• Brian Dooreck, MD

Your Microbiome and You | Part 2 of 2

Updated: Oct 4, 2020

Blog based on Time's "What is Gut Health? Here's Everything You Need to Know About Gut Health" | Time.com

What are the symptoms of an altered microbiome?

When the delicate balance of your microbiome is thrown off, here is how you can tell clinically.

  • Gas

  • Bloating

  • Diarrhea

  • Cramps

  • Abdominal pain

  • Nausea

What to do for an imbalanced microbiome?

Usually, testing is not needed or warranted. Time is usually all that is needed to re-balance your gut. It usually does not take a long time. However, if the symptoms are more chronic in nature, then a Gastroenterologist may need a test for specific conditions, such as bacterial overgrowth. Small intestinal bacterial overgrowth (SIBO) is another topic in itself, and one I will write on soon.

Are the symptoms of an altered microbiome immediate?

Immediate symptoms are not typical for the changes or irregularity in the microbiome, or gut bacteria. You may not have the gas, bloating, or diarrhea due to changes in motility.

What about testing my microbiome?

There are commercial kits available, but they are not covered by insurance and are not specific enough at this time to associate certain bacteria to diseases. Thus, they are not typically necessary nor recommended. It can show certain bacteria that may be considered inflammatory, but that again does not correlate at this time with specific diseases. Bottom line; not worth the expense.

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How to maintain a healthy microbiome?

It is pretty basic. Follow a balanced diet, minimally processed foods, stay well hydrated with water, sleep, and practice an overall healthy lifestyle.

Processed foods are convenient, but may have large amounts of hidden sodium, fats, and sugar. Not all processed foods are bad for you, such as pre-chopped vegetables or fruits canned in their own juice.

Avoid the things you know to avoid. Excessive alcohol and smoking clearly will affect your microbiome negatively. Moderate amounts of red wine may be beneficial. Review your medications with your doctor and take antibiotics only when truly necessary.

Common sense in lifestyle, eating, exercise, and choices will help you maintain a "healthy gut."

Follow a balanced diet, minimal processed foods, stay well hydrated with water, sleep and practice an overall healthy lifestyle.

What about my diet and my microbiome?

As mentioned above, diet plays a role in bacterial health in your intestine. Focus on the following.

  • Limit dairy

  • Limit red meat

  • Limit processed meat

  • Limit sugars

  • Eat fiber (20 to 40 grams per day typically is recommended by eating fruits, vegetables, whole grains, nuts, and seeds; but introduce more fiber slowly to avoid bloating, and drink plenty of water)

Any foods that are proven to benefit the microbiome?

There have been some studies on certain foods, but, try what works for you. The bottom line is to choose foods that are high in nutrients and fiber, and those low in saturated fats and refined ingredients. Refined foods include oil, sugar, white flour, and products made of these ingredients.

  • Mangoes

  • Cherries

  • Cranberries

  • Broccoli

  • Walnuts

  • Leafy greens

Not all foods that benefit your gut healthy will react well with your body. A diet diary is a great way to track what works for you, and what may cause symptoms. There is no one right diet for everyone.

What is the best approach for a healthy gut and microbiome?

Eating diversely with a focus on fiber-rich foods, vegetables, whole grains, and avoid processed foods. As the food you consume is digested, the nutrients and proteins are in your cells, so what is left is there for the bacteria to consume. So the better quality fiber and foods, there is a higher chance of having a healthy selection of diverse gut bacteria.

Eating diversely with a focus on fiber-rich foods, vegetables, whole grains, and avoid processed foods.

Are there dietary supplements I can buy for a healthy microbiome?

The issue is the regulation of the probiotics and industry. Although live bacterial cultures should be in the probiotic pills or capsules, they are not always present in what you buy or take. So, there is no guarantee that what is being advertised as a "boost" to your gut's health or what will be "introduced" as good bacteria, actually does what it says it does.

What about probiotics?

The medical literature is not overwhelming conclusive that probiotics work for everyone to improve the microbiome. However, that does not mean not to try them.

There is a clear role for people with certain medical conditions such an Inflammatory bowel disease (IBD) or antibiotic-associated diarrhea. The issue is that the bacteria introduced as a probiotic may not colonize your gut, thus not have any real impact. The best advice is focusing on a balanced and healthy diet with lifestyle choices, not pills, supplements, or fad diets.

Focus on a balanced and healthy diet with lifestyle choices, not pills, supplement, or fad diets.

What about natural foods as probiotics?

There are many foods that will introduce beneficial bacteria to your gut. Try some of the following fermented foods.

  • Yogurt

  • Kefir

  • Sauerkraut

  • Kimchi

What about fecal transplants to improve the microbiome?

Fecal transplantation (or bacteriotherapy) is the transfer of stool from a healthy donor into the gastrointestinal tract for the purpose of treating recurrent C. difficile colitis. There is a growing role too for treating Inflammatory Bowel Disease (IBD).

Recently there has been in the news increasing regulation on fecal transplants due to unfortunate events, and even death, from drug-resistant bacteria.

To get off-topic. IBD and IBS. What is the difference?

Inflammatory Bowel Disease (IBD) is a broad term used to describe disorders that involve chronic inflammation of your digestive tract such as Crohn's disease or Ulcerative colitis (UC).

Inflammatory Bowel Disease (IBD) is not the same as Irritable bowel syndrome (IBS). IBS is a common disorder that affects the large intestine with cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is also a chronic condition that requires symptoms management, dietary changes, and sometimes medications.

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine with cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.

What about my microbiome and what to do now?

Much remains unknown. So, for now, stick to common sense and the basics. Follow a healthy diet, lifestyle, exercise, drink plenty of water, know your body, and see a doctor if something does not "feel right."

The takeaway is; what is good for you and your "overall health" is also good for your microbiome and "gut health."


I eat a high fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.

"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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Connect with Dr. Dooreck on LinkedIn where he focuses his sharing on Health, Diet, Nutrition, Exercise, Lifestyle, and Balance.

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