(upbeat music) - And how are y'all? Dr. Islam here, AKA your poop guru and gut microbiome expert. I am a board certified gastroenter on this train at the Mayo Clinic. I've have over 10 years of treating patients, all sorts of GI issues. If you're new to this podcast or new to this channel, the way we do this is that I do a deep dive on a topic that people have asked me. And then if you're watching me on the live stream as well, I also answer your questions you guys have on the live stream as well. So if you haven't already, don't forget to smash that like share and subscribe. Let me know in the comments if you're watching live, if you're watching this live or on the replay, but also let me know where you guys are watching at as well. So today we have a great show today. We'll talk about what happens to your gut as we get older. We'll talk about the five signs that I've seen of a healthy gut. And we'll talk about a common question I get as a GI doctor. How do I know if I'm pooping enough or what I'm pooping is the right amount? Any questions you guys have live as well? Hope you guys are having a great week. Hope you guys are having a great day. Now let's go ahead and begin. So gut, health and aging. So what exactly happens whenever we age? So we'll talk about exactly what happens at the gut microbiome. We'll discuss what happens to nutrition. And we'll discuss exactly what happens with your risk of developing cancer as we get older. And then I'll talk about what recommendations I have for us to do whenever it's, you know, whenever we get older. So if you have a gut and you age, this video is for you as we get older, a lot of things change in our body, not just inside our gut, but outside the gut as well. So I can tell you my own personal story. As I'm getting to my mid 40s, early 50s, I know that my joints are hurting more often. I know it's harder for me to get up. I know I can't play basketball the same way, but also I've noticed that my gut issues or my gut, my GI tract has changed from where it used to be back in my 20s and 30s. You know, back in I was younger, I can eat whatever the heck I wanted. I had no problems whatsoever, but as I've gotten older, I have noticed, man, I can't eat what I use to eat. But not only that, whenever I do eat some of the health things, I may notice some issues that are going on inside my GI tract that weren't there before. So what exactly is going on? What is the consequence of that? So there is a change in your gut microbiome as we get older. So the gut microbiome as a review is a combination of trillions. You heard me with the T, trillions of bacteria, fungi and viruses that are constantly interacting with the environment, with what you're eating, with your environment, with stress, with your gut microbiome. It's this whole smorgasbord of things going on inside your GI tract that are constantly evolving and changing. And we've seen studies in which as we get older, the gut microbiome can change just as a consequence of us getting older. So as we get older, we get a decrease in the diversity of our GI tract. One of the best predictors of having a good gut microbiome is how diverse your bacteria is. And as the consequence of getting older, that diversity gets less and less and less. We don't have as much different bacteria and viruses and fungi inside our GI tract. The second thing that happens is that you actually get more harmful bacteria as we get older, as degradation occurs, as our immune system is not working as effectively as what it used to be, we're seeing an increase in bad bacteria as well. Thirdly, is that you also have a change in the gut bacteria barrier. So you have this barrier inside your GI tract that protects your gut from some toxins going on inside your body. So you may have heard of the turtle leaky gut. This is where this comes from. Because we have this layer that are tight junctions that prevents things from going in and going out. But as we get older, it just becomes more separated and separated and separated. And as that occurs, that can cause more inflammation and destruction to occur within the lining of the GI tract. Next is that you also have less substrates that are bringing produced that help improve your gut microbiome. So whenever we try to measure the gut microbiome, what's going on, we look for what's called short chain fatty acids. Kind of keep this in mind. This is the buzzword that we see in the literature when it comes to the GI tract. And the more short chain fatty acids that you have, this is an indirect marker of seeing how much inflammation and less inflammation than we have. So you want to have a lot of short chain fatty acids inside your GI tract. As we get older, that also decreases as well. And we measure this as an indirect response of how your gut bacteria is doing as well. And because of the consequence of all this and maybe even more, you may notice that your gut is just not working as effectively as it would happen. You know, a lot of my patients, as we get older, they start to develop more issue of constipation, more bloating, more reflux symptoms, sometimes even diarrhea. And this is all as a consequence of the change in the gut microbiome. And this is solely only due to aging. That this does not include any of the other insults that may be occurring inside your GI tract as well. So these insults include maybe you're changing your diet for the worse, maybe you're taking on more stress with work, maybe you're more stressed overall, maybe you're drinking more, maybe you're taking more medications, medications commonly can also affect the GI tract. Maybe you have other medical conditions that are affecting your gut like heart failure, heart disease, high blood pressure, being obese. These things also occur as we get older because of some of the habits that we picked up whenever we were younger. And so if you add an age and you add in all these other medical conditions that are going on top of that, this brings up almost the perfect storm of why GI issues occur as we get older. But this also explains why the risk of cancer also occurs as we get older. So I know people have seen the risk of colon cancer in young individuals and this is true. But by and large, the vast majority of all cancers, not just colon cancer, but all cancers inside the gut and outside the gut is a consequence of as we get older. And that buildup of toxins, the buildup of the DNA not working correctly, of inflammation going on, the change of the gut microbiome, the change in the bacteria, all of this will substantially increase your risk of developing all sorts of cancers, including colon cancer. And this is why starting the age of 45, where can everyone just start getting their colonoscopy done to minimize this risk because of the change that are occurring inside the GI tract, the gut microbiome, and kind of exactly what's going on. So we cannot change the fact that we can eat older. It happens, we want to live longer, and we want to live as healthy as we can. We can't necessarily change the problems that occur as we get older inside our GI tract. It's just the consequence of life. But there are things that you can change to make it more likely for you to have a better gut microbiome as you get older, which should also help you live longer, live fuller, and just feel better. I've done this for my own patients, I have my own practice as well, because I truly believe that what is going on inside your gut can manifest a lot in terms of how you feel, whether it's skin issues, your joint issues, how you sleep, depression, anxiety. A lot of our medical conditions are rooted in terms of what is going on inside our gut microbiome, and how, and exactly the interactions going on there. So what can you do? I'm gonna give you some five practical tips. You can do today to change your gut health. It doesn't matter how old you think you are, because doing these changes will make a dramatic change within one week of your gut microbiome. So don't think it's too late, you can do this. So tip number one is that we need to increase the amount of plant and fiber in our diet. So you know how I told you that one of the predictors of a bad gut microbiome is how less diversity that you have? Well, the number one way to increase the diversity in your diet and to increase the diversity of the gut microbiome is to add more plants in your diet. And so if you do this, you're gonna make a dramatic change. So practically, how can you do this? I want you to incorporate one plant into every single meal. That's it, start off small and go from there. Now, if you can, if you want extra credit for Dr. Islam, make the plants the vast majority of your plate, because that'll be the best thing for you. But if you do this one small change, that will make a tremendous difference in your body. Number two, I would switch to how you eat. Having smaller, frequent meals all throughout the day may be a better way for you to digest. In the past, maybe whenever you were younger, you could have those big meals, it'd be not a problem I can handle this. But as we get older, as the motility of our gut changes, as the gut microbiome changes, it may be easier for you to have smaller, frequent meals throughout the day, and that's okay. I've changed my dietary habits. I tend to graze throughout the day. I don't have three large meals anymore, because I've noticed for me, it makes me feel a lot better when it comes to my GI tract. Number three, avoid those trigger foods, which are notorious to causing GI issues, especially as you get older. So these things we all know, process foods, we know you shouldn't be eating that. So don't start, you know, minimize that. Don't go out reading fast food, or minimize that. Minimize or eliminate alcohol. We know that alcohol is also a direct toxin to your gut and to your GI tract. So smoking, smoking is terrible for you. There's so many problems that occur with smoking. If you can stop that, stop that. But also incorporate some of the other foods that are good for your GI tract besides plants. So in addition to avoiding those trigger foods, you also want to incorporate the good foods. And these are fermented foods. So fermented foods are nature's powerhouse to get you feeling better, and to improve your GI tract. Nature made it easy for us to improve our gut microbiome. And fermented foods are the shortcut to get you there. So these include things like sauerkraut, kimchi, keefir, miso. They're good, they taste great. They also work fantastic to improve your GI tract. So if you can incorporate, just pick one fermented food that you like, pick one, it's okay. Add this to your regimen, add this to your meals. You will feel a lot better. So for me, I love pickles, and I love pickled cabbage. These are my things. I love these. I don't know why I'm obsessed with these things. So for every meal, I try to add this to my diet. And this has made a tremendous difference in terms of how my gut microbiome is, but also how I feel as well as I get older. And then lastly, consider adding probiotics. Now, I will tell you the spiel on what you need to know about probiotics. There's a lot of myth, there's a lot of hype, and keep in mind that probiotics are a multi-billion dollar industry. However, having said that, there are some pages that do benefit from this. There are some people that have noticed a change and with very minimal side effects, it may be beneficial for you. Now, before you start a probiotic, always make sure you speak to your doctor. It's from a well-vetted source, has research based on it, and it makes clinical sense. And not everyone needs to be on a probiotic. So don't take this as a end-all, be-all for probiotics, but try to incorporate one and see if it helps out. These are the tips that I recommend to my patients to improve their gut health, get them feeling better, but also it'll help change what's going on as we get older. And I'll tell you, at some point in time, you're gonna age, and you're gonna notice, hey, I'm getting a lot more bloating and distension, just not feeling good. So try to incorporate these things to help you get you feeling better, and to improve your gut health and see how you're doing as well. (water splashing) So, second topic, I'm gonna give you five signs that I look for to make sure you have a healthy gut. So if you're one of those individuals, you're wondering, hey, I am wondering, is my gut healthy? What is going on with my GI tract? Instead of spending thousands of dollars on some sort of stool sample, which no one can interpret or understand, use your common sense and use what I'm gonna recommend. Here are five signs I ask my patients to see if they have a healthy gut microbiome. So question number one I ask is how often do you poo? Your poo can act as a break engine light to see how you're doing, and I use this all the time, because the frequency or the infrequency of how often you use the restroom can be a sign of how your gut is doing and exactly what's going on inside your GI tract. And so what we wanna find out is, do you fit it within kind of what's the normal pattern? And you'd be surprised to hear what that normal pattern is. It can range between three times a day to as little as three times per week. That's crazy. But what's important for me are a couple of things. So number one, is it normal for you? It has your pattern changed. Or number two, have you noticed a new change in that pattern because that's more important for me than the actual number. And that number though, at least gives us kind of a reference for exactly what normal is. Question number two, how long does it take for food to move throughout your gut? So when you eat food, do you see it immediately? Do you see it within a couple of hours? Or do you see it weeks later? Because the colon transit for me is important. So normally when we eat food, it typically takes between 24, maybe 36 hours for it to go from your mouth to your bottom to where you see it. And that's considered normal. But if you come to realize, oh my gosh, things are passing immediately through me. And I can see like undigested food, or it takes weeks for it to go, that colon transit time also gives me good information about whether your gut is healthy or not. Because that's important for me to really understand what's going on. Number three, how does your poo look? Now I want you to be a poo sleuth. Take a look at your poo, see what's going on. See exactly how it looks. 'Cause what's important for me is the color, the shape, and the consistency of your bowel movements. Now I have a lot of videos on here about all that, but just keep in mind, if you want to have, we go graphic here, a smooth, compact, sausage shaped, brown stool that passes easily out with little splashes. You want to like the perfect poo, that's why I consider the perfect poo. But if you have any changes from that, whether it's red, black, yellow, green, orange, who knows, and it's orange, not the right shape, these are things I want to know as a GI doctor to see exactly if this is something we need to investigate to find out what's going on, or see if there's something else that could be causing some of these issues as well. The next one is that I also want to see, for me, do you have any abdominal pain, whatever you poo? Because having that pain may not be something that's normal, or may need to be investigated as well. Because pain when you poo is asking that I want you to have, and this can tell me you have a sign of a non of a poo, that's probably not the way that we want to do as well. And then lastly, a perfect gut means you don't have a lot of bloating and gas with your bowel habits. So when you have bloating, when you have gas, this could be a number of different things. It could be what you're eating is not appropriate. It could be what you're eating is appropriate, but you can't digest it correctly, you don't have the enzymes. Or it could be number three, you're digesting correctly, but it's not passing through the way we want it to do. So if you have a lot of gas and a lot of bloating, when it comes to bowel habits, this could also be a sign that your bowels are just not as healthy as you want it to be. So if you notice out of these five things that you kind of fall within category of having not healthy poo, what can you do? Well, here's my recommendation for you. Oh man, that was great, I just came up with that. Off the cuff, that's my rhyme. So number one, eat more plants. We know that plants are critical for gut health. We know plants are critical for your GI tract. We also know plants can make it easier for you to have a better bowel movement and how about with bowel issues. Tip number two is remove processed foods. The things that are fast foods, sugary foods, foods that are just not good for you. We know this can make things a lot worse as well. Number three, the easiest thing you can do is add in fermented foods. Fermented foods are key for improving your gut health. It really is a shortcut to get you what you need to be. Number four, move around. Your body likes rhythm, likes to move, likes the physical activity. The more you move, the easier it's gonna be for you to digest and the easier it's gonna be for you to digest. The better it's gonna be for your gut health overall. And then lastly, come see someone like me. GI doctors, this is our specialty. We're knee deep in this poo business and our goal is to get you feeling better, to improve your gut and help it get you on track for what we can do to get you feeling better as well. So if you do these things, I think you'll feel a lot better. Those will improve your gut, but also you don't have to waste money and time spending thousands of dollars on a test that may not be the best thing for you to give you the information that you need as well. All right, next question. Hey, Dr. Islam, how often should I poo? Well, this is probably the most common question that I get as a GI doctor. Dr. Islam, am I pooing normal? Dr. Islam, I think I'm pooing too little. Dr. Islam, I think I'm pooing too much. What is going on with my poo? So let's kinda do a deep dive in this. What, how often should you poo? And I'll tell you what I want you to really take away from this. So, you know, when we have the normals, we actually do research. And in this particular question, we actually ask individuals how often do you poo? What is considered normal? And we take all of that information and we put it together, we use some really fancy mathematical formulas and we publish this paper and we have paper to tell you, tells us kind of what is considered normal. So let me tell you, you'd be surprised. Normal is between three times per day to as little as three times per week. Yes, so you can poo five times a week only and that'd be considered normal. And that's okay. And so that's kinda with the spectrum here. And so whenever somebody asks me, say, "Hey Dr. Islam, how often should I poo?" I tell them that answer, but I'll tell you, I'll tell you my follow-up answer. What's important for me? Has your poo changed for you individually? Meaning if you're the type of person that's gone to the bowel, this had maybe three bowel movements a week and that's been the way for your rest of your life. And all of a sudden it's changed to, "Oh my gosh, I'm going once every two weeks." Or now I'm going three times or four times a day. That's important for me. A new change in your bowel habits for me is a sign of something growing inside your colon that needs to be investigated. I worry about that. And so if you have a new change in your bowel habits, don't ignore that. Don't think everything's a-okay. This could be a sign that something bad is going on. Number two, do you also have a abdominal pain that occurs with your bowel habits? Because that could also be a sign of a condition like irritable bowel syndrome or it could also be a sign of something nefarious growing inside that colon as well. Number three, do you have other associated symptoms with this like weight loss or blood in the stool? Because those things are not normal. It doesn't matter how often or as little as you go, if you have those particular things, those are things that are not normal, that needs to be investigated to hopefully get that taken care of you as well. Next, do you actually have to get up in the middle of the night to have a bowel movement? Because that's not normal as well. We do not want you to be getting up normally in the middle of the night to have a bowel movement as well. And then lastly, do you have other symptoms that may be associated with that? So for example, you have a lot of nausea, you have a lot of indigestion, a lot of heartburn, you have some back pain, what is going on there? And so these other associated symptoms may be a sign that something else's going on in terms of your GI trial. So what's important? The take-home message is that how often you go to the restroom doesn't matter to me. What matters to me is exactly if there's a new change. I'll kind of bring this home with a story that I have. I had a patient who came to see me. It was in his 50s who typically was having about three bowel movements a day, or sorry, three bowel movements a week. Not a big deal, it's kind of how his normal is. But he came to see me because all of a sudden, he was going every day. He was ecstatic, I was like, oh my gosh, I feel great. I'm using the restroom every day. I don't know what's going on. But you also notice, hey, I have a little blood in my stool. It's a little different. And so his wife, thank goodness, actually made him come see me. And so I talked to him, and even though he was happy about how frequent he was going, that built up a red flag in my mind. All right, this guy has a new change in his bowel habits, what is going on? So he did a colonoscopy. And unfortunately for him, well, I guess we caught it early, we found stage one colon cancer. We found a cancer in his colon. That cancer was the reason he had that new change in bowel habits. Now luckily we found the cancer early. It was taken out, he was cured, and he did well. This helps us to drive home the point. If you're having a new change in bowel habits, don't ignore that, because that could be a sign of something bad going on in which we need to investigate to see exactly what we can do to get this taken care for our patients and for you as well. All right, perfect. All right, let's go into the live stream here and see if we have any questions here. (water splashing) So one question was asked, hey, Dr. Islam, what is the cause of excess gas in the bowels? Well, there are three main causes for excess gas. The first one is just being constipated. So what I mean by that is even if you use the restroom every single day, you can still be constipated. Whenever you have a bowel movement, the goal is to get all that stool out. And so I want you to feel like you got everything out. If a little bit of stool is still in the colon, you're gonna have bloating and gas and distension, which can cause a lot of discomfort to occur. Reason number two is that you can also be certain foods that you eat. We know that certain foods are notorious to cause a lot of gas and bloating. Dairy products, especially if you are lactose intolerant. Beans, legumes, high fodmaps, apples, pears. These also can cause a lot of bloating to occur. And so this one you have to be aware of. And then number three, it could be a change to your gut microbiome. Maybe eating things correctly, eating the right things, but you're not metabolizing that correctly because your gut microbiome is not working appropriately. So if that's the case, here's what I recommend. Number one, make sure you're having good bowel movements. Are you happy when you use the restroom? Are you happy that everything is out? Are you happy that everything is gone? Because if you are, then you're good. Number two, make sure that you are eating the things that are good for your gut microbiome. Plants, fermented foods, things like that. And then number three, maybe eliminate the foods that are known to be gas-trigged. I have a lot of videos on this, but things like apples, pears, high fodmaps, beans, legumes, certain breads. These are things that commonly can cause a lot of gas to occur, a lot of distension to occur as well. Great question. I think that's what we have today. And thank you for watching. If you like what you see, you'll like what you hear. Subscribe to my podcast, give us a five star rating. Subscribe to my channels as well. And if you live here locally, come see us on the gas show so we can find out what's going on, get you taken care of. And if you have a question you wanna ask me, send me a comment, send me a DM, we can incorporate those. So we do more topics just like this. But thank you for watching. I look forward to see you guys on future videos. (upbeat music)
