(upbeat music) - Hey guys, welcome to our Let's Talk About Poop podcast where every Monday I do a podcast where I do a deep dive on a GI topic and then towards the later half of the podcast we enter any live questions you guys have on my live streams as well. For joining for the first time, my name is Dr. Isom. I'm a board certified gastroenter, trained at the Mayo Clinic. I have 10 years of treating all sorts of patients with all sorts of GI and liver issues. I've treated medical students, trained fellows, and also do I publish papers on this topic as well. And so if you have a question you wanna ask me, don't forget to join me in the live stream. And also too, if you want to learn more about my information, don't forget to subscribe to my channel. I also continue to watch this on further videos as well. Well, thank you guys for watching. We have a great show tonight. We have a lot of topics we're gonna talk about. We're gonna talk about vehicle and continents, what it is, how do we treat it, what do we do. We're gonna talk about erosive esophagitis. We'll talk about hernias. We're talking about chicory, a new herb that I've learned about and read about as well. And we'll talk about some of the best probiotic foods as well. So we'll do a deep dive and then later on, we'll go into the main topics as well. If you were joining me on my live stream, don't forget to let me know if you're watching this live or on the replay. And also let me know what stream you're watching this at and where you guys are watching this at as well. We have a wide audience that we've seen before, all the way from all across the world. So I wanna know where my audience is watching this as well. So without any further ado, let's go ahead and begin our deep dive on vehicle and continents. (upbeat music) So this is a common question I get from patients. Hey Dr. Islam, sometimes I've noticed I've had some issues going on with my rectum or my bottom when it comes to vehicle and continents. So what exactly is this? So vehicle and continents is the inability to really know that you're using the restroom. And so you just all of a sudden use the restroom and either you can't make it in time and you soil yourself or you actually don't even realize they're using the restroom and you don't notice it as well. And so this is the medical term what's called fecal and continents. And this is gonna occur whenever we're having trouble using the restroom or even feeling the sensation of going to the restroom as well. Basically is when feces can leak without your control whatsoever. So how do you know if you have fecal and continents? Because whenever I see patients, I know it's an embarrassing condition to have and a lot of patients don't tell me that they have this. I would love to hear if you have this because there are options that we can do, there are treatment options that we can give you that can allow me to determine if you actually have this condition or not. So one of the signs or symptoms is that you actually poop whenever you're passing gas. So you actually feel like you're having a gas down below but you end up actually passing stool and said. Now certainly that can be very embarrassing. This can be a sign of some fecal and continents issues going on. Number two is that you actually poop whenever you're being active. So a lot of, especially my patients who have had serious pregnancies or pieziotomies, they cannot be active or whenever they are active with physical activity, they don't realize that they're sore on themselves or they actually notice that also whenever they're doing any type of activity like that. Number three is that you feel like you have the urge to poop but you cannot make it in time. So you feel the urgency to go and then as soon as you feel the urgency or very quickly right after you actually find yourself that you're sowing yourself in your toilet or in your underwear and you can't make it on time. I feel so fine stool in your underwear and you don't understand why. This could be a sign of fecal and continent as well. And then lastly, if you just don't have the inability to control your bowel habits. So you know that in the past you can control how you go or you can at least make it to the rest of your time but you don't realize that you actually have the inability to control. So what actually causes fecal and continents? Well, one of the obviously is diarrhea. So your rectum is not made to hold in loose stools. In fact, your rectum is made to hold in solid stools. And so if you have diarrhea, if you have liquid stools things are just gushing out all the time. And so because of that, you have the inability to hold things in. So if you have issues like chronic diarrhea or irritable bowel syndrome, you can also have fecal and continents with that. On the other side of the spectrum, another cause actually too much constipation. So if you're holding stool in and nothing will pass through, you can have what's called overflow constipation where you have this ball of stool that's in your rectum and you have this liquid stool that goes around and trying to get out and that liquid still coming out and actually beat the fecal and continents or the issues with the continents that you're feeling. You can also have muscle damage going on inside the rectum. It's a very common cause. I mentioned earlier that a lot of my pregnant patients actually have incontinence because if you're delivering a big baby or there's a complication from that, you have an episiotomy, you have a tear, that can cause your rectum muscles to not work or properly or at least not close down as it normally should. That can cause you to have incontinence as well. And for some individuals, if the rectum is too tight, you cannot stretch it out. Having a condition called pelvic floor dysfunction, this can also predispose you to develop fecal and continents as well. And because of that, it can cause a lot of symptoms to occur. A lot of embarrasses for a lot of my patients. So how do we diagnose somebody with fecal and continents? Well, the first thing we do is we ask you, yes, we need to take the initiative to ask you if you're having these issues because patients, understandably, will not have volunteer information to me. I understand this because they're embarrassed by this. They don't want people to know. They don't want that embarrassment around them. So we as doctors need to make a better idea to actually ask our patients, are you having issues with this? And not saying you have issues with incontinence, but are you soiling yourself? Are you not making to the restroom in time? Do you move and you just all of a sudden notice that there's stool in your bowel and your underwear? These are things we have to ask. Number two is that we just do a simple rectal exam. So a digital rectal exam can give us so much information. We can assess for a rectal tone, how much tone is in there. We can check how the muscles are. We can check to see if there's any problems with the spasm or there's anything going on inside the area. Number three is that we actually may want to take a look with the scope to see what's going on. Unfortunately, a rectal exam does not give us all the information that we need. And there could be things going on in the area that we just cannot see unless we actually take a look with the scope ourselves. And some of the best ways for us to know what's going on is to actually take a physical look with the scope so we can visually see what's going on. And for some individuals, we actually may do what's called manometry testing, which we actually test to see how well the muscles of the rectum are working. Because if it's not working appropriately, it's working too much. The treatment for that may be very different than somebody who has issues that may be something else going on beyond that. So sometimes doing testing like that will give us an idea. And we may want to do further imaging of the rectal area. So we can check to see how, if there's a prolapse, if there's a cystocele, if there's a rectocele, because these can also contribute when it comes to incontinent problems. Now, if you're suffering from incontinent, what can you do? Here are seven recommendations I give to my patients who's coming to see me when it comes to dealing with their incontinence. So number one is that we want to try and reduce the constipation. If we feel like constipation is a main source of what's going on, we feel like they have overflow constipation. So you significantly will want to increase your fiber intake and also give you plenty of water. Now, what I tell all my patients is that fiber is a dual edge sword, meaning too much fiber can cause bloating and dissension. And sometimes it goes low and goes slow to help out. Number two is that you don't want to try and strain, especially if you have constipation because that straining can make those muscles more impaired, make it more weak, and make it more difficult for you to have good rectal tone, which can make the incontinence issues a lot worse. Number three, there are certain foods that we know get that can trigger or make it more likely for you to have incontinence. So things like Sorbertol, which are found in artificial sweeteners, shoeless gums, candy. These are certain foods that we know can make incontinence issues a lot worse. Also, fructose, which are found in honey and certain foods can make incontinence issues worse. So if you're having incontinence, try to search your foods and see if you have these particular sugars that are there. Next is that you want to try to reduce the gas-producing foods because the more gas that you produce, the more likely it's gonna be for your rectum to be open to cause the incontinence issues to occur. So try to minimize those gas-producing foods, things like beans, cabbage, broccoli. These are foods that are known to produce gas and in turn can make it more likely for you to have incontinence issues as well. Also, there are certain foods that we know produce a lot of odor themselves and that odor can also make it more likely for you to have incontinence. So things like alcohol, asparagus, sometimes even chicken or cabbage can make things worse as well. Sometimes you want to give medical therapies to treat what's going on. One of the more effective therapies that we do give is lymodal. Lymodal can give you better rectal tone. It can make it less likely for you to have any incontinence issues. And then lastly, like I mentioned before, fiber supplementation can help out when it comes to incontinence issues. So when do you need to see a doctor when it comes to incontinence? Number one, if you have these issues, if you're noticing, "Hey, I am soil-ing myself. "I don't know what's going on. "I'm making myself dirty. "I don't feel very clean. "I want to find out what's going on." Number two, if you have new onset incontinence, you don't understand why. This could be a sign of something bad going on inside your gut that may need further investigation. And number three, if your quality of life is impaired because of these issues, because you don't have to live within incontinence, there are a lot of things that we can do to get to the root cause of what is going on. And for a lot of my patients, sometimes dealing with a root cause will allow you to feel better as well. So I don't want you to feel like you're suffering from incontinence, you're not. Come see us where we can find out what's going on and I'll forget a plan to hopefully get things taken care of for you as well. All right. So if you have any questions about incontinence, put them down below and hopefully we can address those as well. All right. Next topic, chicory. So I just learned about this root. I want to talk about it. What are some of the health benefits of chicory? So in today, in this particular video, we'll talk about what exactly is chicory? What are some of the benefits we have found with chicory in the gut? How can chicory, how about with other things including weight loss? How should you consume this herb? But also some of the risk factors would take in this herb as well because not all herbs are meant to be taken out this way because some herbs may not be good for you. So what exactly is chicory? Chicory is once you get in this herb, another name for this is Blue Dandelion. This is found in nature in which a certain plant which you can digest in and of itself or you can add it on to certain foods you're eating or even grind it up in certain coffees as well. And there is some evidence that Chukie can help out with the gut microbiome and help out with blood sugar control and help out with weight loss and actually has a lot of antioxidant activity as well. So I'm excited to always introduce new herbs and spices to my audience and to my patients to get them feeling better and to kind of understand what's going on. So when it comes to your gut microbiome, we've seen excellent evidence of how chicory can help improve your gut microbiome. It is actually a very good source of inulin which is a very effective source of fiber. Fiber as you know is the foundation for gut health. It can help improve your gut microbiome and this is basically what everything is built upon is a fiber base and having chicory can give you an effective fiber base to improve your gut microbiome. But not only that, it actually act as a food source for your good bacteria. Your good bacteria thrive on making sure it can have the substrates and needs to do with the job that it needs to do, the fight off inflammation and anything bad going on inside your gut. And so by having chicory, you're able to give your good bacteria the food that it needs to help fight off what's going on. Not only that, it can actually reduce inflammation inside your GI tract. So if you're feeling inflamed, you have IBS, you have bloating, distension. Chicory is a very natural herb which can help to minimize that and to get that feeling better as well. In addition, it's been shown to help enhance mineral absorption in certain minerals that we're not able to absorb as effective as we would like. It can actually be more effectively absorbed with chicory as well. And then lastly, we've seen some benefit of reducing harmful bacteria inside your gut microbiome. It's not only just to promote the good guys, not only does it fight off inflammation, and also decrease the bad guys as well. So I really am using wanting to incorporate chicory for a lot of my patients who have problems with the gut microbiome. But not only that, we've actually seen some evidence where chicory can actually help out when it comes to blood sugar control. So if you have diabetes, stay tuned or listen up because this may be a good option for you to make sure your diabetes is well controlled. We have seen evidence that chicory can actually help out when it comes to carbohydrate digestion. We know that carbohydrates, at least the ingestion of carbohydrates, is one of the sources of diabetes and complications from that. And by enhancing that, we can actually minimize the blood sugar control. But not only that, it actually can slow down the glucose absorption in your intestines. Glucose, going into your gut, into your body, is the source for diabetes and complications from that. And if there's a way to minimize that, we can actually use this as a supplement to help minimize diabetes effects. And so if you're having issue with diabetes, maybe we'll consider adding this as a supplement. But always be sure to speak to your doctor about this, whether you can do this. Next is that it can also help out when it comes to weight loss. Yes, another option for weight loss. But if you don't want to be on these other GLP1 agonist and tagnus, this is an, sorry, agonist. This is an option which you can do as well. We've seen chicory as a way to help reduce appetite. Very similar to medications like ozempic and Rogovii. By minimizing your appetite, you don't eat as much and because you don't eat as much, you don't have as much issues when it comes to eating more than what you normally should do. The way it does that, it actually forms like a gel-like substance inside the stomach to kind of keep up and to keep more space in that stomach. So you don't eat as much. You don't eat as big amount. You're able to minimize the amount of food going into your body. And so because of that, actually decreases the overall caloric intake when it comes to eating in your food. And then lastly, we've seen that chicory actually can give you some really effective, powerful antioxidant effects in your body. You want to have as much antioxidants in your body to find out the inflammation going on inside your gut at all times. Whether it's inflammation for food, inflammation from diet, inflammation from stress. And chicory seems to give a good amount of antioxidant material in there. Has a lot of vitamins and amino acids to help decrease inflammation and get things better as well. We've seen a lot of good anti-inflammatory effects when it comes to chicory. Now with all herbs, you need to know that there are some risks associated with this. Not all herbs are safe. And just because you take an herb or just because you take a supplement doesn't mean it's the safe thing for you. So keep in mind there are some risks that you should be aware. Taking a large amount of this can lead to GI symptoms like bloating, essential, and diarrhea. So if you take a large amount, this may cause a lot of side effects. So you typically want to start off low and then gradually improve. Always going to come as a pregnancy. Do not take an herb or a supplement without talking to your healthcare provider first because you just never know exactly what that may be and what you can do. So how exactly can you take this herb? But what is that? You can actually take the herb and a supplement. So you can get a supplement chicory over the counter. Go to your natural food store and see if you can try that out and see if it helps out. I typically don't like to do that because I usually like to take this as a natural way. And so whether you get it as a powder or actually have the herb itself and incorporated into your foods, this may be an option where you can do that as well. So some things you can do, you can either mix it up with other lettuces that have it in the salad. This is a very effective way to add in chicory with other probiotics and prebiotic foods in that salad. You can saute with olive oil, maybe add this as a garnish to your foods. This is also be a very effective way to get you feeling better and get you tasting better as well. There are some individuals in some cultures who actually can brew the chicory roots and add this into coffee to help improve the texture of the coffee as well. And sometimes you could actually add this as a separate supplement or a recipe to whatever food you're adding on as well. And so I'm very excited about the way chicory can be used. I'm gonna try and incorporate this more to my patients to help out when it comes to your gut issues, to help out when it comes to weight loss, and also how about when it comes to fecal and continence as well. Hernia, all right. So this is a great topic I get. I get this question all the time, "Hey Dr. Eslam, I got a Hernia, what is going on?" And so what I want to do is I want to do a D dive on hernias. We'll talk about the types of hernias that you have. We'll talk about how do we diagnose hernias. We'll talk about the treatments of hernias. Then I'll talk about the nine causes of hernia pain. And at the very end of the video, I'll give you six reasons of when you need to see a doctor for your hernia. So when it comes to hernias, you have about five different types of hernias that we have that are out there. You have inguinal hernias, you have hiatal hernias, you have umbilical hernias, you have ventral hernias, and you have femoral hernias. So let's do a D dive into each one of these hernias. It's very important to understand the language of hernias so we know exactly what we're trying to treat and what we're trying to do as well. So the first type of hernia is an inguinal hernia. This is a hernia which is typically in the groin area where your legs are at. This one part of the intestine or fat can protrude in the area. So you may feel a sensation of something protruding in your groin area, either a burning or an achiness or a fullness that's going on there. And typically this type of hernia will get worse with activities. The next type of hernia is a hiatal hernia. This one that I typically see when I do an upper endosophy. This one part of the stomach bulges above the diaphragm up here and this can make it a lot more difficult for us to control acid reflux. In fact, when we're common causes of uncontrolled acid reflux is a hiatal hernia. So how do you know if you have a hiatal hernia? You'll feel acid reflux or reflux that's not controlled with typical acid reflux medication. Maybe you have some pressure, some here, or some pain or difficulty swallowing, or sensation of things are just not moving down correctly. That would be a hiatal hernia. The third type of hernia is an umbilical hernia. So as you can tell by the name, it's near the umbilical cord where your belly button is. So this is when a hernia protrudes it, protrudes it. This is when a hernia goes through the navel to allow it to pass through. This is what an umbilical hernia is. Now, this is very common in infants, but it's also very common when you're pregnant, but also obesity is a significant risk factor for this. And sometimes this umbilical hernia can get worse whenever you cough, whenever you lay down, whenever you have a bowel movement, when you lift heavy things, you can see this thing protruding out of your umbilical cord. Next is a ventral hernia. This is a hernia in the middle of your abdomen. And that's the most common causes as a consequence of a prior abdominal surgery. When you're doing a abdominal surgery, you're cutting through all the layers of the middle part of your abdomen, and that can cause you to have a hernia protrude out and cause that sensation that's there. And so, sometimes you can see this ventral hernia popping out. You may feel this sharp pain in this area, or a dull egg that's there, or actually physically see it coming out as well. And then lastly, you have another type of hernia called a femoral hernia, which is another hernia that is within the groin area as well. Sometimes these small ones don't cause pain, but you notice something you made, but if it does cause discomfort, it'll be a dull egg within the groin area as well. So how exactly do we diagnose hernias? Well, the first thing we want to do is a physical exam. A physical exam, you'd be surprised that alone, can give us the type of hernia that you may have, so I can see a ventral hernia. I can see an umbilical hernia. I can sometimes feel an angle on a hernia, and so an exam will be the first thing. The second thing we can do is we can do imaging, whether it's an ultrasound, CT, or an MRI. This allows us to kind of better visualize what type of hernia that you have, how big it is, and is it causing issues, specifically for a high-adle hernia. We can only see this with an upper endoscia, or an E-G-D, or a barium x-ray. And so this is the only way for us to see that part of the stomach is protruding above where it should be up into the diaphragm. So what do we do for hernias? Well, for large hernias that are symptomatic, we need surgery. Surgery is the only way to close up that hernia, to close up that sac, to allow the hernia to not come out again. But for other hernias, in which you don't have to really worry about it, it's not causing a pain or symptoms. You don't even worry about them, not a big deal. Now, hernias can still cause pain, and there are nine reasons why hernias can cause pain. So number one is that, quite a coffee and sneezing, that pressure whenever you cough or sneeze, can make the hernia feel bad, and can cause you discomfort as well. Number two is whenever you strain during a bowel movement, that pressure whenever you strain, can cause the hernia to protrude out, because it's discomfort and pain to occur. Number three, being obese, that physical pressure of all that fat, can make it more likely for the hernia to cause symptoms. Number four, heavy lifting or lifting improperly. So you see a lot of weight lifters, who are trying to lift heavy weights, not have good form, and that can cause a hernia to occur. Next is aging. As we get older, our body is not as tight, or as good as it used to be. I'm noticing this as I get older as well. So getting older, unfortunately, the consequence of age, can make the hernias worse as well. Pregnancy, as that belly gets bigger, with the baby being in there, that protrusion can make it more likely for the cause hernia pain as well. Smoking also is a risk factor for hernia pain. Overusing abdominal muscles, whether it's doing a lot of core exercise, or doing something that can strain it, including golfing, that can cause you to have a hernia as well, and having a prior abdominal surgery, can cause you to have a hernia as well. So, now that I talked about that, when do you need to see a doctor when it comes to a hernia? There are six indications to see a doctor. So, number one, if you wanna find out what's going on sooner rather than later, to get a diagnosis, come see us 'cause we can treat and see what's going on, and give you a better idea of what type of hernia that you have, and what can we learn about it. Number two, you have severe sudden pain. That means that hernia can be strangulated. Those bowels can be twisted and become dead. So, if you have this sudden, strong pain, that doesn't go away, go see a doctor. Number three, you've not as involved in this hernia. This can also mean there's something impending going on, like a narrowing or a twist, which needs to be addressed. Number three, you have the inability to pass stool or a gas. This could be due to an obstruction that may be due to a hernia that needs to be assessed. Number five, give redness or skin discus coloration around the hernia side. That means something else is going on, that needs to be investigated, so we can hopefully do investigate to see what's going on. And then lastly, if you have fevers with your hernia, this could be there's some sort of infection going on, and then hernia that needs to be addressed as well. So, if you have these sick symptoms, go see doctors so we can find exactly what's going on, and hopefully get your hernia taken care of. I have a lot of questions on hernia, so I appreciate you guys icing this question well. (water splashing) You want to watch this? Just so you know, thank you for watching. Thank you for watching. And Dwight, thank you for watching as well. So, Christina asked, "Any thoughts on travel, constipation, or diarrhea?" You have a lot of road trips, and sometimes you have to hold it, which I understand. So, here's what I recommend. So, travelers constipation and travelers diarrhea is very common, and it really has to do with the type of environment that you're in. So, let's talk about constipation. So, TMI here, I get travelers constipation all the time, because I like to go in my house. I have a setup, I love it, it's relaxed, it's chill, and I have a difficult time going to the restroom when I'm traveling. I know, TMI, so here's what I recommend. So, number one, know how your body is. So, I know how my body is. So, I fill up on fiber-rich foods beforehand. Number two, I take a probiotic. I take a probiotic to help me get you to get me going and flowing. Number three, I have a lot of coffee. Coffee gets me going, and I take that to help when it comes to constipation. Number four, I make sure that I use the restroom consistently at the same time, like it would normally when I'm at home. And then, number five, I make sure if I need to, I take a laxative, so it takes a mirror lax. Now to be a deal, you can take this, help you have better bowel habits. That's how you treat traveler's constipation. Traveler's diarrhea is the opposite, opposite spectrum. So, always make sure number one, you don't have an actual infection going on when you have diarrhea because it's very common for that traveler's diarrhea to be due to infections. So, get that treated and make sure you have the right treatment for that. Number two, add in fiber. Farber's gonna help out to bulk up that stool to make it less likely for you to have diarrhea. Number three, cut back on the drinks and the foods that we know can trigger diarrhea. So, coffee, alcohol, spicy foods, processed foods, these foods we know can trigger diarrhea as well. Number four, make sure you're hydrated because you're losing that volume. You don't wanna lose those electrolytes as well. So, keep that in mind. And then lastly, if you need to take something like an anti-diary medication and you don't have an infection, do that, not a problem. I can understand, you do one of your own vacation, you don't wanna be having the runs of the diarrhea. So, take something to help out with that as well. So, that may help out. Hope that gave you the tips that you needed. When it comes to treating, traveler's diarrhea and traveler's constipation. (food sizzling) All right, next topic, heat up for Islam. I have been diagnosed with a rose of esophageitis. What is that and what does that mean? All right, so, let's talk about this. This is a very common problem that I've seen and in a common condition I see in my clinic. So, we'll talk about exactly what is a rose of esophageitis. We'll talk about the nine symptoms that can occur from this. We'll talk about some of the causes. And we'll talk about the risk factors and the treatment options that we do for these individuals. So, a rose of esophageitis means that there's significant inflammation inside that esophagus itself. Orosophagus is not made to have acid. It does not like acid. The stomach loves acid. In fact, the cells in the stomach are made to bathe into acid, not your esophagus. It does not like acid. And so, anytime the acid goes up to the esophagus in a consistent basis, it does not like it. It causes irritation and inflammation to occur. And it can manifest those symptoms as bad heartburn, trouble swallowing, painful swallowing, and chest pain as well. And so, there are nine main symptoms that I look for when I think somebody has erosities in their esophagus. First one is heartburn. Do you have burning in your chest area that tells you you may have a rose of esophageitis? Number two, is it difficult for things to go down? Is it slower down as it's going down? This could be a sign of a rose of esophageitis. Number three, does it hurt when you swallow? Is it actually painful when things go down? That is also a sign of a rose of esophageitis. Number four, do you have a sore throat? That could be a sign of irritation inside the esophagus. Number five, do you actually have regurgitation of things coming up? Are things actually coming up into your esophagus? There's also a sign of inflammation going on in the esophagus. Number six, do you have this sensation of something inside your throat, this globus sensation? Does it feel like something is there? If you have this sensation, you have this frog in your throat, that can also be a sign of a rose of esophageitis. Number seven, do you have increased salivation? You're just secreting more saliva. This could be a problem when it comes to acid inflammation. Number eight, do you have chronic cough? And number nine, do you have hoarseness? They're kind of two peeves in the same pod. These are also signs and symptoms of a rose of esophageitis or inflammation that's going on there. So why do you have that? Once again, the end cause is chronic inflammation inside the esophagus, but why do you have that? So number one is acid reflux. Acid can be the root cause of why you have a rose of esophageitis. Too much acid going up into the esophagus can cause an issue to occur. Number two, do you have a problem with the lower esophageal sphincter? That is the main reason why people have issues that sphincters open longer and more often causing acid to go up into the esophagus to cause symptoms to occur. Number three, have you had radiation to this area? I've had individuals who've had breast radiation. I've had individuals who've had radiation because of ENT issues. This may be a reason why you're having the erosive esophageitis. So that actually may be the case as well. And then lastly, sometimes taking medications without water, it can get stuck inside the esophagus that cause erosions to occur. And so big pills like calcium pills or bisphosphonates, if it gets stuck in this area, that can cause erosions or inflammation to occur. So how exactly do we diagnose somebody with this? The only way to diagnose somebody with erosions in the esophagus is to do what's called an upper endoscia or an E.G.D. This is where I go down with a scope. I take a look and see exactly what's going on. I can tell you the degree of inflammation that's there. I can tell you how bad it is. I can tell you there's any complications from that. That's the only way for us to know that. So how do you prevent yourself from having this issue? Cause it's a literal pain in the esophagus. There are six things that I recommend to prevent this. Number one, is that you wanna make sure you sit or stand upright when you're taking medications and you swallow plenty of water. This phosphonase are notorious for this. Phosomex is notorious for this. Big pills like potassium are notorious for this. So if you're taking these big pills, don't take a lie down, sit up or stand up and drink a lot of water with that. Number two, if you have a treatment plan for GERD, make sure you follow that treatment plan. Cause that's gonna get your symptoms taken care of. Number three, have smaller frequent meals all throughout the day. Grazing throughout the day is a lot easier when it comes to your gut than having three big meals. Number four, avoid lying down immediately after eating. Typically wait at least 30 minutes to an hour so you can get the food, time to digest and process through. Number four, all right, number five, quit smoking. If you are smoking, that is a risk factor for developing significant esophageal issues including inflammation of the esophagus. And then lastly, manage your weight. We know that obesity is a risk factor when it comes to these symptoms. So let's say that you've been diagnosed with inflammation of the esophagus. How do you treat it? What do you do? How do we fix this? Would you, I recommend as a mayo-trained gastroenterologist to get this taken care? Here's what I tell my patients. Number one, you want to limit or minimize the foods that we know that can trigger heartburn. So coffee, tomato-based foods, carbonated drinks, fatty foods, these things that we know we enjoy are triggers for some individuals when it comes to heartburn and inflammation. So you want to minimize that as much as you can. Number two, it mentions before. Try to have small, frequent meals all throughout the day. Have five to seven meals all throughout the day instead of having three large meals. Number three, cut solid foods into smaller pieces especially if you're having trouble swallowing. So you're not having as much food going down. Next, try to avoid eating close to bedtime. So maybe have dinner at seven and go to bed like nine or 10, or have dinner at five, go to bed at seven or eight, try to have an earlier bedtime to help out. Next, quit smoking. Smoking is terrible. Why are you smoking in 2024? There's absolutely no reason why you should be smoking. Minimize that or get rid of that. Next, try to maintain a healthy body weight. We know that obesity is a risk factor for multiple different conditions including a roasted esophageitis to try to make sure you have a healthy weight. And then lastly, consider taking a medication therapy like a PPI or proton pump inhibitor. These work, they're effective. In fact, I will tell you, they're the most effective treatment options of when it comes to treating a roasted esophageitis. They're better than any of the ones over the counter. They're better than in acids. And if you've been diagnosed with a roasted esophageitis and you're not on some sort of acid reducing medication like a PPI, there's an excellent chance we will not be able to cure your inflammation until we can actually get you on these medications like that. And then lastly, sometimes surgery can be an option as well because surgery treatment can help fix the root cause of what's going on when it comes to that inflammation going on in your esophagus. But the very question is, hey Dr. Islam, I don't give a flip. Who cares about a roasted esophageitis? Who cares if there's inflammation to my esophagus? What's the big deal? Well, let me tell you why. There are a couple of things you should be aware of. When you have that much inflammation, you are at risk developing cancer of the esophagus. I mentioned in the very beginning, your esophagus does not like to have inflammation there. It does not like acid. And so the more acid that you have in the esophagus, the more likely it's going to cause damage, the more likely it's going to be for the damage to mutate. And there's more likely a chance for that damage to mutate to esophageal cancer. So when you have inflammation in the esophagus, it leads to a condition called baritosophagus. Baritosophagus is a precancerous lesion. It will lead to esophageal cancer unless we get it treated. And so if you have this inflammation that's there, it may not feel like a big deal, but it actually is because there's a good chance that you're going to have a progression of this progressing into cancer in the future. So you wanna make sure we can get the same care for you and get this resolved. All right, I went off my soapbox, but that's all you need to know. When it comes to a rose of esophageitis, if you have this condition, this is what we do to hopefully get the same care for you. (upbeat music) So do I ask, can mild or chronic and active gastritis be cured or healed? Absolutely it can. So when it comes to chronic gastritis, we wanna find out the cause. Why do you have gastritis? Is it an acid problem? Is it, are you taking things that can make you have gastritis? I leave naproxen, advil, motrin, alcohol, certain foods. Are you having symptoms from this? Is it from an infection? So once we can get down to the root cause, we can get this taken care of and treated. I actually have a lot of videos to write on my YouTube page and my Facebook page about what we can need to treat gastritis. I would encourage you to go to those pages. Told you to get some information on that. (upbeat music) Last topic I have here. Hey, Dr. Islam. I've known that you talk about prebotic foods. What are the best prebotic foods that I recommend? All right, so I'll go over exactly what I recommend as a GI doctor when it comes to treating my patients or giving the best prebotic foods. The first one is kefir. Kefir is fermented milk. It works really well. It's milk mixed in with fermented kefir grains. I don't like the taste of kefir myself. I have kind of a tangy taste to it, but it is a good source of protein. It's a good source of calcium and it's a good source of prebotics as well. It's actually low in lactose, and so you can usually have this if you have lactose issues like yours truly. I'm not a big fan, but actually it's a very effective probiotic food that I do recommend. Number two is kimchi. Kimchi are fermented vegetables, which I love. These include vegetables like cabbage, radishes, cucumbers, and actually these are certain foods that are high in lactic acid. And you can actually make this at home. You can ferment your own kimchi at home and it actually helps to change the gut microbiome to get rid of the bad guys and to help out with the proliferation, the good guys as well. Another very effective prebotic food. Next is kombucha, which is also, I'm sure you heard about it. There's so many things I've seen online about this. There's actually carbonated beverages made from tea, from sugar, from yeast and bacteria. Often you add fruit to this as well. One thing about kombucha, you have to be aware of is that it can have a lot of sugar and a lot of caffeine as well. So be aware of that because it may actually cause you to be a lot more jittery and be careful of the sugar content because that can make things worse for you as well. And also you have sauerkraut, which is similar to kimchi, is that this is specifically only for cabbage. Now I love this, I love sauerkraut, I love cabbage. And this gives you the fermentation in the lactic acid bacteria that you need as well. And then lastly, everyone's favorite yogurt. Yogurt is probably the most common source of probiotic foods that we have out there. As calcium and vitamin D, it's also good for your gut overall health as well. So what do I recommend to make sure I consume the right probiotic food? So number one is I check the label to make sure you have live bacteria in them because there's no point in taking a probiotic food if you don't have live bacteria. Number two, I would recommend adding kimchi, or sorry, adding yogurt or kefir to smoothies. Yes, add into the smoothie, add in some berries, add in some fiber, add in some greens to give you a nice, healthy mix to improve your gut microbiome. Consider having kamucha as a sort of cocktail which you can have this in the morning as well. I'd also recommend if you want to, to your burgers and sandwiches, add in things like sauerkraut or kimchi to help out, to improve the taste and to give you the pre-biotic foods that are in there. I use commonly Greek yogurt for my salads and also use it to help out with add in berries because you're adding the benefit of antioxidants with the benefit of the Greek yogurt as well. And then if you have oatmeal, top it off with certain yogurt and berries to give you the added benefit of not only the pre-biotic yogurt, but the antioxidants when it comes to berries. But these are the pre-biotic foods that I recommend to my patients. What are your pre-biotic foods that you recommend? Let me know in the comments down below. I would love to hear what you guys have to say. Well, I think that's it for today. I want to thank you for watching. We had a great show today. If you haven't already, don't forget to smash that like button, like, share, and subscribe. If you like what you're hearing, if you like what you're listening to, give us a five star rating on iTunes and Spotify. If you like what you're seeing, give us a thumbs up on our YouTube page and our Facebook page. They're free to join me every Monday where we do our podcast where I can answer your questions. If you want to learn more, subscribe to my channel, subscribe to our newsletter, and you can see us up at Gaster for all your GI needs. And thank you for watching. I want to see you guys next week. [MUSIC PLAYING] (upbeat music)
