Expert tips for a healthier gut: diet, routine, and brain-gut connection

Dr. Ajay Verma, a consultant gastroenterologist at Kettering General Hospital in Northamptonshire, described the gut as a complex machine that constantly provides nutrition for growth, survival and repair. He said keeping it functioning well requires a balanced diet and adequate waste clearance.

Dr. Nisha Patel, a consultant gastroenterologist at Imperial College Healthcare NHS Trust in London, said the most common conditions in her clinic are irritable bowel syndrome, gastroesophageal reflux disease, inflammatory bowel disease and constipation. She emphasized that a healthy gut depends on balance, diversity and routine.

Patel recommended a diet high in fiber, fruit, vegetables, legumes and wholegrains, while avoiding alcohol, caffeine, fatty or spicy foods and artificial sweeteners. She noted that large, late meals can trigger gastrointestinal symptoms.

Verma advised moderation and giving the gut occasional breaks, such as having lighter meals after a heavy one to allow recovery from excesses.

Dr. Nurulamin Noor, a clinical lecturer in gastroenterology at the University of Cambridge, said studies show a Mediterranean diet leads to better digestive health. He recommended plenty of fruit, vegetables and fish, and low intake of processed foods, high-dairy foods and red meats.

Verma said kiwi is one of the most effective dietary interventions for constipation, and also recommended linseeds or flax seeds as low-cost natural laxatives, to be stirred into yogurt with fruit.

Dr. Wendi LeBrett, a California-based gastroenterologist, noted that over 90% of Americans and 96% of British people aged 11 and up do not meet their fiber goals. She said the accepted recommendation is 25-35g of fiber per day, with an apple providing about 4g and a serving of beans 5-6g.

LeBrett said people often must consciously choose fiber from foods like almonds, broccoli and oranges, and some may need a fiber supplement. She added that fiber is strongly associated with lower colon cancer risk, feeds the gut microbiome, and benefits cardiometabolic health by aiding blood sugar regulation, cholesterol and heart health.

Verma warned that those focusing on protein may reduce fiber intake, and urged mindfulness of balance, adding more fiber where necessary.

On wind, Verma said it is a normal phenomenon during digestion, but excessive wind may indicate food staying in the bowels too long. He recommended increasing fiber to clear the bowels.

Verma noted a rise in bowel cancer cases among people under 50, citing high-profile cases like Deborah James and Adele Roberts. He said ultra-processed foods may be a component, though evidence is not conclusive.

Verma said a completely UPF-free diet is virtually impossible, but a burger twice a day every day is a problem. He advised regular meals with fresh components, plenty of fruit and vegetables for essential vitamins and minerals.

Verma urged people to take up bowel cancer screenings when offered. In the UK, individuals aged 50-74 receive a faecal immunochemical test every two years, and if positive, they are offered an urgent colonoscopy.

Patel said she eats a varied, plant-rich, low-sugar, moderate-fat, low-UPF diet and avoids too much alcohol, but never says no to things like pizza, emphasizing balance.

Noor focuses on a healthy Mediterranean-style diet and restricts takeaways and processed foods. LeBrett limits processed meats like sausage, bacon and ham due to colorectal cancer risk, but allows occasional bacon in a sandwich.

LeBrett said besides UPFs and alcohol, certain medications like NSAIDs can harm the gut, and overuse of antibiotics should be avoided.

Verma said smoking can cause reflux and increase bowel cancer risk.

Verma stressed the importance of clearing the bowels properly when defecating, feeling empty and not gassy or bloated. He mentioned squat stools as helpful for easier defecation.

Patel said normal bowel frequency varies widely, from three times a day to three times a week, and any pattern is healthy if it is usual for the individual.

Patel explained the gut and brain are in constant conversation; stress can speed up or slow down gut motility, heighten pain sensitivity, trigger bloating and cramping, and alter the microbiome. She advocated slow diaphragmatic breathing, cognitive behavioral therapy and gut-directed hypnotherapy for stress management.

LeBrett said the brain-gut connection is only beginning to be understood, with conditions like IBS and functional dyspepsia possibly linked to miscommunication. She noted there are more serotonin receptors in the gut than in the brain, and the same hormones and neurotransmitters affect both.

Patel called hydration one of the simplest yet underrated ways to stabilize digestion, particularly when the gut is sensitive to stress. Water softens stool and supports movement through the colon; low intake leads to harder stools and bloating. She recommended 1.5-2 liters per day, including coffee, fruit and soups.

LeBrett recommended walking after meals to promote digestion and prepare the body for sleep.

Patel noted the general recommendation of 150 minutes of exercise per week, and said core strengthening exercises like Pilates and yoga help regulate the gut-brain axis through diaphragmatic breathing.

Noor pointed out that oral health is important for the entire digestive tract, from mouth to anus, and is relatively underappreciated. He advised good oral hygiene, brushing, flossing and dentist visits.

The gastroenterologists all stressed prioritizing sleep. LeBrett cited studies showing that poor sleep in IBS patients worsened symptoms the next day.

Verma said some people swear by probiotics, but there is not compelling evidence for wide use. He said probiotic yogurt drinks are inexpensive and not an unreasonable step if they make someone feel well.

LeBrett emphasized focusing on prebiotics — fiber from fruit, vegetables, wholegrains and legumes — that the microbiome thrives on.

Verma said stomach bugs and minor bleeding from a sore bottom are common, but persistent rectal bleeding or change in bowel habits for three to four weeks, or unintentional weight loss, requires medical attention.

Patel said patients often apologize for discussing digestive symptoms, but she reassures them there is no embarrassment. She encourages early help, saying symptoms matter and people deserve to feel well.

LeBrett cited a study linking smartphone use on the toilet to increased risk of hemorrhoids and pelvic floor dysfunction, and said she tries not to do it for hygiene reasons.

Verma took a more relaxed view, saying a direct link between phone use and bowel issues has not been proven, and those spending a lot of time in the loo may use their phone to pass the time.