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

A new study is challenging long-held assumptions about coffee’s effects on digestive health, suggesting the popular beverage could offer benefits for both the gut and the brain.

The research, published in Nature Communications, examined 62 participants, half of whom were regular coffee drinkers, to explore how coffee consumption influences the gut microbiome and mental well-being. Using psychological assessments alongside dietary tracking and biological samples, researchers found that individuals who drank coffee, whether caffeinated or decaffeinated, reported lower levels of stress, depression and impulsivity.

The findings point to a growing scientific consensus: coffee is more than just a caffeine delivery system. According to the study’s authors, it acts as a complex dietary component that interacts with gut bacteria, metabolism and even emotional health.

Researchers also observed higher levels of beneficial bacteria among coffee drinkers, including strains linked to protection against harmful microbes and inflammation. Caffeinated coffee, in particular, was associated with reduced anxiety, improved attention and lower markers of inflammation.

Still, OSF HealthCare gastroenterologist Omar Khokhar, MD, cautions against drawing sweeping conclusions.

Kinds of coffee could make a difference

Dr. Khokhar points out it’s a small study that supports a hypothesis, but it’s not definitive proof that coffee will improve gut health or mood.

“There are so many different kinds of coffee. There’s Turkish coffee, there’s South American coffee, there’s Dunkin Donuts coffee, there’s Folger’s and Sanka for some of the people watching this on Facebook.” He points out, “It just comes down to each person and their own individual microbiome and how it responds to whatever particular type of coffee they’re ingesting.” 

Instead, Dr. Khokhar believes the study contributes to a broader shift in how scientists understand nutrition. Rather than labeling foods as strictly “good” or “bad,” researchers are increasingly focusing on individual responses, particularly how a person’s unique gut microbiome influences their reaction to what they consume.

Coffee itself is chemically complex, containing compounds such as polyphenols, which Dr. Khokhar says might act to feed beneficial gut bacteria.

“Now let’s suppose you’re at baseline and you have overall good gut hygiene and function; coffee could potentially be a good thing. It could be a prebiotic of sorts, that could potentially support your microbiome in that case.” 

This could help explain the observed microbiome changes in coffee drinkers.

However, those same compounds can have downsides. Coffee is known to relax the lower esophageal sphincter, potentially triggering heartburn, and Dr. Khokhar stresses coffee exacerbates symptoms in people with conditions such as irritable bowel syndrome.

The study did not differentiate between types of coffee, such as espresso versus brewed coffee, highlighting another limitation and an area for future research.

More research is needed

Dr. Khokhar says the study shows a link but not a direct cause and he thinks more controlled studies are needed to determine how specific varieties and preparation methods influence health outcomes.

“What I would like to see personally is if you controlled for what specific coffee a group of volunteers ingested and then either through blood or stool, looking at their exact gut microbiome diversification or pattern to see if that improved or how that changed from a robustness and a diversity point of view,” he says. “That would be more objective.” 

The research also raises intriguing questions about the gut-brain connection. Scientists now understand that the gut microbiome plays a role in producing neurotransmitters like serotonin, which can influence mood, sleep and behavior.

Whether coffee can enhance mood indirectly by improving gut health remains a hypothesis but an appealing one for millions of daily coffee drinkers.

For now, the takeaway is about embracing moderation and self-awareness. As Dr. Khokhar puts it bluntly, “If it makes you feel bad, don’t do it.” But he says if people can tolerate coffee well, in moderation, it might not be as harmful as once thought and could even be helpful, but more research is needed to prove that.

If you have questions about what's best for their health, talk to your primary care provider. 

Video clips with Dr. Omar Khokhar

B-roll-Coffee and gut microbiome

An OSF HealthCare gastroenterologist says recent research strongly supports the case that the brain and the digestive system are closely connected through one key communication pathway: the vagus nerve.

The vagus nerve, the longest in the nervous system, acts as a biological “superhighway,” carrying messages between the brain, stomach, intestines and other vital organs. Researchers say this pathway is crucial for regulating digestion, inflammation and even mood.

Omar Khokhar, MD, a gastroenterologist at OSF HealthCare, says at first, researchers thought the brain impacted gut health. But now, they know a person’s gut bacteria – known as the gut microbiome – can influence mental health as well. So, it’s a two-way connection, and when the vagus nerve is functioning well, it helps keep digestion steady, reduces inflammation and supports a stable stress response.

How do you know when the gut microbiome becomes imbalanced? Dr. Khokhar says it can show with bloating, pain or irregular bowel habits.

“The best way to sort of self-assess if you have a good, healthy gut microbiome is how many bowel movements you’re having. Are they robust, big bowel movements? This is what we’re looking for,” Dr. Khokhar explains. (He holds up an example of at least a six-inch-long plush toy as an example) “That’s what we want from everybody. Also, the gas you pass. Everyone knows the difference between the gas that actually feels good – like decompressive – versus the gas that is not satisfying.”

Reduce stress before eating

Chronic stress, poor sleep or traumatic experiences can reduce vagal tone – the nerve’s ability to send calming signals – which might worsen gut conditions like irritable bowel syndrome. Dr. Khokhar says the vagus nerve can be distracted to respond to the brain too often in states of chronic stress or anxiety, ignoring the role it needs to play in digestion.

“There’s no question there’s a correlation between mental health and optimal efficiency or efficacy of your GI tract. Whether that’s motility, hormone secretion or digestion, it all ties in together,” he stresses. “That’s why it’s really important to address that.”

Holidays can be exciting but also a stressful time. So, Dr. Khokhar believes some deep breathing, especially before and after a big holiday meal, can help to reset the vagus nerve and improve how it works.

“Kind of like you restart your phone or computer. It’s a very similar concept. Let’s clean it out. Let’s do some deep breathing for five or 10 minutes. It’s all it takes. Then the vagus nerve says, ‘OK, I’m more relaxed here. I can then do my job, which is to secrete hormones, to squeeze and to help with the GI tract.’”

Early evidence suggests deep breathing, meditation, regular exercise and even humming or singing might stimulate the nerve and help restore balance. What kind of breathing exercises does he recommend? Dr. Khokhar says the diaphragm should be engaged by using a 4-4-4 technique.

“Four seconds in, four seconds hold and four seconds out. Navy SEALs have mastered this when it comes to sleep and other regulation. I think they have a 4-6-7 where you inhale four seconds, hold for six seconds and then exhale for seven seconds. Personally, I have a hard time exhaling because you have to time your exhale. You can’t just blow out that.” (needs to occur slowly).

Scientists caution that much of the research is still emerging, but they agree the vagus nerve is a promising target for future treatments. For now, Dr. Khokhar says deep breathing, staying hydrated and getting into the habit of walking or moving after a meal are all good approaches to help improve digestion.

Dr. Omar Khokhar

B-roll-Deep breathing for healthy digestion

OSF HealthCare gastroenterologist Omar Khokhar, MD, says it’s a homemade drink that includes a few main ingredients.

“It’s oranges, coconut water and salt. It can be derivatives of each one of those ingredients but that’s sort of the nuts and bolts of it. The thought process is that each one of those ingredients helps with the electrolyte balance in your body once you ingest this mocktail.”

The drink is designed to promote development of cortisol, a stress hormone that influences several systems in the body.

“Cortisol is one of many chemicals produced by a small gland on top of your kidney called the adrenal gland. And so, cortisol plays a key role in metabolism, immune function, blood-sugar metabolism and so any disruption in your cortisol metabolism can have a downstream effect in other parts of your body leading to potential health issues.”

The drink claims to help with something influencers have labeled “adrenal fatigue” and weight loss by increasing cortisol. But here’s the catch — Dr. Khokhar says the science doesn’t back it up.

“Adrenal fatigue has been debunked in 2016 by a meta-analysis, and it is not a true condition. The other pertinent point that people should know is that taking a cortisol mocktail does not in any way shape or form alter your cortisol levels. It has no impact on producing more cortisol or reducing cortisol levels in any way.”

There is a condition known as adrenal insufficiency, which is a serious medical condition in which the adrenal glands fail to produce enough cortisol. Symptoms include nausea, vomiting, low blood pressure, low blood sugar and extreme fatigue. Dr. Khokhar says if you experience these symptoms, see a doctor right away.

If you want to improve cortisol levels in a meaningful way, Dr. Khokhar suggests other approaches.

“There are things that are much more data-driven that can help with that. That includes getting seven or eight hours of sleep. That includes reducing your stress through meditation or other practices.” He also suggests, “That includes eating a healthy diet. Those are things that are maybe more difficult to do but they’ve been shown to improve cortisol levels, whether they’re high or low.” (

Dr. Khokhar says a cortisol cocktail as its being touted likely won’t harm you if you don’t have an underlying condition such as diabetes or high blood pressure that could be impacted by a sugary, salty drink.

On its own, he says coconut water has health benefits because it has electrolytes and hydrating properties. So, it can help with rehydration, especially after exercise or illness, and could also support heart health, blood sugar management, and digestive health. 

Additionally, coconut water and orange juice are a good source of Vitamin C and other antioxidants so benefits worth sipping, even if cortisol isn’t part of the picture. 

Dr. Omar Khokhar

B-roll-Cortisol Cocktail

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 20% of people in the United States have gastroesophageal reflux, commonly referred to as GERD. One of the complications of GERD is esophageal stricture, when a person’s esophagus becomes too narrow. This can lead to major problems with swallowing.

There’s a minimally invasive procedure available that can provide serious relief for patients dealing with these issues. One that can be done in one sitting and have you back to normal life as soon as you leave the hospital.

Introducing upper endoscopy

"This procedure is an upper endoscopy. We frequently refer to it as EGD (esophagogastroduodenoscopy). There are various treatments we can do with this procedure, including balloon dilation," says Raza Hamdani, MD, attending gastroenterologist at OSF HealthCare St. Mary Medical Center in Galesburg, Illinois. "Balloon dilation is one of the techniques we have for patients who have obstruction of the esophagus."

Common complaints that lead to EGD:

The main complaint seen when patients get referred for an EGD is difficulty swallowing certain food like bread or meat. However, depending on the severity, it can even be soft foods or liquids causing issues while being consumed.

“It's usually described as a sensation of choking or things slowing down," Dr. Hamdani says. "Things not being able to go through”

Carrie McCance, the public relations communications coordinator (PRCC) at OSF St. Mary, usually is creating content about the work OSF providers do. This time, she has become part of the story.

“I was having frequent issues with food getting stuck in my esophagus, so much so that I couldn’t even swallow bread. After undergoing an X-ray, I was diagnosed with dysphagia, which is the medical term for difficulty swallowing,” McCance says.

McCance spoke with her care team at OSF and underwent an X-ray to try and get answers. The X-ray revealed she had scar tissue in her esophagus created by acid reflux, creating an esophageal ring that narrowed her esophagus.

“A normal esophagus measures about 20 millimeters in diameter, but mine had narrowed to 12 millimeters,” McCance says.

How the upper endoscopy works

McCance decided to get the upper endoscopy procedure, performed by Dr. Hamdani. Done under sedation, a thin, flexible tube called an endoscope gently passes through the patient’s throat.

A dilating balloon that has been inserted through the scope is carefully inflated, stretching the esophagus back to its normal size.

“This definitely improved my swallowing,” McCance explains.

Her treatment became a family affair, after Carrie’s mother, Mary Guenther, who had been experiencing similar issues, saw McCance go through the process.

“I was happy she told me about this. After I saw her go through the procedure without issues, it was easier for me to go through the process,” Guenther says.

Guenther’s esophagus was even narrower than McCance’s, at eight millimeters. Guenther says she went directly from the hospital and out to breakfast, and her swallowing has been better ever since.

McCance says having this procedure available in Galesburg saved her from hours of travel time, which she is very grateful for.

“I was in and out of the hospital within just a few hours. It couldn’t have been more convenient. Originally, I was expecting to travel to Peoria for the procedure, but thanks to Dr. Hamdani coming to the area, I was able to receive care close to home,” McCance says. “It also meant a lot to have the same option available for my mother. Being able to take her in for her procedure and have her back home in less time than would take just to drive to and from a larger city made a big difference for the both of us.”

What puts people at risk:

For those with trouble swallowing, it normally starts off with a slight feeling and then progresses to a “strong sensation,” Dr. Hamdani points out. This looks like food items are not passing through the throat or even getting stuck. This can even send some patients to the emergency department.

"If you cannot control the acid sensation or burning. Or even if you can, but you've had that kind of sensation for several years, that puts you at some risk for developing scar tissue and obstructions," Dr. Hamdani adds.

Dr. Hamdani encourages patients to "take action" if they are experiencing these complications, just like McCance did.

“Having this procedure truly changed my life. I can now eat without the constant fear of food getting stuck in my esophagus,” McCance adds.

Dr. Hamdani and McCance agree, saying first speak with your primary care provider. They can start by prescribing medications that can help relieve symptoms. If these symptoms don't go away completely, then you should get further consultation with a gastroenterologist to prevent issues from becoming more serious.

Acid reflux isn’t the only challenge these patients can face. Allergies can also affect the esophagus, creating the need for an EGD procedure.

For more information on gastroenterology specialists in the Greater Galesburg region, visit the OSF HealthCare website.

Video Interview Clips

Remember the chia pet? Well chia seeds are not just for gag gifts anymore. They do have positive health benefits. For example, seeds (two tablespoons) offer an impressive 10 grams of fiber, or roughly one-third of the daily requirement for adults.

There is also a TikTok trend, made popular by celebrity wellness influencer Daryl Gioffre, which makes use of chia seeds and fresh lemon juice to jumpstart a person’s digestion with a goal of alleviating constipation.

Omar Khokhar, MD, a gastroenterologist at OSF HealthCare, says the concoction is also referred to as an internal shower. To make it, combine one to two tablespoons of chia seeds with eight to 16 ounces (one to two cups) of water and lemon juice. Let it stand for at least 15 minutes, so the chia absorbs much of the water.

Dr. Khokhar says it’s one way to get fiber into your diet.

“It’s a very good, natural way to incorporate fiber and protein into your diet. However you want to take it [chia seeds] – a salad, as part of a parfait – there are other ways to ingest it. With this particular phenomenon, you’re mixing it to sort of help it expand ahead of time outside of your body instead of inside your body.” 

The concoction can make you feel full and adds to hydration, which is good for digestion.

Can the drink be dangerous? Dr. Khokhar says if you’re dealing with gastrointestinal (GI) disease or distress, skip the internal shower drink.

“If you have any history of esophageal swallowing issues or any history of intestinal obstruction, this is something you might want to talk to your doctor about ahead of time. Because what you don’t want to do is ingest this gel-like material and cause some kind of blockage.” 

He also warns that if you have constipation that lasts more than just a few days, see a medical provider, particularly if you’re in your 20s. Constipation can be an early sign of colon cancer.

“If you are constipated, for example, don't mask that symptom with a chia seed phenomenon that you saw on TikTok. Go see your doctor. Make sure you get checked out. And if you get checked out, then, by all means, go back to the chia phenomenon.” 

And start slowly. Adding too much fiber too quickly, Dr. Khokhar says, could have the opposite effect. It can cause GI symptoms such as stomach pain, gas, diarrhea, constipation and bloating.

“It can potentially cause bloating or make bloating worse, so I would be careful. If you have any kind of GI or pre-existing issue, it’s something you might want to start maybe a half dose and see how you respond before going with a bigger, normal dose.”

Generally speaking, Dr. Khokhar recommends also trying to get more fiber through your diet. Although, after trying the drink as part of this story, Dr. Khokar declared, “I’m not going to lie, it actually tastes pretty good.”

Dr. Omar Khokhar

B-roll of chia seeds and lemon water-drinking it

There have been numerous studies suggesting gut health is linked to brain health and can influence the development of diseases such as Alzheimer’s. Now, there’s research results that specifically advance the idea that a person’s gut microbiome and damage to the upper gastrointestinal tract significantly increase a person’s risk of developing Parkinson’s disease.

The study points out Parkinson’s disease is a progressive neurodegenerative disorder that affects 8.5 million people worldwide based on 2019 estimates. The number of cases has more than doubled over the past three decades. It is considered the fastest growing neurodegenerative disorder globally, even surpassing Alzheimer’s, according to the World Health Organization.

Omar Khokhar, MD, a gastroenterologist with OSF HealthCare suggests there’s a strong connection between damage to the lining of your gastrointestinal tract and the impact of damage on the rest of the body.

“There's this whole theory about absorbing things we shouldn't be absorbing, leading to systemic inflammation. And in this case with Parkinson's, is it neuroinflammation? Is it absorption of things you shouldn't be eating quickly or eventually, over time, could potentially accumulate in the brain to cause Parkinson's?”

The research involved more than 9,300 people who had a scope of their upper gastrointestinal tract, including their esophagus, stomach or upper part of the small intestine that required a biopsy. The study showed those whose mucosal lining was damaged had a 76% greater risk of developing Parkinson’s disease during the follow-up period – an average of 14.9 years for the group.

It has been a long-held belief that Parkinson’s disease has its origins in the brain, but now researchers see growing evidence it might begin in the gut. The latest study shows a strong correlation but doesn’t definitely link problems with the gut lining as a cause of Parkinson’s. However, Dr. Khokhar says it appears that gut health makes a big difference.

“If your gut lining is intact and strong, it will absorb what you should absorb for adequate nutrition, digestion and healthy living and not absorb what you shouldn’t be absorbing.”

According to the study, a protein called alpha-synuclein found in the gut can travel to the brain and form clumps called Lewy bodies, which are a hallmark of Parkinson's.

As he glances at a screen with research results, Dr. Khokhar says he looks forward to a day when a person’s microbiome health could be evaluated through a blood or breath test, and then specific prebiotics or probiotics could be ordered to address deficiencies, much like what’s done today with vitamins.

“Once we can get to this point where we can look at ‘this is what you’re eating and what you’re eating is resulting in these different changes and levels of your specific microbiota,’ that’s where it gets really, really groundbreaking.”

But, that type of precision medicine could be five to 10 years away. So until then, what’s the best approach? Dr. Khokar says it’s important for anyone with gastrointestinal issues to improve their diet and be diligent about following up with regular check-ups. In fact, with increasing evidence that what we eat can impact gut and brain health, Dr. Khokhar says it’s time for everyone to start paying more attention to what they eat.

“I challenge everyone who eats a granola bar or who eats a bag of Doritos or whatever the case may be. If I can’t tell you and the scientists can’t tell you what ingredients six through 22 are, should you really be putting that in our mouth? Or is there a trade off or is there a cost to that?”

What about prebiotics and probiotics? Should people be taking them to keep a healthy gut? Dr. Khokhar advises a better approach is to get those nutrients through food by regularly eating things such as Greek yogurt, kefir (milk or non-dairy based milk such as soy, coconut and water), sauerkraut, kimchi, pickles, miso, tamari (soy), kombucha, sour cream, cottage cheese and aged cheese.

If those are too challenging to include in your diet, Dr. Khokhar says to talk with your medical provider. If you feel better after taking prebiotics or probiotics, then go for it.

Video with Dr. Omar Khokhar

The colonoscopy has a special place in comedy, but colorectal cancer is no laughing matter. The reality is that a colonoscopy is the best way to detect the second-deadliest type of cancer.

However, fear prompts many people to avoid a colonoscopy. Now, comes a new, less invasive way to screen for colorectal cancer – a new FDA-approved blood test that can be used for people who have an average risk. Dr. Harishankar (Hari) Gopakumar, MD, a gastroenterologist at OSF Medical Group in Bloomington says the new test is aimed at improving the screening rate for colon cancer which currently stands at 63% of all eligible people.

“This blood test could bridge some of gap; that is where I see its main role. If for whatever different reason somebody is not able to get one of the approved colon cancer screenings, other than this latest blood-based test, this could be a bridge to offer some form of screening to them.”

The American Cancer Society says overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. However, each person’s risk might be higher or lower, depending on their risk factors for colorectal cancer, including but not limited to family history.  In people younger than 55 years of age, rates have been increasing by 1% to 2% a year since the mid-1990s, so it’s recommended screening start at 45 years, beginning with a baseline colonoscopy.

The recently approved blood test is easier than the current stool sample option that’s available for people at average risk, but Dr. Gopakumar suggests it is not good for detecting pre-cancerous cells. He says the sensitivity is enough to detect about 13% of pre-cancerous lesions. The success at detecting actual cancer is about the same with the blood test as the stool-based analysis. However, Dr. Gopakumar stresses testing a stool sample offers a better way to detect those early-forming cancer cells and that’s what’s most important.

Detecting colorectal cancer sooner

“Our goal is to be able to pick up these pre-cancerous lesions way before they even have a chance to become cancer and then treat them because at that stage, it’s relatively easy to treat the polyp – you take the polyp out. Nothing after that except maybe a follow up colonoscopy. That is where the difference comes in.”

Currently, about 60–70% of colorectal cancers are diagnosed at an advanced stage. Research suggests if the healthy population regularly submitted to annual screening, the 5-year survival rate could be increased to 73% (currently 65%). So, does Dr. Gopakumar think this new blood test could become part of annual exam testing?

He thinks it could eventually, but not until the test is improved to increase early cancer cell detection.

“This is probably an early stage and with more effective (technology) where we can match the sensitivity and specificity numbers where they detect what we need to detect – close to the stool-based testing or even better than that – then I see this as the future, but it may be a bit further out.”

Dr. Gopakumar says the blood test should not replace the more intensive colonoscopy procedure which, for people with average risk, should be given every 10 years. The FDA recommends getting the blood test every three years starting at age 45 for people not at high risk.

With the various options now available, Dr. Gopakumar recommends having a conversation with your medical provider.

“Make an informed decision so you get the best test that you can and it’s most appropriate for you so you can feel confident you got what you needed done in an appropriate and efficient way.”

The Affordable Care Act (ACA) requires both private insurers and Medicare cover the costs of colorectal cancer screening tests, because these tests are recommended by the United States Preventive Services Task Force (USPSTF). This includes a blood test, but Dr. Gopakumar says check with your insurer and make sure whether prior authorization is needed and to know whether you will have a co-pay.

Video clips with Dr. Hari Gopakumar