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The importance of a healthy gut
The gut — which includes the stomach, small and large intestines, rectum and anus — plays a vital role in the body’s overall health and wellbeing. Not only is it where food is digested and waste excreted, it’s also where nutrients and medications are absorbed into the blood. But there’s far more to the gut than that.
The gut is controlled by a complex nervous system made up of hundreds of millions of neurons from the oesophagus to the rectum, leading scientists to dub it the ‘second brain’. Indeed, the gut is the only bodily organ able to think for itself and function independently from the brain. And while it’s long been known that the brain can affect the gut — butterflies in the stomach when we’re nervous or excited for example — what’s lesser known is that the communication goes both ways, with the gut able to send signals to the brain. The brain interprets these signals as emotions (which is why you should always trust your gut instincts).
About two-thirds of the cells that make up the body’s immune system are found in the gut, which is why HIV’s first and most destructive assault occurs there. Within the first month of infection, the virus can overwhelm 50 percent of the gut’s immune cells. These immune cells (CD4) are especially susceptible to HIV because they have a protein on the surface — CCR5 — that the virus latches on to in order to invade.
The gut is also home to around 100 trillion bacteria (collectively known as the microbiome). HIV upsets the gut’s ecosystem by changing the composition of its microorganisms. Some scientists believe that an imbalanced microbiome contributes to the increased inflammation in people with HIV. People recommend probiotic foods — yogurt, sauerkraut, pickles, dark chocolate — to help rebalance the system.
When starting or switching HIV treatment it’s common to experience gut complications such as nausea, vomiting, loss of appetite, stomach pains, constipation, gas or bloating, and heartburn. These symptoms are usually mild and temporary. If, however, they persist it’s important to contact your healthcare provider.
The most common gut complication of HIV is diarrhoea. It can range in severity from occasional loose stools to becoming an ongoing chronic condition. Living with diarrhoea long-term can be distressing, isolating and embarrassing. A healthcare provider can help identify the exact cause of the diarrhea and prescribe treatment for long-term management. Untreated diarrhoea is especially dangerous because it can lead to a loss of crucial nutrients (electrolytes) and dehydration, which can be life-threatening.
Indeed, any change in bowel habits needs to be discussed with your doctor so that investigations can be performed so as to rule out serious disease. Bowel cancer and inflammatory diseases such as Crohn’s or ulcerative colitis, for instance, can present with diarrhoea.
Diet, sleep and exercise all help to manage your gut and keep it healthy. Being mindful of what you eat and drink is the first place to start: drink lots of water (two-three litres a day); eat high-fibre foods (whole grain rice, bread, oats, vegetables, and fresh fruit); and cut out processed foods and bad fats. A healthy gut is linked to everything from an improved immune response, disease prevention, even a happier mind.