That gut feeling

“I never imagined I’d be taking 10 pills a day. Now I am on vitamin D, iron, omega, magnesium, selenium, vit B12, B1, B2, vit C, quercetin, L-glutamine and L-carnitine,” says 33-year-old Deepti Siddhanti, who hails from Bengaluru and works at an intergovernmental organisation in Germany. 

“Figuring out what to eat has been thoroughly exhausting and overwhelming,” says Deepti, diagnosed with food intolerances. “When I first developed lactose intolerance, I found studies suggesting that processed foods can disrupt gut bacteria and lead to intolerances. Although I didn’t consume much processed food to begin with —avoiding sodas and junk food and rarely ordered out — I still chose to eliminate all processed items from my diet. I also stopped eating fake meat for protein and now rely on eggs, tofu, and legumes,” explains Deepti. 

“Histamine and gluten intolerances have meant I cannot eat any fermented food. Nothing with gluten. Histamine-high veggies and citrus fruits are a no-go. As a south Indian vegetarian, this literally wipes away three-fourths of my diet,” Deepti adds. Histamine is a natural compound that aids digestion and produces an immune response. 

Deepti was also diagnosed with gut dysbiosis, an imbalance in the gut microbiome and ‘leaky gut’, which is often used in gut health conversations. While increased intestinal permeability, called ‘leaky gut’ in popular parlance, is a recognised phenomenon, it is primarily associated with specific conditions like Inflammatory Bowel Disease (IBD) and Celiac disease rather than being a universal cause of health issues. The gut barrier is dynamic, and not all cases of permeability indicate disease, says Vineet K Sharma, Professor, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER), Bhopal. 

Gut issues have troubled 31-year-old Prathamesh, a resident of suburban Mumbai, for over a decade now. He has struggled with bloating and food intolerances. “I have been to a few doctors, including family practitioners and a specialised gastroenterologist, but I have never gotten an exact diagnosis,” he says. He has tried probiotics and “some herbal powders”, which, he says, haven’t worked.

A Reddit user told this writer that they have tried to be “kinder” to their gut by taking probiotic supplements. Having taken a food sensitivity test, the Redditor has realised that they are allergic to gluten and lactose, apart from foods like tomatoes, white rice and red/green peppers.” The solution this Redditor has been given by their nutritionist was to consume more fibre and avoid stress. 

Dr Kumar Parth, lead consultant surgical gastroenterologist at Sagar Hospital, Bengaluru’s Kumaraswamy Layout branch, says that a lot of patients who seek his advice suffer from lifestyle-related issues. Long work hours, untimely meals, skipping meals altogether, eating out and a lack of physical activity all contribute to gut health issues, he says. He points out that lifestyle-related problems have shot up post-Covid because of work-from-home schedules. Some of his patients who complain of bloating and flatulence also seem to consume an excessive protein-rich diet, he observes.

Probiotics prescribed by doctors and direct-to-consumer pills (D2C) have different dosages, says Dr Amarnath A, consultant medical gastroenterologist, Bangalore Gastro Centre Hospitals. “I have had eight to ten patients in the last six months who have come to me after using D2C gut health supplements that didn’t work in their case,” he adds. 

Citing the example of two conditions – Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) – Dr Amarnath explains that some symptoms like diarrhoea and bloating may be common to both conditions. People may opt for probiotic supplements based on symptoms, but these two conditions need different treatments, he adds. 

In India, the probiotics dietary supplements market is forecast to touch a little over $3,564 million by 2030, from a revenue of $1,207 million in 2023, according to Grand View Research’s market report. 

Not all probiotic supplements are equal, and different bacteria play different roles in gut health, explains Dr Kumar Parth, noting that buying probiotic supplements off the shelf is not a solution.

Ditch the detox

A cursory search on any shopping website will fetch you dozens of gut detox formulation results from a variety of brands. Does a detox work? “The idea that you can cleanse your gut is a myth. The process may flush out good bacteria with the bad bacteria and cause an imbalance in your gut flora. Detoxes or consumption of Chinese herbs may harm the liver,” warns Dr Kumar Parth. 

Can you ‘heal’ your gut?

Explains IISER Professor Vineet K Sharma, “The gut has a remarkable ability to adapt and recover from certain disruptions, but there is no universal 'gut healing' solution, and not all damage is fully reversible. Conditions such as IBS, IBD, and celiac disease require individualised medical treatment. Quick-fix detoxes or restrictive diets are not scientifically supported. Maintaining gut health involves a diverse, fibre-rich diet, polyphenol-containing foods (for ex: berries, green tea, onions), adequate sleep, stress management, and limiting unnecessary antibiotic use. When antibiotics are medically necessary, fibre intake and post-antibiotic recovery diets may help.”

Gut health on social media

The #guthealth hashtag has over 6.5 million posts, and #probiotics has over 2.2 million posts on Instagram. The hashtag for #kombucha, a popular fermented yeast tea, ‘booch’ in slang, has over 2.8 million posts, an indicator of the volume of gut health talk online.

Mumbai-based Barkha Surana, 31, an anthropologist and a freelance brand strategist, says that gut health talk has now turned into a “cultural commodity that signals wealth, self-discipline and even moral superiority.” “Pictures of people in fancy cafes sipping oat milk or artisanal kombucha signal that they can buy into a certain lifestyle,” she says. 

Barkha was diagnosed with an autoimmune disorder and joined a support group, which was when she realised that there was a dissonance between what brands were pushing out and the ground reality. Barkha observes how “self-care” has turned into “self-surveillance.” “Instead of better health, many are stuck in a cycle of anxiety, restriction, and wellness burnout,” she says.

Deepti Siddhanti, who has been diagnosed with food intolerances, says social media has helped her connect with others experiencing similar issues, but she’s cautious about where she sources her information, although she looks up Instagram and Reddit. Mumbai-based Prathamesh is equally cautious. He also uses platforms like Reddit and ChatGPT for information. “Social media influencers play a minor role for me. I have been facing my issues before social media influencers became a big deal,” he says, while noting that there are influencers who play a role in creating awareness. 

D2C gut microbiome tests: What’s the fuss all about?

Startups have begun to offer direct-to-consumer (D2C) gut microbiome tests that help examine the microorganisms in your gut through stool analysis. These companies also offer personalised nutrition advice based on such tests. 

Gastroenterologist Dr Kumar Parth says such D2C microbiome test kits are expensive and not very helpful. Further, D2C gut microbiome tests don’t operate in a regulatory landscape, he adds. 

While D2C gut microbiome tests may give you a broad picture, they are not trustworthy because the testing and reporting are not adequately evidence-based, says Tarini Shankar Ghosh, Assistant Professor at the Department of Computational Biology, Indraprastha Institute of Information Technology Delhi (IIITD).

Consultant medical gastroenterologist Dr Amarnath points out that the diagnostic methods that are validated and ideal are endoscopy and hydrogen breath tests (the latter used for problems like lactose intolerance or small intestinal bacterial overgrowth).

Gut Health 101

Here’s all you wanted to know about your gut and some more.

1.  What’s the gut microbiome?

The gut microbiome, also called gut flora or gut microbiota, refers to all the microbes that live in your digestive tract. The microorganisms in the gut aid digestion and keep your immune system and nervous system in good shape. 

2.  Is there a gut-brain axis?

The gut-brain axis is a two-way communication route. An intestine that is troubled can send signals to your brain and vice versa. The enteric nervous system (ENS) within the walls of your gut is called the second brain. Research says that a major portion of serotonin, the happy hormone, is synthesised in the gut. 

3.  What does the latest research say?

Computational microbiologist Tarini Shankar Ghosh says, “While a lot of data is emerging, we need more evidence-based studies across Indian cohorts. We also need more studies that track the same individuals over some time because the expression of the gut microbiome is variable.” 

Ghosh’s paper, published in Nature Reviews 2022, says that “age-related alterations in the gut microbiome are influenced by personal factors, including progressive physiological deterioration, as well as by lifestyle-linked factors such as diet, medication and reduced social contact.”

4.  What’s the deal with crapsules?

What is a buzzword when it comes to emerging gut microbiome research? ‘Crapsules’ are one area, according to Dr Ghosh. Before you wonder, crapsules refer to faecal microbiota transplantation/transfer (FMT), where freeze-dried faecal matter from a healthy donor is transferred to a patient. Another area of emerging research, he says, is the identification of future disease risk from the current gut microbiome in an individual. 

5.  What are prebiotics and probiotics?

Prebiotics: They are dietary fibre from legumes, nuts, seeds, and whole grains that nourish beneficial gut bacteria, supporting microbial diversity and metabolic health.

Probiotics: They are live microorganisms that may offer health benefits, but their effects are strain-specific. Most commercial probiotics do not permanently colonise the gut; their effect is temporary. 

Red flags to watch out for

According to Professor Vineet K Sharma and doctoral student Deepika Pateriya from IISER, Bhopal, here are the red flags to watch out for when it comes to gut health chatter online:

1.   Overpromising results: Claims like “heal your gut in seven days” or “fix your microbiome overnight” are largely exaggerated. Anyone pushing a universal "gut healing protocol" (for example, "everyone must avoid gluten”) is ignoring individuality.

2.   Demonising or idolising foods: If someone insists that a single food (like ‘kombucha’ or ‘kimchi’) will “cure” your gut issues or that all carbs/gluten/dairy are harmful, they may be oversimplifying science.

3.   Selling supplements or health programmes: If the person is pushing expensive probiotics, gut detoxes, or meal plans, be cautious. Many gut health supplements have little regulation and may not work as claimed.

4.   Lack of scientific references: Influencers often cite personal anecdotes and “it worked for me” stories. Reliable sources should reference systematic reviews, meta-analyses, or clinical trials (not just in vitro or rodent studies). 

5.   Fear-mongering language: Terms like “toxic,” “leaky gut,” “gut reset,” or “gut cleanse” are often misleading. The gut is resilient and doesn’t need “cleansing” through detox. Language like "toxic foods destroy your gut" or "leaky gut is causing all your health problems" is alarmist. 

6.   Self-proclaimed gut health coaches: Many influencers are self-proclaimed experts. A registered dietitian (RD), gastroenterologist or microbiome researcher is far more reliable than an online wellness coach.