A Gastroenterologists 10 Step Guide to Great Gut Health

10 years of experience in a 10-minute read…

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Below is your one-stop shop guide filled with actionable and (relatively) simple steps to improve your gut health. For deeper dives check the references at the end. As an experienced Gastroenterologist Buckinghamshire patients visit regularly, I’m here to provide as much guidance as I can.

Ok here goes…

1. Hold on….I think I have good gut health

Fantastic!

If you have no symptoms, you should know your height, weight and body mass index (BMI).

https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-adults

BMI is a great start, however, if you want to take it to the next level, calculate your waist circumference and body fat percentage. Most gyms have a scale which can measure this.

An increased waist circumference increases the risk of type two diabetes mellitus

Relative risk of type 2 diabetes in men and women in dependence on BMI and waist circumference

An ideal body fat percentage is 12-20% in men and 20-30% in women. Aim for the lower end.

For the advanced people out there, you should audit and improve some basic health measures including:

• Time taken to run 1 mile
• Ease of body weighted exercises such as press ups, pulls ups, squats and burpees
• Balance and flexibility measures – sit to stand test, sit and reach test, one leg stand (eyes closed)

2. Get the basics right

If so, you may be eligible for surveillance to potentially pick up and treat the cancer early.

If you are experiencing gastrointestinal (GI) symptoms, best to speak to your doctor to get some blood tests.

Specifically, I recommend liver function tests, C-reactive protein (if raised this is a marker of non-specific inflammation), full blood count, bone profile, kidney function, coeliac screen and thyroid function.

Magnesium, vitamin D levels, iron profile, b12 and folate may also be required depending on your symptoms.

Your doctor may also recommend a faecal calprotectin.

This is a is a protein released by white blood cells in your digestive tract that can be measured in stool samples to detect inflammation in your bowel.

Indeed, It is a valuable screening tool to help distinguish between inflammatory bowel diseases (like Crohn’s disease or ulcerative colitis) and less serious conditions without requiring invasive procedures. As a gastreoenterololgist Buckinghamshire patients from all walks of life visit, I have worked with patients with every kind of condition and can help support you in managing your condition.

3. Recognise the red flag signs

A gastric ulcer found on gastroscopy. The severe and persistent abdominal pain and reflux you’re experiencing may be caused by this

If you get any of the symptoms described below, don’t dilly dally! Speak to a qualified healthcare professional…you likely require further investigations:

• Blood in stool (especially if dark/black or mixed with mucus)
• Persistent vomiting, particularly with blood or “coffee ground” appearance
• Sudden, or worsening abdominal pain
• Unintentional weight loss (especially rapid)
• Progressive difficulty swallowing or painful swallowing
• Changes in bowel habits lasting more than 2-3 weeks
• Jaundice (yellowing of skin/eyes)
• Severe, persistent diarrhoea
• Abdominal distention or swelling
• New onset of gastrointestinal symptoms in people over 50 years old
• Family history of colorectal cancer with new digestive symptoms
• Regular heartburn unresponsive to medication
• Unexplained anaemia (especially iron deficient anaemia)
• Palpable abdominal mass

If you have any of the above symptoms seek medical attention promptly as this may be associated with a serious condition which requires urgent treatment

4. Take part in Bowel Cancer Screening

That’s a small polyp in the colon (large bowel). A gastroenterologist can remove most of these endoscopically and reduce the risk of you developing bowel cancer

Even if you have no bowel symptoms this is an absolute no brainer.

Colon and rectal cancer is the third most common cancer diagnosed in both men and women in the United States, with about 154,000 new cases and over 52,000 deaths expected in 2025.

The lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 26 for women.

Bowel cancer screening involves a test you can do in the comfort of your home to exclude bowel cancer.

A quantitative Faecal Immunochemical Test (qFIT) is a simple stool test that detects tiny amounts of blood in your poo, which could indicate bowel cancer or other digestive conditions.

Screening in the UK is offered to everyone from 54 to 74 years old. For more information, please see the link below:

For more information please visit the link:

https://www.nhs.uk/conditions/bowel-cancer-screening/

5. Prioritise fibre and protein

Priortise protein

Weight Loss and Body Composition

• High-protein diets are effective for weight loss, as they help reduce body weight, body fat, and waist circumference, even when total calorie intake is controlled
• Protein increases satiety by boosting levels of appetite-reducing hormones (leptin) and reducing hunger hormones (ghrelin), leading to reduced calorie intake
• Higher protein intake preserves lean muscle mass during weight loss, helping to maintain resting energy expenditure (REE) and prevent the loss of metabolically active tissue

Prevention of Weight Regain

• After initial weight loss, high-protein diets help prevent weight regain. Studies show that individuals consuming more protein after losing weight regain less fat and more lean mass compared to those on lower-protein diets

Muscle Mass and Strength

• Protein is essential for muscle growth and repair. High-protein diets support muscle gain, especially when combined with resistance training, and help maintain muscle mass during calorie restriction.

Metabolic and Cardiovascular Health

• High-protein diets can modestly lower blood pressure and triglyceride levels, and may improve HDL cholesterol
• They increase the thermic effect of food (TEF), meaning more calories are burned during digestion compared to fats and carbohydrates, which can aid in weight management

Bone Health

• Contrary to old concerns, recent evidence suggests that high-protein diets, especially when combined with adequate calcium, may support bone health and reduce the risk of osteoporosis

Stick with eggs, beans, tofu, fish, chicken and red meat. Protein powder (whey, soy or casein) is a great supplement.

Priortise Fibre

Reduced Risk of Mortality

• Multiple large systematic reviews and meta-analyses of prospective cohort studies show that higher dietary fibre intake is strongly associated with a reduced risk of all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality. For example, one meta-analysis of over 3.5 million participants found that higher fibre intake reduced the risk of all-cause mortality by 23%, CVD mortality by 26%, and cancer mortality by 22%.

Cardiovascular Health

• Increased dietary fibre intake is convincingly linked to a lower risk of CVD, coronary artery disease, and CVD-related death. These associations are supported by high-quality evidence from prospective studies and umbrella reviews of systematic reviews

Cancer Prevention

• Higher fibre consumption is associated with a reduced risk of several cancers, including pancreatic and gastric cancer. Some studies report convincing or highly suggestive evidence for reduced risk of specific cancers with increased fibre intake

Dose-Response Relationship

• The protective effect of dietary fibre is most pronounced with daily intakes between 25 and 29 grams, with additional benefits observed at intakes above 30 grams per day

  

6. The gut brain axis – protect it with regular exercise and sleep

However, it’s more accurate to say that they work together and are in constant communication with each other.

Imagine if you are about to speak to a large audience?

You might feel nauseous; you might even get a loose bowel motion just before.

That is your brain talking to your gut.

Recent research reveals the crucial interplay between your gut microbiome and brain health.

This “gut-brain axis” influences everything from mood to immune function through neural, hormonal, and immune pathways.

Exercise Benefits

When you exercise regularly, you’re changing the makeup of bacteria in your gut for the better.

Physical activity boosts dopamine, which not only makes you feel good about moving but also helps your gut and brain communicate better in a natural, positive way.

The longer and harder you work out, the more you create an oxygen-rich environment where the good bacteria in your gut can thrive. As a result, regular exercise offers significant benefits to the gut-brain axis.

Sleep Advantages

There’s also a two-way relationship between sleep and gut health.

Sleep well, and your gut bacteria are happier.

Have a balanced gut, and you’ll likely sleep better.

When sleep gets disrupted, it throws off your gut bacteria, but interestingly, targeting specific changes in your microbiome might actually help improve how well you sleep.

Both regular exercise and consistent sleep patterns help keep your gut in balance, reducing inflammation and supporting the production of important brain chemicals like serotonin—which benefits both your digestion and your thinking.

7. Cut the toxins – drugs, alcohol, smoking and sugar

Liver cirrhosis secondary to alcohol excess….no thanks!

I won’t labour on this for too long.

Tobacco use is causally associated with oesophageal, stomach, pancreatic, biliary, liver, colorectal, and anal cancers.

Alcohol disrupts the gut microbiome, builds up oxidative stress and is associated with liver cirrhosis and liver cancer.

Therefore, just cut them both out.

Excessive processed sugar consumption significantly increases risks of obesity, type 2 diabetes, fatty liver, and heart disease.

It also promotes systemic inflammation and dental deterioration.

For optimal health outcomes, I strongly recommend limiting added sugars, particularly from sugar-sweetened beverages, which often contribute substantially to daily sugar intake.

8. Fermented food to nourish your gut microbiome

Fermented foods like kimchi, sauerkraut, kefir, and yogurt boost gut health by increasing microbiome diversity and reducing inflammation, particularly beneficial for irritable bowel syndrome (IBS).

Clinical trials show daily kimchi consumption (210g) improves IBS symptoms by modulating gut bacteria, while sauerkraut’s lactic acid bacteria may ease bloating and irregular bowel habits.

In essence, these foods introduce beneficial microbes and bioactive compounds that strengthen gut barrier function and combat dysbiosis linked to small intestinal bacterial overgrowth (SIBO).

Opt for unsweetened, traditionally fermented options (e.g., live-culture yogurt, unpasteurised sauerkraut) to maximise benefits.

9. Supplements – vitamin D and Omega-3

I plan to write a whole article on this topic.

There are a lot of questionable supplements out there. However, I do recommend there two…

Omega-3

Omega-3 fish oil supplements effectively lower triglycerides and reduce heart attack risk, particularly in high-risk individuals.

Moreover, these beneficial fats decrease inflammation and support cardiac health.

Natural sources include salmon, mackerel, sardines, anchovies, and plant options like flaxseeds, chia seeds, and walnuts.

Aim for two weekly servings of oily fish or consider supplements when dietary intake is insufficient.

Vitamin D: A Gut Health Ally

Vitamin D is made in the skin when ultraviolet B (UVB) sunlight converts 7-dehydrocholesterol into vitamin D3, which is then activated by the liver and kidneys into its biologically active form.

Sadly, in the UK, we don’t get much Sun! Consequently, if you live in a cloudy country, you likely need to supplement it!

Vitamin D does more than just support bone health in fact, it’s also a powerful ally for your gut. Indeed, it also helps with many other aspects of your health.

Research shows it enhances microbiome diversity, promoting beneficial bacteria like Akkermansia and Bifidobacterium while strengthening your intestinal barrier to reduce inflammation, which can help manage conditions like Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO).

Beyond gut support, vitamin D helps regulate your immune responses, potentially reducing risks of autoimmune conditions.

For optimal health, aim for blood levels between 30-50 ng/mL. If you’re deficient, supplementation with 2000 IU daily may help restore gut balance and protect against dysbiosis. Therefore make sure to consult with your healthcare provider before starting any supplement regimen. As an expeirenced gastroenterologist Buckinghamshire I can help ensure your levels are optimal for gut balance.

10. If struggling – seek professional help (don’t DIY)

While lifestyle modifications can significantly improve gut health, persistent or severe gastrointestinal symptoms warrant professional medical attention.

Self-diagnosis and treatment may delay proper care or mask underlying conditions that require specific interventions. Therefore visiting an experienced gastroenterologist is always recommended.

Gastroenterologists can provide comprehensive testing, personalised treatment plans, and appropriate monitoring. Specifically, they can distinguish between IBS, IBD, SIBO, food sensitivities, and also more serious conditions like Crohn’s or coeliac disease. As a gastroenterologist Buckinghamshire patients see regularly, I know exactly how to handle any gut problem.

Remember that gut health is complex and highly individualised.

What works for someone else may not work for you.

Professional guidance ensures safe, effective care for your specific situation.

References

General Disclaimer from Dr Hussenbux, Gastroenterologist Buckinghamshire