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Doctor’s Tip column: The gut microbiome plays a huge role in health

Dr. Greg Feinsinger
Doctor's Tip
Dr. Greg Feinsinger

Last week’s column was about Will Bulsiewicz, M.D., a respected gastroenterologist who wrote “Fiber Fueled,” which came out in 2020. Today’s column is the first in a series of columns based on this book.

For centuries, physicians looked at bacteria as harmful — causing wound infections and infectious diseases such as pneumonia and meningitis. Following the discovery of penicillin in 1928, multiple antibiotics were developed to fight against bacteria. Indeed, there are harmful bacteria, and — although over-prescribed — antibiotics have saved millions of lives. However, it turns out that there are also beneficial bacteria.

Prior to 2006, scientists were aware of about 200 species of bacteria in our colon, but assumed they were “just along for the ride” and that they weren’t beneficial for human health. Because most gut bacteria didn’t grow on traditional culture plates, they were not studied extensively until a laboratory breakthrough in 2006. Now, over 15,000 species of gut bacteria have been identified, and it’s estimated that there are at least another 20,000. Over the last five years, 12,900 scientific papers have been published about the gut microbiome.



As Dr. Bulsiewicz puts it, “when things are working the way they’re supposed to, we have a diverse, abundant [some 39 trillion!] community of microbes living in harmony in our colon.” These bacteria “eat what we eat,” and if we eat the right food, our microbiome supports immunity, metabolism, hormonal balance, cognition, and gene expression. If we eat unhealthy food, the gut microbiome becomes dysfunctional—a condition called “dysbiosis.” Following are common symptoms associated with dysbiosis:

GASTROINTESTINAL: abdominal pain or cramping; gas and bloating; food sensitivities and allergies; diarrhea and constipation; mucus in stool; nausea and indigestion; GERD (gastroesophageal reflux).



EXTRAINTESTINAL: weight gain, fatigue, brain fog; moodiness; anxiousness; joint and muscle aches; weakness; bad breath.

Below are common medical conditions in which dysbiosis plays a role:

IMMUNE-MEDIATED CONDITIONS: type 1 diabetes; celiac disease; multiple sclerosis; asthma; food allergies; eczema; seasonal allergies; psoriasis; scleroderma; chronic fatigue syndrome; Sjorgren’s syndrome; rheumatoid arthritis; ulcerative colitis and Crohn’s disease; lupus; sarcoidosis; fibromyalgia.

METABOLIC CONDITIONS: Obesity; type 2 diabetes; atherosclerosis/heart attacks and strokes; high cholesterol; chronic kidney disease; gout; fatty liver disease; pancreatitis.

ENDOCRINE AND HORMONAL CONDITIONS: endometriosis; polycystic ovary syndrome; female infertility; sexual dysfunction; hypothyroidism; breast, prostate, and endometrial cancer.

NEUROPSYCHIATRIC CONDITIONS: Alzheimer’s; Parkinson’s; schizophrenia; ADHD; ALS; anxiety and depression; autism; bipolar disorder; migraine headaches; restless leg syndrome.

The next few columns will discuss how good gut bacteria help us, how bad ones hurt us, and how to optimize the good ones. For additional information read Dr. Bulsiewicz’s book, available on Amazon, or go to his Instagram account: @theguthealthmd.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.


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