Listen to your poo

To be able to plan what she eats through the day Sharel Bernadine needs to pay attention to her poo ldquoIf itrsquos solid and once a day I might dare eat fast foodrdquo says the Andheriresident ldquoIf I get cramps have to go to the loo a few times I know the gut biome has changedrdquo And then she goes back to her careful food preparation Millets and rice and not roti gluten is harder for her to digest Dals watered down so that they are broken down easily by her system Seasonal vegetables Everything is fresh and she cooks it herself having learned through experience how much spice and oil her gut can withstand ldquoAfter all your energy goes into your foodrdquo says the independent talent managerIf Bernadine spoke to Swetha Ashok the nutritionist and lifestyle consultant who goes as the The Gut Guru on Instagram shersquod recommend adding tubers to her diet Arbi potatoes sweet potato purple yam carrots beets radish ldquoUnfortunately wersquove become a carbfearing nationrdquo says the Goregaon resident who comes from a background of microbiology and biochemistry ldquoBut these carbohydrates feed two important groups of probiotic bacteria bifidobacterium and lactobacillus A good balance has to be maintained between protein and carbohydrates as excessive proteins feed the bad bacteria Eat tubers thrice a week with a slight tadka as a sidemdashthe oil helps nutrition absorption More than anything diversity in your diet based on seasonality is what balances gut florardquoAnd if Bernadine had found herself in Dr Vipulroy Rathodrsquos consulting room at Fortis Hospital in Mulund the director of gastroenterology would quiz her about her screen time and social media consumption ldquoThe mindgut axis is a proven and established sciencerdquo he explains ldquothe two are in constant dialogue with each other through neurotransmitters Imagine a family receives some bad news a member may rush to the toilet Thatrsquos nothing but the chemicals affecting the motility of the bowels Of the 100 patients who would come to me complaining of abdominal pain acidity acid reflux or bloating in 60 to 70 of them itrsquos a direct psychological impactrdquoWhat does this have to do with how much time wersquore spending glued to screens ldquoIn the predigital revolution erardquo Dr Rathod expounds ldquobad news would be broken in a soft mannermdashthrough a telegram or a phone call Today you utter one wrong word on the Internet and you are bombarded with psychological damage from all across the world in five seconds We are a generation seeking instant validation and when we donrsquot receive it we experience rage anxiety and depression all of which make your brain emit chemicals that mess with your gut florardquoBut Bernadine wisely did what Ayurveda proponent Amrita Kaur Rana preaches as amritaoflife on ironically Instagram even though she did not consult her directly She listened to her body to find out what works for her and made lifestyle changes that included becoming an independent professionalSwetha Ashok nutritionistldquoThough you could consult an Ayurveda doctorrdquo Rana ldquoYou could also observe your body and reflect you have enough data How you feel when you wake up in the morning How does your skin look How is your tongue Does it have a white coating or sliminess That indicates undigested food Do you have a pimple It could also be caused by a hot emotion not just hot foods Envy anger jealousymdashthese are all hot emotions you encounter while scrolling through social mediardquoBernadinersquos is a case of preexisting irritable bowel syndrome IBS made worse by a bout of COVID19 in 2022 And thatrsquos just one symptom in a bouquet of them that indicates bad gut health The gut colloquial for the gastrointestinal system comprises the oral cavity pharynx esophagus stomach small intestine large intestine and anal canal It accessorises with teeth tongue salivary glands liver gallbladder and the pancreasThe vagus nerve is the bidirectional highway on which information between the GI and the brain travels Itrsquos key part of the parasympathetic nervous system which plays a role in regulating and communicating to involuntary functions such as digestion heart rate blood pressure respiration immunity mood mucus and saliva production and urine output There are more nerve cells in the GI tract than anywhere else in the body outside of the brainMaintenance is key as gut micro biome changes as we age says nutritionist Swetha Ashok with a 30 per cent decrease in it every 10 years So we have to tend to it like an exotic garden of bonsais with food diversity and sulphurrich foods such as onions garlic ldquoEven our pickles and fermented foods such as dosa idlis dhokla are probiotic As simple as a bowl of curd will also dordquoAnd research has linked weak gut to autoimmune conditions such as irregulation of the thyroid glands rheumatoid arthritis multiple sclerosis and type 1 diabetes Since damage to the gut affects concentration and mental faculty it has been linked to learning disabilities in children and difficulty in adapting behaviours such as impulsivity and temper controlAs much as 70 per cent of dopamine a type of neurotransmitter and hormone that plays a role in memory pleasurable reward and motivation is produced in the gut Serotonin the chemical that carries messages between nerve cells in the brain and is crucial for mood regulation sleep and sexual desire is also made in the gutmdash90 per cent of itIn January this year a study conducted by researchers from the University of Surrey and the University of Alabama at Birmingham suggested that Parkinsonrsquos disease begins here too It found that healthy people and people with preclinical Parkinsonrsquos disease have markedly different species of bacteria and the biological processes in which those bacteria are involvedmdashdespite being on the same dietDr Vipulroy Rathod Director Gastroenterology Fortis Hospital MulundSwetha says a lot of research on the gutbrain axis was initially done in the 1600s but then was not explored further till the 17001800s ldquoIn the 19th centuryrdquo she says ldquothey slowly figured out that some form of nervous energy or irritability is happening when the food patternsdiet is not the best In the 20th century came the word probiotics and microbiological developments were supported Now we know that poor gut microbiome manifests through a compromised immune system tons of health issues stubborn weight malnutrition Crohnrsquos disease and slow brain performancerdquo And lately there has been evidence linking it to Crohnrsquos and Alzheimerrsquos tooAnd with this knowledge came the pre and probiotic drinks supplements and foods Kombuchas kefir saurkrauts yoghurts kimchi tepache in rainbow hues line posh kirana dukkans and sachets to be mixed in water sit in as many flavours on the shelves of the chemist In 2022 the drinks market in India reached R955 million it is estimated to grow at a rate of 199 per cent to reach R77 billion by 2027ldquoNot all fermented foods are created equalrdquo says Swetha ldquoSome may contain excessive salt sugar or artificial additives which can negate the benefits We think medication or supplements can help heal our gut but the truth is without proper nutrition and mindfulness practices gut recovery can be an uphill battlerdquoChange will come with a shift in the way doctors diagnose the illness ldquoSpecialists will look at an organrdquo says Dr Rathod ldquoBut the body is an organism The physiological and the psychological have to be treated parallellymdash70 per cent of organic tissue is bacteria virus and fungi that are not attuned to digital bombardment that we see in our daily lives This needs a formidable solution I only recommend some probiotics in that form and of course Calcium Vitamin D3 and B12 are also important supplementsrdquoHe draws attention to the difference between hygienic and sterilised food and living Lack of exposure to the bacteria necessarymdashthrough food environment and lifestylemdashto build immunoresistance ldquoOur roads are paved we live in towers and we eat food out of packages that is made using GM crop loaded with pesticides We pop antacids after eating heavy food are prescribed steroids and antibiotics for the little of things so that we can get back to work quicklyrdquo says the doctor ldquoIt is not enough that we eat an ancestral diet we must also to some degree follow ancestral activityrdquoThe serial popping of antacids after heavy meals is also a culprit The stomach produces 15 litres of gastric juices most of it hydrochloric acid to break down food An antacid will bring it down to a quantity insufficient to digest that heavy meal leaving it sitting undigested Dr Rathod suggests that the selfaware patient should not opt for medicines over the counter at the pharmacist and also see a doctor if the symptoms persist for two weeks or you have frequent relapsesSo what does a healthy gut with its balance of 300 to 500 bacterial species comprising nearly 2 million genesmdashin a population thatrsquos 10 times all of the cells in the human bodymdashlook like ldquoThatrsquos what we donrsquot knowrdquo says Dr Rathod ldquoTo find an ideal specimen wersquoll need to find a human being from Bastar who eats seasonal and local food untouched by pesticides whose skin is exposed to naked earthrdquo He adds that the next Nobel prize in medicine would go to the scientist who successfully maps the entire gut genomeIn the West the epidemic of sterilisation has given rise to faeces banks like blood and sperm banks where faecal deposits from healthy human specimens are invited dried and processed and mixed with saline and transferred to a patient in need of recultivating their gut microbiota The process is called Faecal Microbiota TransplantationWe donrsquot want simple solutionsrdquo says Rana ldquoEverything has to be complex no In Ayurveda wellness comes from tending to your agni digestive fire so that you have balanced or sama agni Simply eating fresh local and seasonal produce chewing your food so that sufficient salivamdashcontaining enzymes that breakdown foodmdashis released eating mindfully while sitting down keeping a gap between bedtime and dinner not bathing after eating are all sufficient As they say sayseer rakho thanda pair garam aur pet naramrdquoAs with everything Ayurveda knowing your doshas and balancing them and a little selfknowledge from peeking into the toilet bowl to observe the deposits goes a long way As does the process leading up to it Can you go easily is it quick and pain free and thorough Do you strain Is it excessively oderous Is there a presence of mucous or blood Does it stain the sides Does it sinkHow often to goBernadinersquos stomach cramps strongly and distinctively when her gut goes haywire and she needs a bio break often ldquoIBS can be controlled but may not be reversible in most cases and I was diagnosed sixseven years agordquo says the 37yearold ldquoAnd it took me six months post COVID to bring back gut health I was constantly fatigued and had no focus I used to manage music artistes and that was a job that did not have regulated hours I would need to sleep as soon as I ate Antibiotics are not a longterm solution I chose instead to eat the right food in the right way to find a cure It took six months of supplements trialanderror to regain guilt health and know what I can and cannot eatrdquoShe cut out sugars lactose and gluten completely and saw a drastic change within three months Even high sugar fruits such as bananas chickoos custard apples and corrosive citrus fruits are out ldquoI ate a lot of millets and can eat all vegetables but I dare not eat dairy at allmdashit disagrees with me terribly In fruits I can only eat pomegranates kiwi papayas berries and boiled applesrdquoMaintenance is key as gut micro biome changes as we age says Swetha with a 30 per cent decrease in it every 10 years So we have to tend to it like an exotic garden of bonsais with food diversity and sulphurrich foods such as onions garlic ldquoEven our pickles and fermented foods such as dosa idlis dhokla are probiotic As simple as a bowl of curd will also dordquoThe most chronic and debilitating of urban lifestyles diseases depression is greatly linked to the gut as the main factory for serotonin and dopamine A content writer in her first job had a target of 15 stories in eight hours going viral ldquoI struggled with depression and anxiety and would drink tea to stay awake I would miss meals and live on chaibiscuitrdquo says the now 26yearold ldquoThis was seven to eight years ago and I would need 10 to 12 hours of sleepmdashIrsquod go to bed at 11 pm and sleep until 11 am to 1 pm I had debilitating stomach cramps since childhood to the point that my parents took me to a baba who said I had been possessed by a chudail It came to a point where my stomach would hurt the moment I ate An endoscopy showed that my oesophageal sphincter was loose causing acid refluxrdquoNutritionists prescribed water in which raisins had been soaked overnight water with hulk and in the morning palm sugar solution and she admits it may have stopped things from getting worse but real change came with a change in psychiatric medicine in 2019 that regulated sleepAnd the biggest change Regular fresh homecooked meals enforced by her boyfriend of threeandahalf years