Healthy Beginnings

5 gut health questions answered by a Reno gastroenterologist

Dr. Sam Nourani is a gastroenterologist at Digestive Health Associates and Center of Reno. Go to to learn more. Courtesy photo

There’s a lot of information — and misinformation — floating around the Internet on what one should and should not be ingesting to promote a healthy digestive system. But what’s actually true?

Healthy Beginnings recently sat down with Dr. Sam Nourani, a gastroenterologist at Digestive Health Associates and Center of Reno, to discuss everything you need to know to keep your gut happy.

Spoiler alert: You don’t need to blow the bank on supplements.


Question: What are the signs of a healthy gut versus an unhealthy one?

Dr. Nourani: When most people are talking about a healthy gut, they are thinking and feeling how food is being processed within them and then the emptying that is occurring. What we feel and what we see, in terms of our bowel movements, gives us an impression of the health of our gut.

But there is so much more. Are we having reflux after meals, pain or distention in our abdomen between meals, and what is the behavior, frequency and consistency of our bowel habits? Any reflux, abdominal pain, change in bowel habits, or blood in the stool is a sign of an unhealthy gut.


Question: What are the “good bacteria” you want in your gut? And what do they do for your digestive system?

Dr. Nourani: We have approximately 10,000 different species of bacteria in our colon and they number to over a trillion. They do a number of different things: They produce vitamins, they digest leftover food, and make up 40 percent of the biomass of our stool. They are integral to our daily lives. And we are integral to their lives as well.

It’s just like the adage, “you are what you eat.” The food we eat will determine which bacteria live or die. We self-select for certain types of bacteria based on our diets. Some bacteria are better supported by fruits and vegetables. Other less desirable bacteria will flourish better when we eat fast food or preservative-rich foods.

These types of foods are obviously not good for us in the long term, but when we eat like this regularly, it’s a double punch to our guts. We are eating foods that our systems have difficulty digesting, causing us to have reflux, abdominal pain, or change in bowel habits and then we allow less desirable bacteria to flourish within us as well.


Question: What types of food help maintain a healthy gut?

Dr. Nourani: At the very minimum we should be eating a wide variety of vegetables, fruits and protein rich foods. This can be accomplished with a wide variety of dietary choices.

I am not a vegan or vegetarian, frankly I enjoy eating meats. I choose to eat them sparingly and make a conscious effort to be aware where the animal product is coming from.

But with all my studies, a diet that is rich in vegetables, fruits, beans and legumes will provide all the necessary building blocks to maintain health and thwart disease.

The problem arises when our desires for food outweigh our choices to have a healthy lifestyle. This is a personal decision, however, that will have ramifications on one’s health, family and community.

Think about this: Why do we have preservatives in foods? The preservative increases the shelf life of the food for us. The preservative makes it difficult for the bacteria “to eat our food.” But realize that the machinery in the bacterial cell that is used to break down food is very similar to the machinery in our own cells. That is part of the reason why we feel different (bad) after eating these foods.

One should become familiar with fermented foods (like sauerkraut, kimchi and yogurt) as they are awesome to eat and give your gastrointestinal system a boost of healthy bacteria.


Question: What causes bloat?

Dr. Nourani: There is such a broad spectrum of causes that could cause bloating in a person, ranging from “I just had a beer and pizza and I feel so bloated and ill” to diseases like celiac disease or a cancer.

Things that are serious can start out sporadically and then they become more regular, so it’s always best to consult with your doctor.


Question: Should we all be taking probiotic pills? And what the heck are prebiotics?

Dr. Nourani: In very simple terms, a probiotic is a bacteria and prebiotic is the food source that helps support the bacteria.

In general you don’t need to take probiotic pills unless you have some disorder where there is an imbalance of bacteria in your colon. There is very little evidence that says we need to take a probiotic pill. If your diet is healthy, you’re automatically going to support good bacteria. The best source for probiotics is from food: yogurt, sauerkraut, kimchi, kefir, kombucha, etc.

Food for thought: Starting early on in life — and it’s never too late to start — learning how to cook properly, having a wide variety of fruits and veggies, staying hydrated, and getting adequate sleep and exercise … we can be healthy and prevent the development of diseases.

Claire Cudahy is a special assignments reporter for the Sierra Nevada Media Group, which publishes Healthy Beginnings. Email her at with feedback.