Somewhere between 60 and 70 million Americans have digestive conditions like inflammatory bowel disease, acid reflux, chronic constipation, irritable bowel syndrome, and hemorrhoids. Some of these will need to be treated through medication and possibly even surgery. But others can improve by making a few daily tweaks to your lifestyle.
Even if you’re not experiencing any GI symptoms right now, certain habits can help ensure your gut stays in tip-top shape. Below, five gastroenterologists offer their advice on the single best thing you should do every day to improve your digestive health.
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1. Eat the right foods at the right time
Most experts agreed: The No. 1 thing you can do to take care of your gut health is eat the right foods.
A balanced diet is crucial for building good bacterial flora in the gut, says Dr. Harpreet Pall, a pediatric gastroenterologist and chair of pediatrics at Hackensack Meridian School of Medicine. “The intestines contain billions of bacteria,” Pall says. “There’s good bacteria and there’s not-so-good bacteria, and ensuring that we have the right types of good bacteria that promote gut health is really, really important.”
Pall recommends a diet high in fruits, vegetables, and whole grains, and says it’s wise to limit red meat and ultra-processed foods, since both can have adverse effects on gut health. As long as you’re not lactose intolerant, he says it’s also good to include some dairy in your diet; it provides nutrients like calcium and vitamin D. It’s also important to get enough fiber each day. Current U.S. dietary guidelines recommend that men eat about 38 g of fiber each day, and women eat around 25 g.
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Although various fiber supplements, such as psyllium husk, can help with constipation, there are other more natural ways to get enough fiber. Kiwi, for example, is full of fiber and has been found to speed up digestion and increase stool weight, says Dr. Justin Field, assistant clinical professor of medicine in the division of gastroenterology at the University of California, San Francisco Medical Center. Apples, prunes, and raisins have been found to have a similar effect, he says.
What we eat is important, but so is when we eat, especially for those who struggle with acid reflux, Field says. “Something as simple as spacing out dinner and bedtime by at least two hours can alleviate a lot of nighttime reflux symptoms,” he says. Smaller meals throughout the day, as opposed to the traditional three large meals, can also help with reflux.
Though diet predictably took the top spot, the gastroenterologists also offered four other gut health priorities.
2. Be on the lookout for bowel changes
One of Field’s top pieces of advice is to pay attention to your daily bowel habits, as they offer insight into your overall health. “It’s important not to ignore certain symptoms or certain stool characteristics,” he says.
Occasional loose stools and diarrhea happen to all of us from time to time, “but if it starts to pop up more often—more than a couple days in a row—or if it seems to keep coming back,” that’s a red flag, he says. Things like blood in the stool, having a bowel movement at night that wakes you up, loose stools that last for more than a few days, and weight loss along with GI symptoms could also be signs of things like celiac disease, inflammatory bowel disease, intestinal infections, or other GI disorders, Field says.
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Even if your bowel habits haven’t changed, a visit to the doctor might be necessary if you meet the requirements for certain screenings, Field says. Current U.S. guidelines recommend colorectal cancer screening at age 45 (and those with a family history could be eligible for earlier and more frequent screening). People with certain risk factors—including being over 50, male, white, a smoker, and having obesity or a history of acid reflux—could also make you eligible for esophageal cancer screening. Anal cancer screening is also recommended at age 35 for men who have sex with men and transgender women living with HIV, and at age 45 for all others with HIV and for men who have sex with men and transgender women who do not have HIV.
3. Move your body
Being physically active is crucial for gut health, especially for those who are constipated, says Dr. Reezwana Chowdhury, a gastroenterologist and assistant professor of medicine at Johns Hopkins University. “Exercise does wonders for the gut,” says Chowdhury, who’s also an inflammatory bowel disease specialist. “I tell my patients: the more you move, the more your gut moves.”
Exercise is beneficial because it helps with colonic transit, which is how fast food moves through your colon. Studies have shown physical activity can not only help with constipation and fatty liver disease, but it can also improve the diversity of the gut microbiome and produce more of the gut bacteria that’s beneficial to our health, she says.
Chowdhury recommends 30 minutes of intense physical activity three times a week, but says even low-impact activities like a daily 30-minute stroll around the neighborhood can be beneficial. The key is to move around as much as possible throughout the day. “We should never underestimate the power of movement,” she says.
4. Drink enough water and avoid artificial sweeteners
Dr. Rachel Schiesser, a gastroenterologist at Houston Methodist Hospital, says her favorite piece of advice is to drink enough water each day. Most people should strive for around 64 oz. of water a day, she says, or 8 8-oz. glasses. Another good rule of thumb is to drink half your body weight in oz. of water each day. “Our systems are mostly made out of water, and without enough water, people do not get good digestion,” she says. (Just don’t overdo it, she adds, as this can cause bloating.)
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Some research has suggested that adequate water intake can aid in the digestive process, especially when someone is drinking water in conjunction with eating a high-fiber diet. Drinking enough water can also promote a healthy gut microbiome.
Schiesser adds that it’s important to avoid beverages with artificial sweeteners, since some studies have suggested that artificial sweeteners can alter the gut microbiome. If you need a sweetener, opt for a natural one like honey or stevia instead.
5. Limit your alcohol intake and NSAID use
It’s important to protect the gut from two common and potentially harmful substances: alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (in brands like Advil and Motrin) and naproxen sodium (in brands like Aleve), says Dr. Benjamin Lebwohl, a gastroenterologist and professor of medicine and epidemiology at Columbia University Irving Medical Center.
Most people are familiar with the downsides of excessive alcohol intake, especially when it comes to liver health, Lebwohl says. “But alcohol is also a direct irritant on the stomach and intestinal tract,” he says. “It’s not unusual for people—after a night of heavy drinking—to have a stomachache and irregular bowels, even if the intake falls short of a binge that results in nausea and vomiting.” He adds that after doing an upper endoscopy—a procedure that allows gastroenterologists to take a close look at the upper GI tract—he can tell if someone has had a large amount of alcohol in recent days, as the stomach will look inflamed.
There’s really no “healthy” amount of alcohol, Lebwohl says, but, “being mindful of excess alcohol intake is important…certainly after the second drink is the time that gastrointestinal symptoms might start to happen.”
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Lesser known threats to gut health are NSAID medications, Lebwohl says. People often think these drugs are benign and safe because they’re available over the counter, but “they promote inflammation in the stomach and intestinal tract if used more than sparingly,” he says. They can cause ulcers in the stomach and small intestine, as well as gastritis or general inflammation in the stomach, Lebwohl says. “The more they’re used, the more likely someone will have gastrointestinal side effects.”
Most people who take the recommended dose on the bottle two or three times a month for a headache or sore back will likely have no ill effects, Lebwohl says. If someone has to take NSAIDs more frequently to recover from an injury, their physician will likely advise them to take famotidine or another acid suppressing medication each day to prevent gastrointestinal side effects, Lebwohl says. Acetaminophen, or Tylenol, is safe on the stomach, gastrointestinal tract, and liver when taken according to the package instructions, but it can also be toxic in high doses, he adds.