The gut fixes to try and the ones to skip

Telegraph

11 hours ago

'There are more pills than ever out there claiming to optimise, cure and treat all things gut health,' notes Dr Megan Rossi, the founder of The Gut Health Doctor. However, the gut health market – expected to be worth £47 billion globally by 2030 – isn't just a fad, it's based on solid science. Research has repeatedly shown that the status of our gut influences our overall health, from how well our immune system functions to our risk of having a heart attack.
However, despite the proliferation of products promising to boost your gut health, there is no guarantee that pricey probiotic shots, herb blends or vitamins will keep your gut microbes happy or banish bloating.
'The vast majority of these products lack any solid scientific evidence to back up their claims,' Dr Rossi says. 'I think we're experiencing the wild west of gut health right now.'
The reality is that no single product is a silver bullet for better gut health. 'The things that are going to make the biggest impact for looking after your gut health are just the simple, practical, everyday things,' says Dr Emily Leeming, a microbiome scientist at King's College London, dietician and author of Genius Gut. Here are the gut experts' take on the fixes to try – and the expensive fads to avoid.
Try: Psyllium husk for diarrhoea or constipation
'Psyllium husk is a unique water-loving fibre,' Dr Rossi says. Made from the seeds of a plant grown in India, it is available in the form of powder or capsules that cost around 10p to 40p per dose.
Dr Rossi, who has researched psyllium husk with a team at King's College London, found that it is poorly digested by the bacteria in the gut, unlike most other types of fibre. As it isn't broken down, it maintains its gel-like consistency as it travels through our digestive system. 'This explains why it has dual functionality – thickening up loose poops and softening hard poops, making it a supplement that you might want to consider if you are suffering from either constipation or IBS-related diarrhoea,' she says.
It may also help improve other troublesome gut symptoms, such as incomplete evacuation, which is when you feel like you haven't completely emptied your bowels after a bowel movement, she notes.
Dr Rossi recommends starting with half a tablespoon (3g) daily. 'If well-tolerated, you may want to increase to 1 tbsp per day after one week, and gradually increase up to a maximum of 3 tbsp per day,' she says.
Try: Gut massages for bloating and gas
You may raise your eyebrows, but a self-performed gut massage is a free and effective way to tackle uncomfortable gut symptoms, according to the experts. 'They can be beneficial for promoting gut motility [the movement of food through the digestive tract] and alleviating symptoms such as bloating, gas, and constipation,' says Dr Rossi.
'There's a specific technique,' Dr Leeming notes. The NHS recommends lying on your back, then placing your hand at the bottom of your stomach and stroking upwards 10 times. Next, stroke from the right hand side of your lower stomach, moving upwards and then over to the left side and down, repeating for two minutes. 'You're mimicking the pathway of your intestines to help you do a poo when you've constipation,' Dr Leeming explains.
One review of 13 randomised controlled trials showed bowel massages improved the frequency and quality of stools. 'If constipation is an issue, dedicating five to 10 minutes in the morning could make a real difference,' Dr Rossi adds.
Try: Fancy fruit, veg, beans and nuts to improve gut diversity
It's our everyday diet that makes the biggest difference to our gut health and there are some small tweaks you can make to improve it. The main goal is to eat more fibre (aim for 30g per day) and get plenty of diversity into our diet, according to Dr Leeming.
'It could be an extra portion of fruit or veg each day, having a cup of beans daily or adding delicious herbs and spices to your meals,' she says. 'They're high in fibre and great for the gut microbes.
'With gut health, people think they have to have all this weird, wacky stuff that they don't like or enjoy. That's not the case. It all should be about enjoying delicious things.'
Instead of spending money on supplements and powders, buy the fancier tomatoes, nuts, fresh rye bread and packets of pre-cooked mixed grains that will make you want to eat these gut-friendly foods, she suggests. 'Or berries, which are really expensive, but one of the best things we can do for our health is to eat them daily, whether fresh or frozen.'
'For the everyday person, it's about feeding your gut microbes the food they need to do their job well,' she notes. 'The most pricey foods I would get for gut health would be chia seeds or flax seeds. You don't need gut health supplements. There's no such thing as a silver bullet for your gut.'
Try: Drink more water for regular bowel movements
'Hydration is so important for gut health – but, on average, we're not drinking enough water,' Dr Leeming says. Fluids help the food we eat move through the gut at a regular pace, while being dehydrated slows our gut transit time (the duration between eating something and it leaving our body), she explains.
'Your gut microbes are going to have less fresh food landing on their kitchen table in your gut,' Dr Leeming says. Failing to drink enough liquids (we should have around six to eight glasses per day) will also leave you feeling bunged up and tired, she notes.
'How you stay hydrated doesn't need to be anything fancy,' Dr Leeming adds. 'Tap water, tea and coffee all count.'
Probiotics are live bacteria and yeasts that have been shown to have health benefits. They're sold as supplements and often described as 'good' or 'friendly' bacteria.
However, the now-popular daily probiotics – you may have seen them sold as supplements in pharmacies and health shops, with promises to support the gut and digestion – can do more harm than good, warns Dr Rossi, who did her PhD on probiotics.
Despite the buzz, most aren't just ineffective but may actually worsen symptoms like bloating. Additionally, research from her supplement company Smart Strains shows that three-quarters of people who take probiotics haven't noticed a meaningful improvement in health.
'That's not because probiotics don't work, but because we haven't been using them correctly,' she says. Like medicine, probiotics should only be taken when needed, such as after a course of antibiotics. While antibiotics are crucial for fighting bacterial infections, they don't distinguish between strains and therefore also wipe beneficial bacteria in our gut.
However, the LGG strain of bacteria, when taken at a dose of 10 billion units (the amount in one capsule) twice a day while taking antibiotics and for one week after, has been shown to reduce diarrhoea, bloating and changes to taste, all of which are side effects from taking the medicine, she notes.
'Fermented foods as a whole are a really nice, cherry on top add-in to your diet,' Dr Leeming says. The category – which includes kefir, sauerkraut, kombucha and sourdough bread – is thought to support your gut microbiome and lower inflammation.
However, while kombucha is a fermented tea and therefore rich in antioxidants called polyphenols, there are only a couple of human studies which have investigated its benefits – and the results haven't been dramatically positive, she notes.
'Supermarket kombucha is on my list of 'don't bother',' says Dr Leeming. Manufacturers tend to either pasteurise the product, so it contains less microbes, and they also tend to be higher in sugar, to make them more palatable. 'It ends up just being the same as many other fizzy drinks,' Dr Leeming says.
'Small batch producers tend to be of better quality,' she notes, with less sugar and more microbes. You can spot these products from mass-produced versions, as they usually need to be stored in the fridge, Dr Leeming says.
Skip: Green powders
Green powders, which can cost around £80 a month and are usually combined with water to have as a drink, often make bold promises that they will improve digestion and support the gut lining, as well as overall physical and mental performance.
However, Dr Leeming doesn't recommend them. Despite being expensive and having long and fancy-sounding ingredient lists, 'it's not hugely different from taking an everyday multivitamin', she says. 'It's potentially a small benefit if you aren't already getting those nutrients from anywhere else in your diet but it's at a huge cost.'
Another problem is that users frequently have green powders in the place of a meal. 'If you're having it instead of a proper breakfast that has protein, fat and fibre, which you need for whole body wellbeing, you're coming out at a net negative,' Dr Leeming explains. 'I'd much rather someone have an actual smoothie than a green powder juice.'
Sea moss supplements are billed as being a potent source of live bacteria and fibre. 'It's been called a superfood for its 'prebiotics',' Dr Rossi says.
However, they have a high carrageen content (which is used to make emulsifiers) and there is a lack of studies in humans showing that they offer any benefit. 'I'm not convinced,' she says. 'A daily portion of beans is a much better bet for real gut-loving prebiotics.'
Collagen is another popular supplement. 'It's one of the things I'm asked about the most,' Dr Rossi says. 'Unfortunately, the standard products you see on shelves today, priced under £50, are usually very similar to gelatin, which is found in jelly, and are unlikely to be backed by scientific claims.'
While there is growing evidence that some specific hydrolysed collagen may be beneficial for joint and skin health, these are not typically available in powder form and tend to be very expensive, she adds.
Skip: Activated charcoal
Commonly found in skincare products, activated charcoal is a fine black powder that acts like a sponge, absorbing toxins and other substances.
'It actually gets used in hospitals if someone's taken a poison because it binds to toxins and prevents them from being absorbed by the body,' Dr Leeming says. It is sometimes touted as a gut health product, as it is claimed that, when taken as a tablet or capsule, it absorbs bacteria in the gut that contribute to bloating and flatulence.
'The problem is that it also soaks up all the good stuff,' she explains. 'Things like nutrients and helpful bioactives. So that's not actually going to be doing anything great, if you're taking that on a regular basis.'