Gut health

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-host Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Rajay Seudath.

CARMENN MILES
Hello, and thank you so much for joining us today on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles, and I am absolutely honored to join the podcast as your new Docs in a Pod co-host alongside amazing veteran co-hosts, Dr. Seudath and Dr. Tamika Perry. Each week, we'll discuss a wide range of health and wellness topics, especially those that impact seniors. Our goal is to share practical information on how we can all live healthier, happier lives and to better manage chronic conditions. We're super excited to have you listening today. So, thank you for joining us. Our co-host today is none other than Dr. Rajay Seudath. He's no stranger to Docs in a Pod. Dr. Seudath is a board certified family medicine physician. He's a Tampa native and currently lead physician of the University location for Optum. He's very enthusiastic about primary care and always keeps health literacy in the forefront. HeÕs always guiding his patients to meet their health care goals. He's passionate about teaching, and that's one of the many reasons we love having him on the show. Dr. Seudath, how are you doing today?

DR. RAJAY SEUDATH
I'm doing great. I'm happy to be talking about probiotics, gut health and things like that today.

CARMENN MILES
Yeah, and today's topic could honestly be broken down into several segments or podcasts, and we may need to continue the conversation, down the line if we don't cover everything today. But let's talk gut instincts and why gut health matters. Dr. Seudath, I've heard many refer to the gut as the second brain or the control center of the brain. Even controlling our moods, our energy levels and our immune system. It's really our overall well-being. I bet you would agree. I don't know if you've ever heard of the southern colloquial expression from the ruda to the to tuda.

DR. RAJAY SEUDATH
From the ruda to the to tuda. That's right. I remember that fondly from Friday with Oh, Pops.

CARMENN MILES
Oh, yes. One of my favorite movies. For those who don't know what we mean when we say from the ruda to the tuda, it means from the beginning to the end. I tell you what, Dr. Seudath, I was surprised to learn that there are seven main organs included in the digestive tract, starting from the mouth, the ruda, and ending with the tuda, which is the colon, not the liver and the pancreas and the gallbladder that are not part of the actual digestive tract, but they play a vital role in digestion. So, the gut is a big deal. The science I find pretty fascinating. So, tell us, Dr. Seudath, what factors influence our gut health and why is it so important?

DR. RAJAY SEUDATH
Gut health is so important because the bacteria in our intestines are what absorb our nutrients. They break down things for us so that we can absorb them. If our gut bacteria is imbalanced, if we have more virulent or negative types of bacteria that are not positive for our body, that are not good for our health, that affects our health. The things that we absorb in our body are minerals, vitamins, the carbohydrates, the proteins, the fats, everything that gives us energy comes from what we eat and what we absorb. There's a whole slew of topics when we come into this, and a lot of different things can disrupt the biome, which just means the environment. The gut microbiome, or the gut biome, are all of the different organisms that live in our intestines. Many different things can disrupt that. There are many different ways that we can improve it to optimize it. Even in very extreme situations, there are ways that we can do transplants of bacteria for people who are very, very sick. We notice that even in those extreme situations, people who get transplants of bacteria from healthier people, they themselves start to become healthier, which is kind of amazing in that sense as to are these bacteriaÕs that people are eating, are that is that affecting their longevity? Is it affecting their day to day life? Is that affecting their mental acuity? This study of the microbiome, of the environment of the intestines, is still fairly new. It's only been this in-depth for the last maybe 15 to 20 years. So, there's still a lot of research to go through, and it's still very fascinating.

CARMENN MILES
Very good. Let's take just a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod. I'm Carmenn Miles. Our podcasts are available wherever you listen to your podcasts. You can also tune in as we are on the radio in several Texas markets and in Florida. We're talking with our co-host, Dr. Rajay Seudath today about the importance of maintaining good gut health. Dr. Seudath, outside of protruding midsection that can sometimes, but not always be an indicator of maybe not so great gut health. What are some of the signs of poor gut health? And are there certain diseases that relate to, gut health?

DR. RAJAY SEUDATH
Oh, absolutely. There are a lot of diseases that are associated with the intestinal flora and your health in general. One of those can be ulcerative colitis or Crohn's disease. Those are inflammatory diseases where the body is attacking itself. There can also be overproduction of acid in the stomach. So, that could be a person could be having too much acid in their stomach because of the things they're eating. So, you eat a lot of spicy food, you drink two pots of coffee a day, you're having a handful of vodka each day. Those are things that are going to worsen the acid and the mucus of your stomach, which in turn can affect the amount of good bacteria versus bad bacteria in your intestines. It also affects the mucosa, which is the mucous lining that first thin layer of tissue on the inside of your intestines. So, those are some of the things that can affect our health in that regard. Now, what are some of the things that are good for our gut health? When we think of good gut health, what are things that have positive, healthy bacteria are going to typically be fermented foods. So, foods and cultures that have fermentation are often going to have very good bacteria in them. Things like Kombucha are a type of fermented, yeast type of drink. It's some of the microorganisms we use to make vinegar. So, if you drink kombucha, it has that vinegar sour kind of flavor to it. Sour flavors are usually those type of fermented things. So, we could do something like kimchi is a fermented dish. Sauerkraut is a fermented fruit. Natto, which is a Japanese fermented soybeans. So, there's fermented foods. Greek yogurt, which is a fermentation of milk. So, those are things that have probiotics in them. Those can be very, very healthy in terms of keeping the good bacteria in the majority of our body.

CARMENN MILES
For those of us who don't know, when you say probiotics, because there's probiotics, there's prebiotics. Explain what you mean when you say probiotic.

DR. RAJAY SEUDATH
Again, probiotics are going to be good bacteria. Good bacteria that are instead of antibiotics, antibiotics are going to kill off bacteria. Hopefully the bad ones, but they often end up killing the good ones too. Probiotics are going to be the things that help our gut flora by providing healthy bacteria. That's one of the things that I can focus on here, and there are a lot of them. When you go to pick up a bottle of probiotics, you're going to see that it's got 20 different strains and 10 million units. Or it's got three different strains at 100 million units. Which one is the best? At this point, we can't tell you exactly which one is the best and which one is not the best. I will tell you that having a combination of probiotics can be helpful. There are concrete situations when probiotics has definitely been shown to have a benefit. I think we should go into some of those and kind of give some people those kind of ideas because just in general, taking a probiotic capsule or taking a probiotic tablet can be helpful. If you don't like yogurt or you're not a fan of sauerkraut on your hot dogs or fermented foods are not on your menu, taking a probiotic supplement can absolutely be helpful.

CARMENN MILES
When is the best time to take a probiotic? Is it on an empty stomach in the morning? In the evening? How do you get the best results from a probiotic supplement?

DR. RAJAY SEUDATH
Some people are going to say doing it on an empty stomach can get better absorption. I typically want patients to do it whenever they're going to do it consistently. If I tell you to take it before bed and you forget to take it before bed, you didn't have it that day. I typically tell my patients to take it with a meal because sometimes it can give you a little bit of upset stomach. It's true, you'll probably have better absorption on an empty stomach, but if you take something and it makes you feel bad, you're not going to keep taking it. So, what are some of the times when a probiotic could be very, very helpful? I think the best times that a person could use a probiotic is if they're taking antibiotics. Antibiotics are going to wipe out all of the good bacteria and all of the bad bacteria. Probiotics are one of those things that can offset that. So, sometimes antibiotics are twice a day. Well, I say take your antibiotic breakfast and dinner and then take the probiotic at lunch. So, it's kind of separated in time from that antibiotic. That's kind of one of the ways that we can you use our timing on doses to make sure that we're getting the best bang for our buck, so to speak. I think that could be very, very helpful. For people who have recurrent yeast infections, UTIs, who have problems with intestinal issues when they're on antibiotics, this is one of the ways that we can try and cut down some of those side effects from antibiotics.

CARMENN MILES
Very good. We're going to take a short break, and we will be right back to discuss gut health and why it's so important. I'm interested to know if our gut health changes over time as we age. Stay with us. We'll be right back with Docs in a Pod presented by WellMed.

AD
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CARMENN MILES
Welcome back to Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside Dr. Rajay Seudath and we're talking about good gut health and how to maintain good gut health. I'm curious to know, Dr. Seudath, does our gut health change over time as we age or is it in a state solely based on how we manage our health?

DR. RAJAY SEUDATH
I will say it's both. One of the things that happens as we age is our muscles get weaker. A lot of people say that when they get into their 60s and 70s, I'm just not as strong as I used to be. Or you see that they lose weight. Our muscles naturally atrophy. That also happens in the intestines. Our intestines have muscles and those do become weaker. So, you often might notice that people, grandma, grandpa, patients who are over 65, they're always battling constipation. Prunes are associated with old folks, right? If I go to events and they're like, let's get some candy to hand. I am like, no, no, no, you got to know your audience. Get some of the single wrapped prunes. That they'll love that. Because again, people want to be able to have bowel movements and stool softeners and things like that. So yes, when your bowel transits the speed in which the food goes through your intestines is altered, that can also change the type of bacteria that's in your body. Also, there's immunological changes. As we get older, we kind of lose some of the ability to fight off viruses. Our ability to fight off a lot of bacteria becomes a little bit lessened because our immune system weakens over time. So, that can also change the gut health. That's one of the reasons we see a lot of some of the intestinal changes. Like enterocolitis colitis, so inflammation of the bowels, inflammation of the intestines, whether it's the large intestine or small intestine. We see that a lot more in people who are over the age of 65 than we do in younger people. That's because their body is starting to have more of those bad bacteria in higher abundance. When we talk about probiotics, there's tons and tons and tons of different brands. There's tons and tons of different combinations of which ones are in there, which ones aren't in there? Which one is the one I should get? Which one is okay? Which one is going to serve me the best? It's kind of hard to tease that out. I'll tell you, in some regards, you can say specifically disease by disease, there have been some studies to say this brand like Activia or Align or Garden of Life can be better than other for a specific disease process like, H pylori, which is a bacteria in the stomach, or C. diff, which is a bacteria in the large intestines. But really and truly, any of those brands at this point are going to be helpful. I can't tell you exactly which one, but some is going to be better than none. There are studies where they look at them head to head in terms of a specific disease, but for your general health, what I've been telling my patients is the biggest jar for the cheapest dollar.

CARMENN MILES
ThatÕs right.

DR. RAJAY SEUDATH
If you're trying to break your bank to buy probiotics and you can't afford your blood pressure medicine or you can't afford healthy food, no, then it's not worth it. That's the way, I would say. Some is better than none. If we talk about what are those type of diseases they've studied, we just touched on C. diff. C. diff is a very, very scary disease. C. diff usually occurs when a person's been in the hospital and when they've been on a large amount of antibiotics. If person had a lung infection, they were on antibiotics for about 10 days, and then after that they got a urinary tract infection because they were the hospitals, so now they're on another course of antibiotics, and then boom, now they're having watery bowel movements up to 14 times a day and they can't stop it. That is very suspicious of Clostridium difficile, which is C. diff. It's usually a hospital associated infection. What they have found is people who use probiotics while they're on those antibiotics reduce the risk of C. diff. C. diff was actually kind of a medical emergency in the medical world. It was getting to the point where that bacteria was becoming resistant to everything. We would give a person very, very strong antibiotics and the bacteria was resisting it. So, they actually had to do a fecal microbiota transplant, which is a poop transplant. They would get healthy family members get fecal samples and purify them and they would either do it through an enema or they would do endoscopy passed the stomach into the small intestine, and they would give this person healthy bacteria to try and put that Clostridium difficile, that C. diff, that bad bacteria to try and put that back in balance. That's what probiotics are doing. As they started this radical treatment of I'm going to put my poop in somebody else. As they did it, this kind of treatment that you would never think to do, that is one of the things that they found that the younger and healthier the person was, that donor that we were getting, the healthier that that receiver was getting. So, they started to track that, and they found that, yeah, these healthy bacteria were really helping these people out. Typically, the people who were getting Clostridium difficile, the bad bacteria, this diarrheal infection, were very the sickest of the sick people. Fairly frail, fairly aged, with lots of chronic diseases. They found that these people were getting healthier after that fecal microbiota transplant. So, that kind of pushed open the gates to what is in our guts and how can we optimize this? So, that's where we get all of this wonderful literature and all these different probiotics. That's the major one, but there's other ones like diarrhea. Just having antibiotics giving you diarrhea as a side effect that helps with that. For people who have liver disease. If your liver is not working, your body is not getting rid of all the toxins in your body, and that can cause you to have mental changes. You can become confused. They found that people who were using probiotics that have that type of liver disease have a reduced risk of hepatic encephalopathy, which is confusion, mental changes when your liver is not doing well. Another one we had talked about earlier, we touched on it, Crohn's disease and ulcerative colitis, which are both inflammatory diseases, but they're a little different. Ulcerative colitis shows that there's improved remission. It can be under control when a person is using probiotics. For Crohn's disease, not so much. We haven't found that it helps that much. Even in babies, babies can have something called necrotizing enterocolitis, which is preterm infants. They have this type of disease where their intestines are getting inflamed and they can get so inflamed they start to basically die on the inside. They found that probiotics can reduce that risk and the dangerousness of that. So, the one that most people know nowadays is with yeast infections and urinary tract infections. Gals who are over 65, they typically don't have your burning urgency or have those urinary tract infection symptoms that you had when you were in your 20s and 30s. When you're over 65, those symptoms are usually I'm really tired, I don't have a lot of energy or I'm getting confused if a person has dementia or memory issues. So, having probiotics can reduce the incidence of those urinary tract infections. So, that's one of things. For people who are over the age of 65 or even in young women, it's been shown that oral probiotics as well as vaginal suppositories with probiotics can be helpful to prevent those kinds of urinary tract infections. One of the things that we see is when a person is taking antibiotics, it's killing off all the good bacteria. Well, in the vaginal canal there are good bacteria, and the antibiotics are killing us off so we can get a yeast infection, which are not bacteria. A yeast infection is thick, white discharge, foul smell, itching, burning. When a person is on antibiotics for something else, it can cause a yeast infection. So again, my rule of thumb is if a person is taking antibiotics twice a day, I want a probiotic at lunchtime. That can prevent you from getting a yeast infection while you're on antibiotics.

CARMENN MILES
I mean, it sounds like everyone should take some type or some form of probiotic or at least be eating the foods that you recommended. Right? We should not wait until we have a problem. Is that correct? Am I reading this correctly?

DR. RAJAY SEUDATH
Absolutely. I think probiotics could be a wonderful part of your daily health. Again, getting it from food sources, getting it from natural sources is always better because the processing of these things we do lose something. We can't measure exactly everything that's in these things in terms of what's beneficial. So, getting the natural source is always a very good choice.

CARMENN MILES
What about drinking water? Does that help to kind of move things? What are some things that we can do in our daily walk? What are some things we should limit as well?

DR. RAJAY SEUDATH
Again, limiting very, very sugary things. Drinking lots of water. For most people is going to be 64oz of water. Trying to do exercise so that we keep our bowels moving. Having regular bowel movements and having consistent bowel movements. We don't want it to be too watery. We don't want it to be hard and constipated. We want it to be thin, smooth, long, like a snake. That's what should be healthy stools. All those things together can have healthy bowel movements and have healthy gut health. So, I think all of those things are very, very important. Hydration, making sure we're cutting down on very processed foods, cutting down on very sugary foods, trying to eat nutrient dense foods and then making sure that we're having good bowel habits and bowel regiment. I think those are all very, very good things.

CARMENN MILES
Wow, a wealth of information, Dr. Seudath, as usual, thank you very much for all of those are great tidbits. That's all for today. We're out of time. Thank you for joining in on this episode of Doc in a Pod presented by WellMed. Thank you for joining as we explored ways to live healthier lives. Don't be a stranger. Subscribe to this podcast, listen to us weekly and sharing is caring. Share this podcast with your friends and loved ones who might also benefit from these conversations. You can listen to Docs in a Pod wherever you get your podcasts. Don't forget, you can also catch us on the radio in several Texas cities as well as Florida. Until next time, stay well!

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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