In the recent years, the conversation around gut has increased tremendously. Although awareness on gut health has increased, there has been a rise in the cases of gut-related issues.
A 2023 survey has found that 7 out of every 10 people in urban India experience digestive or gut health issues. The survey also found that 59 per cent complain about it every week and 12 per cent suffer daily. A majority of the consumers (80 percent) believed that digestive/gut health issues could lead to long-term lifestyle diseases.
“The gut is the gastrointestinal system that starts from the oral cavity and ends at the anal canal. It is responsible for digesting food, absorbing nutrients, and excreting waste. Gut health refers to a balanced microbiome of bacteria, fungi, and viruses,” Dr Ronak Tate, Consultant Gastroenterology at Fortis Hiranandani Hospital, Navi Mumbai told Financial Express.com.
A 2023 study published in the Frontiers in Public Health, the epidemiology of digestive diseases has changed over the past decades. “Upper digestive system diseases, cirrhosis and other chronic liver diseases constituted the highest proportion of digestive disease DALY burden globally, which continued to increase and disproportionately affected low- to middle-SDI countries, underlining the need for effective disease-control strategies in these locations,” the study stated.
Why gut health is important?
Gut health is about how well your body digests food, absorbs nutrients, and maintains a balance of good and bad bacteria. Consequently, gut health can impact every system in the body, causing conditions like epilepsy, chronic fatigue, neurodegenerative disorders (e.g., Alzheimer’s), psychiatric illnesses, thyroid issues, autoimmune diseases, rheumatoid arthritis, food intolerances, IBS, IBD, skin problems, and heart and kidney issues.
“From an endocrinological perspective, the gut plays an integral role in regulating hormones such as ghrelin, leptin, insulin, and glucagon, which are responsible for appetite regulation, energy balance, and glucose metabolism. The gut also produces enteric hormones that signal the brain to regulate satiety and digestion,” Dr Mahesh Chavan Sr. Consultant Endocrinology, Apollo Hospitals Navi Mumbai told Financial Express.com.
Additionally, the gut houses a significant portion of the body’s immune system, influencing both metabolic health and inflammatory responses. Maintaining healthy gut function is therefore crucial not only for digestion but also for regulating metabolic processes, hormonal balance, and immune function, Dr. Chavan said.
What is the reason behind poor gut health?
Recent trends in poor gut health are primarily driven by lifestyle factors, including poor dietary habits, lack of physical activity, and chronic stress, Dr. Chavan revealed.
“Diets rich in refined sugars, unhealthy fats, and low in fiber are linked to gut dysbiosis—an imbalance in the microbiota—which in turn disrupts gut function. This dysbiosis contributes to insulin resistance, obesity, and other metabolic disorders. In India, dietary transitions associated with urbanization have led to increased consumption of processed, calorie-dense foods, further exacerbating gut imbalances,” Dr. Chavan told Financial Express.com.
It is noteworthy that the widespread use of antibiotics, both in clinical settings and agriculture, has been linked to gut microbiota disruption, increasing the risk of conditions like obesity and autoimmune diseases.
“Chronic stress, common in urban environments, also affects the gut-brain axis, influencing the release of stress hormones such as cortisol, which can negatively impact gut function. Inadequate sanitation and infections due to contaminated food and water contribute to gastrointestinal diseases, which in turn impact gut microbiota and metabolic health. As a result, India faces a dual burden of malnutrition and emerging metabolic disorders, with rising rates of diabetes, cardiovascular diseases, and gut-related diseases like Inflammatory Bowel Disease (IBD),” he said.
How gut health is linked with other disorders?
Poor gut health has significant consequences, particularly on metabolic and endocrine functions. “When the gut microbiota becomes imbalanced, it can interfere with glucose metabolism, leading to conditions like insulin resistance and Type 2 diabetes. Gut dysbiosis has been shown to impair insulin signaling, making it harder for the body to process glucose and store energy properly, which contributes to obesity and Type 2 diabetes,” Dr. Chavan told Financial Express.com.
Additionally, the imbalance in gut bacteria can lead to chronic low-grade inflammation, which plays a role in the development of various autoimmune disorders.
Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis, is an example of an autoimmune condition triggered by abnormal immune responses to gut bacteria. Chronic inflammation in the gut is also associated with other autoimmune diseases, such as rheumatoid arthritis, Hashimoto’s thyroiditis, and Type 1 diabetes.
Globally, metabolic diseases related to poor gut health are becoming more prevalent. According to the World Health Organization (WHO), over 422 million people worldwide are affected by diabetes, and the obesity rate has tripled since 1975. In India, more than 77 million adults are living with diabetes, and approximately 135 million adults have metabolic syndrome.
“These statistics highlight the growing burden of metabolic diseases linked to poor gut health. Similarly, conditions like IBD are rising in India, particularly in urban areas where dietary changes and sedentary lifestyles are more common,” he said.
What are the symptoms of poor gut health?
Poor gut health can manifest in a variety of symptoms, many of which may seem unrelated to digestion. Gastrointestinal symptoms like bloating, gas, constipation, diarrhea, and acid reflux are common indicators of gut dysfunction.
“From an endocrinological perspective, symptoms can also include metabolic disturbances such as difficulty losing weight, unexplained fatigue, and abnormal hunger or satiety. Disrupted gut health may impair the production and signaling of hormones like ghrelin, which stimulates appetite, and leptin, which signals fullness, leading to overeating and weight gain,” Dr. Chavan said.
In addition to metabolic issues, poor gut health is often associated with mental health symptoms such as anxiety, depression, and brain fog. This is due to the gut-brain axis—the communication between the gut and the brain—which affects mood and cognitive function. Skin conditions like acne, eczema, and psoriasis are also linked to poor gut health, as inflammation in the gut can trigger immune responses that affect the skin.
Moreover, autoimmune symptoms such as joint pain and chronic body aches may occur as a result of systemic inflammation originating in the gut, he said.
Can gut health-related issues be treated?
Treating gut-related diseases often involves addressing both the microbial imbalance and the associated metabolic or hormonal disruptions. Dr. Chavan maintains that the primary approach is through dietary changes.
“A diet rich in fiber, prebiotics (which feed beneficial gut bacteria), and probiotics (which replenish beneficial microbes) can help restore gut health. Prebiotic foods like onions, garlic, and bananas nourish gut bacteria, while probiotic-rich foods like yogurt and kimchi help replenish beneficial microbes. Reducing the intake of processed foods, refined sugars, and unhealthy fats is essential to reducing inflammation and promoting gut healing,” he said.
Physical activity is another key treatment for poor gut health, as exercise has been shown to increase the diversity of gut microbiota and improve gut motility, aiding digestion and metabolism. Stress management techniques, including mindfulness, meditation, and yoga, can significantly improve the gut-brain connection by reducing the release of cortisol and promoting gut health.
For individuals suffering from conditions like irritable bowel syndrome (IBS), Inflammatory Bowel Disease (IBD), or Type 2 diabetes, medications may be required. Antibiotics are used to treat infections, though they should be used sparingly to avoid disrupting the gut microbiome. Probiotic supplements may also help restore microbial balance. For diabetes management, medications such as metformin regulate glucose metabolism, while GLP-1 receptor agonists help improve insulin sensitivity. For autoimmune conditions, immunosuppressive drugs may be prescribed to reduce inflammation and control disease activity.
In severe cases of gut dysbiosis or metabolic diseases, advanced therapies like fecal microbiota transplants (FMT) or anti-inflammatory treatments may be considered, he said.
Brain-Gut Connection
Moreover, endocrinologists are increasingly recognizing the role of the gut in managing and preventing metabolic diseases such as diabetes and obesity.
“The gut-brain axis, which links gut health to mental and emotional well-being, is an area of growing interest in research. Advances in gut microbiome research suggest that personalized medicine may become an important tool in treating metabolic disorders, as treatments tailored to an individual’s unique microbiome profile may prove more effective,” Dr. Chavan told Financial Express.com.
In India, addressing poor gut health requires a multifaceted approach, considering both dietary habits and the rising stress levels in urban areas.
Education on the importance of gut health and promoting healthier lifestyle choices, including increased physical activity and dietary modifications, can have a significant impact on reducing the incidence of gut-related diseases and improving overall metabolic health, he said.