The more we learn about the gut, the more we realise it's basically the control centre for everything - mood, skin, colon cancer risk, and your ability to enjoy a good burrito without regret. A panel of gastroenterologists has weighed in with 16 ways to keep the ol' digestive tract humming, and spoiler: most of them involve fibre and not scrolling TikTok on the toilet.
“Our gut is a complex machine,” says Dr Ajay Verma, a consultant gastroenterologist at Kettering General Hospital in Northamptonshire. “It is constantly providing us with the nutrition we need, initially to grow and develop, and then for us to survive, thrive and repair from injury and illness.” The secret to keeping it running? Verma puts it simply: “Make sure what you put into it is balanced, and that you clear out its waste products adequately.”
Dr Nisha Patel, a consultant gastroenterologist and interventional endoscopist at Imperial College Healthcare NHS Trust in London, says the most common gut complaints she sees are irritable bowel syndrome (IBS), gastroesophageal reflux disease, inflammatory bowel disease and constipation. Her recipe for a happy gut: “balance, diversity and routine.”
Start with a diet high in fibre, fruit, vegetables, legumes and wholegrains, says Patel, and avoid the usual suspects: “alcohol, caffeine, fatty or spicy foods and artificial sweeteners. We know that large, late meals can also trigger gastrointestinal symptoms.” The Mediterranean diet gets a gold star - Dr Nurulamin Noor, a clinical lecturer in gastroenterology at the University of Cambridge and Cambridge University Hospitals, says studies show it leads to better digestive health. So: plenty of fruit, vegetables and fish, and try to go easy on processed foods, high-dairy foods and red meats.
Need a specific fibre hero? “Kiwi is one of the most effective dietary interventions for constipation,” says Verma. He also recommends linseeds or flax seeds as “low-cost, natural laxatives that are very well tolerated.” Stir them into yoghurt with some fruit, and your colon will send a thank-you note.
You're almost certainly not eating enough fibre. “Over 90% of Americans don’t meet their fibre goals,” says Dr Wendi LeBrett, a California-based gastroenterologist. A 2023 report found that 96% of British people aged 11 and up are also fibre failures. The target is 25-35g per day depending on your size. “An apple has about 4g of fibre. Then for lunch or dinner, a serving of beans can get you 5-6g of fibre,” says LeBrett. From almonds to broccoli to oranges, you have to consciously choose fibre - or, as LeBrett admits, “some people need to take a fibre supplement to reach that goal.”
Fibre isn't just about keeping things moving; it's also a cancer-fighting champion. “We know there is a strong association between how much fibre you have and a lower risk of getting colon cancer,” says LeBrett. “It feeds your gut microbiome, and that plays a role in your mood, skin and many other factors around your body. Fibre has been shown to be beneficial for cardiometabolic health: it helps with blood sugar regulation, cholesterol and overall heart health.”
Even if you're on a high-protein diet, don't ditch the fibre, warns Verma: “You may be having more protein in your diet to help with muscle building and the way your body functions, but that may mean you reduce how much fibre you have.” Add more fibre where necessary.
More fibre can also help with wind. “Wind to a degree is a normal phenomenon as we digest our food,” says Verma. “If you have a lot of wind, it is probably because you’ve got stuff sat in your bowels for longer than it needs to be. Increase the amount of fibre in your diet to clear your bowels as much as possible.”
“We’re in a bit of a mess with bowel cancer,” Verma adds. “We are seeing more and more people with these cancers under the age of 50, with high-profile cases such as Deborah James and Adele Roberts. We are still not fully sure why these cancers are rising among younger people, but some have suggested, without concrete evidence, that ultra-processed foods (UPFs) may be a component.” He notes that a completely UPF-free diet is “virtually impossible” - “Having a burger is not a terrible thing: having a burger twice a day, every day for a week, is a problem.” He recommends regular meals, fresher options, and plenty of fruit and vegetables. And take up bowel cancer screenings: in the UK, those aged 50-74 get a free poo test every two years.
What do the experts actually eat? Patel says she eats “a varied, plant-rich, low-sugar, moderate-fat, low-UPF diet, avoiding too much alcohol. It sounds boring, but I try not to make it boring. I never say no to things; I will eat pizza very happily. It is all about balance. Life’s got to be fun.” Noor focuses on a Mediterranean-style diet and limits takeaways and processed foods. LeBrett restricts processed meats like sausage, bacon and ham because “we know that they have a strong colorectal cancer risk.” But she admits, “sometimes I really want bacon in my sandwich, and once in a while is fine. I don’t buy it to cook at home.”
Beyond UPFs and alcohol, LeBrett warns about certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and the overuse of antibiotics. Verma adds that smoking can cause reflux and increase bowel cancer risk.
When it comes to pooping, the goal is to feel empty - not gassy or bloated. Squat stools help “open up the bowel, allowing easier defecation,” says Verma. “Some swear by them.” How often is normal? “Anywhere from three times a day to three times a week,” says Patel. “Any of those will be healthy if it’s your usual pattern.”
The gut-brain connection is real. “We know that the gut and brain are in constant conversation,” says Patel. “Stress can speed up or slow down gut motility. It can heighten pain sensitivity, and trigger bloating and cramping. In some people, it can alter the microbiome as well.” Her advice: slow, diaphragmatic breathing exercises, and if that fails, cognitive behavioural therapy or gut-directed hypnotherapy. LeBrett notes, “People always quote the fact that there are more serotonin receptors in your gut than there are in your brain. The same hormones and neurotransmitters that affect the brain can also impact the gut.”
Hydration is underrated, says Patel: “Water softens the stool and supports the smooth movement of stools through the colon, so low intake obviously causes harder stools, which affects draining and you get bloated.” Aim for 1.5-2 litres per day, including coffee, fruit, soups and other food. Patel uses a bottle that reminds her to drink 150-200ml every hour.
Movement matters: “I always recommend walking after a meal if you’re able to,” says LeBrett. The general exercise recommendation is 150 minutes per week, with core strengthening exercises like pilates and yoga helping with diaphragmatic breathing and the gut-brain axis.
Don't forget your mouth: “The digestive tract is anywhere from your mouth to your bottom end,” says Noor. “We know that oral health is really important and probably has a major role in diseases lower down the gut, but it is relatively underappreciated.” So brush, floss and see the dentist.
Sleep is crucial. LeBrett has researched its impact: “Studies show that, in patients with IBS who had poor sleep, it was associated with worsened symptoms the next day.”
Probiotics get a lukewarm review from Verma: “We don’t have compelling evidence that they can be used for a wide variety of conditions. Probiotic yoghurt drinks are not expensive, so if someone taking them feels well on them, then it’s not an unreasonable step.” LeBrett prefers prebiotics - “the food that we eat - fruit, vegetables, wholegrains, legumes - that the microbiome thrives on.”
Red flags to watch for? Verma says: “If you have rectal bleeding or a change in your bowel habits that persists for three to four weeks or more, then you should get that checked out. Another red flag symptom is unintentional weight loss. If you suddenly lose half a stone, then it is always worth seeking medical advice.”
And about that phone on the toilet? “There was a study that found scrolling on the toilet and smartphones in the toilet increases your risk of haemorrhoids, and can also cause pelvic floor dysfunction,” says LeBrett. “I won’t say I never do it, but it is something I try not to do. Plus, it’s not very hygienic to have your phone in the bathroom.” Verma is more relaxed: “A direct link between phone use and bowel issues has not been proven and perhaps may be a simple association. Those who need to spend a lot of time in the loo will often use their phone to pass the time.”
Patients often apologise for discussing digestive symptoms, says Patel, but “we talk about it every day, and there is really no embarrassment on our side. It is only a desire to help people feel better, put their mind at ease and to rule out anything serious. I always say to my patients that their symptoms really do matter, and they deserve to feel well. Getting help early is always the best step.”