Done with Dieting Episode #118: Gut Health with Jillian Teta

 It’s interesting to note that about 25% of Americans we’re just talking Americans here, not worldwide. Americans have constipation, so it’s very, very common.

You are listening to the Done With Dieting Podcast. The podcast for women who are experiencing perimenopause and menopause symptoms and want to feel better like they did before their body started changing. I am your host, Elizabeth Sherman, Master Certified Health, and Life Coach for women in menopause and perimenopause.

I’ve helped thousands of women manage their symptoms, get off the diet rollercoaster, and change their relationship with food, exercise, and stop fighting with their bodies. And I do it through a feminist lens, which means exploring how we are socialized as young women and how it impacts our current relationship with food and exercise. Our bodies, health, and ourselves.

What’s different about this podcast is that we’re exploring your health from all sides, not just food and exercise. We also address the mindset shifts that will make you happier and lead to better health. My goal in this podcast is to illustrate that the reason that diets don’t work long term is because your health doesn’t exist in a silo.

Your health and your weight are a symptom of other parts of your life and how you show up. I want to help you to feel good and live the life that you desire from a 360 degree approach, body, mind, and soul.

Welcome. Let’s get started.

Hey everyone, welcome to the Done With Dieting podcast episode number 118. I have an amazing guest on the podcast today. Jillian Teta is a Naturopathic Doctor who works with folks to improve their digestion and gut health. Now, if you recognize her last name, it’s because I had her brother-in-law, Jade Teta on the podcast back on episode number 57, which is to this day, one of the highest downloaded podcast episodes.

I think this is one of the best conversations I’ve actually had on the podcast because our gut health, as you’ll learn is tied to so many other facets of our general health. Talking to Jillian was such an amazing treat because she’s so incredibly knowledgeable about the body and how our digestion impacts everything, not just our stool, but bloating, headaches, and our menopausal symptoms too.

This episode is jam packed with information, so you are going to want to pause it and take notes. So, let’s get on with it.

Elizabeth: All right everyone, welcome Jillian Teta to the Done With Dieting podcast. Jillian, I am so excited to have you here because I want to learn everything digestive health. So first, introduce yourself. Tell us who you are, what you do, and all the things.

Jillian: Okay. Well first, thank you so much for having me here. I really appreciate it. It’s wonderful to just be on a podcast again and share the Good Digestive bliss. So, my name is Jillian Teta. I’m a medically trained naturopathic doctor, right? So, I hold a medical license. I help people with digestive distress. That has been my go-to clinical style for the last 20 or so years.

So, I treat a wide variety of digestive symptoms for a wide variety of people, and I’ve been in clinical practice since 2007.

Elizabeth: Wow. Okay. So, what does digestive distress mean?

Jillian: Digestive distress is basically any type of problem you have with digestion. Whether it’s like too much gas and bloating, whether it’s a motility issue of like constipation or diarrhea, or if it’s a diagnosis of irritable bowel syndrome, inflammatory bowel disorders, gastroparesis, celiac disease, like acid reflux, indigestion, like all of those things.

So, for folks who have both formal diagnoses of things and then for folks who maybe don’t have a formal diagnosis but are just really sort of struggling on the gut front. Either in the bathroom or just like out in public, like with their symptoms.

Elizabeth: Okay. And so, how you approach that is through digestive health. Is that right?

Jillian: Yeah. So, there’s lots of ways into digestive health. And digestive health and digestion in general is really important because our digestive tract, like our GI tract is interconnected with every single other system in the body. I call it like the ‘grand central station’ of the body.

So, it has roles and I can go into this a little bit more if you want but it plays roles in defense, not just like in terms of the immune system. Which by the way like about three quarters of our immune system actually resides in specialized tissue in the gut. Like in the gut mucosa such pretty cool cause we are primarily exposed to stuff through our guts, like what we intentionally or unintentionally swallow.

And then, also our stomach itself is a very powerful defense organ with its very low PH and like its mighty stomach acid, it can kill a lot of things. But the gut also plays really important roles in things like detoxification, and neurological health, and nervous system health, and hormonal health.

So, all of those things have like direct tributaries and bimodal feedback and communication in relationship with the gut. So, the gut really is a central player of our overall health and wellness.

Elizabeth: Yeah. And I have just a little, little bit of training on gut health, and I was fascinated to learn how many different symptoms that not having good gut health could cause in everybody but not just that, but every female body as well. Things like menopausal symptoms, menstrual problems, thoughts like brain fog, things like that. It’s really surprising.

Jillian: Well, so for example, I guess we want to talk about something like maybe detoxification slash hormonal health. Our body, the gut, our digestive tract actually houses two of the five major organs of detoxification. The large intestine that’s actually like what is forming stool and helps us like poop out all of our spent hormones, particularly estrogen, metabolic byproducts, all of those types of things.

All right. So, in terms of detoxification, removing spent estrogens, our gut is extremely important. Next, on the hormonal front like our relationship to hormones in the gut is that our gut converts a significant, about 20%, right? So, it’s not nothing. It’s not 80%, but it’s still significant of inactive thyroid hormone to the active form. So, that becomes important especially, when things like estrogen also come into play.

So, there is a lot of interconnection particularly, when it comes to the perimenopausal and menopausal time in a woman’s life. And we haven’t even talked about the neurological stuff yet, right? Like the nervous system stuff. But there absolutely is a very intimate relationship and connection there.

Elizabeth: Okay. So, let’s back up a little bit. So, when we’re talking about gut, gut health. What are all of the different components in our bodies that comprise the gut?

Jillian: Okay. So, your gut, it starts in the mouth, right? It’s your mouth, your esophagus, your stomach, the small and large intestines. And then, all the ancillary organs of digestion like your pancreas, which creates the pancreatic enzymes. It also makes insulin and glucagon very important hormones for blood sugar balance. And then, we also have the liver and gallbladder. Right? Liver again, very important for detoxification, makes bile, the gallbladder stores the bile. Bile is also very important in detoxification and appropriate motility, right? So, that is what our gut is.

And what I define good digestive health as is pretty much normal daily bowel movements. Meaning like one to three bowel movements per day that are well formed, easy to pass, that aren’t overly foul, that don’t create overall disruption in your daily life, and that your gut is not giving you a ton of different symptoms. Like you’re not belching constantly. You’re not like passing gas constantly. You don’t walk around feeling bloated all the time.

Those are some of the measures that I use as a filter for good digestive health is basically, are you pooping every day and are your poops reasonable? And does your gut like actually impede or interfere with your activities of daily living? And that’s kind of like the basic bare bones thing.

But if we tie back into what we were just saying, if you’re someone who is perimenopausal and say you’re not moving your bowels every day. So, you’re a little bit constipated, and you’re having headaches, and you’re maybe having a little bit of like eczema, or a rash, or like you’re having acne and you’re like, why do I have acne? I am 47 years old. I shouldn’t be having acne. Those types of things that can be indicative of a gut problem, right?

So, if constipation is that problem like you’re not having a daily bowel movement, that will create essentially, I don’t even want to say a backlog with estrogen specifically. Like how it works is we’re supposed to poop out estrogen every single day. If we don’t, and the estrogen is sitting in our stool and the stool is sitting in the intestine. Well, our intestine has a blood supply. It’s right there. Like our intestinal walls are only one cell layer thick.

So, those spent hormones get resorbed back into the body. Right? They end up back at circulation. They end up back at the liver, which has already dealt with them and now it has to deal with them again. But it’s also dealing with today’s stuff. So then, the liver can get a little bit constipated for lack of a better term. And then, that can translate into perhaps more acne, perhaps more headaches. Because we have inappropriately exposed ourself to these spent hormones that should be removed from the body.

And then, the solution is resolving the constipation. Not necessarily like getting on a migraine medication, getting on like skin medication, those types of things. I mean, you might need those things. But if there’s a digestive issue present, and again, in perimenopause and menopause, any hormonal change can create digestive disruption. Then, that’s what I look too there. That’s sort of like that flag that I look too there.

So, let’s try to improve digestive function, aka bowel movements. And you can actually make a pretty significant impact on hormonal balance just by pooping every day.

Elizabeth: I think that there are probably a number of listeners right now who are still stuck on, because I am still stuck on your statement that we should be pooping one to three times a day.

Jillian: Yeah. Yeah.

Elizabeth: Wow.

Jillian: Yeah, at least once a day. At least once a day. So, plenty of folks poop three times a day but it’s also totally normal to just poop once a day. But you do want to have at least one daily bowel movement a day. That’s how we’re designed. Unless something weird happens, like you’re having a wicked stressful day or you’re traveling. Constipation is really common when we travel. And then, it’s also worth mentioning like during hormonal shifts in a woman’s life, right? Like around menses a lot of women will notice that they either slow down or they speed up.

So, as hormonal levels are falling as we approach menstruation, that can have impacts for gut motility. Early pregnancy can certainly introduce a lot of digestive chaos, perimenopause and menopause can introduce a lot of chaos. So, those areas in women’s life, those times in women’s life, whether it’s on a month-to-month basis or on a lifelong schedule, those certainly can impact our digestive function. But generally, overall bowel movements should be daily, again, fairly well-formed, easy to pass, no pain, no strain, not overly foul, where like the entire house knows that you’ve gone to the bathroom.

And then, gas and bloating should be the same thing, like fairly noninvasive, minimal, those sorts of things. Yeah, everybody daily bowel movements. Like if that’s like my gift to the world. It’s like everybody needs to go to the bathroom every single day. Everybody needs to poop every day.

Elizabeth: Okay. So, you’ve explained what a healthy poop is. Let’s actually go into some of the less desirable. So, too much water or not enough.

Jillian: Yep. Like a constipated stool would be like hard and dry. We call that like the classic like rabbit pellet stool. That’s not like the healthiest stool that we have. It’s not like it’s these things are like irreversible or not workable. It’s just this is definitely not an ideal stool. And then on the other side of things, like on the faster motility, we can have looser stool. Stool that has undigested food in it. Stool that has mucus in it or blood. Stool that has a halo of pigment. Stool that is like constantly floating a halo. Like a halo.

So, what can happen is if our bile is not resorbed, like brought back into the system, it overly, it colors our stool, right? And so, it can leach of the stool in the bowl. And people will actually see this in the bowl, like their stool it’ll look almost fuzzy. And then, there’s like a yellowish pigment around the stool and that is the bile. So, that’s not a healthy stool. That’s not an ideal stool. Stool that is constantly floating like that has either too much air, too much fat in it. That’s probably not healthy either. There’s lots of different ways that the stool can be not ideal.

Elizabeth: Okay. So, what are some of the things that each of those less ideal stool types are telling us? Because that’s indicating that things just aren’t right. Right?

Jillian: Yes. So, if somebody has chronic, meaning daily or almost daily, several times a week. If they have that hard, dry, roundish pellet shaped stool that we pretty much can hang it up that this person has constipation. It’s interesting to note that about 25% of Americans we’re just talking Americans here, not worldwide. Americans have constipation, so it’s very, very common. Constipation can have a number of factors that range from things we can control like fiber, and mineral, and water intake, right? To things that in our activity levels because unfortunately being sedentary and sitting at a desk all day like that does not help are actual motility, right? So, those things are sort of under our control, but then they can be caused by things that aren’t under our control. Like maybe chronic stress, or past trauma, or an infection like small intestine bacterial overgrowth. So, there are quite literally like dozens of reasons for why something like constipation could happen.

Now, if we look on the other side on a faster motility, on a looser stool, there also is sort of a list of things that we can work through and look through in terms of how are we going to identify this root cause. Which is very important because identifying the root cause like gives us a much clearer path of how to treat it.

In terms of if you’re having chronic aka most days, or at least every week, a couple times a day. If you’re having loose stool, we can look to our foods and what we are eating, right? Are we eating foods that we are sensitive to? Are we eating too much fat? Are we eating not enough of something? Are we not eating any fiber?

The same things that can cause constipation can also cause loose stool. If we’re seeing a lot of things in the stool like undigested food or mucus. Could it be that the pancreas is not creating or making appropriate levels of digestive enzymes? Could we be having low stomach acid output where literally our food is not being digested and then that speeds things up? And then, we see the actual like undigested food there.

Elizabeth: Like corn.

Jillian: So, corn, I joke. Like corn almost doesn’t count because corn is very difficult to digest. And like most folks, if they eat like two corn on the cobs or something like that, like you’re going to see the corn. But if you’re seeing things like salad, like your lettuce, or tomato skins, or nuts, or seed casings, that is definitely a signal that something like enzymes could be warranted.

Elizabeth: How much does chewing your food have to do with that as well?

Jillian: Yeah. Well, so chewing your food actually is very helpful, especially if you’re stressed because that mechanical digestion actually does start in the mouth with chewing and mechanically breaking down those bits in the mouth with the teeth. And so, if we eat too fast or we’re like bolting down our food, you know, we’re not actually chewing. That puts more mechanical pressure on the stomach and also more biochemical pressure on the stomach to break things down.

And so, when I say mechanical, I mean our stomach is like a mixer. So, our stomach also mixes. It’s not just like it’s this passive pouch that just sits there. It actually is mixing up the food that we eat as well. And then, you also have the additional biochemical aspects of digestion like our digestive, I call it ‘digestive fire.’ Which is the pancreatic enzymes, your stomach acid, and your bile.

So, if any of those are slightly stressed or a little deficient, and then you’re just like wolfing your food down and not chewing well, that definitely will exacerbate a problem. If you don’t have loose stool but you see undigested food in the stool, this is probably definitely what’s going on. Because sometimes fast motility like even if you do have wonderful digestive factors on board and you’re chewing your food, if you have fast motility, right? From maybe inflammatory bowel disease, or small intestine bacterial overgrowth. Things are going to cruise through and you’re going to see undigested food anyway.

So then, that becomes like a diagnostic nuance where you’re like, all right, maybe we should do some blood work or some imaging to see if other things are going on. But you can get a lot of clues when you ask people in depth about the quality and frequency and comfort of their stool. You actually can get an unbelievable amount of information from people asking about their daily bowel movements.

Elizabeth: Let’s bring it up at a party.

Jillian: I know. Well, I joke about that a lot. Digestive stuff is very taboo. Nobody likes to talk about it, and I understand why. People are like, yeah, I have the worst gas ever, and sometimes I have a little incontinence. Like nobody wants to talk about that. Not at a cocktail party, not like at the Christmas party, or the office party. It’s taboo and I don’t know, everybody poops, and everybody should be pooping every day. I try to normalize it for folks.

Elizabeth: Well, yeah. Because the more that we do talk about it, the more we realize that it’s everyone does go through this, right? Everyone has these same, I don’t wanna say issues, but potentially.

Jillian: Digestive issues are very common. The United States spends between eight and 850 million a year on like over-the-counter digestive aids. That’s just over-the-counter digestive aids. That’s not counting supplements. That’s counting like the stuff you get at Walgreens or CVS, like your Peptos, your Metamucil, like all of those things. That’s a lot of money.

And again, if 25% of the population is having constipation at some point in their life, and like another 25% is having functional diarrhea at some point in their life, we’re getting into like a big chunk of people where one of every two people that you pass on the street is or has or is going to deal with digestive distress.

Elizabeth: Right. Yeah. Wow.

Jillian: It’s common.

Elizabeth: I have no idea.

Jillian: Yeah, it’s very common.

Elizabeth: Okay. So, let’s talk about a few of those digestive aids. So, cilium husk or Metamucil. Is that helpful? I know that there are two different types of fiber, and we want both of them in our diet naturally. But those can help, right?

Jillian: Yeah. So, fiber supplementation is a fabulous sort of inexpensive way to help with motility. It can help both with constipation and loose stool, right? So, it can add bulk to the stool to help us pass it through and move through. And it can also add more volume to the stool to help slow things down and have fewer bowel movements.

Fiber also is great for treating things like fatty liver, what we call dyslipidemia or any type of our blood lipids, like total cholesterol, HDL, LDL, triglycerides like if those are imbalance, it helps treat those two.

Now, there are some fibers that are better than others. For folks that have say, IBS. And I keep bringing up IBS because IBS is irritable bowel syndrome is also extremely common. It’s very, very, very common. I think especially like us coming out of the pandemic with all the increased stress, like I think we’re just seeing skyrocketing levels of that.

So, folks that have irritable bowel syndrome, they want to use more gentle type fibers. Cilium. Flax. These are not gentle fibers. These can be quite irritating and can create a lot of gas and bloating, frankly. Especially, if they are not taken with adequate water. So, if you’re constipated and you add fiber, especially an irritating fiber like cilium to a dry system. Like you’re going to worsen your problem and you’re going to feel a lot more uncomfortable. And then, you’re going to be like, fiber doesn’t work. I don’t need this.

So, in terms of fiber, I do think it’s important and I do think it’s a great supplemental intervention. It’s just for most folks, I don’t want to even say most. It’s important to qualify if somebody has IBS, even inflammatory bowel disorders. Anywhere where there’s like some type of irritation, small intestine bacterial overgrowth.

We don’t want to go for a Metamucil, you’d want to go for something like an acacia fiber or one of like the gel-based fibers that gun Yahoo Root or whatever. You don’t want to go straight in for the Metamucil. I know the Metamucil is highly available. It’s kind of the one that doctors say in all of this, but Acacia Fiber also does all of those things with a much lower ferment ability score. Meaning it’s going to be much gentler and more comfortable. It’s going to do all those same wonderful things for blood lipids, blood sugar, fatty liver, forming the stool for more firm or less firm or whatever we need it to do without having all of those more deleterious uncomfortable consequences.

The solution has to be comfortable, right? It has to be sustainable. Otherwise, it doesn’t work. I mean, it won’t work. Something that’s not sustainable, does not work. Even if it works for the week that you do it. It’s like still, if it’s not sustainable, it does not work. And I wish people, we need to like, absorb that in our brains.

Elizabeth: Well, you’re essentially, treating the symptom and not the root cause.

Jillian: Well, yes. But even if you’re treating the root cause, if you are treating the root cause by doing something that’s really uncomfortable or unsustainable, it’s not gonna work. If you cannot maintain a result, it doesn’t work. Even if it does work for a short time.

It’s something like fat loss. Like anybody can fast and like just eat salads three times a day and like drop whatever, however many pounds in a week. But that ultimately is not a sustainable way to eat or live or be. We can make that same analogy or comparison to digestive health. Like putting folks on wicked restrictive diets or getting them on like a ton of products or getting them on products that make them wicked uncomfortable. it’s not going to last.

Unless you’re like, okay, we’re going to do this for two weeks and it’s going to really suck, but we’re going to do it for two weeks and like, see what happens. Unless you do a lot of that kind of stuff to help people through and let them know that it’s like there’s a finite end. That’s maybe more effective, but just having someone take an uncomfortable fiber like indefinitely, like that’s not sustainable.

Elizabeth: Got it. Got it. Okay.

Jillian: It’s not going to work. It’s not going to exert lasting change. And that’s ultimately the goal, right? When I think about it, like ultimately the goal is how do we make people more comfortable? Not only just like digestive wise but like in their skin. Because digestive distress comes with a lot of psychological distress and like identity stuff. So, how do we maintain those things?

Elizabeth: Yeah. So, since you brought it up and we’re kind of on the topic, let’s talk a little bit about IBS. I don’t really know that much about it other than stress exacerbates it. And so, what is IBS? How does it manifest itself? What are the causes? How does someone get through it?

Jillian: So, IBS again, exquisitely common and it used to be thought of as like a waste basket diagnosis. Someone would come in and be like, oh, I have diarrhea all the time. And the doctor does all the tests. They do a colonoscopy; they do an endoscopy. They don’t have inflammatory bowel disease, they don’t have cancer, they don’t have this, they don’t have that. Oh, you must have IBS then. Try to relax, goodbye.

Elizabeth: Let’s try to relax.

Jillian: Try to relax. That basically, I mean, you know how it is, right? That basically is like a lot of visits to healthcare providers. Maybe not even that much. You might not even get that much.

Now, we have a bit more of an understanding of what IBS is. So, IBS basically can be any type of digestive distress that has both upper GI symptoms like bloating in the stomach, kind of like that indigestion sour stomach, early satiety, belching, those sorts of things and the upper GI. And then, we also can have or often have lower GI effects and that can either be constipation, diarrhea, or a mixed type where we go back and forth, either on long or short cycles. So, it can look a whole different types of ways.

But here’s the cool thing. In terms of diagnosis, there actually is a test now for IBS. Because again, we understand that IBS is not a waste basket diagnosis, but there’s actually a couple factors that contribute to the pathology. The first is an imbalance in our microbiome. So, our microbiome is that vast, trillion cell colony of microbes that lives in the large intestine.

So, just for a perspective, us human beings have about a trillion human cells. So, we are like at least as bacterial as we are human. And that microbiome does a ton of stuff for us in terms of helping us digest, helping us talk to our immune system, activating the thyroid hormone that we were talking about. Digesting fibers more actually fighting off bad guys. Like we have a couple like assassins in our microbiome that are like actively hunting and killing bad guys.

Anyway, with IBS, we now know that that healthy balance is somehow disrupted. So, it could be we maybe have too few good guys, maybe from our early childhood nutrition, our current diet, history of antibiotic use, those sorts of things. It could be that there’s an overgrowth of opportunists and opportunists aren’t necessarily pathogens or parasites, but they’re not the healthy organisms either. They’re kind of like frenemies. They can kind of go either way, depending on context.

And so, if those are overgrown, those can create just as many problems as a frank infection or low flora. And then, another option for dysbiosis of course is a frank infection with a parasite or a pathogen. Or also a translocation of bacteria, like in the case of small intestine bacterial overgrowth where bacteria is where it shouldn’t be like in the small intestine. So, it’s interesting to note too, that small intestine bacterial overgrowth is present in about two-thirds of IBS cases. So, that’s one piece is dysbiosis of IBS. And so, that can be tested with a blood. And I can tell you what that blood test is if you want.

And then, the second piece of IBS is an imbalance in our second brain, our enteric nervous system. So, from the base of our esophagus all the way down through our small, large intestines all the way down to the rectum, we have an enormous amount of nerve cells. In fact, there’s just as many in our gut as there is in our spinal cord. And this brain manages and monitors all aspects of digestion. So, it knows the volume of food and gas and solid and liquids of every square centimeter of your gut, top to bottom. It knows how fast or slow things are moving. It knows it all.

And so, in folks with IBS, there is an imbalance there. And that’s why to bring it back to like kind of your opening statement, that is why stress exacerbates IBS. Because our central nervous system, our brain and our spinal cord is intimately hooked in. They are hooked in together with our second brain. And then, our second brain, the ENS in our central nervous system, the CNS are chatting with each other constantly. And are constantly giving each other feedback.

So, when the gut is worse and you probably experience this with your clients, I know with my clients. When the gut is feeling worse, things like irritability, anxiety, depression, all of those ramp up. Likewise, when folks are having a really bad anxious day, they’re more likely to experience digestive distress. So, it can become this really nasty like feed forward cycle of disruption that is actually stress generated, even though it’s manifesting like in the gut.

And that can also become really important in perimenopause and menopause because during this time in a woman’s life, as we lose the help of progesterone. Progesterone helps buffer the negative effects of cortisol. And I’m sure everybody’s heard of cortisol. Cortisol is a necessary crucial hormone. We would be dead without it, right? But it can become dysfunctional, just like our nervous system can become dysfunctional. We can get too much in that stress out state. We can be too much in like a hyper cortisol state.

And so, as we lose the help of progesterone that helps temper cortisol, we become more stress sensitive. Right? We are more sensitive to the ups and downs of life than normal or abnormal, like daily stressors of life. We are less physiologically and neurologically equipped to deal with those because we’ve lost this help.

And so, that is another major reason why in perimenopause and menopause digestive symptoms can be created or exacerbated. You know, some women will be like, you know, what? I never had heartburn before and now I have heartburn. Or I always used to have like daily poops, and now it’s like every three days, buddy. So, that’s why.

Elizabeth: Yeah. Okay. So much to unpack there. I don’t know if I can remember everything that was like going on in my brain. That was beautiful. But yeah, to go back to what you just left with, I’ve been experiencing symptoms of GERD. And it comes and goes, and I haven’t quite figured out what exactly the problem is or maybe it’s a mix of ‘I love sparkling water.’ And so, I think that in combination with some other food things has makes it pop up every once in a while.

Jillian: Well, so something about GERD that I can just say is the site of action in GERD is that lower esophageal sphincter. So, that’s the bottom of our esophagus. We swallow something the little bolus of food or seltzer water goes down. And when it reaches the lower esophagus, we have a little trap door there and the trap door opens. And then, the food or drink plops in, and then it’s supposed to close. It’s not like a door like this, it’s a sphincter. So, it opens and closes like this.

With GERD and with reflux and heartburn, what happens is that door is open when it shouldn’t be. So, it’s open beyond just swallowing. What keeps that closed actually is heavily influenced by our second brain. So, if we are having second brain dysfunction that’s being fed through either hormonal changes or the fact that we’re like in our junior year of a pandemic. That absolutely can have ripple effects on the gut. And one of the major places that we see that in is in that lower esophageal sphincter.

Again, over the pandemic, I can’t even tell you how many people I have worked with that like have new onset heartburn. It’s the same in the perimenopausal community, like kind of just new onset stuff. And that really comes from that lower esophageal sphincter opening and closing when it shouldn’t be. It’s not that all of a sudden your body is making too much acid. The body almost never makes too much acid unless we have like a tumor in the stomach. It’s more likely for us to under produce acid.

But if that trapped door is open when it shouldn’t be, what does that do? That allows all the acid and all these contents of your stomach to splash up into the esophagus. And that’s extremely uncomfortable because your stomach acid is acid and it has a PH of like one to two. Like it burns. If we had our stomach acid out, it would burn a hole through our skin. And I mean, essentially that’s what an ulcer is. So, yeah, it hurts.

But heartburn is more of acid in the wrong place because a second brain is not keeping that lower esophageal sphincter closed than it is like, you’re all of a sudden, making too much acid.

Elizabeth: Yeah. I love that you’re calling it the second brain. Because as you were talking about it, it really made a lot of sense as to why we feel a lot of emotion and things in our gut.

Jillian: Yes. And everybody can relate to that, right? You finally get the phone call you want. How do you like your gut like it just rises, right? Like it just comes from your gut. On the other side, you get news you don’t want or you get like devastating news, you’re ready to throw up or like your stomach gets hot or cold. Like we definitely, all humans I think intuitively understand that connection between our brain and our guts. And the reason why technically it’s called a second brain is because just the number of neurons that are there again, it like equals a spinal cord. It’s an unbelievable amount of neurons.

Elizabeth: That’s great.

Jillian: And I can get like on a side tangent, we were designed this way. Our body nature is so amazing. If we were to have a spinal cord injury, we still could digest our food. If the body had all of the neurons that were responsible for digestion running through the spinal cord and up to the brain. First of all, our spinal cords would be so thick we wouldn’t even be able to bend over. We wouldn’t be able to like tie our shoes or get dressed. But if we had any type of injury to the spinal cord, we wouldn’t be able to digest our food, we would die.

So, it’s a very interesting like conservation of the body to basically put the brain for digestion in the actual digestive system, the digestive tract. So, it is fascinating. Intimately connected with again, our central nervous system.

Elizabeth: Well, yeah. And thinking about like when we make decisions, do we trust our brain or do we trust quote unquote, our gut?

Jillian: Our gut.

Elizabeth: Right. Fascinating.

Jillian: Yeah. Our gut doesn’t lie. And I would argue that like a lot of our intuition comes from our gut. Like gut instincts, gut feelings, there’s a lot of that like colloquially in our language. Trust your gut. Go with your gut. Listen to your gut.

Elizabeth: Okay. Awesome.

Jillian: Also think about the emotional impacts for that statement when someone like can’t go to the bathroom for seven days. You know what I mean? So like that in and of itself becomes a source of mental stress. I can’t trust my gut because my gut doesn’t function. So, that becomes like a whole other layer of emotional distress for folks that struggle with like digestive problems is like, they feel like they can’t trust their gut because they can’t be far away from a bathroom or what have you.

Elizabeth: Yeah. Okay, this is all fascinating. So, let’s shift a little bit into menopause and perimenopause and going on that same tangent of women being able to trust their bodies and do you have any data on the gender differences between gut health? Like that gut dysbiosis?

Jillian: So, women do tend to have higher rates of irritable bowel syndrome and chronic constipation because the intestines are slightly longer, and the large intestine is longer. And the reason for that is because in pregnancy the body has to resorb a ton of water, like just extra fluid. That’s one of the functions of a large intestine is to basically resorb water that in part is like how poop is made. Like we resorb the water from our food and what we drink and all of that.

Women have a longer, large intestine. And then, also the way that the pelvis is shaped, the hips are broader, so the pelvic bowl is larger, so there’s more room. So, there’s more room for there to be like kinks in the gut, and to get things like sort of twisted where stool and gas can get trapped, painful areas. Areas for diverticulosis, those types of things.

There are some conditions like some inflammatory bowel conditions that men are more prone to. But there are definitely some that women are more prone to particularly, if then you throw on the hormonal changes associated with perimenopause and menopause.

Definitely, that’s like a primo time for digestive distress for women, unfortunately. It’s like a broader reflection of again, like hormonal changes before you get your period or something like that. Or excuse me, digestive changes. Like a lot of women would be like, oh, you know, I loosen up the day before I’m about to start. Or like, I have diarrhea my entire period, or those types of things. Perimenopause, menopause is like a larger reflection of those things.

Elizabeth: Okay. And it sounds like it’s kind of a chicken and an egg thing. Like not knowing which one’s coming first. Is it the hormone dysregulation, or is it the stress, or both?

Jillian: It’s really like a symphony. It’s kind of like all the things going together. So, I know like in our society, we’re very linear, right? Like A leads to B, which leads to C. The way that our bodies are set up and just physiology and feedback loops and all of that. It’s more like a symphony. We have a string section, we have the wind section, we have the percussion. It’s everything working together at once.

So, if you pull on one aspect, you’re going to have reverberations throughout the whole system. It’s not easy to say like, it’s less easy to say. It’s easier to see what all the symptoms are, and you can tackle things multi modally, right? Like through multiple different ways. In the case specifically of digestive distress in perimenopausal women, if a woman has had like solid digestion her whole life. And then, the first time that she begins to experience digestive distress is when she’s going through perimenopause, then we can say that that first pull on the string is falling or inconsistent levels of estrogen, progesterone level and like the reverberations there.

If someone who is coming into perimenopause already with IBS or some form of digestive problem, that absolutely could be exacerbated through perimenopause. But we couldn’t say that perimenopause is the cause, right? So, it can be heavily nuanced.

Part of my job with working with folks is looking back to when things started. So, sometimes things started like as a baby or a child. In these cases, it’s like, all right, well maybe someone like had a cesarean section. They were born via cesarean section. They were formula fed. They lived in a very sterile environment. They didn’t have pets. They didn’t go to daycare. They weren’t exposed to things. And that sets them up for this lifetime of struggle, right? Or maybe it was the time they went abroad and got that really gnarly food poisoning and have never been the same since. Or maybe it was when they got like that breast cancer diagnosis and were completely devastated.

So, it can be very individual teasing out the strands of somebody’s unique situation. But there are definitely frameworks that we can use.

Elizabeth: Okay. So, I wanted to switch gears a little bit and talk about probiotics, prebiotics, and then any other supplementation that you might recommend for folks because people always ask about what should I be taking?

Jillian: Yeah. Yeah. Well, the cool thing is plenty of times nobody has to take anything. So, a probiotic is a supplemental form of beneficial bacteria. So, folks are probably familiar with like lactobacillus acidophilus, the one that’s commonly found in yogurt, right? These are supplemental forms of beneficial bacteria that we get either through food or supplementation. You can eat fermented foods. Again, yogurt, kefir, kimchi, sauerkraut, kombucha, those types of things. Or you can take actual supplemental forms of probiotics.

A prebiotic is essentially the food for a probiotic for the bacteria. And that is simply like fiber and plant compounds. I usually don’t recommend prebiotics ever because if you eat vegetables or you eat anything that has fiber in it, rice, I don’t know, whatever. If you anything has fiber in it, you’re already eating prebiotics. You don’t need to supplement more. It’s not like the probiotics are going to die if you don’t take prebiotics with them.

I do recommend probiotics in certain cases. One is definitely during or after antibiotic treatments. Another is if we know that somebody has low beneficial flora through stool testing, through microbiome testing. Without testing, there might be some instances that I recommend probiotics in terms of maybe getting a good history, like they’ve been doing a lot of travel, or maybe there’s like a lot of skin stuff like eczema, or there’s a lot of allergies, probiotics can be beneficial there.

But it’s rare that someone just comes in and willy-nilly, I’m like, oh yeah, you need to be on probiotics. Like it’s not something that’s required. Especially in folks that are pooping every day, well-formed, easy to pass, no pain, no strain. And don’t have intrusive or disruptive symptoms on any level with the gut. Like those people definitely don’t need to like be on probiotics. They can eat fermented foods, certainly. But don’t need to be on probiotics.

So, I hope that that answers that. The thing with this stuff is that it’s not like always black and white. There’s a lot of like contextual information that has to be laid out to make the best recommendations for folks. Like, I don’t know. Some folks are just like, yes. Get on probiotics and here’s my special brand of probiotics. You know, it’s like a commercial motivation and I don’t like that.

Elizabeth: Yeah, no. I 100% agree. So, what I hear you saying is people don’t need to be on probiotics forever. It’s not like a multivitamin where they would have to take a probiotic.

Jillian: Yes. I’m much more likely to recommend a multivitamin and be like, yes, most folks should be on multivitamins most of the time. Especially, if you’re on a medication under any type of stress, drink alcohol, don’t sleep well, travel, you know, like the list goes on. So, something like a multivitamin is much more of like a generalized recommendation that I’d be way more comfortable being like, you know what? Most people can benefit from being on a multivitamin, most of the time. A probiotic has not fall in to that same category.

Fermented foods. I mean, I do think people like eating fermented foods is good and healthy, but in terms of like formalized supplementation where it’s like, okay, yes. Like I need to take my probiotic today. I’m far, far more reluctant to be like, yes, everybody needs to do this.

Elizabeth: Yeah. Okay. That’s great to know because most of my clients are huge fans of yogurt, or kombucha, or other fermented foods.

Jillian: Yes. And rock out with that. Yes. Yep. I think as long as you have that on board, like you’re definitely covering your bases. And for folks that do want to take a probiotic, I can give like a couple pointers for what to look for in a probiotic.

One. And this is based on my clinical experience. If you’re taking a probiotic, it should just be a probiotic. It doesn’t need to be like probiotic and enzymes and greens and prebiotics and like amino acids. Like just a probiotic. Second thing, talking about prebiotics is you want to minimize or avoid as much as like the inulin and what’s called FOS, like fructooligosaccharides.

These are prebiotics that are added to the probiotics. A lot of folks that they’ll come in and they’ll say, all right, I take a probiotic, but it makes me gassy. I always want to see what the probiotic is because sometimes it’s not the actual bacteria that I’m making folks gassy. Sometimes it is. But more often it is the prebiotics, which are heavily fermentable that are added to probiotics.

Another thing that could be creating gas around probiotics is you want to make sure that you’re getting a hypoallergenic probiotic because a lot of these are grown on either the cheap ones are grown on soy or dairy mediums. And so, in that case, again, you’re not reacting to the bacteria you’re reacting to like the residual growing medium, right?

So, you want a hypoallergenic, just probiotic option. And then, you want it to kind of mimic what a human microbiome would look like. So, you want one that has multiple strains. Our microbiome has thousands of species of bacteria. So, I know we like hyper fixate on lactobacillus, and there’s more and more studies on different unique strands of probiotics. Which is awesome, and necessary, and needed.

And there’s lots of therapeutic options for that. For like a generalized probiotic. We want one that has lots of strands. We want one that like kind of mimics what our own would look like. And no probiotic has 5,000 strands in it. But you want one that has like a nice long list of all your different types of probiotics.

And then, I tend to like powder probiotics because you can really titrate the dose up or down. And I prefer higher dose probiotics. Although, there’s a caveat to that which is we usually start out people a little bit low and ramp up. It’s kind of like fiber, right? Like you don’t just throw in like 20 grams of fiber like into your day. You kind of like start slow and ramp up.

If I’m using probiotics therapeutically, I do like to aim for about 50 to a hundred billion CFUs a day. And sometimes we have to ramp up over several weeks to that dose. So, I tend to like, again, the higher dose, powder based probiotics that are just probiotics that don’t have a ton of other things in them and that are multi strain. That’s what I look for probiotic.

Elizabeth: That’s great.

Jillian: And there’s lots of examples like that you can get. You can get one from a supplement company, but you also could roll into a Whole Foods or whatever and just look on the back of things. Some people ask me like, is it better for it to be refrigerated or not refrigerated? Way back in the day, like 20 years ago, the more shelf stable ones were in the refrigerator. But technology and like the spore stuff, like that’s so much more advanced now that there are so many other options that like you can just leave out on your counter, like in your cabinet that are wonderful options for probiotics.

Elizabeth: Oh, my God. That was just such great information. Well, everything that you’ve said has been great information.

Jillian: Yeah.

Elizabeth: So, tell us in wrapping up, if people want to work with you, can they? How can they find you? Tell us all the things.

Jillian: Okay. So, I am on social media, I’m on Instagram. I don’t always post, but I usually do stories. Although, I should maybe start posting again so people don’t think I’m incognito. So, you can always hit me up on Instagram. I also have a website. It’s called, jillianteta.com. And from there, you can join my email list. I have dozens of free programs and like education courses and checklists about a variety of specific and general digestive things. And then, you also can call or email my office manager, Melissa, at the clinic. So, I can give you all that information and you can kind of share it with folks if they want to work with me.

Elizabeth: Yeah. And that’ll all be in the show notes. Yeah, I am part of your email list and yes, you give out just amazing, great stuff. So, highly recommended for anyone who’s interested in improving their gut health, for sure.

Jillian: Yes. It’s great stuff. I mean, there’s so much to do. There’s so much that can be done. I like to give people hope in that way. There’s lots we can do.

Elizabeth: Well, and one of the reasons why I really wanted to have you on the show today was because I think that too many times people don’t see the importance of having proper gut health. And it’s just something that we don’t really think about. We take it for granted, definitely.

Jillian: Well, yeah. Until you have a problem. Right? Like when it’s all good until you like have to find a bathroom and you have 30 seconds to find it. Then, people are become highly motivated. But what I find is interesting about gut health is that again, this kind of goes back to the beginning of our conversation. We are very fixated on the stuff that we can control, right? Like, what am I eating? So, when people come in, they’ll have this like perfect diet and they’re like, what am I eating? What am I doing wrong? And it’s like, actually, like your diet is great. Do you sleep? Well, no.

So, it’s like we treat the gut through sleep. Right? Or through going for a daily walk or something that feels very seemingly unconnected or disconnected. But again, like when we think about the myriad of ways that the gut is connected to all other systems of the body, like a major way we treat the gut is through the nervous system.

Again, like that just relaxed comment I made, like it’s really like how are we going to get you to de-stress? Cause if we can de-stress you, we can de-stress your gut. And that prevents a ton of digestive distress. So, not only are our digestive issues so common, but many of the ways that we might think about approaching them can be quite uncommon. Like, go for a daily walk, or like go to bed. Sit down and chew your food when you eat and don’t have your laptop or your phone, like no electronics, like little, tiny things like that.

Elizabeth: I love it.

Jillian: So, there’s a lot to like fiddle around with gut health.

Elizabeth: Very cool. All right. Thank you for being here. I really appreciate it.

Jillian: Oh, thank you for having me. I appreciate you.

After we stopped recording, we decided that we’re going to have to do a follow up episode all around IBS, FODMAP Diets, and auto immunes protocols. This is such a rich topic of conversation, and I loved every second of the interview. I hope you enjoyed it too.

Have a great week, everyone. I’ll talk to you next time. Bye-bye.

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