Digestive health usually gets attention only when something goes wrong. But the truth is, good digestive health is built quietly, through small daily habits repeated consistently over time.

As we recognize World Digestive Health Day this month (May 29), it’s worth stepping back from the trends, supplements, and internet “gut hacks” to focus on what actually works.

Omar Khokhar, MD, a gastroenterologist at OSF HealthCare, says your digestive system is remarkably resilient and if you support it well, it often returns the favor for decades.

One way to avoid digestive issues and inflammation, Dr. Khokhar says, is to avoid eating convenience or ultra processed food.

Avoid ultra processed food

“So for me, ultra processed food is something that comes out of a wrapper, out of a box, out of a can. It’s something that was made in a factory 300 miles away, two months ago that you now see in your local grocery store. So, there is a convenience factor, but we're starting to see that we're paying for that convenience because those foods are difficult to digest and they can result in inflammatory changes to your gut.” 

Dr. Khokhar notes that while genetics can influence the risk of conditions such as celiac disease, inflammatory bowel disease and digestive cancers, daily habits still play a major role in long-term gut health. He says research now shows that when the lining of your gut is disrupted, it can have negative impacts.

“So, the more that we don't do on a daily basis, whether it's fiber, having good bowel movement, making sure we keep a good microbiome, that may result over time in disruption of the mucosal or lining of your stomach and your intestine,” he says.

When that happens, Dr. Khokhar points out, the body will absorb things it shouldn’t, and it won’t be getting what nutrients it should be getting.

If you can only do two things to improve your gut health, Dr. Khokhar says adopt these two habits.

“Flush the pipes. Make sure you drink enough water. Make sure you get enough fiber – whether that’s in diet, whether that’s a supplement, it really doesn’t matter to me at this point. If you get enough fiber and you flush your pipes and you’re evacuating your G.I. tract, it’s going to help remove the waste product.” He adds, “Once you remove the waste product from the colon, everything else can flow down.” 

For fiber, Dr. Khokhar says focus on foods found around the perimeter of the grocery store, including fruits, vegetables, and lean proteins.

Walk after meals

One other good habit to consider – taking a walk after meals. Dr. Khokhar advises even short walks can improve digestion and reduce discomfort.

“After you eat, go for an eight-to-10-minute walk. The activity helps everything, literally from a gravity point of view, a physical point of view, a gas expulsion point of view.” He adds, “It almost helps you reset and recalibrate before you inevitably in our society – we sit back down.” 

A final point from Dr. Khokhar – do not to ignore persistent abdominal pain or major changes in bowel habits. He warns those symptoms can sometimes signal more serious conditions, including colon cancer.

Dr. Khokhar is a gastroenterologist practicing at OSF HealthCare in Bloomington, Illinois.

Clips with Dr. Omar Khokhar 

B-roll-World Digestive Health Day

Terminology

David Rzepczynski, MD, an OSF HealthCare gastroenterologist, says it’s important to first lay out some similar sounding terminology.

• Diverticulum (singular) or diverticula (plural): These are the bulges that form when an inner part of the colon sticks out through a weak spot in the colon wall.
   
• Diverticulosis: This is the name of the condition when the bulges occur.
   
• Diverticulitis: This describes when the bulges become inflamed.

Causes, symptoms and diagnosis

Dr. Rzepczynski says diverticulosis occurs when your colon is trying to push stool forward, and the organ is not as bulky as it should be. The diverticula bulges then form.

The condition has been more common in people over 60, but Dr. Rzepczynski says health care providers are seeing a rise in cases in people in their 40s and 50s.

Diverticulosis can run in families. It’s also tied to your lifestyle.

“A diet that has more red meat, less grain and less fiber might put you at a higher risk,” Dr. Rzepczynski says.

Smoking, excess alcohol and obesity are also risk factors.

Symptoms of diverticulosis include abdominal pain or constipation. But it often comes with no symptoms and is found during a colonoscopy.

Treatment

Dr. Rzepczynski says in mild cases, a provider may tell you to change your lifestyle, such as getting more fiber in your diet. This makes bowel movements smoother.

“Often, people will look to use fiber supplements,” Dr. Rzepczynski says. “The amount of fiber intake from supplements pales in comparison to what you can get from your diet.”

Also, eat a healthier diet overall. Dr. Rzepczynski says there used to be a myth that nuts, popcorn and seeds would get lodged in the colon bulges. He says studies have shown those foods are not a risk factor.

Other lifestyle tips: exercise and cut out tobacco and alcohol.

Dr. Rzepczynski says more serious cases of diverticulosis can come with two complications. One is bleeding.

“You could have a blood vessel on the outside of the diverticulum. If it ruptures into the diverticulum, it could cause sudden bleeding from the rectum,” Dr. Rzepczynski says.

Dr. Rzepczynski says bleeding from diverticulosis is not common. He ballparks it at around one in 2,000 cases. People on blood thinning medication who develop diverticulosis have a higher risk of bleeding.

While unpleasant, Dr. Rzepczynski says most bleeding cases resolve on their own.

The second, more serious complication is diverticulitis, or when the diverticula bulges become inflamed. This happens when there is a tear in the diverticulum, and bacteria from stool leaks. And it can lead to a host of other problems: pockets of pus known as abscesses, issues passing stool and a urinary tract infection.

Symptoms of diverticulitis include pain in the lower left abdominal area, abnormal bowel movements, nausea and vomiting. If you have these symptoms, it’s important to been seen by a health care provider quickly. A doctor may order a computed tomography scan (commonly called a CT scan) to diagnose diverticulitis.

Dr. Rzepczynski says it’s not common for diverticulosis to progress to diverticulitis, and most cases of diverticulitis can be treated at home with oral medication. But, he says 12 to 15% of diverticulitis patients spend time at the hospital. Treatments there include antibiotic medication through intravenous therapy (IV) and surgery. If surgery is necessary, a doctor will drain any abscesses then remove the inflamed area of the colon.

“They’ll try to reconnect the colon at that time,” Dr. Rzepczynski explains. “But if the surgery is done on an emergency basis, sometimes the person may have a colostomy where part of the colon is coming out through the skin. That’s a temporary measure.”

A colostomy comes with a bag on the outside of your body that collects the waste that would normally leave your body via a bowel movement.

Dr. Rzepczynski warns that surgery isn’t a permanent fix. He says around 15% of diverticulitis patients who have surgery end up with another bout. It reinforces the importance of lifestyle changes. You should also get on a colonoscopy schedule as advised by your health care provider.

Learn more

Read more about how to avoid diverticulosis on the OSF HealthCare website.

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