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

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

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