Month: January 2017

Seeking a ‘Happy Gut’ for Better Health

By ANAHAD O’CONNOR  Well.Blogs.nytimes

For much of his life e, Dr. Vincent Pedre, an internist iwoman-254133_960_720n New York City, suffered from digestive problems that left him feeling weak and sick to his stomach. As an adult he learned he had irritable bowel syndrome, or I.B.S., a chronic gut disorder that affects up to 10 percent of Americans.

Through the process of elimination, Dr. Pedre discovered that his diet was the source of many of his problems. Cutting out dairy and gluten reversed many of his symptoms. Replacing processed foods with organic meats, fresh vegetables and fermented foods gave him more energy and settled his sensitive stomach.

Dr. Pedre, a clinical instructor in medicine at the Mount Sinai School of Medicine, began to encourage many of his patients who were struggling with digestive disorders to do the same, helping them to identify food allergens and food sensitivities that could act as triggers. He also urged his patients to try yoga and meditation to alleviate chronic stress, which can worsen digestive problems.

Dr. Pedre now has a medical practice specializing in gastrointestinal disorders and is the author of a new book called “Happy Gut.” In the book, Dr. Pedre argues that chronic health problems can in some cases be traced to a dysfunctional digestive system, which can be quelled through a variety of lifestyle behaviors that nurture the microbiota, the internal garden of microbes that resides in the gut.

Recently, we caught up with Dr. Pedre to talk about what makes a “happy gut,” how you can avoid some common triggers of digestive problems, and why fermented foods like kombucha and kimchi should be part of your diet. Here are edited excerpts from our conversation.


How did you end up focusing on the treatment of digestive disorders?


It starts from having grown up with a sensitive digestive system, which was very challenging my entire life. But it wasn’t until I went to medical school and then ultimately learned functional medicine that I really understood what was going on inside the gut. I experimented and changed my diet and tried probiotics and started to resolve my issues. At first I was just doing this because the gut was one of those places where you could make a big difference for patients. I was seeing rapid results. My patients started referring their friends and before I knew it that part of my practice had grown tremendously.


You say that functional medicine informed your ideas about gut health. What is functional medicine?


Functional medicine is a branch of medicine that looks at the body as a system. It is patient-centered rather than disease-focused. We spend more time with our patients listening to their histories to look for interactions between genetic, environmental, mental and other lifestyle factors that can influence the course of their diseases. I think it’s best equipped to deal with the ever-increasing complexity of conditions that patients are going to their doctors for.


What is a “happy gut”?


A happy gut is a gut that is able to do all of the work of digestion. It has a healthy microbiome, it’s able to extract all the nutrients you need from your food without causing any pain, discomfort, bloating or distress, and it creates a bowel movement at least once a day.


Why did you write this book?


I wanted to be able to help more people than I could possibly reach through my practice. And as I was working with people on gut issues, I also came to realize what an essential role the gut plays in so many other aspects of health.


How common are digestive issues in America?


The estimate is that around 70 million Americans suffer from some sort of gut issue, including I.B.S. And I think if you broaden that out to people who suffer intermittently from some sort of gut distress, the number is much larger. There are also many people who maybe don’t realize they have a gut issue but are experiencing other related health issues.


What are the most common gut issues you see?


The biggest one would be irritable bowel syndrome. Behind that there could be something called dysbiosis. That’s basically an imbalance between the good and the bad bugs in the gut. That includes bacteria, yeast and parasites.


What are some of the more common causes of the gut problems you see?


The majority of it comes down to two main factors: diet and environment. And within that, environment can be defined broadly. The overprescribing of antibiotics is a big problem. There was a study recently that showed that just one course of antibiotics will alter the gut flora for up to 12 months. The study looked at a very common antibiotic, Cipro, which we commonly use to treat urinary infections, traveler’s diarrhea and food poisoning.


Can you elaborate on the diet aspect? What are some of the more common offenders?


It’s a variety of things. A lot of people are sensitive to wheat, gluten, soy and dairy products. It could be individual dairy proteins like casein or whey. Humans lack a certain enzyme that breaks down the casein protein. Some people are more susceptible than others. And that can lead to food sensitivities. For some people it could be food additives, or things like preservatives, artificial sweeteners and food colorings. For some people it can be enzyme deficiencies.


What’s the diet you advocate in general?


I think that it should be individualized for every person. But in general I tell my patients to basically eat mostly plants. My approach is a combination of Paleo and vegan. I advocate eating a lot of vegetables, complemented by meat. You should try to choose meat that’s organic, hormone-free and grass-fed. I also believe in incorporating a healthy amount of fats like omega-3’s from avocados, cold-water fatty fish, nuts and seeds.


You also advocate cultured foods, correct?


Yes. Cultured foods have a long tradition. If you go back in history, culturing was a way to extend the life of food and preserve it. But cultured foods also help nurture the good flora in our guts. Whether it’s through a yogurt or kefir or fermented vegetables like kimchi, or a fermented probiotic drink like kombucha, fermented foods are going to help promote a healthy, balanced gut flora. We know that the gut flora can shift very quickly depending on your diet. And I think it needs this continued support from cultured foods.


What is your diet like?


My diet is very similar to the “Happy Gut” diet that I write about in the book. I try to make the majority of my diet salads, greens and steamed vegetables. I bring in healthy fats through nuts and seeds, ideally sprouted. And I love kombucha, so that’s a regular part of my diet. I stay away from dairy and gluten, and during the season when the farmers’ market is near my home, I like to buy my produce there so I can support the local farmers. I also try to minimize my exposure to pesticides.


What do you expect people will take away from this book?


I hope people who are suffering from gut issues and other conditions that may be related to gut health – like fatigue, migraines, allergies and asthma – will see that there is a way to achieve wellness by changing the way you eat and the way you approach your lifestyle. I hope people will learn that it’s more than just a diet. It’s a 360-degree approach to your lifestyle, and the way you balance your stress is just as important as the way that you’re eating.

Food Allergy or Digestive Problem?

foodallergiesNeither one is fun, but there are some key differences between food allergies and digestive problems. One example: With a food allergy, you might get hives but you probably won’t with a digestive condition. Find out how to determine which is behind your symptoms.

When Loring Gotschall of Marblehead, Mass., eats avocados, bananas, raw chestnuts, or kiwi, she has an unusual reaction — severe abdominal pain for a couple of hours.

“I used to eat a banana every day for breakfast, and over time they started affecting me,” she says. At first, she thought a digestive problem was causing the cramps, but she soon discovered that it might be a food allergy related to her known allergy to latex, found in some medical gloves and bandages. Certain foods, including avocado, banana, chestnut, kiwi, and pineapple, contain some of the same proteins as latex, which is made from natural rubber.

Is It a Food Allergy or a Digestive Problem?

It turns out that Gotschall probably has a food allergy, but determining whether a reaction is a food allergy or digestive issue can be difficult. Food allergies and digestive problems, known as food intolerances, can have similar symptoms. With both conditions, eating certain foods can result in abdominal symptoms, including diarrhea, abdominal pain, and gas.

But with most food allergies, certain symptoms can help distinguish them from a non-allergic digestive problem. “Food allergies, in most cases, are going to be associated with an acute onset of hives and/or lip or tongue swelling that is going to happen within 10 to 15 minutes of digesting the food, if not immediately,” says Julie McNairn, MD, an allergist and immunologist in Cincinnati. This is not an uncommon problem: More than 3 percent of adults have one or more food allergies, according to a study in the Journal of Allergy and Clinical Immunology.

If you often feel sick after consuming certain foods, it is possible that you could have a food allergy. Common symptoms include:

  • Hives (itchy, raised, areas of redness on the skin)
  • Eczema (red, sometimes scaly patches that may itch)
  • Asthma
  • Vomiting
  • Diarrhea
  • Abdominal cramping and/or pain
  • Skin rash around the mouth
  • Itching of the mouth and throat
  • Swelling of the mouth or throat, or difficulty swallowing
  • Gas
  • But if you experience mainly abdominal symptoms after eating a certain food, such as milk, you may simply have a food intolerance, which means that your body cannot properly digest that particular food. That means your body cannot properly digest that food.

    “If you eat a food and it just causes your stomach to be upset, that is probably just an intolerance,” says Dr. McNairn. dinner parties with friends. The sooner you know what the problem is, you can begin correcting it, and get both your diet and your social life back into gear.

    Diagnosing a Food Allergy

    If you notice a reaction when you eat certain types of foods, talk to your primary care physician. If he suspects a food allergy, you may be referred to an allergist who can determine whether you are allergic to certain food allergens or if you have an intolerance. Either way, your doctors can help come up with a plan to avoid the food and manage the symptoms when and if a reaction occurs.

    You should do this sooner than later. Fear of having a reaction to foods can keep you from enjoying dinners out in restaurants or





Appendicitis occurs when your appendix, a worm-shaped pouch attached to the large intestine, becomes inflamed.

It can be life threatening if the appendix bursts, but doctors usually remove it surgically before this happens.

Belly-button pain
Appendicitis pain often occurs in the lower-right side of the abdomen. The first sign, however, is typically discomfort near the belly button, which then moves to the lower abdomen.

Some people, including children and pregnant women, may experience pain in different areas of their abdomen or on their side.

The pain also will get worse if you move your legs or abdomen; cough or sneeze; or are jarred—during a bumpy car ride, for instance.

Rapidly worsening pain
Once the pain is in the lower part of the abdomen, it can be very intense.

ow-grade fever and chills
Appendicitis symptoms may mimic those of a stomach bug, including a low-grade fever, chills, and shaking.

Vomiting, nausea, or loss of appetite

Constipation or diarrhea
Like many of the other symptoms, these may not be severe and probably will come on after you’ve already experienced abdominal pain.

But if you have mild diarrhea—especially if there is a lot of mucus in it—in addition to lower-right abdominal pain, see your doctor.

Rebound tenderness
Rebound tenderness occurs when you push on the lower-right part of your abdomen and then experience pain when releasing the pressure.

Surgeons Stay Focused for Hours


“. . . concentrating for hours straight, is something we can aspire to.”

Trauma surgeons . . . on their feet the whole time, hunched over the operating table. They minimize breaks for the bathroom or refreshments. And they need to be on call, ready to perform an operation whenever the call comes.

Desert  Surgical Associates, Matt Johnson, MD, a member of the Sunrise trauma team,  and other member of the DSA team, are ready for the trauma call 24/7/365.