One Of A Kind

With gut health a having such a major effect on our overall health, Abode2 spoke to two Digestive Health consultants from specialist facility OneWelbeck to find out more about this key factor of our health

OneWelbeck is a healthcare facility that empowers its staff to deliver exceptional patient care. With 200 consultants, across 9 floors with 12 bespoke centres of excellence, covering a wide spectrum of conditions including; Ear, Nose & Throat, Endocrinology, Endoscopy, Digestive Health, Heart Health, Imaging & Diagnostics, Lung Health, Neurology, Orthopaedics, Skin Health & Allergy, Surgery Centre and Women’s Health.

L-J Andrew spoke to Mr James Kinross, a Colorectal Surgeon at OneWelbeck Digestive Health, specialising in minimally invasive surgery for colorectal cancer and inflammatory bowel disease:

What’s your top tip for a healthy digestive system?

Everybody’s gut is different and unique. However, there are some general rules to maintain a healthy one. The first and most important is fibre - the more you eat, the lower the risk of bowel cancer, inflammatory diseases of the gut, cardiovascular disease, diabetes and lots of other chronic health care conditions. Diet is extremely important, so cutting out junk food, fizzy drinks and refined sugars are a must. Omega-6fats and trans fatty acids aren’t good for your gut. We should be eating 30 grams of fibre a day, we simply don’t eat enough of it. Smoking is not just incredibly bad for your lungs and other aspects of your health, but for your gut too. Generally as a population we are all vitamin D depleted, so taking supplements are great for good gut health. Lastly, exercise regularly as the more mobile you are, the happier your gut will be. If you can manage a target weight appropriate to your age, gender and height, this is so beneficial.

Best advice to promote good gut health and a preventative or relief for digestive related issues?

One of the best things you can do to promote gut health is to minimise the amount of antibiotics and medicines you take. We take a lot of antibiotics as a society, which decimate our bacteria that can cause long term health problems. Common pain killers like ibuprofen cause inflammation in the gut and antacids medicines also influence the gut microbiome in unproductive and unhelpful ways so really you should only be taking this medication as recommended by a doctor only. Much else depends on gender, age and social circumstances. The most important thing is to look at your diet - it’s a good idea to keep a food diary, to note what and when you eat, to give clues as to what specific food types might cause the issue. Speak to a doctor or dietician to think about excluding specific fibre types that can cause bloating, to minimise symptoms. Exclude sugary drinks, regulate alcohol and exercise can help.

How important is diet for a healthy immune system?

That’s the million-dollar question - the answer is that there is a middleman in the relationship between food and the immune system, known as the microorganism bacteria, that lives in our gut. These bugs break down the food that we eat into small molecules, commonly referred to as the gut microbiome, and the key regulator of the immune system. The type of gut bacteria determines the health impact of some of the food we eat. Foods that are high in proteins or fats, when they get broken down by bacteria, they become molecules that cause or promote inflammation and upset the regulation of the immune system. So, when you eat afresh leafy salad, or a healthy large bowl of porridge or lots of steamed vegetables, these foods are broken down into protective molecules that prevent inflammation in your gut. So good gut health is all about preventing inflammation. It’s also why obesity, which is a proinflammatory state, is so bad for your health. So by reducing your intake of sugary foods, you prevent those bugs from metabolising, protecting your gut and immune system. Microbiome research indicated that everyone’s microbiome is completely unique. With 100trillion bacteria in your gut, (about a kilo and a half of bugs)- you and I will probably share very little 1-10% of the same bacteria, leading to massive variation in people, extending across the population. Microbiome is dictated by diet and of course diet varies person to person. It is also defined by your culture, lifestyle, who you live with including pets and pollution in your environment. All of these factors influence the bugs that live on and within you and are important for gut health. This is why individuals who live in busy, urban environments, work night shifts or suffer economic hardships have unhealthier guts, as they are exposed to more environmental toxins and negative influences on their microbiome. This leaves them less able to process or deal with gut stressors and more prone to gut problems as a result.

Is the microbiome changeable? If so, can we change our lifestyle to change our microbiome?

That’s the really good news. The important thing about the microbiome is it’s absolutely changeable and much of our work is on how diet can change the microbiome. If you adapt your diet drastically enough, in the right way you can a receive dramatic results on the microbiome and the metabolites it produces. Having said this, some genes determine the type of bugs likely to grow within us and we will no doubt share bugs with our family. The bugs gifted to us by our mothers during birth, and the bugs we inherit in our youth, have a tendency to stay fairly stable within us through the rest of our lives. Some bugs stay with us forever, but you can change their functions by changing your diet.

What sort of effect does stress and fatigue have on digestion?

A lot – the interesting thing is that we are just beginning to understand how this works. Referred to as the gut-brain axis, researches have found that a direct line of communication exists between the brain and the bowel. So when you feel stressed, worried or upset the brain communicates with the gut directly, via nerves that stretch down into the gut. If the gut isn’t happy or if it’s inflamed it can also communicate directly to the brain and is able to do that via the same nerve, called the Vagus nerve. The gut is able to produce hormones and our gut bacteria can also produce neurotransmitters and other small molecules that can signal directly to the brain. So, in fact the microbiome, the bacteria that we have is incredibly important in influencing your mood or your feelings of stress and anxiety. When we suffer with a bad gut, it can make us feel unhappy or sad, due to the unpleasant symptoms we experience. Similarly, an unhealthy gut can exacerbate mental health symptoms through these pathways. Improving or acknowledging this as part of treatment for gut disease is incredibly important and we would recommend strongly that patients with irritable bowel syndrome, think about mindfulness and embrace therapy treatment strategies that may help alleviate stress and anxiety, such as acupuncture, yoga, Pilates or exercise. Just allowing time to reflect and think about what’s happening to them is a helpful way of managing chronic problems with the gut.

Natalie Flaum spoke to Mr Oliver Warren, a Colorectal Surgeon at OneWelbeck, specialising in colorectal and anal cancer, groin and abdominal wall hernias and minimally invasive surgery

What healthcare experience can patients expect to receive at OneWelbeck?

I’m one of the founding partners of the Digestive Health centre here at OneWelbeck. It’s a very exciting and special place to work, that enables me to give the sort of care I had always aspired to. My main motivation to join was to do something different and to be able to deliver world class care. In terms of patient experience and care, this centre was created to become a premier healthcare facility not only in London, but in the UK. When you enter the OneWelbeck building, it feels very light, airy and peaceful. No patients stay in the building overnight, so it doesn’t have a hospital feel. The reception and administrative staff are incredibly well trained to give impeccable customer satisfaction in an architecturally designed reception and bespoke waiting areas. The OneWelbeck experience is second to none, from the minute you arrive. The clinic, nursing staff and doctors are all patient focused and strive to give an individual experience. There isn’t a single doctor or healthcare professional that I wouldn’t have look after my own parents or family members.

What is your advice for anyone too embarrassed to consult a doctor about gastrointestinal symptoms?

Colorectal surgery is the second largest surgical speciality after orthopaedics and trauma, but we really wouldn’t know it. Most patients who come to see me they think they’re the only person complaining of an ‘embarrassing issue,’ when they are one of literally hundreds of people who suffer with common digestive complaints such as constipation, bloating, urgency, bleeding and continence issues. One of the key public health messages that we are keen to send is that if you are suffering from symptoms or have risk factors for things such as bowel cancer, now is the time to re-engage with diagnostic screening services. I’ve seen a number of tragic cases during Covid, in both private and NHS sectors, of patients who have ignored their symptoms and then present with much later disease. The relative risk in terms of covid, compared to ignoring a bowel cancer, lies very much on the side of early testing. The clear message is to seek help and access diagnostics, here at OneWelbeck, where you will receive compassion, empathy and understanding - chances are the symptoms are incredibly treatable, regardless of the underlying cause.

www.onewelbeck.com