Gut Health Unveiled: How Your Digestive System Shapes Well-Being

In this episode, host Erin Brinker welcomes Dr. Timothy Jenkins, a board-certified gastroenterologist, for an in-depth discussion on gut health and its far-reaching impact on overall wellness. Dr. Jenkins explains the anatomy and function of the gastrointestinal system, the crucial role of the gut microbiome, and the gut’s influence on immunity, weight, cravings, and even mental health. 

The episode covers the effects of antibiotics, the importance of fiber, probiotics, and lifestyle habits such as diet, stress management, sleep, and exercise. Dr. Jenkins also highlights warning signs of gastrointestinal issues and offers practical advice for New Year's resolutions focused on improving gut health. 

The conversation concludes with a look toward the future of gut health research and resources for accessing GI care.

Transcript

Erin Brinker: 0:00

Aaron, welcome to the hope table. I'm Erin Brinker, and I am absolutely thrilled to welcome back to the show. Dr Timothy Jenkins. He is a board certified gastroenterologist with Kaiser Permanente here in San Bernardino County, and he's here to talk about gut health and how it impacts the body overall. Dr Jenkins, welcome back to the show.

Dr. Timothy Jenkins: 0:25

Thank you so much, Erin. I really appreciate the invite back. I had such a wonderful time last time, so I'm looking forward to spending some more time with you.

Erin Brinker: 0:34

Outstanding. Outstanding. I am too. So let's get to the like. First things first. What does gut health mean.

Dr. Timothy Jenkins: 0:40

So what does gut health mean? I mean, really, if you think about it, one of the most important systems in our body is our gut. And when we talk about that, you know, in medical terms, we talk about our gastrointestinal system, but it really involves everything that goes in our mouths and that comes out at our bottom and everything in between, and there's a long pathway that that follows, and when that's healthy, we're healthy, and we feel better, and we feel feel good. And when that's not healthy, it leads to a whole host of different problems. And so those are some of the things we'll talk about. But, but really, gut health means that your intestinal systems healthy, and as a result, you feel good about yourself.

Erin Brinker: 1:25

So what is a healthy gut? What is that? What does that look like when? Because when we've all had times where we've had an upset stomach, maybe something didn't agree with us, but it's so much more than that.

Dr. Timothy Jenkins: 1:35

Yeah, no. Thank you. So there's, there's several different parts of the of the gut, and I could talk a little bit about that, just so everyone knows, you know, kind of the road map of what we're talking about. And so you start with your mouth, and so you're that's where you take the food in and you chew. And what that accomplishes is it breaks the food into smaller pieces, and that enables you to swallow that food down. Once you've swallowed and it's past your throat, it goes into something called the esophagus, and that that looks like a tube. It's a straight tube. It's 12 to 16 inches long, and it connects your mouth down to your stomach, which sits in your midsection of your body, so in your torso, in your body, and so the esophagus connects those two parts. The food travels through the esophagus. It ends up in the stomach. And the stomach is an organ that churns and starts the digestion process of your food. And so it does that in two different ways. It does that through acid that it produces. So acid breaks down food and it and it helps to start that digestive process. And it also the stomach also contracts, and it squeezes, and so it churns the food, and that also helps break it into much smaller pieces and actually into kind of a liquid form. After it leaves the stomach, it enters what's called the small intestine. The small intestine is about 20 feet long, and it winds around. It looks like a circle, kind of curlicue circle that goes in your in your midsection, and it's twisted and turned. But if you took it out and stretched it out, it's about 20 feet long, if you could imagine you got it. You got a 20 foot long intestine leaving your stomach, and that is where the absorption of all the nutrients happens. It happens in the small intestine, and it travels at long distance, because humans need that much distance to really get all the maximum nutrition out of the food they eat. All the stomach does is just breaks it into smaller pieces and moves it along. But the stomach is really not absorbing in you know, the nutrition that you get that happens in the small intestine, and that process can take several hours. So when you eat a meal, you swallow, it goes down the esophagus. It's in your stomach within a matter of seconds. It stays in the stomach an hour or two to churn and get the acid and grind everything up. And then it gets in your intestine, and it stays there for several hours to pass all the way through there to get that nutrition. Then it exits the small intestine. There's a little valve at the very end that kind of regulates the materials leaving the small intestine, and it goes into the large intestine, which is also called the colon. And the colon is about six feet long, and so it wraps around, also down in your abdomen, and the food there that's already been processed is now reduced all the way down to waste products and bacteria, and that passes through the colon until it passes out with a bowel movement. And so that's a that's just the long and the short of the whole process of what happens with your gut. But when we talk about gut health, we're talking about that whole system being healthy, and that leads to a huge impact of how you feel, in your mind, in your body, and your own personal wellness.

Erin Brinker: 4:52

So gut health is a huge topic, and it has been for the last couple of years, as more research has been done about. The impact of a healthy gut on every system in the body. Now, we've heard terms from from the homeopathic community, like leaky gut, or, you know, that sort of thing. What? What does all of that mean?

Dr. Timothy Jenkins: 5:14

Yeah, yeah. So, so what are the what are those key components that make it a healthy gut? And the first thing I would start with is what's called the the gut microbiome. And the microbiome biome is kind of like an environment. If you go out into the world and you're in a jungle or in a forest, that's the type of a biome, but you've actually got a biome inside your body, and those are bacteria, there's there's viruses, there's funguses, there's a whole lot of different organisms that are not you, but they're inside of you. And all of that together forms the gut microbiome, and it's an it's like an ecosystem that helps you with your digestion, and it also protects you against other harmful, harmful bacteria, for example, that could cause something like food poisoning. So that's one very, very important component. The other part is how everything moves through there. So your gut has to be very coordinated. I talked a little bit about the stomach, but there's also contractions and movements that are happening through your small intestine, where it's absorbed in your colon to have a bowel movement, and also your esophagus, when you swallow for food to go down. And there's a very it's kind of like a dance, like it's a very careful dance that has to happen to make sure you know something's not running into something, it's not getting clogged, it's not getting stuck, and so that all has to work properly. And then the last part of it is symptoms that you could have. And so if you're getting bloated or you're getting cramping or pain or things like that, it can be an indication that there's something happening there that may not be as healthy as it could be. So those are the different parts of that. So then your question about, you know, the different parts of the gut health relate to those three areas. So we could, we could get into talking a little bit about that, but those are the key components to having a healthy gut, your microbiome, your bacteria and all that, your your coordinated function of the GI tract, and also the symptoms you're having.

Erin Brinker: 7:13

So how does the digestive system impact other parts of the body? So immunity, mental health, energy levels, cognitive function, etcetera. Yeah.

Dr. Timothy Jenkins: 7:23

So, So, great question. So the the gut is actually an immune system organ itself. So we think about, we think about the gut being your digestive organ, but it has a huge component of immune system function that's in the GI tract and if you think about it, it really makes sense why it has that. Because I just mentioned before that you have all these bacteria that reside in your gut, and so what keeps those bacteria in the right place, helping you with digestion and not causing harm to you? Well, that requires a very, very active immune system in your gut to really regulate everything that's happening that goes through the gut, including those bacteria. And so that immune system is not just like a fixed it's, you know, it's not like a tree stump just sitting there. It's moving around. And so those those cells that make up your immune system travel between the bloodstream and the gut and other parts of your body. So whatever's happening in your gut gets communicated to other parts of your body, your mind, your extremities, you know, all those different areas. So the gut is a very, very important part of your of your immune system, no question, and that is important to keep you healthy. Now, if your immune system in your gut is not functioning properly, it can cause many, many different symptoms, diseases. There's other conditions that can happen with that. So that is a very, very important part of this whole gut, brain connection and other parts of your body.

Erin Brinker: 9:00

So you know, I, and I, it would seem to me that your gut then would because of the signals it's getting from the body. It would, it would drive your cravings. So the bacteria in your gut would drive the cravings because of what it needs to do its job. And if things were out of whack, then you're craving out of whack, like you're craving too much sugar, I'm guessing, and you're going to disabuse me of this idea, because it's just coming into my head right now. If you are, if you need vitamin D, you're going to you're going, well, like vitamin D you get from the sun. If you need other things that you get from food, folic acid, your body's going to crave that based on what that bacteria needs. Is that true?

Dr. Timothy Jenkins: 9:37

Yeah, it's very interesting. And that's, that's a great way of thinking about it, it actually the gut, I guess I would say the gut is not tuned so much to make sure the bacteria are healthy, in that the gut works in teamwork with the bacteria to help your body. If I could put it that way. So for example, if you're deficient. In a certain nutrient, your body can sense that you have different sensors in your brain and your different organs, that can tell there's a there's a deficit of something, and it caught it can cause some cravings. So for example, if you're if you're deficient in iron, and iron gets absorbed in the first part of the small intestine when food just leaves the stomach. That's where the iron gets, gets absorbed. You start having cravings, and people start thinking, Gee, I can sure you chew on an ice cube right now, because I'm they don't even know why they want to do it, but their body is telling them you've got a your their your iron deficient. And that is one of the responses that happens with that not so effective for iron, because there's not a lot of iron and ice, but that's

Erin Brinker: 10:43

just better with a steak.

Dr. Timothy Jenkins: 10:47

So, so it's so I guess my point would be, the bacteria are doing fine. They're not deficient. They're they. They figured out ways to subsist on just about anything it. It really is your body that can sense that, and when that gets out of balance, it sends signals to your brain that you need to do something, change something, eat something like that. And there's a whole there's a whole set of hormones, and there's things like insulin. You people know about insulin, and they know if someone has diabetes, they don't have the right amount of insulin, or their body doesn't respond to insulin, and those, those are some examples of things that are connected to the gut that have effects on your whole body, that tell you you need to eat, or you're you're full and you should stop eating. All those kind of things are just transmitted from the nerves and the hormones that are connected to your gut.

Erin Brinker: 11:40

So what does the use of antibiotics do to that bio right?

Dr. Timothy Jenkins: 11:45

And so antibiotics are antibacterial medicines. And so if someone has a pneumonia from a bacteria that got in their lungs, we give them anti but we give them certain antibiotics for a bacterial pneumonia, we don't give it for virus because, back, because antibiotics don't work against viruses, but for a bacteria, it's very toxic to the bacteria. And so what happens? You can imagine, if you're taking an antibiotic for a pneumonia, for bacteria in your lungs, and you swallow a pill of amoxicillin or or something like that, that not only gets into the lung, because the blood flows there, and so it carries the antibiotic to the lung. It also goes throughout your gut, because you swallowed it, and this goes through your GI tract. Well, guess what? You've got all these bacteria that normally live in the gut, and it also affects them as well. So you take the antibiotic, and now you're you're causing damage to those bacteria that live in the GI tract, and that can set set up for some other problems that can happen. Now, why do we do there? Say, Well, why do we take antibiotics that doesn't sound good, that sounds even potentially dangerous? We're willing to accept that there are some risks to antibiotics, but we but we think the risk of the pneumonia that you've got is an even greater risk, and so we'll take the antibiotics, we'll let it have that effect on the bacteria. You don't keep taking antibiotics for pneumonia. You finish it, you go off the antibiotic, and the bacteria grow back, and they come back from that. But it is, it does have that effect on your GI tract. Now there's some, and I was gonna say, and I'm so sorry, what I was gonna add? No, you're good. You're good, yeah, yeah. So there's some pretty there's some dangerous bacteria that are out there. And there may even, we may even carry them around ourselves. For example, something called Clostridium difficile, which is a hazardous bacteria that can live in our in people's track GI tract, and they don't have any symptoms of it, but if they take an antibiotic, it kills off those other bacteria that are keeping the Clostridium difficile in check. So your bacteria, there are kind of a defense against that they they don't allow the, you know, the C difficile to grow. It's kind of like a tree that's over the grass and there's shade, so the weeds can't grow underneath that, but you chop down the tree, and all of a sudden the weeds take off. Well, that's kind of what happens here. And so people can get very sick after they take an antibiotic, and especially if they never needed the antibiotic. They said they took a risk. They didn't need to, and the C difficile takes off, and now they're sick from that bacteria which needs a whole different kind of treatment. Wow.

Erin Brinker: 14:31

And so that's really a balancing act. It's like a tightrope, yeah, if you end up with a with a antibiotic resistant bacteria, you know, then you you are, you really got to weigh the risk, obviously, the pneumonia is going to kill you quicker. Yeah, yeah. And so, you know, you have to work with your doctor to make sure that that you're handling it correctly,

Dr. Timothy Jenkins: 14:52

exactly, yeah. I mean, and if you've gone to an urgent care and you come in with a cough and cold and a runny nose, and the doctor said, you know. I think you've got a virus, I don't think you have a bacterial infection. And and you may ask, you say, Well, shouldn't I start some antibiotics? And the doctor says, No, this is one of the reasons why we don't. You don't just usually buy antibiotics over the counter, because they do have some risk to them. If we want to be sure they're absolutely need to be used. We use them at the right time. It's appropriate, it's necessary, but we also there is some risk, and we don't want to take them if we don't

Erin Brinker: 15:29

need them very good. So what are some Oh, before I get on to what are some good habits? What does poor gut health? How does it affect weight loss or weight gain? You know, this is, this is the beginning of the year. This is New Year's resolution time. So Can, can poor gut health actually affect weight loss or weight gain? And, if so, how?

Dr. Timothy Jenkins: 15:52

Yeah, so it can do both. And it really has to do, like you were saying, I think you put it really well, Erin, it has to do with that balance. And so, you know, too much or too little of something is is often that's a problem for the for the gut. And so if someone is malnourished and they're just not getting enough calories, and that they lose weight, and their gut health is poor because they're just not getting the nutrition they need. And and tragically, there's people out there in this country where there's food insecurity, people aren't getting enough food, and they need the food, and they can become malnourished from that. We see that in other parts of the world. So that's one example. The other example is when the body systems for control of appetite and of metabolism, of how the food is is burned, how the fuel in your body gets burned? If those get out of sorts, and diabetes is a good example of that, then the food can actually be associated with a lot of weight gain, and so the gut is not healthy in that situation either, because the person continues to feel the need to continue to taking in, to take food in, but their calories are actually okay, and they really don't need the food, but they keep taking it, and so they gain weight, and they have poor health on that basis. So it really can be either direction for that. And there's disease conditions that that can develop in the gut that can lead to either weight loss or weight gain, depending on that condition.

Erin Brinker: 17:25

You know, you talked about poverty and and how not enough calories are consumed by many people around the world, but in the United States, very often, poverty and malnutrition comes with an obese person. It comes in an obese body because they are eating enough calories, they're not eating enough nutrition, and the food is not giving their body what they need, and so it tries to compensate for too many carbohydrates, or whatever, and and they people crave junk food. I read an article recently, and I'm going to be super transparent. I am on ozempic, and it has been, it has been such a game changer. And what I what I read, is that some junk food, and again, you'll disabuse me if I'm incorrect, some junk food can suppress the body's ability to create GLP one. And so your body's natural way of saying, hey, you've eaten enough, stop eating is has been hijacked. And now that I'm taking a GLP one. It's like, oh, that's what this is supposed to feel like. And the the the noise, the hunger, noise for my body is gone. And it's been great. It's been fantastic. I feel, Oh, this is what I'm supposed to feel like. And what are you seeing in your patients?

Dr. Timothy Jenkins: 18:35

Yeah, no. And I really am glad you brought up that topic, Erin, and I'm and I'm also very glad to hear you're, you're having a good result with that medication. It turns out that these medications are very widespread, and there's estimates that about one in every eight people in the whole country have have used them at some time. And I think it's about one in 16 that's actually on it right now. So if you think about, you think about like a room full of people, most likely there's going to be other people like yourself, Erin, that are taking the GLP one and and for those in the audience who aren't familiar with it, it's it stands for a glucagon like peptide. And what it does is it blocks one of your hormones in the in the body's system, which increases blood sugar, increases insulin and things like that. And so it it gets that it gets involved in that step in the body that then decreases appetite, and it can actually help with diabetes as well. So it's

Erin Brinker: 19:38

and I'm a diabetic, which is why I started taking of God sent,

Dr. Timothy Jenkins: 19:42

right, right? So it's indicated for diabetes, for certain kinds of obesity, and it's very, very effective. There's risk to it, just like there is with everything. But the effectiveness has been really dramatic, and people have said it's a it's a life changer for them, but it but it's what. A was an innovation. It came through research. And I can remember back in medical school, I was in medical school in 1990 learning about glucagon, but I never thought there'd be something that could actually get in there and work through that system to to affect the whole body in a positive way like it does. So so I'm glad you brought that up.

Erin Brinker: 20:21

It's been, it's been great. And I, I it really, we know we are what we eat. And I find even on the medication, if I, if I slip into old habits and start eating junk food, which I really try to stay away from, and have been staying away from, the cravings come back in the you know, I feel lousy and I'm fuzzy headed, and I've asked myself, What in the world just I did? I just do to myself. It just makes you feel lousy.

Dr. Timothy Jenkins: 20:49

Yeah, well, and you mentioned fuzzy headed and so, and that gets to the brain connection and, and there's, you know, they talk about the GI detract or the gut being almost like a second brain. And and if you think about it, it really is, there's, there's not as many nerve cells in the gut as there are in the brain, but there's almost as many. I would say it's, it's, it's, you know, it there's so many, and all those are connected. They connect up through the nerves, up through the spinal cord, up to the brain, and they talk back and forth. So if you're feeling fuzzy headed, there's a reason for that, because there's a direct connection of the nerves in the brain down to the gut, and they talk back and forth. And so if you, if you, if you don't feel good, it's can start in the gut, it's transmitted up to the brain, and that causes you to feel the way you do. And it can cause you, like you said, you can feel fuzzy, cloudy, thinking, like a little off balance. Things like that can happen. And so this, this GLP, one agonist, can really kind of restore some of the balance for patients with various, you know, conditions like you mentioned, and really help them feel better.

Erin Brinker: 21:57

So many people are set resolutions about losing weight. And you know, often the expectation is you lose it fast in bikini seasons coming up. And you know, of course, here in Southern California, it comes much sooner than in other states, but, but nobody wants to feel like they're white knuckling it through their diet. So if somebody is making a resolution this year, what is your advice for them?

Dr. Timothy Jenkins: 22:20

Sure. No. So, what are some of the, what are some of the good health habits for good for gut health? And there's, there's a few of them, so I'll just go through them. And of course, a lot of this is imbalance, and it's, it's kind of looking at, you know, it's not always an all or none. It's an amount of it. But when you look at what's bad for gut health, it's really foods that are high in sugar, high in certain types of unhealthy fats, high in certain kinds of additives, like processed food, fried food, red meat, sugary drinks. You're also talking about alcohol, which can be unhealthy for gut health, artificial sweeteners and too much caffeine. And so when you look at the new year's resolution and say, I'm going to wake up on January 1 and I'm going to change my diet, and I want to I'm going to change for the better, because I'm just I went through 2025 I'm not feeling so good. I maybe I've gained weight, you know, and maybe some health conditions came up. What can you do? Well, what are some of the things to limit, and I'm not saying completely exclude, but I'm saying to limit. These would be processed and ultra processed foods. So you're talking about like chips, pastry, sugary cereal, frozen food that has our additives into it. The next one is refined sugar and high fructose corn syrup. So you see a lot of that in things like soft drinks, for example, they have that. But also sports drinks and even some things that are considered health drinks can have refined sugar and high fructose corn syrup. You also include fried foods, which are high in unhealthy fats, which can increase inflammation in your gut. We talked about that earlier, and they can also affect the speed of the digestion of your food. And you can have either too fast and that can lead to too many bowel movements and cramps and problems, or it can go the other direction, cause constipation and bloating, excessive red meat, alcohol and then artificial sweeteners, which can cause can also cause diarrhea, too much caffeine. Now I know I like my coffee, and I'm people see me. They see I don't want to promote any brand, but they'll see me at the Starbucks and ranch group market, like, Oh hey, hey, Doctor Jenkins, how you doing? But I get my caffeine, but I do have to watch it, because I do watch if I have more than a cup or so, I do start feeling jittery, and I do feel it in my gut, so I so I do have to watch that. But so excessive caffeine, I'm not saying a little bit's not okay, but, but too much. And then there's also some types of foods we call FODMAP, F, O, D, M, a, p. And it's I've seen that. What is that? Yeah, so FODMAP really has to do with foods that are fermented in a certain way. They produce different types of gas and fermentation. And for some people, especially with a condition called irritable bowel syndrome, which is where you can have abdominal cramps and you can have diarrhea, constipation, or back and forth post or just the cramps alone, and the bowels are okay. Foods like onions, garlic, beans, cabbage and some types of fruits can cause excess gas and cramping, but especially people with irritable bowel syndrome. Now, some of those are going to be good for you too. We talked about fiber and fruits are good for that. So we're not saying avoid that, but if the person has irritable bowel syndrome like I just described, their doctor may say you need to go on a, you know, kind of different, different FODMAP, kind of diet to try to help.

Erin Brinker: 25:59

That just makes me sad. I love beans. I love onions well.

Dr. Timothy Jenkins: 26:05

And I think if you don't know now, Erin, if you don't have irritable bowel syndrome, if you haven't been diagnosed with that, that can be perfectly good for you. So I'm not

Erin Brinker: 26:13

okay. I have not. Thank you guys,

Dr. Timothy Jenkins: 26:15

you can, then you need to get your beans. Then that's okay. But if you don't, so that. So that would be like, if I'm making new year's resolution, I gave you a list of things, and it would be cutting back on that. That would be one area. But I also want to talk about non things that you're not eating but that do affect your gut health, and could also be part of New New Year's resolution, and one of those is stress. And so, you know, if we think about stress, and I mean, the one that always resonates with me has to do with, you know, getting up, like doing public speaking. And I can remember before I had done it, and I was a kid, and I was in school, and say, Oh, Tim, you're going to be the lead in this play. I can remember getting this kind of like a cramping feeling in my stomach, and as a kid and thinking, What is that all about? And I hadn't eaten anything, and I wasn't sick, but it turns out that that I was stressed thinking about, Oh my gosh, I got to remember my lines, and I'm going to get up in front of a bunch of people, and I'm getting what's called butterflies in the stomach, and it's, and what is that? Well, that's it's not in my stomach, it's in my brain. I'm thinking about it, but because of those connections we're talking about, it transmits to the intestine, and that's what you feel. You get the butterflies in the stomach from the stress coming down from the brain. And so if you got a New Year's resolution saying, I'm going to do things to lower my stress, and that's easier said than done. We know world's a stressful place. Work can be stressful. Finances, all the things family, I mean, there's a lot of things that are stressful, but that can affect their gut health, so to the degree that you can do activities to lower stress, that can help sleep also, I'll stop there, but there's a couple others I did want to mention about sleep and exercise that are very, very important, that are great parts of New Year's resolution as well.

Erin Brinker: 28:07

Well, you know? And I was going to bring up the exercise question. I watched a video recently talking about blood sugar, and what a dramatic difference just taking a walk after you eat can do to digestion and keeping blood sugar at a good level, even for those who are not diabetic. So many Americans are pre diabetic, and they may not even know it, that this is something that could really make a difference. I assume it also impacts gut health.

Dr. Timothy Jenkins: 28:31

It really does. And so when someone is sedentary and they're not exercising, and they really and, you know, and a lot of us have jobs that involve that we're at an office, or we're at a desk or something, and we're just, you know, we just, by nature of what we do is it's more sedentary, it can affect the digestion. And so, you know, I'll see patients who may be like a cab driver or Uber driver or truck driver things like that, where they're sitting a lot of the day and they're seeing me, and they said, Doctor Jenkins, I'm constipated. I can't have a bowel movement, and I feel bloated. And that is because a sedentary lifestyle can slow down someone's digestion. And so the antidote to that is, is, is activity. So just like you said, you have a meal, go out and take a walk. And you know, in the interaction of the exercise, even if it's just mild exercise, we're not talking about running a marathon. We're just talking about, you know, walking for 1020, minutes, getting your steps that can really aid the digestion and and I'll notice that, like if I go on a plane flight and I'm traveling somewhere, and I've been on the plane the whole day to fly, say, back to the East Coast. I It does throw me off a little bit on my digestion, and I'm not as hungry, and things kind of slow down. And then once I get active again, it picks up again. So yes, so physical activity is totally connected to gut health.

Erin Brinker: 29:55

So is gut health tied to sleep hygiene? Because you started to talk about sleep. The two of those related,

Dr. Timothy Jenkins: 30:02

it is related. And so that is also connected. So one of those New Year's resolution can be, I'm going to get, you know, a good, good quality sleep. And there's several things you can do to lead to that. I know that's not the topic of this, of this conversation in terms of sleep, but it is connected. And I would just say that if someone eats a meal right before they lay down to sleep, there's a whole lot of things happening in your body to digest that meal, and it throws off the hormones that also help regulate sleep, things like melatonin, for example. And so it's better to, you know, really better to sleep on an empty stomach. So have a meal a little bit earlier, have some time for that food to digest and then sleep, and then really get a good, you know, seven, eight hours of uninterrupted sleep in a comfortable environment and a comfortable place to sleep and all that, and that, in turn, then Improves Your Immune System and improves your gut function, improves how you feel. So those are directly connected.

Erin Brinker: 31:03

You know, I think of, we think of people eating dinner early, and we tend to think of older people. Sounds like they're onto something.

Dr. Timothy Jenkins: 31:08

Yeah, you know, I've noticed myself. I'm getting close to 60, and I love those senior specials. And I would when I was a kid, I thought that's, that's the goofiest thing. I would never do that. And now I'm like, You know what? So my wife and I will make a reservation if we go out at five, five o'clock, or even, like, 430 and I'm like, well, we beat the lines, and we feel better too. So exactly, it's win win. It's a win, win, it's a win, win. So I and you get the special too. So that's a good thing.

Erin Brinker: 31:39

So there are, there are 1000 fad diets, and there's always, there's one book after the other comes out, and there have been for as long as I can remember. This is the key to weight loss. You should eat only steak. You should eat. You should never eat any animal products. You should you know, keto and paleo and Atkins and vegan and all of the diets, you know, and so I personally really like I used to be a vegan. Turned out it was, it was murder on my blood sugar, because rice. But I really like that diet, like a plant based diet. My brother, on the other hand, he is Mr. Keto, meat and vegetables and non starchy vegetables. That's all he eats. And he has, he's begged me to switch. I've tried to switch. It was murder on my stomach. I just didn't like it at all. Are we all different? Or does it take time to for your gut to get used to the new diet? What? What is your approach? What do you think?

Dr. Timothy Jenkins: 32:36

Yeah, and so there's really, there's benefits to these diets, and there's, there's risk to it, and I think that no one's found the magic solution to it. I think if they had, we wouldn't have developed areas like GLP, you know, and so forth. And because, because it, there's so many different factors that go into gut health that there's really not one kind of magic solution to it. And so you mentioned, you know, the Keto, keto diet, and some people really believe in that. But you know, there are also some things where it can throw some things out of balance, if it's too excessive on that, because you really do need a good balance of healthy fats, carbohydrate, protein and all of that for good nutrition, plus your vitamins, and for all that to be in balance. And so if it's too out of balance, it can really, you know, it could have some adverse impacts. Another example would be intermittent fasting. And you know, someone you know, would say, Well, I'm going to eat one meal, but then not have any any nutrition for a certain number of hours. And you know, that's another example, and it can be helpful, but for some individuals, they can become hypoglycemic, and it can cause them symptoms and problems if they do that. So especially if they get older, it's more difficult to do the fasting with age, the body's kind of resiliency is is not the same as it is when they're 20 years old versus they're 80 years old. So that's, that's another different so I think there's, you know, there are different diets. There's some benefits to them. But I would say, you know, overall, some of the things I've just talked about already, about an overall healthy diet, those New Year's resolution, I think that's really something that can be put into practice by most people.

Erin Brinker: 34:23

It sounds like you're telling people to really listen to their body.

Dr. Timothy Jenkins: 34:26

Yeah, absolutely right. Listen to how you feel. One of the when I see a patient and I'm evaluating them and they are coming to me with GI symptoms, one of the questions is, well, well, what causes the symptoms? What are the types of foods you're eating? And we go through the list of that, and that helps me zero in on what might be the condition that's causing their symptoms. And so you do listen to your body and say, You know what, what works for you, what doesn't and and my wife, I mean, she there's certain things, she says, If I have certain type of spicy food or something, I. Really feel it, so I have to watch out for that and and whereas, for me, that doesn't make as much of a difference. So so people can be different in that regard.

Erin Brinker: 35:08

So let's talk about when, when there's trouble with the gastrointestinal tract. And last time you were on, we talked a lot about colon health and colon cancer, so we just kind of revisit that a little bit. So how do you know when the cramping that you're getting or the upset that you're getting might be a problem, right?

Dr. Timothy Jenkins: 35:25

And so there's so, of course, with any symptoms, and in this program we're doing is these are general terms, and so you always need to see your doctor and have a conversation with them and and have an evaluation. But there are certain symptoms we call red flag symptoms that are that are not normal, and they're also potentially more indicative of something more significant in the GI system. So, you know? So I go through a list of questions when I see a patient, and one of the things is unexplained weight loss, for example. So if I have a patient who says, you know, Doc, I'm just not feeling so good. I'm having stomach cramps, and I've lost 20 pounds, and I used to weigh 150 and now I'll weigh 133 months later, and I'm and I don't really know why I'm eating, you know, normally, and all that that would lead me to do further evaluation, blood test and maybe other types of tests, a scope or an imaging test, or thing like that, to evaluate that. So that's one example, is unexplained weight loss. Another symptom that is potentially concerning and something we need to look at more would be vomiting. And so if someone is describing, you know, I just get vomiting. And you know, that's not a normal part of digestion. It can be if someone has something that's highly irritating to the stomach and they need in the body reacts and wants to get that out of the system. But if they're having recurrent vomiting, there can be other situations going on with their gut or with other parts of their body that could lead to that, vomiting is also triggered out of the brain, and so there's things in the brain that can lead to that. So that would lead to further testing. Bleeding is another example. So if someone's having bleeding with their bowel movements, that's not normal, and so there needs to be some evaluation for that, and so I asked about that when I you know, when I see a patient. So those are just three different symptoms, and there's more, but those are some that would tell you there's something that could be more serious. On the other hand, symptoms such as bloating, such as cramping, alternating diarrhea, constipation, without any of those other symptoms may not be as serious of an issue than some of the other ones that I talked about. It still could be, and you should see your doctor and have it evaluated, because there's potential for things that are serious. But those are those, to me when I hear those symptoms are, they're not the same as someone who's vomiting, bleeding, unexplained weight loss, things like that. So, so those are some of the, some of the things we look at. You know, just a quick thing about diarrhea, constipation. So how often should we have bowel movements? We always hear about, oh, it should be once a day, and at this time of day and all that. And there's some people like clockwork, and that's the way it is, but there's a range. And so it's really up to three times a day bowel movements, or three times a week, and everything in between that is considered kind of the range of normal. And people are different. So some people tend to one side of that or another, or they kind of go back and forth

Erin Brinker: 38:39

between that. Now that is greatly impacted from from what I've read and understood, and may not be true, but by the amount of fiber and the amount of water that you consume. Is that correct? And what role do both of those play?

Dr. Timothy Jenkins: 38:53

Yeah, it is. So fiber is super important. And one of those New Year's resolutions to be I'm going to have more fiber this year, and I notice it myself. If I, if I don't have some fiber, and I'll, I'll buy some bananas at the store, or I'll have salads or beans or things like that. If I, if I travel and I'm just not kind of eating my routine, I notice it, and it can make a difference in my digestion. So in general, the more fiber, the better, because it really assists your body and digestion in it, and it is a food source for those bacteria that are in your in your gut. So it helps, it actually helps them stay healthy. It helps you stay healthy. It helps everything move through the system. And kind of, kind of lubricates the system and helps things move properly and leads to better feeling of abdominal symptoms, reduces that and more regular bowel movements.

Erin Brinker: 39:49

So should we be getting fiber just from our food? Because you talked about beans and leafy greens, and I know apples, for example, are high in fiber. Or should we be taking madame? Was sold every day. What do you what do you suggest?

Dr. Timothy Jenkins: 40:02

Yeah, I think it has to do with the amount that you take in your regular diet. And so there's guidelines in terms of how much fiber we should take per day. Like, for example, like 25 grams of fiber a day. And there's different tables, like, Okay, I have a salad, an apple and a, you know, banana and some brand cereal, and you can kind of figure out about how much you're taking per day. For individuals who are not where it's irregular, like they may be traveling a lot, they don't have a more regular diet, and they need to supplement that. That's okay, but if someone is able to just have that intake of daily fiber through their diet, they really don't need to take a supplement, because they're going to get it there. So I think it just depends on the individual and what their lifestyle is. You know, I've taken it off and on. I would have taken Metamucil in the past, or take it. I didn't take it. And I seem to remember maybe Erin residency when I was in training, and I used to work 36 hour shifts, and like, eating

Erin Brinker: 41:03

out of vending machines.

Dr. Timothy Jenkins: 41:06

Like I was, my best friend was the vending machine. And you kind of just get food when you can not, not you know, is good for learning about medicine, not so good for your gut. So, so I think I did take, like, some Metamucil or something like, I got it, I'm not going to get a salad today. I got chips and a, you know, soda, which is not healthy for me to do all the time, but, but, yeah, so I, so that's what I would do. Look at your diet, if you're not getting that good intake of fiber, you may want to supplement it with, like, a, you know, a fiber supplement. And there's plenty. There's also fiber supplements that have sugars and additives and all sorts of stuff. So you do have to look at, look at what you're buying, but that's what I would do.

Erin Brinker: 41:48

Chia seeds are a great addition to to your food, if you want to get lots of fiber, and they don't take up a lot

Dr. Timothy Jenkins: 41:53

of space. Yeah, that's a great example. That's a great example. So let's

Erin Brinker: 41:57

talk about probiotics and supplements. Because, you know, some I hear supplements are a big fat, hairy waste of money, and then I hear other people swear by them that they feel so much better when they're taking supplements. What does your body do with them? And can they absorb them?

Dr. Timothy Jenkins: 42:10

Yeah, so the probiotics are something that really kind of goes, goes hand in hand with the, you know, with the gut bacteria that you have so and they can be things like lactobacillus, for example, is a type of probiotic that can be in yogurt and some types of food products, and it really helps keep that balance of the good bacteria in your gut that helps you with your digestion. And so what we have found is for certain people that have gi conditions like irritable bowel syndrome, which I talked about earlier, and they take probiotics. Some of them really can benefit from that, and they feel better because of that. And the reason that happens is those probiotics help to restore the balance of the bacteria in your gut.

Erin Brinker: 43:00

So which, which makes a lot of sense. So if you go through, I went through a period years and years ago where I had sinus infections that were really hard, hard to clear up, and I took antibiotics for way too long, ended up clearing up the problem. But then, you know, needed probiotics, and so I ate the yogurt, I had the kefir. I did, you know, I did. I took probiotic supplements, and it eventually evened out. The challenge, though it was, it's not a quick fix. It takes a minute for it to for you, everything to become, to go back to normal,

Dr. Timothy Jenkins: 43:31

right, right? Yeah, we've had patients, and I'll talk about something. This is a little little queasy for some people, but we've actually, we've actually gone as far is something called a stool transplant for a patient who has, for example, one of those conditions with the bad bacteria and the good bacteria, we just can't get them restored back, and so they continue to have symptoms. They continue to have problems with the bad bacteria. They've taken probiotics, it's not working and so forth, and they still have an illness. They've actually gone to the extent of having a stool sample from a close family member, and of course, we test it and make sure there's nothing harmful in there. And they go in, you know, and I go with the scope into their colon and plant the stool sample in there to restore the bacteria in their culture. So that's crazy, not, not exactly dinnertime conversation, but, but it's but it is. It makes sense when you think about it, because really, their family member, who has a normal gut is good health, has normal bowel movements. They have a normal mix of bacteria. Can donate that to their other family member, and can do that. Now, this has to be done under medical conditions, lots of testing involved. We don't do this. This is pretty rare for this to happen, and it's not done that often, but it just, it just shows the reality of. Of the gut health and the gut flora, the bacteria that are in there. How important that is, that we would go to that extent, and I can remember, and that didn't exist back when I was in medical school. We hadn't tried this, and it's been in the last 30 years. But someone had I said that 30 years ago, they would have looked at me like I was.

Erin Brinker: 45:19

But it makes sense, right? I mean, the biome is like a garden, and if your garden's out of whack, you have to give it the nutrients that it needs, or give it the fertilizer that it needs, or give it the whatever that it needs, so that your garden is restored. Absolutely.

Dr. Timothy Jenkins: 45:33

It's like you've gone over to your neighbor's garden and they've got all the great things growing and say, Hey, give me some of that soil, and you bring it back to your garden, and lo and behold, it works. It works.

Erin Brinker: 45:45

Yeah. So, so for the person who's starting out new year's resolution and they want to make gut health, health a priority, what first step do you recommend?

Dr. Timothy Jenkins: 45:55

So I would say the first step really, would be to look at those foods and foods and drinks to live it, because that's really, that's what you're taking into your body. And I gave that list earlier in the show, but that would be the first thing. And then I would say number two, three and four would be to work on the stress. So, you know, whatever that is for that for you, in terms of the things that cause stress, the sleep and the physical activity. Those are the three. Those are three other things. So the foods are taken in, limiting those areas. I talked about stress, sleep and activity, and I think that's really, you know the going to be the best thing. Now, if someone's smoking cigarettes to about using tobacco, that's detrimental for many reasons. If they're using antibiotics and they shouldn't be, they, you know, that should be avoided. So there's other individual things that can be done, but for everybody, it's really the diet, the sleep, the exercise and the stress management.

Erin Brinker: 46:55

You know, we you talked about alcohol a little bit, and the more research that comes out, it used to be they having thought having a glass of wine a day was considered beneficial and and now the research is showing that it's actually could be quite harmful for the body. Should people just avoid alcohol, or is there a safe level of drinking alcohol? What do you think?

Dr. Timothy Jenkins: 47:16

Yeah, and it's and it's kind of we're in dry January, so one of my one of the doctors I work with, I did it last year. I did the dry January. Didn't drink any alcohol for the month of January, and I think it's become more popular, but we're in that month, it's been difficult for research to really conclusively prove what level is it of alcohol that you know that does cause more and more problems. What we do know is that the more we drink, the greater risk there is to that. And so less is better. Avoiding it completely means there's no risk from that. And so I would say it should be minimal. And the whole idea that if you drink a glass of wine a day, like you're saying, and I can remember when that used to be the talk of the town, really, really, that's been debunked. And what I find interesting, I have a son and my daughter. They're in their mid 20s now, and what I'm seeing with their generation is there does seem to be less alcohol. When I was in college in the 80s, and I went to and I went to Harvard College. I went to a pretty good school, but the students we would they would wander from building to from dorm to dorm, and there would be the alcohol parties going on, and that's what happened. And in this in the kids this day, I call them kids, minor, mid 20s or adults, but they don't seem to be as interested in alcohol as being part of that. And I think that's a healthy trend that's better now than it was when I was in college back in the 80s. And so I think the next generation probably, you know, each generation gets smarter. Each generation learns from the previous one. I think there's some benefit to that. And and I just find my kids and their their friends and all that don't seem to be as interested in, so that, I think that's a good thing

Erin Brinker: 49:03

well, and I think they're, I think they're interested in cannabis, and I think that's that alcohol has been displaced.

Dr. Timothy Jenkins: 49:09

Well, that's another that's an interesting one. And, you know, and there's become more social acceptance of it. And what I would say about that gets to, you know, kind of how much of something people use, but we do see something where if someone uses cannabis on a regular basis, or something called cannabis vomiting syndrome, and so that's that red flag symptom I was telling you about earlier, someone says, you know, I'm just I get up. I'm throwing up every day, and I don't know why. One of the first questions I ask them is, well, do you use cannabis? And if they say, Well, you know what I do? I use it for various reasons, and I do it every day and and in Sure enough, I'll make the connection. I'll say, well, there is this vomiting syndrome that happens with that, and it's thought to trigger from the brain. And the effect of cannabis on that, that can, that can cause vomiting when it's used on a regular basis. Is so they discontinue it. And I've seen some very dramatic I've seen patients who we've done every test we've scoped up and down and done all kinds of scans, blood tests, everything's normal, and they're still vomiting. And we ask one question, are you using cannabis? We find out they are, and they're honest with us, and we appreciate that, and then they stop and they feel better. So that's just an example of what it can do. Wow.

Erin Brinker: 50:26

Okay, so what does the future of gut health research look like? So what's on the horizon?

Dr. Timothy Jenkins: 50:32

Yeah, so there's, there's a lot of interest right now in the connection between the brain, gut connections and mental health, and there's so much more awareness of mental health, and that's another topic that's not, you know, not part of this conversation today, but there's so much more awareness of the importance of mental health and the impact of mental health compared to what it used to be many years ago. And so there's a lot of interest in research to look at the different types of bacteria that are in the gut and the hormones that that connects with in terms of what the body's producing, the signals that happen from the gut up to the brain, and how that influences not only things like sleep, but also someone's mood, someone's feeling of anxiety, depression, and so there's a lot of interest. So there's, there's a lot of research happening now trying to identify types of bacteria, types of the microbiome in the gut, that could be associated with, you know, with with mental health. So that's one area. The second area is that what we're finding is that certain conditions such as inflammatory bowel disease, so that's Crohn's disease, ulcerative colitis, diabetes, heart disease, various types of cancers, even things like multiple sclerosis. There may be some connection to imbalances in gut health that can be connected to that. So there's research happening in that area as well. And so those are a couple examples of what the future is holding. So there's a lot of research happening. It's very exciting. That is exciting, and that's how GLP happened. It's where we understand it, we see the mechanisms, and then targeted therapies are developed based on that science. So so just to put in a plug, I used to do a lot of research many years ago, and did cancer research in that and I think it's, you know, important to me, and I recommend that our, you know, collectively, we as a country, we as a society, continue to prioritize research, because that's really how we improve our health and learn about the things that are going to be important in the future.

Erin Brinker: 52:50

You know, I It's a couple of the diseases that you talked about are autoimmune, and I there has to be a connection. I mean, logically, in my mind, there has to be a connection between gut health and autoimmune disorders where the body gets hijacked and starts attacking itself, whether it's rheumatoid arthritis or lupus or Hashimotos or, you know, sarcoidosis or whatever. And is there research being done in that area?

Dr. Timothy Jenkins: 53:14

There is actually the researchers have gone to the extent in animal models, and we don't use as much of that today, because we're very mindful of animals and for that role in society that they have. But in the past, we've had animal models where they've been raised in an environment that's sterile, that has no bacteria. And what's interesting, we find that the animal may not develop those auto immune conditions, but as soon as you introduce bacteria that they normally would have, and in the food that they eat, in the activities they have, they develop those conditions and so and so we find that these you know that there's a direct connection in that, and it makes sense, because once the immune system interacts with those bacteria in the gut, then the immune system has certain reactions, and sometimes those reactions lead to disease, like you said, like rheumatoid arthritis or inflammatory bowel disease.

Erin Brinker: 54:15

So I could talk to you all day long. Dr Timothy Jenkins, this has been so great. How do people find you? I know that you're at Kaiser Permanente here in Southern California. What's the best way to reach out to plug in with a Kaiser doctor to get more information?

Dr. Timothy Jenkins: 54:31

Sure. Well, I'm proud to be part of Kaiser Permanente. Thank you for saying that. I work in San Bernardino County. I'm the medical director for the Kaiser Permanente San Bernardino County. So I'm a GI physician of also a physician leader in this area, supporting all of our 1000 plus physicians. And so if you're a Kaiser Permanente member and you have then you're, you know, you're part of our plan, and we're happy to take care of you. And so that. Yes, that's what we do.

Erin Brinker: 55:00

Well. Dr Timothy Jenkins, thank you so much for joining us, and thank you for everything that you do to spread awareness, to offer direct services, to lead the Kaiser Permanente team here in San Bernardino County as a proud Kaiser member. I appreciate you.

Dr. Timothy Jenkins: 55:16

Oh, well, thank you Erin, and thank you for doing such a great service to the public. This is just awesome that you have this program. You do such a great job at it, and I appreciate you. Thank you happy new year too.

Erin Brinker: 55:28

Thank you. Happy New Year to you. Well, that is all we have time for today. Thank you so much for spending this time with me. I'm Erin Brinker. You've been listening to the hope table, and as you work your way through this brand new year 2026 make a commitment to yourself, to your health and to your heart. Have a great week. Everyone. You.