regular exercise further benefits gut health and reduces the risk of chronic disease. “Exercise stimulates weight loss,” Dr. Marulendra says.

Does genetics affect gut health?
Family health history can play a role in nearly all digestive health disorders, from irritable bowel syndrome and gastrointestinal esophageal reflux disease (GERD, or heartburn) to conditions such as ulcerative colitis, Crohn’s disease and many GI-related cancers. Ethnicity may also be a factor: People of Asian descent have a higher risk for gastric or esophageal cancers. Dr. Marulendra says. “Ask your family members if there is family history of any kind of GI cancers or noncancerous polyps.”

What are some warning signs of GI problems?
Routine symptoms such as abdominal pain, cramping, bloating or flatulence may be signs of various illnesses. Red flags to watch for include bloody stools, trouble swallowing, unexplained weight loss, early satiety (feeling full very soon after starting to eat) and persistent vomiting. “Take these symptoms seriously,” Dr. Marulendra says. “Ask your doctor for a referral to a gastroenterologist immediately.”

Are GI-related cancers becoming more common?
“Cancer data show a 1 to 2 percent increase in colorectal cancer every year over the last 20 years in people younger than 55,” Dr. Marulendra says. “That’s a concerning number.” Additionally, studies show that GI-related cancers (of the colon, appendix and bile duct) are growing fastest among adults 30 to 39.

Which screenings can help find GI-related problems early?
Colonoscopy remains the gold standard for identifying colon cancer. The American Cancer Society now recommends that adults start screening for colon cancer at age 45. Dr. Marulendra recommends screenings for Barrett’s esophagus for people who have GERD or those with a family history.

To make an appointment or learn more, call 609-917-9917.

Learn more at rwjhb.org/hamilton.