Experts Sound off on Digestive Health

United Ostomy Associations of America (UOAA) Advocacy Committee:

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The conversation surrounding digestive health and wellness is more relevant than ever. What excites you most about the future of digestive health?

Continued advancements in research that promotes innovation in the diagnosis, treatment, and possible preventative measures for digestive diseases. For example, the research that is going into the role that microbiomes play on digestive health is very exciting.

We now know much more about how this vast ecosystem of micro-organisms that live in the gut impacts the whole body, from its role in nutrition and fighting infection and inflammation to sleep, mood, and even health of the skin. This research is reaching the public and enlightening people to be conscious about their diets. Our hope is to one day see fewer ostomy surgeries related to colorectal cancers and bowel diseases. This give us hope!

How can we eliminate the stigma of having an ostomy?

Between 725,000 to 1 million people in the United States currently live with some type of ostomy, a bowel or bladder diversion due to a disease such as cancer or Crohn’s disease, or trauma resulting in a stoma where a pouch is worn to collect waste. The ages of those living with an ostomy range from infants to the elderly. 

The public needs to recognize that not every digestive disease or medical condition such as an ostomy is visible. The stigma surrounding having an ostomy is fueled by the lack of information the general public has about what having an ostomy actually entails, but more importantly, the reality that undergoing ostomy surgery saves lives. A potential solution addressing the issue could include an educational campaign with public service announcements created by the Center for Disease Control and Prevention (CDC). 

Furthermore, there is public stigma attached to discussing the way the body eliminates stool and urine, something that can involve accidents, messes, and odor. This attitude causes people living with an ostomy to internalize this stigma, creating feelings of shame that can result in isolation. Getting people to talk about ostomy surgery and educating the public to this life-saving surgery and acceptance of people living with an ostomy is the key to fighting this stigma. Through education, support, and sharing stories of people who have undergone ostomy surgery, United Ostomy Associations of America teaches people that they can live well and happily while living with an ostomy.

How can physicians and nurses better advocate for patients living with ostomies and/or debilitating digestive diseases?

Medical professionals need to be more proactive in educating themselves in the care and emotional impact of ostomy surgery. Along with public stigma concerning attitudes toward people with ostomies, there is also stigma among health care professionals. Among nurses, this stems from lack of education in nursing schools. With very little hands-on instruction on the care of an ostomy, there exists a fear of treating ostomy patients. Ostomates who enter the hospital for issues not related to their ostomy have a much better understanding of how to care for the ostomy than the attending medical professional.

Due to the lack of trained ostomy nurses in hospitals, people new to ostomy surgery may face being fit with pouching systems that are ill-fitting, resulting in skin damage and little education on self-care outside the hospital setting. 

In addition, for some surgeons, there tends to be the attitude that an ostomy was an unfortunate outcome of their disease and the patient “will just need to make the best of it.”  

Finally, medical professionals’ attitudes will affect the attitude of their patients. Physical and psychosocial healing can range from one ostomate to the next, and sometimes these timelines don’t always coincide. It is important for medical professionals to not only empathize with the pace at which the patient is healing both physically and emotionally, but also to be able to provide the appropriate resources according to the stage of adaptation in which their patient is at in their journey.

We need medical professional voices to advocate for the following:

• Access to certified ostomy nurses.
• Outpatient ostomy clinics.
• Insurance coverage of medically necessary prosthetic pouching system supplies.
• Access to well-equipped public facility bathrooms for people with ostomies.
• Continued education of medical professionals.
• United Ostomy Associations of America’s Ostomy and Continent Diversion Patient Bill of Rights.

Naveen Jain, CEO, Viome:

Why is the microbiome an important health indicator?

The gut microbiome is the collection of trillions of microorganisms —bacteria, viruses, yeast, fungi, and mold — that reside in the digestive tract. Seventy percent of your immune system is in the walls of your gut lining. When the microbes in your gut are out of balance, it can throw off your immune system, resulting in inflammation.

Scientists have now proven that our gut microbiome is responsible for most chronic diseases, including depression, anxiety, autism, obesity, diabetes, heart disease, autoimmune diseases, and many types of cancers.

Viome analyzes your gut microbiome and offers personalized food recommendations that include superfoods, foods to avoid, and foods to minimize along with the reasons for why these foods are beneficial or not for your microbiome. These personalized recommendations, based on each person’s unique gut chemistry, are designed to reduce inflammation in the gut by helping the gut produce nutrients that our body needs and minimizing the production of toxins that are causing the body harm.

What do you say to those who believe in a one-size-fits-all mentality, especially when it comes to diet?

There is no universal diet. What is healthy for one person may be completely different for another based on what the  microbiome of each individual is doing. This includes foods, supplements, and probiotics. You want to feed your gut foods that your microbes will convert into helpful nutrients and not harmful toxins.

Anyone watching their blood glucose levels has been told to cut down on carbohydrates and starches such as potatoes, bread, and rice. Viome has published breakthrough research showing that the same food can have completely different responses on blood glucose levels based on each person’s gut microbiome. Certain carbs that cause blood sugar to spike in one person might have little or no impact on another person.

Viome also discovered that healthy foods like spinach, kale, or broccoli actually cause inflammation in more than 40 percent of customers but are superfoods for others. This is why it’s important for you to take Viome’s test and find out which foods are healthy for YOU.

What is something surprising many people don’t know about gut health?

Gut health depends on what is actively happening in your gut microbiome. Microbial activities can “tell us stories” about your gut environment and about your digestion. For example, Viome can see if you’re processing proteins or fats properly. Microbial activities can also tell us what the microbes are “doing.” Are they making beneficial nutrients for your gut’s lining such as butyrate? Are they producing toxins that are causing inflammation in your gut? Is too much salt “stressing” out your microbes?

Knowing what is actively going on inside of your gut and following a diet personalized just for you enables you to optimize your health in the most biologically-informed ways. With Viome’s Gut Intelligence Test, you can fine-tune the function of your gut microbiome so that your body functions at peak performance.

How can WOC nurses work to eliminate the stigma of having a digestive disease, digestive disorder, and/or an ostomy?

Stigma develops when a situation is poorly managed. WOC nurses provide expert care and support to those experiencing these issues. We must work to increase public awareness of the normalcy of patients living with digestive diseases, disorders, and/or an ostomy

What is a WOC nurse?

Wound, Ostomy, and Continence (WOC) nurses are highly prepared expert clinicians who treat individuals with complex wounds, ostomy issues, and incontinence. WOC nurses are specialists who provide superior evidence-based care to help shorten lengths of stay, prevent readmissions, and improve overall patient care.

How can nurses improve the care of patients living with an ostomy and/or debilitating digestive disease?

With an estimated 70 million individuals with digestive diseases and 100,000 ostomy surgeries performed each year in the US, nurses must remain current on the management of these conditions. They must also work to provide the necessary education for the entire staff treating these individuals. 

What excites you most about the future of digestive health?

The potential to alter many diseases through manipulation of our gut microbiome. There is some fascinating new research which demonstrates the multitude of interactions between our gut organisms and our organ systems, including the brain.

What is one way we can eliminate the stigma of digestive disease?

I think we have been given permission to talk about our bowel issues through increased media exposure. If we can keep these issues top of mind it will desensitize the public and shed light on important gastrointestinal problems.

How can healthcare professionals better advocate for patients with digestive diseases?

We can advocate for individual patients by being attentive listeners and helping to alleviate their dis-ease, not just treating their diseases. Nationally, we need innovative ways to increase colon cancer screening, thereby saving countless patients pain and suffering from this terrible disease.