Gut check: Doctor explains why some popular health trends miss the mark

Many popular gut-health trends promise better digestion, more energy or a “cleaner” body. But according to Mercy in St. Louis gastroenterologist Dr. Faiza Bhatti, some of the most widely promoted solutions are misunderstood — and in some cases may even do more harm than good.

Bhatti says patients frequently ask about probiotics, gluten-free diets and detox teas — three trends that dominate wellness marketing and grocery store shelves. The science behind them, she says, is far more nuanced than many people realize.

Probiotics aren’t for everyone

Probiotics — live bacteria found in supplements and certain foods — are often marketed as a daily necessity for digestive health. Bhatti says that’s not true for most people.

“Not everyone needs probiotic supplements,” she said.

Early studies decades ago appeared to support routine probiotic use, leading to widespread adoption. But newer research shows benefits mainly in specific situations.

Bhatti compares the gut microbiome — the trillions of bacteria living in the digestive tract — to a delicate ecosystem.

“If you imagine it like the ecosystem of a jungle, and it’s already perfectly designed for your body, you don’t need to meddle with it,” she said. “Changing the microbiota can sometimes cause harmful symptoms like bloating, constipation or diarrhea.”

Probiotics may help in certain conditions, such as after a course of antibiotics, which kill both harmful and beneficial bacteria. They can also be helpful for people recovering from Clostridioides difficile infections, some inflammatory bowel disease complications like pouchitis, and certain cases of irritable bowel syndrome.

Outside those circumstances, Bhatti advises people to talk with their health care provider before starting supplements.

Gluten isn’t harmful for most people

The gluten-free diet has become a widespread health trend, but Bhatti says most people don’t need to avoid it.

“Gluten is not harmful for the majority of people,” she said.

Three groups should avoid it, she explained:

• People with celiac disease, an immune-mediated condition in which the body reacts to gluten and damages the small intestine.
• Those with a wheat allergy, a true allergic reaction to wheat products.
• Individuals with non-celiac gluten sensitivity, in which symptoms such as bloating, diarrhea and abdominal pain occur after consuming gluten.

Bhatti noted that only about 1% of Americans have celiac disease, though a larger portion — roughly 20% — may experience gluten sensitivity.

For those without symptoms, gluten-containing foods can offer nutritional benefits.

“Whole grains that contain gluten are often rich in fiber and B vitamins,” she said. “They can support gut health.”

Because there is no medical test for gluten sensitivity, doctors typically evaluate symptoms by removing gluten from the diet and observing whether symptoms improve.

Detox teas don’t “cleanse” your body

Another booming wellness product is detox tea, marketed as a way to flush toxins and cleanse the digestive system.

Bhatti says the name is misleading.

“Detox teas are basically laxatives,” she said. “They just make you have more bowel movements.”

Rather than removing toxins, the teas simply stimulate the intestines and cause frequent bowel movements.

“You’re not removing toxins,” she said. “You’re just removing regular stool.”

Regular use of laxatives can create digestive problems and is generally not recommended without medical supervision. Bhatti said bowel-cleansing regimens are sometimes prescribed for specific medical conditions, such as severe constipation caused by colon inertia, but those treatments are carefully guided by physicians.

Calling them “detox,” she said, is largely a marketing strategy.

Food sensitivity panels often mislead

Bhatti also cautions against widely sold at-home food sensitivity tests that claim to diagnose digestive problems through blood or stool samples.

Many of those tests measure IgG antibodies to foods. Bhatti said those antibodies typically indicate normal exposure to food — not intolerance or disease.

Major medical organizations, including the American Gastroenterological Association, American Academy of Allergy, Asthma and Immunology, and the European Academy of Allergy and Clinical Immunology, advise against using such tests to diagnose food sensitivities.

“The proper way to evaluate symptoms is through an elimination diet,” Bhatti said, where suspected foods are removed and then gradually reintroduced to see whether symptoms return.

A reminder for patients

Bhatti says the biggest problem with many wellness trends is that they encourage people to spend money on solutions they may not need.

“If it gives someone peace of mind, that’s their choice,” she said. “But medically, many of these things are not necessary.”

Her advice: before buying into a trend, talk with a health care provider about whether it’s actually helpful for your body.

Ella Rae Greene, Editor In Chief