The Gut Health Podcast

Tired of hearing “it’s just stress”? IBS experts Drs. Laurie Keefer and Darren Brenner join Kate Scarlata and Dr. Megan Riehl to set the record straight on irritable bowel syndrome. IBS is a real, biologically based disorder involving the gut–brain axis, the microbiome, immune function, and nervous system signaling. Understanding how these systems interact reshapes how we diagnose, personalize treatment, and support long-term symptom relief. If you’ve felt dismissed, confused, or stuck in trial-and-error care, this episode will help you feel validated, informed, and empowered with a clearer, science-backed path forward. Together we break down: The value of a positive diagnosis (not endless testing) The impact of trauma and adverse childhood experiences (ACEs) on gut sensitivity Using diet to support symptom relief without unnecessary food restriction How to comprehensively match treatment to your triggers Support & Professional Resources If you’ve experienced ACEs or trauma and want support from a GI psychologist or trauma-informed provider, these directories can help: GI Psychology (virtual services available) Rome Foundation GastroPsych Provider Directory Trauma-Informed Mental Health Provider Directory Partnering with a clinician trained in gut–brain disorders and trauma-informed care can safely address both physical symptoms and nervous system patterns. Aggeletopoulou et al. Unraveling the Pathophysiology of Irritable Bowel Syndrome: Mechanisms and Insights. Int J Mol Sci, 2025. Keefer L et al. The Role of Resilience in IBS and Other Chronic GI Conditions. Clin Gastroenterol Hepatol, 2021. Chang L et al. Sex, Anxiety, and Resilience in the Association Between Adverse Childhood Experiences and IBS. Clin Gastroenterol Hepatol, 2025. Dong et al ( UCLA Church Lab ). Experiences of discrimination are associated with microbiome and transcriptome alterations in the gut. Front Microbiol, 2024. Scarlata K et al. Utilization of Dietitians in the Management of Irritable Bowel Syndrome by Members of the American College of Gastroenterology. Am J Gastroenterol, 2022. How Kate Does It: Low-FODMAP Diet (AJG) This episode is sponsored by Ardelyx. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Fiber isn’t one-size-fits-all and for some people, more isn’t better. In this episode, we explore why most people under-eat fiber, why certain fibers can worsen symptoms, and how to personalize intake in a way your body can actually tolerate. Dr. Heather Armstrong shares emerging insights on fiber function, microbiome capacity, and practical strategies for going low and slow. We also unpack new science explaining why fiber supports gut health in some individuals, while triggering issues in others with reduced fermentative activity. In this episode, we discuss: • The fiber gap, health risks, and minimum intake targets • How solubility, viscosity, and fermentability guide fiber choice • Matching fiber types to IBS, diarrhea, and constipation • Why whole foods matter more than isolates • Citrus peel pectin and simple kitchen hacks • Why “low and slow” dosing reduces gas and pain • How long microbiome changes and symptom relief actually take • When fiber supplements help (and when they don’t) • Individualized fiber needs in IBD (and implications for IBS, MS, and liver disease) • Why dietitians are essential for precision nutrition This episode is especially relevant if you’ve been told to “just eat more fiber”—and it didn’t go well. Learn more about Dr. Heather Armstrong's novel research: Gut feeling: new test and precision diet could boost health for people with IBD. U of A research team in clinical trials for their innovative AI-powered tool that could reduce inflammation by “rewiring” the gut microbiome. References: Ramezani F, Pourghazi F, Eslami M, et al. Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies. Clin Nutr. 2024 Chang SC, Cassidy A, Willett WC, Rimm EB, O'Reilly EJ, Okereke OI. Dietary flavonoid intake and risk of incident depression in midlife and older women. Am J Clin Nutr. 2016 Armstrong HK, Bording-Jorgensen M, Santer DM, et al. Unfermented β-fructan Fibers Fuel Inflammation in Select Inflammatory Bowel Disease Patients. Gastroenterology. 2023 Armstrong H, Mander I, Zhang Z, Armstrong D, Wine E. Not All Fibers Are Born Equal; Variable Response to Dietary Fiber Subtypes in IBD. Front Pediatr. 2021 Gao J, Lee AA, Abtahi S, et al. Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet Improves Colonic Barrier Function and Mast Cell Activation in Patients With Diarrhea-Predominant Irritable Bowel Syndrome: A Mechanistic Trial. Gastroenterology. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Glucagon-like peptide-1 (GLP-1) can transform metabolic health, but only with smart dosing, adequate dietary protein, regular strength training, and mental health support. In this episode, we explore how GLP-1 medications work in the brain and gut, why metabolic health is more than BMI or a weight on the scale, and how to use these drugs safely. Our expert guest, gastroenterologist, Dr Supriya Rao shares practical dosing, side effect strategies, and what makes results stick. • Defining metabolic health beyond BMI and weight • How GLP-1s reduce appetite and slow gastric emptying • Healthy weight loss pace and preserving lean muscle • Practical + science-backed dosing and individualized titration • The unknown risks of compounding and microdosing • Managing nausea, reflux, and constipation • Diet shifts: smaller meals, more fiber, adequate protein • Mental health, body image, and stigma in care • Durability of results and maintenance dosing • New indications: MASH (metabolic dysfunction-associated steatohepatitis), sleep apnea, cardiovascular protection • Building an educated care team References/Resources: Tzang CC, Wu PH, Luo CA, Chen ZT, Lee YT, Huang ES, Kang YF, Lin WC, Tzang BS, Hsu TC. Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis. EClinicalMedicine. Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks. Obes Pillars. 2024;12:100127. Published 2024 Aug 31. Moiz A, Filion KB, Tsoukas MA, Yu OHY, Peters TM, Eisenberg MJ. The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions. EClinicalMedicine. 2025 Jul 17;86:103363. Supriya Rao's practice site) Book: The GLP-1 Kitchen: A Cookbook for Living Well on Weight Loss Medications Escobar S-N et al. (contains affiliate marketing link) Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

This year on The Gut Health Podcast, we dug deeper than ever into the science that shapes our bodies, the myths that confuse us, and the everyday habits that actually move the needle. We challenged probiotic controversies, rethought alcohol culture, explored resilience from gravity to mindset, and turned stress management into practical, usable skills. We broached the topic of vagus nerve stimulation and the potential role of psychedelics and the gut-brain connection! The theme in 2025 was connection: the conversation between food and microbes, the way those microbes steer our mood and gut motility, the posture-driven shifts in biology, and the everyday choices that ignite changes across the whole body. It’s not just gut health—it’s a map of how we think, feel, move, and live. And we’re just getting started. Key topics in this episode include: • the evolving research with gut science and why personalization matters • facts vs fads on probiotics, ferments, and “leaky gut syndrome” • lifestyle foundations that beat quick fixes • alcohol reduction strategies and social swaps • food–mood links, excess fructose, and serotonin • stress prescriptions such as adding diaphragmatic breathing into your daily routine • how to build gravity resilience • what's happening in the psilocybin research landscape and safety considerations • practical habit stacking for hydration, movement, and sleep • communicating with providers when evidence conflicts to help you navigate your personal gut health needs. Looking to boost overall wellbeing with meditation, breathing exercises or better sleep? Calm has you covered with 40% off a premium subscription. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

A growing number of patients with stubborn IBS symptoms are asking: if the gut and brain are wired together, could changing one transform the other? In this episode, we sit down with Dr. Emeran Mayer and Dr. Erin Mauney to explore what the emerging field of psychedelic-assisted therapy could mean for gut-brain health, beyond the headlines and hype. In this episode we cover: Why traditional IBS treatments often fall short. How psilocybin opens a neuroplastic “window” for processing pain, stress, and interoception. The therapeutic process: preparation, guided dosing, and integration. Early study results: symptom relief, reduced visceral sensitivity, and improved self-illness separation. Safety, variability, and practical questions about access and candidacy. If you’re curious about neuroplasticity, the brain-gut axis, psilocybin, and the future of IBS care, this episode offers a grounded, hopeful, and responsible guide to what’s known, and what’s next. This episode is sponsored by GI Psychology. Disclaimer: Participation in the research study mentioned in this podcast is entirely voluntary and independent of The Gut Health Podcast. Please review all study details before deciding to take part. The Gut Health Podcast does not endorse or verify the research, its sponsors or its findings. Direct any questions to the study organizers using their official contact information. References: Psychedelic-assisted therapy: An overview for the internist Barnett BS, Mauney EE, King F 4th. Psychedelic-assisted therapy: An overview for the internist. Cleve Clin J Med. 2025;92(3):171-180. Published 2025 Mar 3. doi:10.3949/ccjm.92a.24032 Psychedelic-assisted Therapy as a Promising Treatment for Irritable Bowel Syndrome Mauney, Erin MD*; King, Franklin IV MD†; Burton-Murray, Helen PhD‡; Kuo, Braden MD‡. Psychedelic-assisted Therapy as a Promising Treatment for Irritable Bowel Syndrome. Journal of Clinical Gastroenterology 59(5):p 385-392, May/June 2025. | DOI: 10.1097/MCG.0000000000002149 Psilocybin and IBS treatment: First psychedelic study in gastroenterology Learn more about the MGH study with Dr. Erin Mauney and colleagues here. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Dr. Brennan Spiegel, author of Pull: How Gravity Shapes Your Body, Steadies the Mind, and Guides Our Health, reveals how gravity shapes everything from our digestive health to our emotional wellbeing in this fascinating exploration of "biogravitational medicine." He presents the revolutionary concept that conditions like IBS and depression may be tied to how well our body resists gravity. • Gravity resilience refers to how well your body manages Earth's gravitational force • People with hypermobility conditions like Ehlers-Danlos syndrome often experience gut issues when their internal suspension systems are compromised • The gut hangs from a suspension system like ‘ornaments on a Christmas tree,’ and if it weakens, the intestines can sag, leading to digestive issues • Our language around emotions reflects our relationship with gravity – we feel "down" when sad and "up" when happy • Most serotonin (90–95%) is made in the gut with help from our microbiome, where it helps regulate muscles and systems that manage our body’s relationship with gravity • Strategies to strengthen gravity resilience • Hypopressive exercises that draw the belly upward can improve internal organ support • The STACK TEN diet focuses on tryptophan-rich foods to support serotonin production • Mental and physical resilience share similar concepts - the ability to "bend without breaking" Check out Dr. Spiegel's new book "Pull" releasing October 7th, which explores how gravity affects human health and how building gravity resilience can help us find balance, stand stronger, and live longer. References and Resources: The Gravity Doctors Podcast Link Brennan Spiegel MD’s book, Pull (This is an affiliate link. We may earn a small commission at no extra cost to you and only recommend products we trust.) Effect of diet on serotonergic neurotransmission in depression. Neurochem Int. 2013;62(3):324-329. Tryptophan-rich diet is negatively associated with depression and positively linked to social cognition. Nutr Res. 2021;85:14-20. J. Obes Res. 1995;3 Suppl 4:477S-480S. Research on sleep & tryptophan Sleep and Diet: Mounting Evidence of a Cyclical Relationship. Annu Rev Nutr. 2021 Oct 11;41:309-332. Amy Cuddy's paper on "The Power Pose" highlights how adopting confident postures can boost mood, increase self-assurance, and positively influence how others perceive you! Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Dr. Mary Ellen Sanders, an expert in probiotic microbiology, helps us decode the often confusing world of probiotics, prebiotics, and postbiotics by explaining their scientific definitions, evidence-based benefits, and practical applications for gut health (and beyond). This episode has been sponsored by Activia. • Probiotics are live microorganisms that confer health benefits when consumed in adequate amounts • For something to be called a probiotic, it must be alive, defined to the strain level, and tested in the research setting for health benefits • When selecting probiotics, look for products with strain designations and doses guaranteed through end of shelf life, not just "at time of manufacture" • The US Probiotic Guide (usprobioticguide.com) offers independent assessments of probiotic products and their evidence levels, including specific conditions or symptoms • Specific probiotic benefits include supporting gut function during antibiotic use, reducing respiratory infections, and decreasing crying in colicky babies • Prebiotics are substrates (often fibers, but also polyphenols) that feed beneficial gut bacteria • Research suggests about 5 grams of prebiotics daily may be beneficial • Postbiotics are beneficial preparations of dead microorganisms or their components, challenging the notion that microbes must be alive to benefit health • When trying probiotics, consult with your health care provider first, as there are some conditions in which they are contraindicated. • Multi-strain probiotics and synbiotics are commonly available but rarely tested in their exact formulations References and resources: Clinical Guide to Probiotic Products Available in USA http://www.usprobioticguide.com Research review: Is There Evidence to Support Probiotic Use for Healthy People? https://www.sciencedirect.com/science/article/pii/S2161831324000991?via%3Dihub International Scientific Association for Probiotics and Prebiotics www.ISAPPscience.org Perspectives on products combining functional ingredients without testing the product as formulated: Cunningham M, et al.. The influence of product formulation on the activity and clinical outcomes of probiotic and prebiotic products. Trends Food Sci Technol: 112, June 2021, Pages 495-506. Sanders ME, et al. 2014. Effects of genetic, processing, or product formulation changes on efficacy and safety of probiotics. Ann N Y Acad Sci. 1309(1):1-18. Probiotic product survey: Merenstein DJ, Guzzi J, Sanders ME. 2019. More Information Needed on Probiotic Supplement Product Labels. J Gen Intern Med. 34(12):27 Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Dr. Mark Pimentel, Executive Director of the MAST program at Cedars-Sinai in Los Angeles, shares groundbreaking insights into the small intestinal microbiome that challenge long-held beliefs about gut bacteria. Findings from his team’s REIMAGINE study reveal that the small intestine is far from sterile, as previously thought—instead, it harbors substantial bacterial communities that play a critical role in health and disease, especially in conditions such as IBS and SIBO. • E. coli and Klebsiella act as aggressive "Ferrari" bacteria that outcompete other microbes and destroy microbial diversity when overgrown inducing a "apocalyptic" disruption of the small bowel microbiome. • Lactobacillus, commonly found in many probiotics, may act as a disruptor in the small intestine and new research correlates higher small intestinal levels with obesity and unhealthy aging (more research needed) • The PLACIDE trial found probiotics didn't reduce C. diff or antibiotic-associated diarrhea but did increase bloating • Food poisoning is the only proven cause-and-effect trigger for IBS, with stress acting as a modifier rather than initiator • Combining rifaximin with NAC works 10x better for SIBO by targeting bacteria in both intestinal fluid and mucus • A new compound (CS06) shows promise for reducing methane production and relieving constipation • Three distinct gas patterns (hydrogen, methane, hydrogen sulfide) correlate with different symptom patterns and respond to targeted treatments This episode was sponsored by Salix Pharmaceuticals. Resources: DDW 2025 Abstracts by the Mast Program and Dr. Pimentel A Novel Microbiome Therapy, CS-06 (MTD Blocker), Reduces Methane Production in Stool Culture Real World Study of Three-Gas Breath Testing Nationwide and The Association with Symptoms Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Dr. Iris Wang of the Mayo Clinic shares cutting-edge insights on gut health across the lifespan, including advancements in pharmacogenomics for personalized medication selection and innovative breathing techniques to relieve abdominal distension. She busts common myths about bloating, revealing how diaphragmatic dysfunction rather than excess gas may be the culprit. Dr. Wang also emphasizes the importance of starting gut health education early, helping kids and parents alike understand that pooping shouldn't be painful or forced. • How pharmacogenomics helps identify why some patients metabolize medications differently, leading to better medication choices with exploration on the hope and/or hype of precision medicine in the GI world (Wang et al 2019) • Explanation of abdomino-phrenic dyssynergia (APD) – when the diaphragm moves downward instead of upward, causing visible abdominal distention • Specialized breathing technique developed in Barcelona that retrain the diaphragm for bloating relief (Barba E et al 2024) - see video link below • The importance of normalizing healthy pooping habits from childhood through education & tools like toileting stools (e.g. Squatty Potty) • Warning signs for parents about childhood constipation – including stool leakage, straining, & urinary problems (Tran DL et al 2023) • How yoga can support gut health through mindful movement, core engagement, & stress reduction Yoga videos: Yoga For Digestion Flow| Yoga With Adriene (26 mins) Yoga for Bloating, Digestion, Ulcerative Colitis, IBD & IBS (12 mins) Check out Dr. Wang's children's book Boo Can't Poo, which helps normalize healthy pooping habits for kids while educating parents too. Personalized medicine in functional gastrointestinal disorders: Understanding pathogenesis to increase diagnostic and treatment efficacy. World J Gastroenterol. 2019 Mar 14;25(10):1185-1196. Barba E, Livovsky DM, Accarino A, Azpiroz F. Thoracoabdominal Wall Motion-Guided Biofeedback Treatment of Abdominal Distention: A Randomized Placebo-Controlled Trial. Gastroenterology. 2024;167(3):538-546.e1. Specialized breathing technique for abdominal distention: Video Demonstration Tran DL, Sintusek P. Functional constipation in children: What physicians should know. World J Gastroenterol. 2023 Feb 28;29(8):1261-1288. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Fermented foods offer surprising health benefits with science showing they can increase gut microbial diversity in ways other dietary interventions cannot. • Expert Elisa Caffrey clarifies what qualifies as fermented food: substrate + microbes + time • While touted as a source of probiotics, most fermented foods don't technically contain probiotics, which require specific strain characterization and known health benefits •Different types of fermentation are used in food production: lactic acid bacteria ferment carbohydrates in sauerkraut and yogurt; acetic acid bacteria oxidize ethanol into acetic acid in kombucha; and filamentous fungi such as Aspergillus oryzae and Rhizopus species are involved in the fermentation of miso and tempeh, respectively. • Fermented foods may benefit gut health through microbial derived metabolites rather than just the microbes in the food or beverage. • Consider starting with yogurt if you are a newcomer and have fun exploring kimchi, sauerkraut and other options for fermented food variety. • Most fermented foods are safe, though some considerations exist for those with histamine intolerance or sodium restrictions • Variety is key – consuming diverse fermented foods appears to help maximize potential benefits • The fermentation process may have mental health benefits beyond nutrition though more research is needed Try incorporating fermented foods gradually into your diet and experiment with different types to find what works for your body and taste preferences. Let us know what makes your taste buds (and gut) happy! This episode has been sponsored by Activia. Unpacking food fermentation: Clinically relevant tools for fermented food identification and consumption Gaudiest G et al. Microbial and metabolic characterization of organic artisanal sauerkraut fermentation and study of gut health-promoting properties of sauerkraut brine Wastyk HC et al. Gut microbiota-targeted diets modulate human immune status (high fiber vs fermented food study) Nielson ES et al. Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation - A pilot study Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Pelvic floor physical therapy (PFPT) is a crucial yet often overlooked component of gut health that can dramatically improve quality of life for people suffering from bowel issues, bladder problems, or pelvic pain. Dr. Alicia Jeffrey-Thomas joins us to demystify and normalize this specialized therapy and explain how proper pelvic floor function impacts everything from constipation to sexual health. • Understand that daily bowel movements don't necessarily mean you're not constipated • What happens during a PFPT session and how therapists create a safe + comfortable environment • The importance of proper pooping position • Why breathing techniques and sounds (like mooing!) can help relax your pelvic floor during bowel movements • Demystifying tools like pelvic wands and dilators for at-home maintenance • How dyssynergic defecation affects approximately 50% of people with constipation and how PFPT can help • Why all women can benefit from pelvic floor PT after childbirth (and even during pregnancy) • Men face pelvic health issues too, like post-prostate surgery incontinence • The downside of "peeing just in case" and how it trains your bladder to signal fullness prematurely If you've experienced pelvic floor issues, don't accept them as normal - seek help from a pelvic floor physical therapist who can address these problems and improve your overall quality of life. Diagnosis and Treatment of Dyssynergic Defecation. J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi: 10.5056/jnm16060. PMID: 27270989; PMCID: PMC4930297. Ye AL, Johnston E, Hwang S. Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies. Curr Oncol Rep. 2024;26(3):212-220. doi:10.1007/s11912-024-01498-6 Where to find a pelvic floor PT: https://pelvicrehab.com/ https://pelvicglobal.com/directory/ Alicia Jeffrey-Thomas' book, Power to the Pelvis. Got constipation? Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Join us as we discuss effective non-diet focused methods for IBS relief. In this episode, Kate and Dr. Riehl review key factors on how gender can influence common symptoms of IBS. Hormones significantly influence IBS symptoms, with women being diagnosed 2.5 times more often than men, in part due to differences in gut function and pain perception. This episode features the following key discussion areas: • Women's fluctuating estrogen and progesterone levels affect gut motility and pain sensitivity throughout the menstrual cycle • Visceral hypersensitivity causes normal digestive sensations to be interpreted as pain - like a car alarm going off unnecessarily • The "microgenderome" refers to gender differences in gut microbiome that may contribute to women's higher rates of IBS and autoimmune conditions • Gut-directed hypnotherapy helps reprogram the subconscious mind to interpret gut sensations more accurately, with 70-80% improvement rates • Pelvic floor physical therapy can help address muscle tension that contributes to both constipation and diarrhea symptoms • Non-diet approaches including medications, supplements like enteric-coated peppermint, and lifestyle factors are effective IBS management tools • Regular exercise (especially in nature), adequate sleep, and stress management techniques complement other treatments For more information on IBS-C treatments, check out our dedicated three-part series in episodes 14, 15, and 16. This podcast has been sponsored Ardelyx and Nerva by Mindset Health. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014;20(10):2433-2448. Gender differences in irritable bowel syndrome. Gastroenterology. 2002;123(5):1686-1701. doi:10.1053/gast.2002.36603 Houghton LA, Jackson NA, Whorwell PJ, Morris J. Do male sex hormones protect from irritable bowel syndrome?. Am J Gastroenterol. 2000;95(9):2296-2300. doi:10.1111/j.1572-0241.2000.02314.x Peters SL, Yao CK, Philpott H, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):447-459. doi:10.1111/apt.13706 Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Is "leaky gut" real or just another wellness buzzword? In this episode of The Gut Health Podcast, we cut through the controversy with Dr. Alessio Fasano, a renowned gastroenterologist and microbiome expert from Mass General Brigham. Dr. Fasano explains what happens when the gut’s protective barrier is compromised, resulting in increased intestinal permeability, and how this can affect not only gut health but also overall well-being. While some level of intestinal permeability is essential for health, in the presence of an altered gut microbiome, it can allow harmful molecules such as bacterial endotoxins and undigested food particles to pass through the intestinal lining. This can lead to inflammation, immune system activation, and may contribute to a variety of health issues, including autoimmune diseases, gastrointestinal disorders, heart disease, and more. We explore the molecular mechanisms that control intestinal permeability, examining how factors like epigenetic changes, diet, stress, and environmental factors can all impact the integrity of the gut barrier. Dr. Fasano breaks down the latest research on how intestinal permeability interacts with the immune system and other organ systems, highlighting the complex bidirectional relationship between gut health and overall wellness. Join us as we explore cutting-edge research on gut health, from breakthrough treatments to personalized diets and biomarkers for gut permeability. Tune in for expert insights and practical strategies—like a plant-forward diet and stress management—to strengthen your gut and overall well-being. References: Effects of dietary components on intestinal permeability in health and disease. Unfermented B-fructans Fibers Fuel Inflammation in Select Inflammatory Bowel Disease Patients. High FODMAP diet causes barrier loss via lipopolysaccharide-mediate mast cell activation A Randomized Placebo-Controlled Trial of Dietary Glutamine Supplements for Post-Infectious Irritable Bowel Syndrome. Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials. What to do about the leaky gut? Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

What if you could navigate the complexities of IBS without falling into restrictive habits or feeling overwhelmed? Erin opens up about her early experiences with gastrointestinal issues, exacerbated by a Giardia infection painting a vivid picture of the emotional and physical hurdles she faced living with the complexities of IBS, in a time in which, IBS research and treatment modalities were limited. Erin's story is a testament to resilience and the important ways resources for IBS management have evolved over the last decade. She reflects on how understanding balanced nutrition, avoiding restrictive habits and adopting an enriched lifestyle have been key to her management strategies. Listeners will gain valuable insights into practical strategies for constipation relief, emphasizing the gut-brain connection's role in managing symptoms. Erin discusses the significance of lifestyle adjustments, such as movement, adequate hydration, supportive dietary changes, and stress regulation, offering a toolkit to empower individuals facing similar challenges. By sharing her knowledge and experiences, Erin aims to foster hope and confidence, encouraging a guilt-free approach to health and wellness for those living with IBS. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Join Dr. Riehl and Kate as they share practical lifestyle strategies for managing IBS with constipation. Studies show that up to 84% of IBS patients experience GI distress related to eating, with most triggers linked to carbohydrate intake—particularly highly fermentable ones like FODMAPs. Learn how the low FODMAP diet, the most extensively researched dietary approach for IBS, stacks up against traditional therapies and medications. Kate also explores other researched diet options for IBS, including the Mediterranean diet and the UK NICE IBS diet guidelines. Dr. Riehl discusses the intricate gut-brain connection and presents evidence-based therapies for managing IBS symptoms. She provides an in-depth review of a range of treatments, including mindfulness techniques, gut-directed hypnosis, and other effective interventions, offering a comprehensive approach to symptom relief. Finally, we explore simple, holistic lifestyle changes that can complement IBS management. From the benefits of eating a wide array of colorful plants, engaging in mindful eating, to stress reduction and healthy living techniques. By the end of this episode, you'll be equipped with a variety of self-care and nurturing practices that align with your personal values, helping you find joy, reduce stress, and better manage your IBS symptoms. Diaphragmatic breathing demonstration Book: Real Self-Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Includes) References: Nutrition: Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis. The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome Clinical Trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome UK Nice Guidelines IBS CAM & Sleep: Complementary and Alternative Therapies for Chronic Constipation Sleep Duration in Constipation This episode is sponsored by Ardelyx. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

This episode launches the first part of a 3-part mini-series on IBS-C, shedding light on the complexities of this widespread condition that affects millions of people across the U.S. It stresses the importance of a holistic, patient-centered approach to managing IBS-C. We explore the various medications used to treat IBS-C, including both over-the-counter options and prescription drugs, offering a comprehensive review. Our expert guest, Dr. Justin Brandler, a neurogastroenterologist at Virginia Mason Franciscan Health, provides valuable insights into the mechanisms and effectiveness of these treatments. Dr. Brandler simplifies the intricate science and treatment of IBS into easy-to-understand concepts. He likens his role in treating IBS to that of both a plumber and an electrician. As a disorder of gut-brain interaction (DGBI), IBS affects how the brain and spinal cord process signals, influencing gastrointestinal symptoms. Different patients respond to different treatment approaches. Dr. Brandler discusses medications that target the "plumbing" aspect of IBS, including pharmaceutical options like linaclotide, tenapanor, and lubiprostone, as well as over-the-counter treatments such as magnesium oxide, senna, and bisacodyl. He also highlights neuromodulators, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), and their role in adjusting the nervous system to help alleviate IBS symptoms. We explore essential tips for making the most of your medical appointments, such as organizing a concise summary of your medical history and symptoms to ensure clear and effective communication, including outlining your goals. Preparing ahead of time can help your healthcare providers deliver the best possible care and make the right referrals for your needs. Resources: Living your BEST IBS Life: Practical Tools to Beat the Battle with your Bowels by Justin Brandler, MD via IFFGD Mechanisms of Action Considerations in the Management of IBS-C Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Can technology transform the way we approach health and healing? In this episode, we explore the intersection of neuroscience, innovation, and the mind-body connection with Dr. Brennan Spiegel from Cedars-Sinai. Dr. Spiegel challenges the long-standing myth that the mind and body function separately, revealing how our thoughts, emotions, and physiological responses are deeply intertwined. We take a deep dive into alternative therapies that go beyond conventional treatments, including vagus nerve stimulation (VNS) and its impact on relaxation, well-being, and potential applications in treating health conditions. From implanted devices to non-invasive, direct-to-consumer options, we break down how VNS works and its role in the parasympathetic nervous system (think: rest and digest). We also discuss percutaneous electrical nerve field stimulation (PENFS), a distinct yet related therapy offering new opportunities for managing gastrointestinal disorders. But the innovation doesn’t stop there. We explore the growing role of virtual reality (VR) in healthcare, examining its influence on physiology, pain management, and patient outcomes. Backed by research from leading institutions like Cedars-Sinai and the Mayo Clinic, we uncover how VR is shaping modern medicine. Also, Dr. Spiegel shares fascinating insights on how gravity affects the body and how cutting-edge technology provides immersive healing experiences for patients in need. Join us as we navigate this exciting frontier where technology and health converge, offering fresh perspectives on how VNS, VR, and the power of the mind-body connection may revolutionize medicine. Tune in now and discover how these advancements could change the future of healthcare and well-being. References: Vagus Nerve Stimulation Therapeutic Efficacy of Neurostimulation for Depression: Techniques, Current Modalities, and Future Challenges Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomized, double-blind, sham-controlled trial Resources mentioned by Dr. Brennan Spiegel www.virtualmedicine.org SynerGI - IBS VR Program available through research studies Xaia - VR support program available through Apple Vision Pro Tripp VR - Immersive meditation program on mobile and VR devices Vagustim - Vagus nerve stimulation product mentioned by Dr. Spiegel (contains marketing affiliate link). Get an extra 20% off by using coupon code: GutHealth20 Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Can drinking alcohol truly offer any health benefits, or is that just a myth we’re eager to believe? In this episode, we aim to inspire a renewed commitment to wellness in the new year with our guest, Dr. Ponni Perumalswami, a prominent hepatologist at the University of Michigan, who helps us unravel the complicated relationship between alcohol, the gut, and liver health. With her expertise, we tackle common misconceptions and explore the notion that less is more when it comes to alcohol consumption. We dive into definitions that may surprise you, such as the different thresholds for binge drinking and heavy alcohol use among men and women. Dr. Perumalswami sheds light on the stigma associated with alcohol abuse and how it can impede access to support, urging healthcare professionals to improve patient assessments for alcohol use while providing a safe and supportive approach to care. We explore alcohol use disorder as a chronic brain condition and emphasize the essential need for comprehensive support for those affected. Additionally, we examine the interaction between alcohol use and common mental health conditions like anxiety and depression. Whether you dabble in an occasional cocktail or perhaps have found yourself drinking more than you like, we provide tangible (and tasty) strategies for reducing alcohol intake and promoting healthier habits. Discover how simple changes such as opting for a fun mocktail and drinking less can enhance sleep, relationships, and overall well-being. Join us as we advocate for making informed choices towards a healthier, happier you. References: Alcohol's Impact on the Gut and Liver Alcohol, the gut microbiome and liver disease Check your alcohol intake with CDC's Quiz Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Did you know that a balanced gut microbiome can improve nutrient absorption, reduce inflammation, and support mood regulation? Incorporating simple habits into your daily routine—such as eating fiber-rich foods, staying hydrated, restful sleep and managing stress—can make a significant difference in how your digestive system works and gut microbiota function. Join Kate Scarlata and Dr. Megan Riehl on this must-listen episode of The Gut Health Podcast as they break down their top 10 tips for gut health and offer actionable strategies for overall wellness! You will learn the key elements that link stress to our digestive health, exploring everything from the impact on gut motility to the downstream effects on our resident gut microbiota. Learn the science behind cognitive behavioral therapy (CBT), meditation, and the connection to digestion. Explore the power of nutrition to supercharge your gut microbiota but also the fascinating impact of diet on mood. With guidance on incorporating fiber-rich and fermented foods into your diet, Kate and Dr. Riehl emphasize gentle introductions for sensitive tummies and the many benefits of regular exercise for both the body and the mind. Tune in for engaging tips and personal stories that empower your journey to a balanced and happy life for you (and your gut!). Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Discover the intricate world of celiac disease with insights from two esteemed GI dietitian experts, Nick Trott of the Royal Hallamshire Hospital in Sheffield, England and Lori Welstead, from the University of Chicago Medicine. Within minutes of this episode beginning, you learn that a celiac diagnosis can happen in the absence of noticeable GI symptoms and that it is possible to find great delicious gluten-free meals outside your home with some tips and tricks! Kate, Dr. Riehl and their guests highlight the challenges and triumphs of living gluten-free head-on, unraveling common misconceptions surrounding gluten-related symptoms and the necessity of gluten-free diets. We shed light on personal stories of dietary transitions (and the often undiscussed topic of food shaming), the grief of losing gluten, and the resilience needed to embrace a new lifestyle. While there can be emotional and nutritional challenges that accompany this diagnosis, you will feel validated and hopeful throughout this episode as you hear the latest research advancements and the evolving landscape of celiac disease management. You are in for a gluten-free treat with Episode 10 as it is packed with practical guidance, hot off the press science and expert insights for anyone touched by or interested in celiac disease. Helpful information and resources Information on the drug development pipeline: https://www.beyondceliac.org/research/drugdevelopment/drug-development-pipeline/ Learn about the clinical trial process: https://www.beyondceliac.org/wp-content/uploads/2020/10/Clinical-Trial-Process-Infographic-from-Beyond-Celiac.pdf The Dating and Celiac Disease Study Lebovits J, Lee AR, Ciaccio EJ, Wolf RL, Davies RH, Cerino C, Lebwohl B, Green PHR. Impact of Celiac Disease on Dating. Dig Dis Sci. 2022 Nov;67(11):5158-5167. https://pubmed.ncbi.nlm.nih.gov/35635630/ Restaurant finding app: Find Me Gluten Free America's Test Kitchen book: How Can it Be Gluten-Free Podcast and documentary: The Celiac Project Third party testing: Gluten Free Watchdog Thank you to Zego Foods for the sponsorship of this episode. Learn more about Kate and Dr. Riehl: Website: www.katescarlata.com and www.drriehl.com Instagram: @katescarlata @drriehl and @theguthealthpodcast Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS. The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.