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    Doctor Answers Gut Questions From Twitter

    Gastroenterologist Dr. Ugo Iroku answers the internet's burning questions about digestion and bowel movements. If your poop is black, are you dying? My does coffee make you poop? Is everyone lactose intolerant? Dr. Iroku answers all these questions and much more!

    Released on 05/12/2022

    Transcript

    I'm Dr. Ugo Iroku, a board certified gastroenterologist

    and digestive disease specialist.

    Today, I'll be answering your questions from Twitter.

    This is Gut Support.

    Queerrepublican, how long is a small

    and large intestine

    'cause that's how many feet per second food moves

    through my body?

    So the small intestine is about 18 feet long.

    The large intestine is about six feet long.

    Oftentimes people will eat food

    and feel like it's running straight through their body,

    but it turns out

    that there is a process called the gastrocolic reflex.

    That's probably accounting

    for that immediate bowel movement you have, what is that?

    It's when your stomach senses that there's food coming in

    and wants to create space in the body.

    So it tells the colon, move things along

    through the process of peristalsis.

    It relaxes the muscles at the bottom of your anus

    and you are able to poop.

    And so the poop you're pooping out

    is not the food you just ate.

    It typically takes about two to three days

    for you to eat a food and actually have it leave your body.

    You should know that.

    @kingofkgn, aren't we all a little lactose intolerant?

    The answer king is no, just you, but just kidding.

    A lot of us become lactose intolerant over a time.

    The whole concept is that we are all born typically

    with enzymes called lactase

    that help us digest breast milk.

    And so as we get older,

    oftentimes many people in the population lose their ability

    to break down that dairy.

    It happens more commonly in African American communities,

    American Indian communities,

    Asian communities, Latino communities

    and that makes us more intolerant to dairy.

    Daleicious98, my poop is dark green

    like the color of spinach, am I dying?

    The color of poop starts off as being green for everybody.

    And that's just the color of the pigment, bile.

    As bile makes its way through your digestive tract

    it's oxidized, it's digested.

    By the time it comes out

    it's the poop that you normally come to no one love

    of a brown color.

    The green color in poop is not a sign of anything dangerous

    but that green it's all coming from you.

    You're probably just having a faster motility movement

    of the poop through your body

    that's letting you still be able to see that green color

    that you normally wouldn't see.

    2BoopsAndAToot, this person needs

    a gastroenterologist badly.

    If you hold all your farts in,

    do you start floating away like a balloon?

    Obviously the answer is no.

    If you were to hold all your farts in

    you would be a very uncomfortable person.

    There would be a high likelihood of gas incontinence.

    So likelihood that you would indeed let one rip

    at some point with some movement.

    But after a while,

    gas being gas just finds a way to dissipate

    from one area and go to another area.

    If it finds it's not able to go out through the anus

    like it usually can, it'll dissipate into your body

    and find its way excreted out your body,

    perhaps through your respiratory system

    or through another method.

    So to make the distinction

    between the anus and the sphincter,

    I can show you on our little diagram here.

    The anus pretty much refers to this entire area

    that includes a number of supportive tissue and muscles.

    It's the thing right at the end of your digestive system.

    Now, as part of your anus,

    you have sphincters external internal

    that help to tighten the bottom of your anus

    to make sure that nothing escapes.

    So pretty much the sphincter are those muscles that exist

    within the anus to help prevent incontinence

    of gas, liquids, or solids.

    And what is incontinence doctor?

    Incontinence just means that you're letting things rip

    without intending to.

    Sometimes people have gas incontinence,

    they're passing gas without meaning to,

    or they could actually have poop incontinent

    where actually having bowel movements at moments

    you just didn't plan on having those, not fun.

    TwinCitiesChick, how long does it take

    for you to get food poisoning

    after having eaten something suspect?

    Asking for a friend, okay, no, that's bull.

    I'm asking for myself, concerned emoji face.

    And so it turns out that

    when you eat something that makes you sick,

    we call that food poisoning.

    It can happen pretty quickly.

    Within an hour you can have toxins that have been formed

    by the bacteria affecting your gut.

    Bacteria like Bacillus found in items like fried foods

    or Clostridium found in dented cans that can have toxins

    that are infiltrated in the food,

    can make you sick again within an hour or two.

    There's some that take a couple of days to develop

    but you might be running for the toilet bowl

    even before you're done with your plate.

    SimplyThinkingg, what is a gastroenterologist

    and why do commercials talk about them

    like we should all have one?

    So a gastroenterologist is a physician

    who spent six years after med school training

    on digestive disease health.

    Oftentimes you need to see us for many reasons.

    20 million Americans have chronic gastrointestinal diseases

    like IBS or IBD.

    One of the most common procedures that we do

    as gastroenterologists is the colonoscope.

    And this is where we look with the camera

    into your colon and look for any signs of any disease

    or polyps that need to be removed.

    And just in case, you're feeling comfortable,

    I'm gonna show you exactly what we do

    during your colonoscope.

    So what I have here is one of our inter scopes

    and particularly this is designed to look

    into your upper abdomen

    but a similar process we use for colonoscope.

    So it has a couple of dials that allows me to drive

    the scope as it makes its way through your intestines.

    It has a light source that lets me have a good look

    and look to look for polyps or any sign of disease.

    It has a few channels through the scope

    that allows me to take samples with the biopsy forceps.

    And it also has clips that let me stop bleeding

    or cauterized and burn any bleeding sites if necessary.

    Next up, Mucosal Immunology,

    are there really 10 times more bacteria

    than cells in our body.

    Mucosal, if I can call you that, the answer is probably not.

    The 10 times number comes

    from earlier on in our examination of the microbiome.

    So the collection of bacteria, viruses,

    and fungi that exist in our gut

    and the estimation at the time was that

    there was 10 times more microbiota

    than there were actually human cells.

    That number has been revised recently

    especially when you're just looking at bacteria.

    It's thought to be more that for every one human cell

    you have about 1.3 bacterial cells, but still

    if your body were democracy,

    you might be voted out of power.

    Rafael Tiriel, okay, who needs a fecal transplant?

    Rafael, we just met.

    First of all, what we call it

    is a fecal microbiota transplant.

    And what that means is yes, we are taking fecal content

    from person A and putting it in person B,

    but this is not something most of you need

    which is a good thing for you to hear.

    It's typically used for people who have a very

    severely damaged environment in their colon.

    One situation is people who have C difficile colitis

    where their gut has pretty much been overrun

    by this bacteria called C difficile.

    And so in those cases

    we have to transport a whole new population

    of healthy bacteria from a healthy person into their gut.

    There are many ways we put it in through a colonoscope

    or sometimes through a nasal gastric tube

    but one way or the other, we get that healthy poop

    into the colon to help it feeling better.

    Just to let you know, again

    there's this whole thing called the gut microbiome.

    And so we're not just transferring poop for poop sake.

    We're transferring a healthy community of healthy bacteria

    from one person to the other.

    We have this entire amazing universe

    that exists inside of us that can keep us healthy,

    and some people need a little help from their friends

    to get through some situations.

    Fran Drescher, could there be a connection

    between your gut microbiome and Alzheimer's?

    That's a great question, Fran.

    It's one that we're closely looking into.

    What we do know is that a healthy gut microbiome

    produces nutrients that are important for a healthy brain.

    Omega threes, polyphenols are all very important

    for proper neuron formation and function in your brain.

    And so it's very possible that having

    a very healthy gut leads to a very healthy thought process.

    In terms of how to actually make that work,

    what to do about that information,

    that we're still working on the answer to.

    KemiAde, the worsting about being a woman, bloating.

    Why must the air in my stomach feel like 10,000 knives?

    Women frequently can have hormonal effects

    that come from the uterus,

    come from the ovary and affect the gut dynamics.

    And so sometimes you have aspects of the gut

    that are not relaxing the way they should

    or that are not moving your bowels

    along the way they should.

    There are many medical definitions of the word bloating

    but typically to be honest, we do tend to use that

    as a description of the symptom.

    When it comes to what the underlying problem is,

    it could be constipation,

    it could be diarrhea, it could be gastritis.

    What can you do about it?

    Modify your diet so that you can tolerate those times

    of the month a little better.

    There are many conditions that can have the symptom

    of bloating and cause people to feel

    like they're having a thousand knives shooting

    through their guts.

    All right, Angry Angry Alice asks, what is constipation

    if not clogged farteries?

    All right, Alice,

    you're creating a whole new terminology here.

    Constipation is essentially when your bowels

    are not empty out as routinely as they should

    in a way that they should.

    And so there's this component of frequency

    and then there's this component of a subjective description

    of how your bowel widths are and how you feel with it.

    So you should be moving your bowels

    at least three times a week.

    Anything less than that is formally constipation.

    If you started off, however, is moving your bowels daily

    and then you drop down to four times a week,

    that might be constipation for you,

    that change in bowel movements.

    RSB90, I know bananas are a good prebiotic,

    but what else is?

    I've started on probiotic tablets for gut health.

    So probiotics are bacteria that exist

    that we intentionally sometimes consume.

    They come in pill form with a concept

    of trying to put healthy bacteria into our body.

    I will say that not everyone needs to take probiotics.

    If you have a healthy diverse diet

    that could actually give you the probiotics you need

    just from your consumption alone.

    So if you're having your kimchi and kombucha and yogurts

    that may be all you need.

    Probiotics essentially eat prebiotics,

    and what are prebiotics.

    In short hand, those are essentially fibers.

    They're things that probiotics like to eat

    so that they can increase in number.

    A healthy diverse diet will contain all the pre

    and probiotics you need to be healthy yourself.

    Cookie4youandme, that's nice.

    My poop is black, am I dying?

    Cookie, I hope not,

    and odds are you're not dying,

    but yes black stool can be very important.

    What Cookie's referring to is the fact

    that black stool often refers to blood in the stool.

    Blood of course starts off as being red.

    By the time it goes to the digestive process

    and gets all the way down to the toilet bowl.

    It's often seen as being black and tarry.

    And so if you notice that change in your bowel movements,

    that might mean that you have

    an important gastrointestinal bleed going on.

    Other reason for having black poop,

    it might be food coloring.

    It might be licorice.

    It might be Pepto Bismol

    but typically it's not something you wanna see.

    And if you have that very important

    to talk to your doctor about.

    Ean Hammond ask, why does coffee make me poop?

    All right, we know not to hang around you

    right after your cup Java.

    There are many reasons why coffee might be making you poop.

    One of them is that coffee in general

    can cause peristalsis in the colon.

    So that's that P word again.

    It just means it makes your colon moves a poop.

    Another thing that coffee can sometimes do

    through caffeine is relax the anal sphincter

    making poop more ready to come out of your body.

    And sometimes it's just having a warm liquid

    and the routine of it all, something entering your stomach

    that really more than anything else

    is just a trigger of that gastrocolic reflux

    for things to start moving along.

    Connorleary64, does my IBS cause my anxiety

    or does my anxiety cause my IBS?

    Question asked for billions of years.

    And the answer is yes.

    So for the uninitiated, the lucky ones

    of those of you who are

    IBS stands for irritable bowel syndrome.

    It really just means that your gut is irritated

    and hyperactive and very sensitive to any amount

    of distension in your gut causing a lot of pain,

    a lot of gassiness and either a lot of pooping

    or a decreased amount of bowel movements.

    Your IBS does cause your anxiety

    often in the form of a person having severe symptoms

    and not having a clear answer

    as to why they're having symptoms.

    Additionally, we do find that people who have anxiety

    or depression have a higher likelihood

    of having irritable bowel syndrome.

    Workoutfrolic, how does gut health impact

    your immune system?

    So it turns out that in your gut, again

    we have this microbiome

    and that's the word that just keeps coming up

    that's intimately involved

    in the function of our immune system.

    It's important to note that your immune system

    70% of it exists within your digestive health tract.

    Having a healthy diet for your microbiome

    keeps your immune system healthy as well.

    It's able to produce short chain fatty acids

    that keep your colon cells very healthy and robust

    and all of this leads towards a healthy immune system

    and a healthy you.

    That's it.

    That's all our questions from today.

    Hopefully you learn something.

    I know I did.

    I learned about farteries and I will see you next time.

    Bye.

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