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Natural Awakenings Washington DC Metro

10 Steps for a Healthy Gut

Jul 01, 2015 12:17AM
By Julie Wendt and Mikhail Kogan

Chronic gastrointestinal dysregulation creates a steady stream of patients into many integrative medical clinics. The goal for these patients is to optimize gastrointestinal function as the primary tool in optimizing health for years. Physician’s understanding of the role that the microbiome—an individual’s balance of bacteria, yeast and viruses—has evolved and today, many physicians understand more clearly how critical a diverse and prolific gut ecosystem is to health.

Their approach has shifted from looking at a general pattern of digestive enzymes—the presence of pathogens, low immune function and food sensitivities, to an entirely new way of looking into intestinal health—using functional tests that provide a detailed picture of our microbiome. Now that they can study the composition of the ecology within the gut, the integrative medical community is turning their attention to the tools that they can use to shift that ecology for the better.

In his new book, Brain Maker, neurologist David Perlmutter does an elegant job connecting microbiome changes to diseases like multiple sclerosis and Parkinson’s as well as depression, anxiety, obesity and diabetes. One might expect obesity and diabetes to appear on the list as we know these imbalances are related to digestion; the surprise comes when we realize that almost all chronic diseases can be traced to an altered balance of beneficial and opportunistic gut microbes. To learn more about the connection between the gut and the brain, check out the excellent interview with Perlmutter in the June issue of Natural Awakenings.

What physicians have found is that chronic microbiome disregulation does not manifest with obvious gastrointestinal (GI) symptoms. A typical scenario is a patient who has suffered for decades with chronic sinusitis and has been on antibiotics at least 10 times every year. An initial assessment of GI health is conducted, using a comprehensive GI analysis. As expected in this particular case, the patient had Candida Albicans overgrowth, a fungi that is pathogenic if present in high amounts in the intestinal track. After one month of changes to diet and lifestyle, the patient’s sinusitis went away and her energy improved dramatically. With the rebalancing of her gut microbes, she had only occasional mild symptoms that were effectively treated without antibiotics.

A growing trend is that patients who have taken antibiotics for chronic inflammatory or metabolic conditions or eat a diet that is lacking in fiber, fermented foods and prebiotics (foods that probiotics like to eat) are likely to have dysbiosis—abnormal changes in intestinal flora. Immense improvements in health are made when patients make these 10 practical changes to support a diverse and prolific gut flora:

  1. Cut out all processed foods—they feed bad bugs.
  2. Increase fiber-rich foods (legumes, grains, fruit and vegetables) as good bugs need fiber for optimal growth
  3. Use prebiotic foods to feed good bugs: artichoke, bananas, garlic, onion, cruciferous vegetables and legumes.
  4. Eat fermented foods every day, such as kefir, kim-chi, kombucha, water kefir or sauerkraut.
  5. Try a gluten-free diet. Gluten often causes inflammation that leads to intestinal permeability and malabsorption.
  6. Minimize refined sugar intake and use natural sweeteners like honey in moderate amounts. Sugar promotes growth of Candida and pathogenic bacteria. Avoid any synthetic sugars except for stevia as they kill healthy gut microbes.
  7. Take probiotic and prebiotic supplements with the consultation of your integrative practitioner.
  8. Assure high Omega 3 fatty acid intake as the essential fatty acids are important for the intestinal cell lining, helping to prevent or repair a leaky gut.
  9. Have at least one bowel movement daily. If not, try further increasing fiber, adding magnesium citrate or ground flax seeds to have regular bowel movements.
  10. Manage stress as it creates the toxic environment where bad bugs thrive.
Julie Wendt is a nutritionist and health coach supporting patients in reaching their health goals through diet and lifestyle support.  Mikhail Kogan, MD is assistant professor of Medicine at George Washington University and medical director of GW Center for Integrative Medicine where he sees patients for integrative medicine consultations and primary care visits.  For more information, call 202-833-5055 or visit  


Fruit Kvass (makes 1 quart)

(by Sally Fallon from Nourishing Tradition)

1 apple, washed and coarsely chopped

1 cup berries

1/4 cup whey*

1 inch ginger (optional)

Add ingredients to a quart jar, fill until 1 inch below the shoulder with filtered water.  Seal and place on the counter for 2-3 days.  Refrigerate and enjoy daily!

*Make your own whey by placing 1 quart of plain, full fat yogurt in a strainer lined with cheese cloth over a bowl.  Allow the whey to drip into the bowl for 12-36 hours.  Store the 2 cups of whey in the fridge and use the 1 cup of yogurt cheese as you would cream cheese.




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