The GutSkin Axis Explained- How Your Diet Impacts Acne, Rosacea & Inflammation_en (auto-generated)
If you are wondering if your skin condition is actually getting worse from the foods that you eat, you might be on to something.
Believe it or not, our gut and our skin actually talk and communicate with each other.
And that is why what we eat and what we put on our skin actually matter and affect each other.
I'm Dr.
Mary Almina.
Welcome to my channel, The Skin Real, where I give real people real information about their skin health so that they can make informed decisions.
On this week's episode, I am so excited to have boardcertified gastroenterologist Dr.
Pia Pash joining me.
She is a GI doctor in private practice in the DC area.
And she is a amazing, phenomenal educator about gut health and patient advocate on the importance of gut health.
and she's on a mission to help reduce the stigma around gut health and some of the gut symptoms that can be downright embarrassing to talk about and maybe you don't feel like sharing with even your loved ones.
I'm super interested in gut health because I see how it affects my patients and their skin conditions, things like psoriasis, acne, hydronitis, rosacea, right? These can all flare and worsen because of our diet and what we eat.
And so that is why it is so important that we actually are what we eat and why it's important to focus on our diet not just for our gut health but also for our overall health including our skin health.
Let's get into it.
[music] Dr.
Pash, thank you so much for joining me.
I am so excited to talk about this cuz I have patients asking me all the time about their gut health and how it relates to skin.
I think a lot of people are like, "Wait a minute, how is my gut affecting my skin and vice versa?" Right? So, I'm so glad you're here and uh yeah, help shed some light on this.
Is there really this connection? >> There is really this connection.
Um absolutely there is this connection.
So we I think are in a time right now where we are really seeing and discovering the importance of the gut microbiome and how that that can the disruption in that gut microbiome can cause inflammation and the question is how is that inflammation presenting in patients? What symptoms are they having and could that be contributing to some skin conditions or flaring underlying skin conditions? >> Right.
Absolutely.
Yeah.
So, we we definitely know in dermatology, right? Like some skin conditions are what we call really inflammatory.
It's like the body's immune system is revved up.
It's hyper.
It's on overdrive, right? Like things like acne, psoriasis, attopic dermatitis, hydrainitis, right? Like I could go on.
And and so we're learning actually that underlying revved up inflammation isn't just affecting the skin and their skin conditions, but we're also seeing it in in their gut and other parts of the body.
And before we dive even further, when you said gut microbiome, like break it down to me.
I'm a 5-year-old.
What is a microbiome? Yeah, absolutely.
So, we all have a collection a makeup of good and bad bacteria in our intestines.
And that is the gut microbiome.
Trillions of bacteria and that microbiome is always changing and shifting with number one where we live in the world which is really interesting.
>> I know that is really cool.
but medications and stress level and underlying diseases um and illnesses and >> age right age as we'll talk about hormones and all the things um >> and I think the focus on how can we protect it how what can we do to keep it consistent and in a good place and how that can help with some of these underlying disease these states, >> right? Yeah.
I I think a lot of people are are kind of blown away when I tell them the skin actually has trillions of bacteria and and microbes on our skin, right? Like we think, "Oh, but I just washed my hands or I washed my face.
Like, it's clean, right?" But but actually, we we want a lot of those microbes and bacteria, right? It's not that we're trying to eliminate them all, right? But they need to be in the right balance and not >> and not have overgrowth or what we call medicine, right? like homeostasis.
>> Exactly.
Yep.
>> So, question about the microbiome.
Is that why people say eat local honey? Because the microbiome is different in depending on where you live and if you eat local that it has better benefits for our health.
>> That's so I haven't heard people say that, but I'm sure that has something to do with it.
Yeah.
>> Yeah.
I thought that was so cool.
Like, wow, that's such a great point.
But yeah, I think that's really cool.
Okay.
So that >> or even the concept behind um soilbased probiotics soil S O I L, right? So maybe the bacteria from the ground is what you know what we need in our intestines.
I mean so so much to talk about, >> right? Well, and I've also read that again getting food locally, right? not just good for the local community, right, and environment and all that, but yes, like the the soil, the ground, where you live, um that will potentially affect your microbiome as well.
>> Absolutely.
>> Well, so I think also people are surprised to know our gut plays such an important role in our immune system, right? >> Can you talk a little bit more about that? >> Sure.
So, we have an intestinal barrier and we want it to be can you am I can you see my hands? We want it to be like this like a tight fence with some small openings and very regulated planned openings to allow the good things through like the nutrients that we get when we eat.
When we have a disruption in that fence and it turns into this where you have holes, that's an issue because now we are having bacteria and toxins coming in through the intestines into the bloodstream and potentially creating an inflammatory response and triggering our immune system.
And then we're in this inflammatory state.
And so stuff that's not supposed to be getting in is getting in >> is getting in.
Exactly.
Right.
And so we know that changes to the gut microbiome or dispiosis can lead to that kind of open fence and cause that what people commonly refer to as leaky gut and that could trigger the immune system.
>> Yeah.
I Well, I'm glad you brought that up because just like in dermatology, right? I'm sure in in GI like they're these like trigger words, these buzzwords that people hear and they leaky gut, leaky gut.
Like what is that? Like to me when I first heard it, I'm like is like my intestine leaking? Is it diarrhea? But >> thank you for for breaking that down.
And it's it's really cool because just you know our skin has a a skin barrier just like the gut has a barrier, right? And when absolutely that skin barrier is broken down, you have rashes, you're itchy, you um have allergic reactions, infections, right? It's just we can't see our gut.
So, we don't we don't see it going on versus we can with our skin barrier.
>> Yeah.
>> So, what are some of the symptoms of leaky gut? Right.
Like if someone's like, "Oh, I might have leaky gut." Like, do you know you have it? What are some symptoms? >> So, GI symptoms can be like, you know, bloating, changes in stools, diarrhea, abdominal pain, but then it goes beyond the GI tract, right? Because now you're in potentially in this inflammatory state.
And is that presenting as joint pain and arthritis again? Is that presenting as a rash? Is that leading to another autoimmune condition? So really that breakdown in the intestinal barrier, that leaky gut, I think can contribute to so many underlying disease states.
And that's why our gut is so important.
>> Yeah, it's it's key.
And we and what we're realizing, right, is how it's so connected.
Really all organs have this connectivity.
>> Absolutely.
Absolutely.
And so right now we know that certain conditions cause that leaky gut, right? GI wise, inflammatory bowel disease, we know obesity, um you know, there many conditions that are known to to cause that open fence.
>> Yeah.
Well, and I feel like we're also hearing a lot about sort of this persistent inflammation in our bodies, right? Like people talk about that like I'm inflamed.
I need to reduce my inflammation.
All that, right? And we know stress is a big cause.
I I diet, right? Not sleeping, right? These can all contribute to this elevated inflammation in our bodies.
So, are there things that we can be doing to help keep our gut healthy? You know, I I would concentrate on diet first, specifically a high-fiber diet, keeping in prebiotics.
So prebiotics are food that we think feed that good bacteria and promote growth of that good bacteria and that healthy microbiome and we think that if you have more of that in your diet then you are contributing and hopefully keeping that integrity for that fence and so that would be my number one.
>> Can you give us some examples of prebiotic foods? >> Sure.
um whole grains, um certain fruits like apple, citrus, berries, certain starches.
Yeah, it's very easy to find a good list, but it's it honestly it's like all the foods that we would think think would be would be healthy, right? That you should eat.
>> Exactly.
The lentils and all things.
>> So, um and then you had said fiber, right? And I think we hear that word a lot, but maybe people don't know what is fiber like is fiber a potato, a starchy potato, or is fiber lettuce? Is it What would you recommend as a GI do? Great.
I would recommend whole grains.
So, um, we're thinking about fiber.
We're thinking about we'll start with carbohydrates, right? So, when you're thinking about bread can be a great source of fiber, but not a white bread.
I would do a sprouted grain bread or a whole wheat bread because that's going to have a lot more fiber.
When we're thinking about pastas, a white pasta is probably not going to offer too much fiber, but if you go to a whole grain pasta, that's going to offer more fiber.
Same thing with tortillas, moving to whole grain tortillas, you know, it's really changing those carbohydrates from white to wheat or whole grain is a great way to increase that fiber.
beans and lentils.
Um, chia seeds, flax seeds.
Yeah.
No, I I feel like there was this movement.
I mean, I I love bread.
I love carbohydrates, I have to admit, but I do try to make the choices to the to the whole grain and the sprouted and stuff like that.
But I I feel like there's this like movement and maybe we're moving away from it a little bit where it's like everything was gluten-free, no breads, no carbohydrates, like there was this kind of fear of eating those, but you're saying our body meets fiber.
I feel so many different ways on this topic.
I I think unfortunately the way gluten, so carbohydrates are processed in this country, it's not the best and it actually can trigger symptoms.
So I do recommend a gluten low diet to patients who are coming in with GI symptoms.
That being said, you know, I think that for instance, sourdough, I push a lot to sourdough or like a whole grain sourdough would be like the ultimate and the best because you're getting the fiber, but just the way sourdough bread is made.
Um, it it's like a probiotic, it has lactic acid, less gluten.
So that's a good shift.
But no, you're right.
I I don't think that we should be I disagree with that.
>> Yeah.
And but like you said, like making good choices, right? Like choosing the whole grain version and and I think it's just good to know like not to be afraid of those, right? Like eating whole grains and everything actually can be helpful for your gut.
>> Absolutely.
And also just kind of in general, these are the things that we want to be doing on the day-to-day, but it's okay, you know, that once in a while to have that pizza or that white bread or that white tortilla and go to Chipotle and enjoy those things as well, right? We want to take away from that.
But yeah, the dayto-day making those good choices.
>> I'm personally having a cheat day today because we had our office holiday party.
So [laughter] >> Oh, yum.
I love that.
>> You know, right, you you have to live your life and enjoy your life.
>> Oh, yeah.
Absolutely.
Okay.
So, so those are great about the fiber, the prebiotics.
Um, what else can we do for a healthy gut? So, fermented foods are fantastic.
Kimchi, um, kefir, fantastic for again that gut microbiome, that intestinal integrity.
Um, probiotics are a big topic.
Um, and you know, the concept behind probiotics is legit.
And you know, it's it's giving where we're trying to give ourselves back what we think are the the good bacteria, the beneficial bacteria, which we want to populate the intestines.
Um, the problem with probiotics is we in in some conditions, we don't have great research um that backs it up.
We don't know always which type of bacteria we need, how much, for who or when.
So the research, we need more, but because probiotics are so safe and we know that they can offer benefit to the gut microbiome and therefore to that barrier and reduce leaky gut, I I think it's worth a shot if you're having symptoms to start a probiotic.
Are you talking about foods that are probiotics or taking like supplements? >> Great question.
I would a supplement probiotic foods.
Sure, foods.
That's fine, but the quantity is important and you're not going to really, for instance, like a a probiotic yogurt is probably not going to give you enough probiotic to to really hit a benefit.
So, I would do a probiotic supplement.
But again, I don't think that's for everybody.
>> Maybe talk to your GI doctor or your primary care doctor.
>> Exactly.
Now, what about Greek yogurt? Um, I put that in my smoothie most days.
Am I doing a good thing with that? >> I think if you do not have symptoms with dairy, so you do not have diarrhea or bloating or constipation, then yes, I think that's absolutely fine.
Again, in my clinic, most of my patients that I see have some GI complaints.
And so, along with a low gluten diet, a low a trial, I should say, a trial of a low dairy diet is something I often recommend.
>> Yeah, that's a good point because that is a lot of people have that issue.
>> Yeah.
So, um am I thinking about pre and probiotics in the right way? Prebiotics are almost like the food for the bacteria and then probiotics are the actual bacteria.
>> Absolutely.
Exactly right.
>> Okay.
It's just taken me a couple years to get the talking to you guys to get this right.
Me too.
Me too.
Amazing.
Okay.
Well, great.
All right.
And then any other tips to help improve our gut health beyond diet? you know just talking about the derm GI connection and now that it's becoming more researched and studied and we really believe that there is this connection I think it's important for uh us to work together so for us to be aware that you know for instance in doing all this research seeing that hey H pylori is actually been tied to rosacea and linked to chronic udicaria urtdicaria I'm sorry and so And that's something that I learned, right? So, should those patients be tested for H pylori? Maybe, potentially.
But it's just great to know these connections.
And anybody with an underlying skin condition or a skin condition that isn't improving that also has GI symptoms, I would absolutely refer them to a gastroenterenterologist to look for underlying GI inflammation, right? Inflammatory bowel disease, Crohn's disease, ulcerative colitis.
that could be playing some role.
>> Oh yeah, for sure.
And I and I think a lot of times people with these conditions like hydrainitis, sepa, it can be really embarrassing for patients.
They feel very stigmatized and psoriasis too.
Like people might think they're infectious.
They don't want to touch them.
They're they might have um inflammation in sensitive areas.
And then the last thing they want to talk about is, oh yeah, I'm also having diarrhea and I'm also having bloating and all that.
like it's I I feel for these patients cuz it can be really stigmatizing but it is important to know that there is that connection and often times treating one can help with the other and vice versa and um and we do know sort of a lot of times like weight management and focusing on diet will help acne will help um hydraonitis like these conditions.
So, it's really amazing uh that connection that's there that people don't automatically think about.
>> I know.
I know.
And I'm so excited to see, you know, what the research brings, what our future brings.
You know, I wish we were in a place right now where we could say if you have acne, I want you to start this probiotic and here's the diet, you know, and and we're not there, unfortunately, but I think we we could be.
>> I I saw this is a funny story.
I saw firsthand my husband, this is years ago, but this is how sometimes you can't see what's right in front of you in your own house, right? But he um has always had great skin, but he started taking a protein powder and I didn't make the connection that all of a sudden he was really breaking out.
I mean, this is someone who's never had acne in his life and it was getting to the point I was going to put him on Accutane and it was it was really bad.
And and then I I like put it together that it was the whey protein powder that was causing him to get this horrible like pretty nodular cystic acne.
So it it that to me was like wow.
Just what he was eating was flaring his acne like that.
Someone who had never had acne in his whole life.
So it's it's powerful.
>> It is really and such a ma it's such a major reaction.
Like that's a that's a big deal, right? Yeah.
It's very practical.
I had a whole list of skin conditions and skin lesions since childhood starting with eczema.
And that's why this topic has been so interesting for me.
And a lot of things like like a patch here that I had for eight years that would flare.
I never knew why that went away to a patch here.
Some person some germ says is subre dermatitis.
You know, like you'll see it flaring.
And even now when these things flare, I don't know why.
I don't I don't really have great answers, right? And so I do turn to, you know, how's my diet been this week? Am I drinking more alcohol? Like what what disruption is happening in my body that could be flaring these underlying things? Um, and I know there's a connection >> for sure.
And and we know our diet like nowadays like even when you try it is so hard to get away from processed food and sugar and I know sugar is a huge culprit in glycation and causing our collagen to become very stiff and brittle.
And so I've become aware of that now that I'm in my mid-40s.
I'm like okay let's like be a little more mindful about the sugar that we're eating.
Um and and then alcohol I'd love to know if if alcohol affects your gut.
It does.
It does.
And it does.
And you know, again, this is a hard conversation to have with patients.
And it it's just difficult cuz, you know, I want everyone to enjoy.
And it's like, well, what do we do? Can we have two glasses of wine? Can we, you know, have that night out where I have five tequilas? You know, what's the impact, right? Um, bottom line is it will impact your gut.
Obviously, binge drinking, I would say no.
And then also I think now big concentration on it being linked to so many different cancers that it's a hard topic um and uh and definitely you know a toxin >> and we don't know really like well what is a safe amount right like is is a glass a day okay is three glasses a week okay like we don't know that >> right and of what right of what of beer of and remember we learned in medical school that you know like the the definition was like three for men or four for ladies and you know and that is so outdated.
We really don't have a good a good measure.
But it kind of brings us back to the other things that we can do to improve the microbiome which could potentially improve our inflammation.
And it's it is it's cutting out those foods, those processed foods, the sugars, the artificial sweeteners and artificial flavors because flip we know that those cause the irritation in the intestines, the disruption of the gut microbiome and again opening up of that fence, >> right? What what about are you familiar with the term SIBO? >> Yes, of course.
Yeah.
Is that a real thing? >> SIBO is absolutely a real thing.
So SIBO SIBO is small intestinal bacterial overgrowth.
That is a very known condition in GI.
It is an imbalance of like exactly we're talking about an imbalance of the bacteria in the intestines, overgrowth of you know the bad bacteria leading to bloating, stool changes.
Um it's we can test for it with a breath test.
Um and and I think some academic centers can actually test for it during um an endoscopy.
Uh but what's important with with kind of all these things is there's usually an underlying cause, right? So if you had the SIBO, is there an underlying inflammation, a Crohn's disease, something that is changing the motility of the small intestine? So you're not you don't have the movement to flush out the bacteria.
Same thing if you have this leaky gut, you know, is there something underlying that we're missing that's actually causing that leaky gut? Yeah.
Yeah.
Is it like the canary in the coal mine? Like it's the harbinger of of something else.
And yeah, we've I I know in dermatology we know about SIBO um with rosacea patients >> that people who have rosacea which is different from acne but inflammatory uh have a higher incidence of SIBO.
>> Yeah.
>> Yeah.
Absolutely.
>> And again easy testing pretty easy treatment.
>> Yeah.
>> You know and if it were it was going to improve the rosacea I mean that that's a game changer.
>> Sure.
Absolutely.
Now I know um in dermatology we at least I' like to say number one prescriber of antibiotics in the medical field which is crazy to me considering we were prescribing more than infectious disease doctors but we were using a lot of antibiotics for these inflammatory conditions and and we still do in some regards but like I am so mindful now um about prescribing antibiotics like I I need to have like a culture rack or I need to know what I'm treating or it needs to be, you know, pretty specific things.
Like I try to use other other things if I can because I couldn't believe these studies coming out showing like even a week of antibiotics can really just like decimate your intestines and and the microbiome in there.
Is is that is that real? >> Yeah, it's real.
I agree with you.
I think we should be very mindful about antibiotics.
Um, and what we see sometimes is patients who are taking these antibiotics or maybe repeat courses, they have a very hard time getting back to that baseline microbiome and then they can have years of symptoms because of that imbalance.
>> Yeah.
I mean, it's amazing.
I think also I just want people to know.
I think sometimes people get frustrated.
They go to the doctor, you're told it's viral, and you you almost feel like, well, I need an antibiotic.
I need a prescription.
I need something, right? Um, and I think that's anatomy.
My husband will say that, too.
Like, oh, the pediatrician didn't do anything.
He didn't give us anything.
I'm like, it's viral, right? Um, but I think it's important for people to know these antibiotics have consequences that you don't necessarily see and that they can last for years, which is really crazy.
>> Exactly right.
I agree.
It should be targeted.
Just targeted therapies.
Absolutely.
>> Yeah.
Exactly.
No.
Um, I'm 45 and I am really interested in like perry menopause and midlife health and I I think at 40 is when it sort of hit me like I can't just like keep burning the candle at both ends and like you know hoping it all works out like I really need to focus on my health and um and I'm noticing my friends are noticing my patients are noticing changes in the skin, changes in their sleep and and uh things.
I used to be able to handle a glass of wine a night and now I I just can't.
Um, so things are changing, right? And we know that our well, we know in our skin that the microbiome changes as we get older.
It becomes less diverse.
Are there changes in our gut as well? Absolutely.
Yeah.
So with pmenopause and menopause, the decrease in estrogen absolutely changes the gut microbiome and absolutely changes that intestinal barrier and that can lead to symptoms.
It also changes motility, right? So new stool changes, new constipation in perry menopause and then the stress, the cortisol levels, right? and and and the sleep changes that then may lead to those you know all the things connected also have independent effect on the microbiome.
Yes.
Yes.
Yes.
Yes.
Yes.
And yes.
Yeah.
So just you know get rid of stress, eat right.
Right.
So easy.
So easy.
Uh does hormone replacement therapy help? Do have they looked at studies on that? >> It will.
Yes.
I I I see many patients in pmenopause and um hormone replacement therapy will help if if if and again not everyone is having GI symptoms and pmenopause, right? But if you are, yeah, it could be helpful.
Well, and I I think that's what's tricky about per menopause, right? There are so many pretty much every organ's affected by estrogen and and everyone's going to experience different symptoms.
So, it's hard to to know and you may not associate feeling more bloated.
You may just think, okay, well, I'm I'm getting older.
That's just what happens, right? Like, you don't necessarily put the pieces together that it can be connected.
So, I think that's why it makes it so tricky and we know there has been such a lack of research in this area, too.
I'm I'm just excited that people are finally talking about it.
Right.
>> Me, too.
I I think that, you know, five years ago, I didn't hear about this.
I wasn't, you know, and now patients are asking and we're talking and it's all over social media.
And I love that because it just gives all of us the opportunity to get more information and learn more and and feel better and just overall feel better, you know? >> Right.
Well, and you know, we're living so much longer, so just 45 hopefully I'm just hitting the halfway point, right? >> 45 is like the new 25.
>> I mean, that's what I say.
>> Yeah.
But um yeah, so we have to think about like how do we want to live the rest the the second half of our lives, right? And and I think people nowadays are like, "No, I want to I want to be healthy, vibrant.
I want to keep doing the things I love." So, um I love that people are talking about it.
Speaking of colonoscopies, right? Yes.
Yes.
Thank you for bringing that up.
45 is the age for colonoscopies.
Absolutely.
Um you should have Yeah.
And that's that's if you have no family history or of colon cancer or you haven't had polyps in the past, 45.
If you do have a family history of colon cancer, talk to your physician.
You may need to come in a little bit earlier than that.
But yes, that is on my to-do list.
I will do it, Dr.
Pash.
>> I I hear you.
I hear.
Please.
But I hear you.
But even Yeah, it's hard.
It's hard to keep up with all the things, right? Like >> Yes.
I I'll just say I had a a mammogram and then they were like, "It's time for your next." And I'm like, "No, no, I promise I just had it." They're like, "No, it's been a year." And I'm like, "Oh, wow.
Wow." Yeah, >> it goes.
>> And now I'm late on that.
It goes.
It just It goes.
Yeah.
>> But if you get it done, you'll most likely be good for 5 to 10 years.
So, >> yeah, that's what I'm telling myself.
I just need to lock it in, schedule it, do it, >> get the small volume prep, not that big gallon.
Oo, >> the small volume, which is like just two tiny bottles.
>> Still doesn't taste great, >> but it's tiny.
So, you know, most of us can get that down.
>> And and I hear it's the best nap of my life.
>> Yes, it is.
That a lot of my my mom just recently had one and she was like, "Can I can I stay longer?" No, you cannot stay long.
>> You got to go.
>> Yeah, it's not a hotel.
you do need to leave the >> it's a very common thing we hear from patients like just a little more time.
Yeah, it's a good nap.
>> Amazing.
Um were there any other points you wanted to hit on? >> No, this has been fantastic.
Thanks so much for having me.
>> Yeah, Dr.
Pash, I I have learned a ton.
I'm definitely going to get that colonoscopy scheduled.
I promise.
And I would love if you could maybe give your top three tips for someone who is maybe wanting to improve their gut health.
and they're not really sure what's going on.
They're having some symptoms.
Like top three takeaways.
>> Great.
I love that.
Top three takeaways.
Number one, let's focus on diet.
So, all the things we talked about, let's increase the fiber.
Let's take away the white carbohydrates like the white breads, the tortillas.
Um increase the fruit, increase the vegetables.
Number two, we really want to decrease red meat.
Um red meat has been shown to increase colon cancer.
and not only red meat but processed meats, right? Like the sausage and the bacon and the deli meats.
So, you know, again, we don't need to cut those out completely, but definitely decrease the processed meats.
Um, so that's diet.
Number two, fiber.
Not not even dietary fiber.
I would I would add a fiber supplement because a lot of times I think that people are not even evacuating their bowels completely and >> a lot of us don't really know what what is normal and how we should be you know evacuating >> and it can't hurt to just get an extra fiber supplement in to kind of add water and bulk so you're eliminating which can really help with bloating and and pain and all the symptoms.
Mhm.
Yeah.
That And I'm always amazed to like how much how much fiber should I be having? Is that 25 grams or 35? >> I'm going to say 35.
I say if you say >> Okay.
>> That's hard.
Hard to hit 35 grams of fiber.
And then also >> you want to hit the fiber, but some of the fiber causes bloating.
So you're like confused like wait, what what you know, how do I do this? >> Do you have do you have a fiber supplement you like? >> Yes.
Oh yeah.
Okay.
So, psyllium husk powder.
>> Okay.
>> Powder.
So, so you don't want like a you don't want the gummy because it has some artificial color and flavor and all that.
You want the powder mixed with water.
So, I also don't want you to mix it into a smoothie because you really need water when you're doing fiber.
>> Okay, that's good.
>> Psyllium husk is a soluble fiber.
So it forms this like beautiful what I think is beautiful gel-like substance in your intestines that really helps to move things along.
Very beneficial.
>> Okay.
Amazing.
>> Okay.
Well, I I would also love to get your thoughts just quickly on like these people who talk about these colonic cleanses.
>> Is that like a whole another >> I love this is a great conversation.
No, it cuz you're hitting on like every one of my videos >> asking truly like I I am just curious because when I see these places I'm like oh my goodness like >> Yeah.
No, no, you do not need a colonic.
You know, I see hundreds of colons >> a month, right, and colonoscopies.
And of course, that's after the prep, but I also see a lot of colonoscopies that they haven't really done a great job with the prep.
And there is no layer of debris or parasite that you need to clean out with a colonic.
That just doesn't exist.
Our bodies do a great job of of getting out what needs to be gotten out.
And um and and again, I think that could be also very disruptive to the microbiome, to the barrier.
And so I I I'm not a big supporter of colonics.
>> Yeah.
No, I I feel like we we need to just like stop getting in the way of our body knows what to do.
We are like our own worst enemy.
we're getting in the way of letting it kind of like with our skin like scrubbing scrubbing trying to get every ounce of oil off, right? Like we're damaging it.
And I I think of a a cleanse like that where you're just, you know, >> overdoing it versus go get that psyllium husk powder, right? And and do it daily.
Exactly.
>> And do it daily.
>> Do these things regularly and just get into the habit and you will have, you know, a very healthy and happy GI tract.
Yeah, Dr.
Pash, I took us on a little detour at the very end, but thank you for uh >> of course >> answering that question for me.
I know people are going to want to find you, follow you.
You have lots of great information on social media.
Where's the best place for people to do that? >> So, um I'm gastroal MD on Instagram, on Tik Tok.
I also that's also my YouTube handle.
Um and yeah, that's where I am.
>> Amazing.
I'll put all of that in the show notes so people can find you.
really appreciate it.
Thank you so much and I'll see you so much.
This is so awesome.
Take care.
>> Bye >> bye.