Early in her career, Rosemarie Fisher often treated patients with diseases like Crohn’s disease. Those patients would lose weight or become malnourished because their intestines couldn’t absorb nutrients properly
“With those patients, it really did trigger my interest in how I can help them by supporting them nutritionally,” said Fisher, professor emeritus of medicine (digestive diseases) at Yale School of Medicine
As a gastroenterologist, Fisher treats patients for a variety of conditions, including malnutrition and short bowel syndrome, and she cares for patients who need nutritional support. She also treats patients with irritable bowel syndrome. For many of her patients, nutrition can play a key role in maintaining their health
In an interview, Fisher discusses common digestive heath issues, why diet is important, and how to improve gut health
The interview has been edited for length and clarity
• Eat adequate <a href="https://healthylife7.com/protein-intake-and-cardiovascular-health-separating-signal-from-noise/” title=”Protein Intake and Cardiovascular Health: Separating Signal From Noise”>protein, carbohydrates, and fats
• Drink water
• Get enough fiber
What are some of the most common digestive health issues?
Rosemarie Fisher: There are a lot of them, some of which seem to have little to do with nutrition. Let’s start with the esophagus and reflux esophagitis, also known as GERD or chronic acid reflux. Bad heartburn can cause people to have a burning sensation in their chest or progress to scarring in the esophagus. If there’s enough scarring, it can actually cause the esophagus to contract and not allow them to swallow food, leading to solid food getting stuck in the esophagus. If I look at my clinic schedule for next week, more than half of the patients scheduled for an afternoon session are coming in because they’ve got persistent heartburn including actual regurgitation of stomach contents. It can affect their sleep patterns as they are awoken by acid reflux. It also affects how they eat and what they decide to eat. It affects what kind of medications they should be on.
Another disease is called eosinophilic esophagitis, which is an immune reaction and produces eosinophils, blood cells that are related to allergies that build up in the esophagus and can cause the esophagus to start closing down. People will get food stuck and need to come to the hospital to have it taken out. We usually see a big surge of this around the holiday times when people are barbecuing and eating foods like hot dogs
Right now, we’re also really worried about a bacteria known as H. pylori, or helicobacter pylori, in the stomach and the beginning of the small intestine, which causes a gastritis, an inflammation of the stomach. It’s probably the biggest precursor to gastric cancer.
Of course, colon cancer is, and should be, at the top of everyone’s digestive health concerns. Colorectal cancer is the third most common cancer in the U.S. and the second leading cause of cancer death in both men and women in the U.S. The increasing incidence in people less than 50 years old, has made screening for this disease even more important for people to be aware of
Why is diet important to our digestive health?
Fisher: Diet is important because having a well-balanced diet is where you get your nutrients from that maintain the rest of your body. It’s not just to maintain your intestine and to keep your intestine functioning well, but it’s to make sure that your entire body functions well. Vitamins and minerals are all absorbed in the intestine; not much is absorbed in the stomach. You want to make sure that your diet is well balanced so that you’re absorbing things like iron, thiamin, B12, folic acid, vitamin D, and more.
What is the role of prebiotics in gut health? What about probiotics?
Fisher: Prebiotics are non-digestible dietary ingredients that may beneficially affect the host by selectively stimulating the growth and/or activity of one of a limited number of bacteria in the colon, thus improving your gut health. Some prebiotic-rich foods include onions, garlic, oats, apples, and seaweed
Probiotics are live organisms, which when administered in adequate amounts, may confer a health benefit on you. Examples include yogurt, kefir, and sauerkraut
We do not yet have a tremendous amount of good data showing us that they definitely confer benefits to gut health in claims that are made. They will definitely affect your wallet though
What does our digestive health mean for our overall health?
Fisher: If your intestine isn’t functioning well, you’re not going to absorb the nutrients, the fats, and more that you need to maintain brain health, bone health, and muscle health. Without the intestine fully functioning, you’re going to be doing some damage to your other organs
What are some of the best ways to improve gut health?
Fisher: Make sure you’re taking in a well-balanced diet with adequate protein, adequate carbohydrates, adequate fats, and adequate water. It’s also important to get enough fiber. Fiber is almost like a probiotic that helps you bind up things, gives construction to your stool, helps move things on through, and maintains your gut health.
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