The Gut Health Podcast

Latest Episodes:

Pelvic Floor PT Explained: Who Needs It and Why? (with guest Alicia Jeffrey-Thomas, PT, DPT) May 01, 2025

Show notes

Pelvic floor physical therapy (PFPT) is a crucial yet often overlooked component of gut health that can dramatically improve quality of life for people suffering from bowel issues, bladder problems, or pelvic pain. Dr. Alicia Jeffrey-Thomas joins us to demystify and normalize this specialized therapy and explain how proper pelvic floor function impacts everything from constipation to sexual health.
• Understand that daily bowel movements don't necessarily mean you're not constipated
• What happens during a PFPT session and how therapists create a safe + comfortable environment
• The importance of proper pooping position
• Why breathing techniques and sounds (like mooing!) can help relax your pelvic floor during bowel movements
• Demystifying tools like pelvic wands and dilators for at-home maintenance
• How dyssynergic defecation affects approximately 50% of people with constipation and how PFPT can help
• Why all women can benefit from pelvic floor PT after childbirth (and even during pregnancy)
• Men face pelvic health issues too, like post-prostate surgery incontinence
• The downside of "peeing just in case" and how it trains your bladder to signal fullness prematurely
If you've experienced pelvic floor issues, don't accept them as normal - seek help from a pelvic floor physical therapist who can address these problems and improve your overall quality of life.

References and Resources:

Rao SS, Patcharatrakul T. Diagnosis and Treatment of Dyssynergic Defecation. J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi: 10.5056/jnm16060. PMID: 27270989; PMCID: PMC4930297.

Ye AL, Johnston E, Hwang S. Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies. Curr Oncol Rep. 2024;26(3):212-220. doi:10.1007/s11912-024-01498-6

Where to find a pelvic floor PT:

Alicia Jeffrey-Thomas' book, Power to the Pelvis.

Got constipation? Check out Kate's constipation guide.

This episode is sponsored by Ardelyx.

Learn more about Kate and Dr. Riehl:
Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast
Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.
The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Living with IBS: How to Manage Symptoms Without a Major Diet Overhaul Apr 01, 2025

Show notes

Join us as we discuss effective non-diet focused methods for IBS relief. In this episode, Kate and Dr. Riehl review key factors on how gender can influence common symptoms of IBS.

Hormones significantly influence IBS symptoms, with women being diagnosed 2.5 times more often than men, in part due to differences in gut function and pain perception.

This episode features the following key discussion areas:
• Women's fluctuating estrogen and progesterone levels affect gut motility and pain sensitivity throughout the menstrual cycle
• Visceral hypersensitivity causes normal digestive sensations to be interpreted as pain - like a car alarm going off unnecessarily
• The "microgenderome" refers to gender differences in gut microbiome that may contribute to women's higher rates of IBS and autoimmune conditions
• Gut-directed hypnotherapy helps reprogram the subconscious mind to interpret gut sensations more accurately, with 70-80% improvement rates
• Pelvic floor physical therapy can help address muscle tension that contributes to both constipation and diarrhea symptoms
• Non-diet approaches including medications, supplements like enteric-coated peppermint, and lifestyle factors are effective IBS management tools
• Regular exercise (especially in nature), adequate sleep, and stress management techniques complement other treatments
For more information on IBS-C treatments, check out our dedicated three-part series in episodes 14, 15, and 16.

This podcast has been sponsored Ardelyx and Nerva by Mindset Health.

References:

Mulak A, Taché Y, Larauche M. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014;20(10):2433-2448. doi:10.3748/wjg.v20.i10.2433

Chang L, Heitkemper MM. Gender differences in irritable bowel syndrome. Gastroenterology. 2002;123(5):1686-1701. doi:10.1053/gast.2002.36603

Houghton LA, Jackson NA, Whorwell PJ, Morris J. Do male sex hormones protect from irritable bowel syndrome?. Am J Gastroenterol. 2000;95(9):2296-2300. doi:10.1111/j.1572-0241.2000.02314.x

Peters SL, Yao CK, Philpott H, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):447-459. doi:10.1111/apt.13706

Is a leaky gut really the root of your ailments? Here’s the science. (with guest Alessio Fasano, MD) Mar 03, 2025

Show notes

Is "leaky gut" real or just another wellness buzzword? In this episode of The Gut Health Podcast, we cut through the controversy with Dr. Alessio Fasano, a renowned gastroenterologist and microbiome expert from Mass General Brigham. Dr. Fasano explains what happens when the gut’s protective barrier is compromised, resulting in increased intestinal permeability, and how this can affect not only gut health but also overall well-being.

While some level of intestinal permeability is essential for health, in the presence of an altered gut microbiome, it can allow harmful molecules such as bacterial endotoxins and undigested food particles to pass through the intestinal lining. This can lead to inflammation, immune system activation, and may contribute to a variety of health issues, including autoimmune diseases, gastrointestinal disorders, heart disease, and more.

We explore the molecular mechanisms that control intestinal permeability, examining how factors like epigenetic changes, diet, stress, and environmental factors can all impact the integrity of the gut barrier. Dr. Fasano breaks down the latest research on how intestinal permeability interacts with the immune system and other organ systems, highlighting the complex bidirectional relationship between gut health and overall wellness.

Join us as we explore cutting-edge research on gut health, from breakthrough treatments to personalized diets and biomarkers for gut permeability. Tune in for expert insights and practical strategies—like a plant-forward diet and stress management—to strengthen your gut and overall well-being.

References:

Effects of dietary components on intestinal permeability in health and disease.

Unfermented B-fructans Fibers Fuel Inflammation in Select Inflammatory Bowel Disease Patients.

High FODMAP diet causes barrier loss via lipopolysaccharide-mediate mast cell activation

A Randomized Placebo-Controlled Trial of Dietary Glutamine Supplements for Post-Infectious Irritable Bowel Syndrome.

Bovine Colostrum in Increased Intestinal Permeability in Healthy Athletes and Patients: A Meta-Analysis of Randomized Clinical Trials.

What to do about the leaky gut?

Part 3 of the IBS-C series: Finding Your Path: A Personal Journey to Constipation Relief with Erin Judge, RD Feb 24, 2025

Show notes

What if you could navigate the complexities of IBS without falling into restrictive habits or feeling overwhelmed? Join us for an insightful conversation with Erin Judge, a registered dietitian nutritionist as she shares her compelling journey from childhood challenges with IBS-C to becoming an advocate for patient-centered care. Erin opens up about her early experiences with gastrointestinal issues, exacerbated by a Giardia infection painting a vivid picture of the emotional and physical hurdles she faced living with the complexities of IBS, in a time in which, IBS research and treatment modalities were limited.
Erin's story is a testament to resilience and the important ways resources for IBS management have evolved over the last decade. She reflects on how understanding balanced nutrition, avoiding restrictive habits and adopting an enriched lifestyle have been key to her management strategies.
Listeners will gain valuable insights into practical strategies for constipation relief, emphasizing the gut-brain connection's role in managing symptoms. Erin discusses the significance of lifestyle adjustments, such as movement, adequate hydration, supportive dietary changes, and stress regulation, offering a toolkit to empower individuals facing similar challenges. By sharing her knowledge and experiences, Erin aims to foster hope and confidence, encouraging a guilt-free approach to health and wellness for those living with IBS.

This episode is sponsored by Ardelyx.

Part 2 of The IBS-C series: Mind Your Gut: Diet and Lifestyle Solutions for Constipation Feb 17, 2025

Show notes

Join Dr. Riehl and Kate as they share practical lifestyle strategies for managing IBS with constipation. Studies show that up to 84% of IBS patients experience GI distress related to eating, with most triggers linked to carbohydrate intake—particularly highly fermentable ones like FODMAPs. Learn how the low FODMAP diet, the most extensively researched dietary approach for IBS, stacks up against traditional therapies and medications. Kate also explores other researched diet options for IBS, including the Mediterranean diet and the UK NICE IBS diet guidelines.
Dr. Riehl discusses the intricate gut-brain connection and presents evidence-based therapies for managing IBS symptoms. She provides an in-depth review of a range of treatments, including mindfulness techniques, gut-directed hypnosis, and other effective interventions, offering a comprehensive approach to symptom relief.
Finally, we explore simple, holistic lifestyle changes that can complement IBS management. From the benefits of eating a wide array of colorful plants, engaging in mindful eating, to stress reduction and healthy living techniques. By the end of this episode, you'll be equipped with a variety of self-care and nurturing practices that align with your personal values, helping you find joy, reduce stress, and better manage your IBS symptoms.

Diaphragmatic breathing demonstration

Book: Real Self-Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Includes)

References:

Nutrition:

Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis.

The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome

Clinical Trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome

UK Nice Guidelines IBS

CAM & Sleep:

Complementary and Alternative Therapies for Chronic Constipation

Sleep Duration in Constipation

This episode is sponsored by Ardelyx.

Part 1 of the IBS-C series: Pathways to Relief: Understanding Medications for Constipation (with Justin Brandler, MD) Feb 10, 2025

Show notes

This episode launches the first part of a 3-part mini-series on IBS-C, shedding light on the complexities of this widespread condition that affects millions of people across the U.S. It stresses the importance of a holistic, patient-centered approach to managing IBS-C. We explore the various medications used to treat IBS-C, including both over-the-counter options and prescription drugs, offering a comprehensive review. Our expert guest, Dr. Justin Brandler, a neurogastroenterologist at Virginia Mason Franciscan Health, provides valuable insights into the mechanisms and effectiveness of these treatments.

Dr. Brandler simplifies the intricate science and treatment of IBS into easy-to-understand concepts. He likens his role in treating IBS to that of both a plumber and an electrician. As a disorder of gut-brain interaction (DGBI), IBS affects how the brain and spinal cord process signals, influencing gastrointestinal symptoms.

Different patients respond to different treatment approaches. Dr. Brandler discusses medications that target the "plumbing" aspect of IBS, including pharmaceutical options like linaclotide, tenapanor, and lubiprostone, as well as over-the-counter treatments such as magnesium oxide, senna, and bisacodyl. He also highlights neuromodulators, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), and their role in adjusting the nervous system to help alleviate IBS symptoms.

We explore essential tips for making the most of your medical appointments, such as organizing a concise summary of your medical history and symptoms to ensure clear and effective communication, including outlining your goals. Preparing ahead of time can help your healthcare providers deliver the best possible care and make the right referrals for your needs.

This episode is sponsored by Ardelyx.

Resources:

Living your BEST IBS Life: Practical Tools to Beat the Battle with your Bowels by Justin Brandler, MD via IFFGD

Mechanisms of Action Considerations in the Management of IBS-C

The Promise of Vagus Nerve Stimulation and Virtual Reality Therapies for Gut Health and More with Dr. Brennan Spiegel Feb 03, 2025

Show notes

Can technology transform the way we approach health and healing? In this episode, we explore the intersection of neuroscience, innovation, and the mind-body connection with Dr. Brennan Spiegel from Cedars-Sinai. Dr. Spiegel challenges the long-standing myth that the mind and body function separately, revealing how our thoughts, emotions, and physiological responses are deeply intertwined.

We take a deep dive into alternative therapies that go beyond conventional treatments, including vagus nerve stimulation (VNS) and its impact on relaxation, well-being, and potential applications in treating health conditions. From implanted devices to non-invasive, direct-to-consumer options, we break down how VNS works and its role in the parasympathetic nervous system (think: rest and digest). We also discuss percutaneous electrical nerve field stimulation (PENFS), a distinct yet related therapy offering new opportunities for managing gastrointestinal disorders.

But the innovation doesn’t stop there. We explore the growing role of virtual reality (VR) in healthcare, examining its influence on physiology, pain management, and patient outcomes. Backed by research from leading institutions like Cedars-Sinai and the Mayo Clinic, we uncover how VR is shaping modern medicine. Also, Dr. Spiegel shares fascinating insights on how gravity affects the body and how cutting-edge technology provides immersive healing experiences for patients in need.

Join us as we navigate this exciting frontier where technology and health converge, offering fresh perspectives on how VNS, VR, and the power of the mind-body connection may revolutionize medicine.

Tune in now and discover how these advancements could change the future of healthcare and well-being.

This episode is sponsored by Ardelyx.

References:

Vagus Nerve Stimulation

Therapeutic Efficacy of Neurostimulation for Depression: Techniques, Current Modalities, and Future Challenges

Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomized, double-blind, sham-controlled trial

Resources mentioned by Dr. Brennan Spiegel

www.virtualmedicine.org

SynerGI - IBS VR Program available through research studies

Xaia - VR support program available through Apple Vision Pro

Tripp VR - Immersive meditation program on mobile and VR devices

Vagustim - Vagus nerve stimulation product mentioned by Dr. Spiegel (contains marketing affiliate link). Get an extra 20% off by using coupon code: GUTHEALTH_20!

Sip Smart: Alcohol and Your Gut (with guest Ponni Perumalswami, MD) Jan 02, 2025

Show notes

Can drinking alcohol truly offer any health benefits, or is that just a myth we’re eager to believe? In this episode, we aim to inspire a renewed commitment to wellness in the new year with our guest, Dr. Ponni Perumalswami, a prominent hepatologist at the University of Michigan, who helps us unravel the complicated relationship between alcohol, the gut, and liver health. With her expertise, we tackle common misconceptions and explore the notion that less is more when it comes to alcohol consumption.
We dive into definitions that may surprise you, such as the different thresholds for binge drinking and heavy alcohol use among men and women. Dr. Perumalswami sheds light on the stigma associated with alcohol abuse and how it can impede access to support, urging healthcare professionals to improve patient assessments for alcohol use while providing a safe and supportive approach to care. We explore alcohol use disorder as a chronic brain condition and emphasize the essential need for comprehensive support for those affected. Additionally, we examine the interaction between alcohol use and common mental health conditions like anxiety and depression.
Whether you dabble in an occasional cocktail or perhaps have found yourself drinking more than you like, we provide tangible (and tasty) strategies for reducing alcohol intake and promoting healthier habits. Discover how simple changes such as opting for a fun mocktail and drinking less can enhance sleep, relationships, and overall well-being. Join us as we advocate for making informed choices towards a healthier, happier you.
References:
Alcohol's Impact on the Gut and Liver
Alcohol, the gut microbiome and liver disease
Check your alcohol intake with CDC's Quiz

Gut Check: Kate Scarlata and Dr. Megan Riehl's Top 10 Strategies for Gut Health and Wellness Dec 04, 2024

Show notes

Did you know that a balanced gut microbiome can improve nutrient absorption, reduce inflammation, and support mood regulation? Incorporating simple habits into your daily routine—such as eating fiber-rich foods, staying hydrated, restful sleep and managing stress—can make a significant difference in how your digestive system works and gut microbiota function. Join Kate Scarlata and Dr. Megan Riehl on this must-listen episode of The Gut Health Podcast as they break down their top 10 tips for gut health and offer actionable strategies for overall wellness!
You will learn the key elements that link stress to our digestive health, exploring everything from the impact on gut motility to the downstream effects on our resident gut microbiota. Learn the science behind cognitive behavioral therapy (CBT), meditation, and the connection to digestion.
Explore the power of nutrition to supercharge your gut microbiota but also the fascinating impact of diet on mood. With guidance on incorporating fiber-rich and fermented foods into your diet, Kate and Dr. Riehl emphasize gentle introductions for sensitive tummies and the many benefits of regular exercise for both the body and the mind. Tune in for engaging tips and personal stories that empower your journey to a balanced and happy life for you (and your gut!).
Podcast Reviews (Thank you!!)

References:

Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement
Alteration of faecal microbiota balance related to long-term deep meditation

Diet and Gut Microbiome: https://pmc.ncbi.nlm.nih.gov/articles/PMC9455721/

Benefits of Forest bathing: https://pmc.ncbi.nlm.nih.gov/articles/PMC6886167/pdf/12199_2019_Article_822.pdf

Navigating Life with Celiac Disease: Insights from Dietitian Experts Nick Trott and Lori Welstead Nov 05, 2024

Show notes

Discover the intricate world of celiac disease with insights from two esteemed GI dietitian experts, Nick Trott of the Royal Hallamshire Hospital in Sheffield, England and Lori Welstead, from the University of Chicago Medicine. Within minutes of this episode beginning, you learn that a celiac diagnosis can happen in the absence of noticeable GI symptoms and that it is possible to find great delicious gluten-free meals outside your home with some tips and tricks!
Kate, Dr. Riehl and their guests highlight the challenges and triumphs of living gluten-free head-on, unraveling common misconceptions surrounding gluten-related symptoms and the necessity of gluten-free diets. We shed light on personal stories of dietary transitions (and the often undiscussed topic of food shaming), the grief of losing gluten, and the resilience needed to embrace a new lifestyle. While there can be emotional and nutritional challenges that accompany this diagnosis, you will feel validated and hopeful throughout this episode as you hear the latest research advancements and the evolving landscape of celiac disease management.
You are in for a gluten-free treat with Episode 10 as it is packed with practical guidance, hot off the press science and expert insights for anyone touched by or interested in celiac disease.
Helpful information and resources

Information on the drug development pipeline:

https://www.beyondceliac.org/research/drugdevelopment/drug-development-pipeline/

Learn about the clinical trial process:

https://www.beyondceliac.org/wp-content/uploads/2020/10/Clinical-Trial-Process-Infographic-from-Beyond-Celiac.pdf
The Dating and Celiac Disease Study

Lebovits J, Lee AR, Ciaccio EJ, Wolf RL, Davies RH, Cerino C, Lebwohl B, Green PHR. Impact of Celiac Disease on Dating. Dig Dis Sci. 2022 Nov;67(11):5158-5167.

https://pubmed.ncbi.nlm.nih.gov/35635630/

Restaurant finding app: Find Me Gluten Free

America's Test Kitchen book: How Can it Be Gluten-Free

Podcast and documentary: The Celiac Project

Third party testing: Gluten Free Watchdog
Thank you to Zego Foods for the sponsorship of this episode.