Chronic digestive issues, like bloating , pain, constipation, or diarrhea can signal a lot of different things, but at the root of the problem is often gut dysbiosis. If you want to get to the bottom of your digestive health issues, read on for everything you need to know about gut health imbalance and why it’s so common.
“Your gut is home to more than 100 trillion bacteria — and that is a LOT,” says Sarah Steinberg, MD, PhD , a physician at Parsley Health in New York City. Together, the bacteria and other microbes in your gut make up your gut microbiome and in recent years, we’ve learned a lot about how this microbiome works and how it influences aspects of our health, including not just our digestion but also our immune systems, inflammatory response, and even mental health. “The field of microbiome science has really exploded in the last 10 years,” Dr. Steinberg explains.
“Dysbiosis” is a term used to describe a maladaptation or imbalance inside the body, and a “gut dysbiosis” occurs when there is an imbalance in the number and diversity of your gut microflora. This can impact your health in various ways; in fact, as the authors of a 2018 study wrote: “Studies in animal models and humans have shown that a persistent imbalance of gut’s microbial community, named dysbiosis, relates to inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), diabetes, obesity, cancer, cardiovascular and central nervous system disorders.”
As you can see, gut health plays a major role in our long-term health and ability to fend off disease.
As Dr. Steinberg explains, “It seems like every day we’re learning new things about factors that contribute to imbalances in the bacteria in the gut.” According to her, some of the main factors that set people up for gut dysbiosis are:
This includes antibiotics, acid-reducing medications, over-the-counter pain relievers, steroids, and oral contraceptive pills . All these medications, “cause a discreet insult to the gut flora that can lead to dysbiosis,” Dr. Steinberg explains. A 2020 multi-drug metanalysis in Nature Communications found that 18 commonly used drug categories extensively impact the gut microbiome composition, with proton pump inhibitors (PPIs), laxatives, and antibiotics having the largest effect. Each drug has a slightly different effect, causing things like an increase in population of certain harmful bacterias and an increase in fatty acid production. These types of changes are related to multiple health conditions.
According to Dr. Steinberg, “the American diet tends to be higher in bad fats and lower in vegetables, which can negatively impact our gut flora.” Why? Because vegetables provide a lot of the roughage and fiber that allow good bacteria to grow. The standard American diet also contains a lot of carbohydrates, which can allow bad bacteria to overgrow and crowd out the good ones. This can, sadly, cause you to crave more sugar , setting you up to eat more sugar and possibly even develop a blood sugar issue , like pre-diabetes or diabetes.
In case you needed another reason why stress is the most toxic thing in your life , we’re learning more and more about how stress negatively impacts the gut microbiome. A 2011 study animal in the journal Brain, Behavior, and Immunity found that social stressors led to less diverse bacterial communities in the intestine and a higher number of potentially harmful bacteria. The authors of a 2018 study also wrote that “it is increasingly recognized that stress modulates gut microbiota community structure and activity, and may be one causal factor in dysbiosis.”
Unfortunately, the use of medications, a diet of more processed foods, and a stressful lifestyle are all extremely common for most people, which means many of us are at higher risk of developing a gut microbiome imbalance and dealing with the impacts it can have.
Some of the signs that unhealthy stress levels, medications, and a poor diet have impacted your gut microbiome are clear cut; others, not so much. “For the majority of people, the symptoms of dysbiosis are very obvious and include things like include diarrhea, constipation, gas bloating , belching, and abdominal pain,” says Dr. Steinberg. But these aren’t the only symptoms to look out for. According to Steinberg, a microbiome imbalance can also be a contributing factor in harder-to-pin-down issues like sugar cravings and carbohydrate cravings. There are also people with dysbiosis who do not present with digestive symptoms at all. “Instead, dysbiosis may be the root cause of issues like rashes, rosacea, and recurrent hives,” she explains.
When left untreated, dysbiosis can contribute to illnesses of all kinds, including anxiety and depression , lupus , MS , leaky gut , and diabetes —just to name a few. So while dysbiosis isn’t anything to panic about, it is something that you should address. “If left untreated, it can become a root cause of a multitude of different diseases,” says Dr. Steinberg. And many of these diseases also require medications and cause stress, which makes dysbiosis worse. “It becomes a matter of imbalanced gut flora propagating the risk factors that caused it,” she continues. That’s why it’s important to get early gut dysbiosis treatment and support your gut health.
Parsley Health takes a holistic, personalized point of view in treating dysbiosis. Typically, this means creating a treatment plan tailored to the individual patient based on their symptoms and lifestyle. But according to Dr. Steinberg, when it comes to dysbiosis, many of those treatment plans have the following things in common:
“One thing that has always been very clear is that glucose transport is a huge mediator of dysbiosis,” says Dr. Steinberg. In other words, the amount of sugar you’re consuming has a tremendous negative impact on your gut flora. The good news is that by shifting gut flora to a healthier balance, your cravings for sugar will decrease because your gut will start to favor healthier bacteria over the unhealthy, sugar-eating ones.
Fiber is another big piece of the healthy gut puzzle. That’s because fiber is a source of prebiotics , which is essentially the food that healthy gut bacteria like to eat. According to Dr. Steinberg, the goal when it comes to consuming fiber is diversity. “We often get stuck in a rut in terms of what we eat. When we approach gut healing, we want to aim to create a diverse ecosystem,” she says. She recommends eating diverse vegetables that provide all different types of roughage. “Inulin powder is also a great prebiotic supplement to add to your routine to feed beneficial gut bacteria,” she continues.
If you want to heal dysbiosis in the gut, getting stress under control is critical. “I’m a big believer in meditation and I’ve been practicing yoga for over 25 years,” says Dr. Steinberg. That said, any kind of mindfulness exercise will do the trick. “Each person has to find their own access point,” she continues. “Some people need to tire themselves out with a sweaty yoga class; others like to do balance exercises.” The key is to get out of your head and into your body. “All these exercises bring all the activity in your brain out of the frontal lobe (the part of the brain that regulates decision making, judgment, and memory) and into the cerebellum (the part of the brain that regulates muscle movement),” says Dr. Steinberg.
Last but not least, sleep is a crucial part of healing gut dysbiosis. This may seem strange at first. What does sleeping have to do with the bacteria in your gut? Well, research shows that sleep and gut bacteria are actually intricately connected. For example, the authors of a 2019 study concluded that total microbiome diversity was positively correlated with increased sleep efficiency and total sleep time and negatively correlated with wake after sleep onset. This means that a diverse microbiome was associated with more sleep, better sleep, and less waking up in the middle of the night (hooray!). To improve your sleep without drugs , Dr. Steinberg recommends getting sunshine and fresh air first thing in the morning, “I’m a huge believer in getting sunlight to reset circadian rhythm,” she says.
At the end of the day, having a healthy gut really is the secret to great overall health. The good news is that even if you are currently dealing with gut dysbiosis, making a few targeted lifestyle changes can help you get your gut—and the rest of your body—back on track.
Gretchen Lidicker is a writer, researcher, and author of the book CBD Oil Everyday Secrets: A Lifestyle Guide To Hemp-Derived Health & Wellness. She has a masters degree in physiology and complementary and alternative medicine from Georgetown University and is the former health editor at mindbodygreen. She's been featured in the New York Times, Marie Claire, Forbes, SELF, The Times, Huffington Post, and Travel + Leisure.