Why is everybody talking about gut health lately?

You've probably seen commercials talking about gut health, probiotics, prebiotics and all sorts of other things that are somehow related to your digestive system, but do you know what any of that actually is or why a healthy gut is so important? Today's guest is Donna Monthei, a registered dietitian and gut health expert with EverVital Nutrition, a company that helps people with chronic digestive issues discover the imbalances affecting their microbiome and teaches them how to transform their gut using a unique customized approach to gut wellness.

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Transcript

Bruce Kassover: Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America's leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers, all available at NAFC.org. 

Welcome back to another episode of Life Without Leaks. I'm your host, Bruce Kassover, and today we're joined by Donna Monthei. She's a registered dietitian and gut health nutritionist with EverVital Nutrition. They're a company that helps people with chronic digestive issues discover the imbalances affecting the microbiome and that teaches them how to transform their gut using a customized approach to gut wellness. So welcome, Donna. Thank you for joining us today. 

Donna Monthei: Thanks so much for having me. I'm thrilled to be here. 

Bruce Kassover: Tell us a little bit about your story and your journey to becoming a nutritionist and a dietitian. 

Donna Monthei: So, I've been a dietitian for years, over 20 years, showing my age there a little bit, but yeah, for a long, long time and focusing more on weight loss and kind of the usual dietitian type thing there. 

About six years or so ago, I was prescribed two different antibiotics, so double, double duty there, double whammy, to take at the same time, and I ended up really annihilating my gut microbiome, just really wiping it clean. And what ended up happening was a big overgrowth of harmful organisms and not enough of the good guys. And so I ended up with SIBO and just all sorts of symptoms.

And so in solving my own problems and symptoms, I've developed a protocol that I now use to help other people with similar problems, whether it stems from antibiotics or from something else, just general gut symptoms, that's kind of where I excel and where I really have a unique approach because I have dealt with all of it myself.

Bruce Kassover: I think that we're hearing more and more about gut health. I mean, you see commercials, they talk about, you know, different things that are good or bad or maybe you could tell us a little bit about what it's all about. I mean, about what, what is the nature of the gut microbiome? What does it mean in terms of your health?

Donna Monthei: So it's really an emerging field and exciting place to be for me as a practitioner, because there's always something new coming out. They don't even know, you know, half of what's going on in there. But what we do know is that the gut is really impactful in the well-being of many of our organ systems.

Some of your listeners have probably heard of the gut-brain axis and the direct connection that your gut health has on your brain and the functionality as far as moods, as far as brain fog, that type of thing goes. But there's also a connection with the lungs, with the skin, with the with the vagina, with the all the organs are really deeply connected to the gut health.

And so, when you have an issue with something going on in your gut, it can affect all these other organ systems as well. And so it might not even look like, you know, gut symptoms, the things that we commonly think of as related to our digestive system. But it could be, you know, skin problems or that type of thing that it's really interesting in that way.

So what we mean by “our gut” is our, basically, our digestive system is a tube, right, from the mouth all the way on out. And we have some solid organs that are impactful, they're included in our digestive system. And that is our pancreas, our gallbladder, and our liver. So all of those together make up what we think of as our digestive system.

Our gut, when we say our gut, a lot of people do think about, you know, that system as a whole. But what I do is I really look at the health of the bugs in there. So we all know that there are millions of bugs in our digestive system, in our gut, that are beneficial to us, and some that are harmful to us. And I look at the balance of those guys overall, as far as how they either help with our health or detract from it. 

Bruce Kassover: I think I'm following you now with the idea of what the gut is. What about the microbiome? What is that exactly? 

Donna Monthei: So the microbiome is the gut organisms as well as the environment in which they live. A lot of people will call the microbiome just to mean the bugs, but really it's the bugs themselves as well as that environment and, you know, that they're living in, so the, so what bugs are in there, right? So that is bacteria, there's also parasites, potentially viruses, fungi. And then we've got, you know, the way that those guys all interact can lead to symptoms or can lead to health.

And so, yeah, it's really an interesting field with those different organisms being so prevalent in our society and some of the factors that we have that can, you know, kill them off, like for me with antibiotics, or can help them to overgrow. So that's what we mean by the microbiome itself, is those organisms and the house that they're living in.

Bruce Kassover: I hear you say things like viruses and bacteria and fungi. And I mean, if I go by what I, what I'm used to hearing, those things don't sound like good things, you know, try to avoid those things. But I'm mistaken, is that, is that so? 

Donna Monthei: So that's really a great question because parasites, we think of as, you know, we don't want those, right? Nobody wants worms, wants the thought of that. Usually whenever I'm going through test results with my patients, I hear an audible sigh of relief when we get to the parasite section and they don't have any right, but there's some speculation or, I guess controversy, about whether certain species of fungus can be beneficial or commensal to us… parasites, not so much viruses, not so much bacteria. You know, we have a lot of beneficial, of commensal bacteria that are important in doing a variety of things that we would be in trouble without them, right? But there's also harmful bacteria that we don't want, you know, the things that we, that we hear of food pathogens, like salmonella, C. Diff or giardia, some harmful parasites there. We hear of those types of things. So yes, you're right, there are lots of things that we don't want in our gut microbiome – but we would be in serious trouble without the good guys 

Bruce Kassover: So I guess this brings me back to your personal story, which is, you know, you started taking some antibiotics and you said that really did a number on your gut microbiome. What exactly happens there? 

Donna Monthei: So, antibiotics are designed to kill, basically, and they're not selective in what they kill. So for me, what happened, and for a lot of people, this is a similar story. I have lots of patients that are kind of in the same situation that – and it depends on where you start, kind of as to when you take antibiotics – so for some people, it's not so impactful and they're able to recover from that without a problem, without symptoms. For me, what happened was, so many of the good bacteria were killed off, and that led to a kind of a perfect storm for the harmful ones to overgrow. And that's what happened over a period of, really a short time, just a couple of months without those, I call the, our beneficial bacteria our “guards.”

So without any of those guards there for me, any of the, you know, raiders or whatever, were allowed to come in and just kind of, you know, cause trouble. And so then they are allowed to overgrow unchecked. And so for me, that led to every symptom that you can imagine. 

And suddenly before that, no gut problems whatsoever, everything was working just fine and dandy. And after that, I gained about 20 pounds in two months, hair falling out, nutrient deficiencies, all the GI symptoms I had, you know. Terrible diarrhea, urgent diarrhea, just kind of the gamut… headaches and just wasn't absorbing my food and it just led to this whole cycle of events that put me in a pretty uncomfortable and not a great place for me to be.

Bruce Kassover: I can imagine that as a nutritionist, as a dietitian that was doubly difficult for you because this is probably, you know, really goes against everything that you're always talking with your patients about also.

Donna Monthei: Yes, a hundred percent. I was like, if I can't fix myself, like, I'm supposed to be the nutrition expert here, right? I have all this education. I have all this experience and yet I couldn't, I couldn't fix myself with just food. It took going that extra step doing some gut testing and figuring out what was going on. But before that, you know, I tried lots of different protocols to kind of… general protocols designed to fix gut problems from a very general perspective.

And none of that worked for me because it wasn't addressing what my problem was, which I didn't know what my problem was until I tested. But then after that, I was like, of course, of course, these general, you know, gut soothing supplements aren't going to benefit me because that's not what my problem was, but it took, yes, it took that extra step to figure that out. And it was kind of a long process, and extremely frustrating. I mean, I know that your listeners deal with this, but having urgent diarrhea and being unable to calm that down. It's not fun.

Bruce Kassover: It’s certainly not. Yeah, you look up fun and that's not going to be in the dictionary.

Donna Monthei: There's no picture of that in there. 

Bruce Kassover: Thank goodness for that. But now I'm guessing also that as distressing as your situation was, you're probably not unique in this experience. 

Donna Monthei: No, no, not at all. It feels like you are when you're the one going through it because it's not really something that you want to advertise, right? You're not telling all your friends, “Hey, guess what? I'm dealing with this!” 

So it does feel like you're a little bit isolated in that respect. Since working with people, I know now that it's not, and there's a lot of people dealing with the exact same symptoms that I was kind-of in secret, trying to manage it on their own or just make it stop or mitigate it or really alter their lives in ways that they can manage it. 

I don't like to manage things though. I like to make them… to fix them, to make them stop, to correct the problem, the reason why they're happening in the first place rather than, you know, slap a band aid on it, as I say. So I was slapping a band aid on it, and it wasn't working, and it wasn't until I figured out exactly what was going on - it's, you know, that's when I was able to make it stop. So yes, not alone, but you do feel quite alone. 

Bruce Kassover: Maybe you can tell us a little bit about your treatment path. I mean, how did you get it properly diagnosed and then been treated? 

Donna Monthei: So I ended up going to a local pharmacy that was offering gut testing and what their tests included was basically a list of organisms in my gut, as well as some digestive health markers, and it's just a simple stool test.

So I did that and got my list of organisms so I could see, you know, this is a pretty unique approach because it provides data on something that we don't usually get data on, right? People that have diarrhea or have constipation or have whatever the symptom is. It's like, well, here's your solution, but that's not always what the solution is because there's lots of reasons why you might have diarrhea, lots of reasons why you might have bloating, lots of reasons why you might be constipated, and there's not one fix for all of them.

So, having that data for me was kind of the turning point. It was, you know, I call it the game changer because tt really allowed me to see, oh, okay, I don't have any good bacteria at all. So that's a problem. Right. And I could see what that cycle was. Okay. So not enough good guys. So not enough of those guards, like I was mentioning.

So that allows the harmful guys to come in to overgrow. My digestion wasn't working properly because certain organisms were adjusting my digestive enzyme levels and a whole host of things going on there, but having that data was really the eye opener for me as to, okay, I'm not imagining this because a lot of people will go to a GI doc and hear, “Well, you know, this is something that you're just going to have to manage,” if it's IBS diagnosis, or SIBO, or you're just imagining this, or this is what everybody that goes through menopause is dealing with, but this is what every, this is normal for you to feel this. And it's just like, well, wait a minute. It's not for me. So, great for me to have that data to confirm what I was feeling in my physical body and find a real clear, solid path forward.

So that's what I did with that functional – it was really a pharmacist – functional doctor at the pharmacist to move me forward towards that path of healing, towards rebalancing my gut, and that was kind of the key for me. It's just that whole rebalancing there. 

Bruce Kassover: So what steps did you actually take to do that rebalancing then?

Donna Monthei: So that was supplements, some of it was lifestyle, like I had to back off a little bit on the activity level because I'm a very energetic person, so I was doing a lot, and I just backed up a little bit so that my body had the time and the energy to heal. So it was supplemental support, it was lifestyle factors, and then there were some dietary factors as well.

And this is what I do for my patients is, I cover all three of those things. I look at, you know, where are they starting and, and what does their test show that they would benefit from? Is it, you know, we've got these huge levels of H pylori for an example, do we need to cut out the foods that feed H pylori? In some cases, yes. 

So for me, that's, that's what I did. I went to a diet that was really, basically, just protein, fruits and vegetables along with some healthy fats. And I didn't give those harmful bacteria the food that they wanted, which, in a lot of cases, it's refined carbs. So I cut that out completely so that I wasn't feeding the things that I was trying to kill and really just overhauled the lifestyle, the nutrition.

And then I did support with supplements – and kill, I killed with supplements, to kill off those harmful bacteria while also really just supporting my gut overall so that it could just have that calming, soothing effect there. 

Bruce Kassover: How long do you think it took you to get to where you were starting to feel like you're back to normal?

Donna Monthei: So once I saw what was really wrong, like I probably toiled around for about nine months or so before I did the gut testing. Once I began that protocol, it was pretty quick. And, and people always want to know that, like, how fast am I going to feel better? It really varies with what all is going on. 

So I have one patient that had really high levels of H pylori. I keep picking on H pylori, but it's a really common one. And she was experiencing significant anxiety from that and had been for about 15 years. That's one of the bacteria that just hangs around for a long time. And so she had GI symptoms, but her overwhelming symptom was anxiety, including something called trichotillomania.

It's a compulsive hair pulling. A lot of times people will pull eyebrows, pull eyelashes. It's a subconscious thing. So it's not like I'm planning to do that, but it's a segment of, I don't know if it's OCD specifically or anxiety generally, but she was experiencing that for a long time. Within a week of treating her, she stopped doing that after 15 years.

And so she called me practically in tears. Like, “I can't believe I, you know, I haven't pulled my eyelashes.” And so for some people it's that quick. She wasn't cured in a week by, by any means, but making improvement over that period of time. 

For me, it was a little bit longer, but I did feel better and better. I wanted the first thing to stop was the urgent diarrhea because it's so impactful in life and so it's just… That was one of the things that I wanted to go away or to just be alleviated or reduced to a degree initially. And so that probably took a couple of weeks for things to just really calm down in my gut for that trigger to stop.

And then as I said with my, with the other patient that I mentioned, it's a slow and steady process of feeling better and better week over week. It's, you know, definitely not a light switch. Unfortunately, I'd love to be able to flip that switch and have everybody feel better immediately, but it really does not work like that. You have to approach it from, “Okay, what's the biggest problem here to take care of that?” and then move on to the next thing and the next thing. 

Bruce Kassover: It's really interesting. You're talking about also about H. pylori. That's the bacteria that's often associated with ulcers, is that that correct with the majority of stomach ulcers? And that's usually dealt with via antibiotics, if I'm not mistaken, is that is that right? 

Donna Monthei: Yes. So the typical treatment for H pylori is something they call triple therapy. I hear now there's a quad therapy, but the triple therapy is the usual approach. And that is two antibiotics, as well as an acid reducer, a proton pump inhibitor type medication is what they call it, like a Meprazole or something like that.

And the idea is to stop the stomach acid or decrease the stomach acid production and then kill off the bacteria with those two antibiotics. The problem is that H. pylori already neutralizes stomach acid in everyone. That's kind of its role. It doesn't like an acidic environment, and so it neutralizes stomach acid.

When you also throw a proton pump inhibitor that's an acid reducer, acid blocker, on top of that, basically the acid production is taken down to nothing. Which, as you remember from my story, that's what allows the overgrowth of harmful organisms. And so, in a short, very well managed situation, that can work to get rid of the organisms, the H. pylori, and then keep the environment where H. pylori will be present and able to be killed, but long term, the problem is that is that a lot of people stay on those PPI's long term, and then that keeps their stomach acid not acidic enough. And so they end up with either H. pylori coming back or with some other organisms regrowing and a state of, they call it “dysbiosis,” when there's too many harmful organisms and not enough of the beneficial organisms. So that it's super common for people to be treated for H pylori and then it comes back or it never left all the way. And then that, those acid reducing medications keep the environment perfect for it to stay around or regrow. 

Bruce Kassover: It sounds like an incredibly delicate balancing act then.

Donna Monthei: Yes. Yes, absolutely. 

Bruce Kassover: So, I'm wondering, your patients, it sounds like you probably treat a variety of people. Maybe those who have had conditions that are as severe and distressing as yours, but maybe people who have things that are not quite as extreme in the way they present. Is that fair to say? 

Donna Monthei: Yes, yes, absolutely. Some people come in here and we test them and we see that they don't really have much in the way of anything harmful overgrown. Their problem is more on the end of, end of the spectrum where they don't have any beneficial bacteria. So what we know is, down the line, they will eventually end up with an overgrowth of something harmful because their guards aren't present in enough numbers.

And then all the way to the other end of the spectrum, I have lots of patients with SIBO, that's the small intestinal bacterial overgrowth. That's when there are harmful organisms overgrown in the small intestine, where usually there aren't many organisms. That's kind of the worst of the symptoms – worst of the diagnoses, rather – that someone can get because they feel like it's a lifetime thing that they can now resolve.

Kind of the same thing with IBS. I do have a lot of IBS patients, which I don't necessarily like the diagnosis of a label of IBS, because docs will tell their patients, “okay, we've ruled out everything else, and that's what it is.” There's not a test for IBS. There's just ruling out everything else. If we can't find out what box you fit into, then you go into the IBS box, which then they're sent home with a low FODMAP diet plan and a pat on the back. And it's like, “Good luck to you,” right? And I don't like that for people because it makes them feel hopeless. It makes them feel like, “Okay, this is something that I have to manage for the rest of my life.” And it's just simply not the case. I have a whole practice full of people that have this IBS diagnosis have been on some medications like those PPIs, as I mentioned, for 20 years, 10 years, a long time, and I'm trying to manage things by, you know, slapping the band aids on there. And once we balance their gut, the symptoms are gone. And so, yeah, I do have all the way from people with just not enough beneficial bacteria or just something like H. pylori, all the way to full on SIBO. 

Bruce Kassover: Well, if I'm a patient who's having some sort of digestive issue, somebody who's listening to this is, you know, probably dealing with something related to incontinence, you know, perhaps, you know, bowel incontinence issues of some sort or another. How do I know it makes sense for me to come and visit you?

Donna Monthei: So most people can benefit from knowing what's in there if they're dealing with any sort of bowel incontinence or any GI symptoms, really. It's just, it's so fascinating. You know, the oral microbiome has an impact and the gut microbiome has an impact really on our health as a whole. But if somebody's dealing with fecal incontinence, then something's going on. So we want to get to the cause of that, the root cause, as we say, and not just manage that symptom, even if that's the only symptom they're dealing with. Likely it's not. Once I start asking questions, H”ey, how's your skin? Hey, how's your mood? Hey, are you experiencing anxiety?” They're like, “Oh yeah, yeah, yeah. I am. Forgot to put that – you know, I forgot to say that.” It's usually much more system-wide rather than, or I should say, body wide, than just a matter of fecal incontinence. So usually there's a reason for that to happen, right? 

And if we've ruled out the physical things that can cause that, then it's like, well, okay, we're left with the bacteria and so, or organisms, I should say, what is causing that? There's a lot of reasons why someone could have that symptom specifically. I see it all the time with parasites. I see it all the time with C Diff. There's certain organisms, just the simple fact of them being present, can cause that urgent diarrhea or incontinence.

Bruce Kassover: There is one problem though, and that is, I don't want to see you. I don't want to talk to you because that means that I have to discuss this problem, right? What do you say, what do you say to somebody who's thinking that? 

Donna Monthei: So I have an ability to put people's minds at ease in that way. I know it's, it's generally something that… people don't want to talk about a couple of things. Like I'm a mom of boys, and so I've spent my life basically poop talking. And so I have a, this way of being and whenever I talk about my own issues that often puts people at ease with discussing their specific issues. And I'm really kind of just matter-of-fact about it, like, “Okay, if you're dealing with whatever it is, I've done that too,” or, “I know people that have had that, too.”

And so, it's just a symptom; it's not, even though we do, you know, think about that, I don't want to tell anybody about this, but it is just a symptom that we can manage. And so we have to know that it's present in order for us to get rid of it. So let's just, I don't know. I haven't really had people once they get to me, have that situation where they're, they don't want to discuss it.

I do a lot of, a lot of my patient discussions and appointments via telehealth. And so I don't know if that helps that they're not sitting in the room, you know, physically, with me, with me staring at them or, or what it is. But I don't really have a problem with people feeling uncomfortable discussing their symptoms with me.

Bruce Kassover: The scariest thing may not even be that, you know, because once you're actually speaking to the professional, you know, you've already sort of gotten through whatever the, the gatekeepers might be that prevent you from getting there. It's that very first call when I know somebody is going to be answering the phone.

What do you recommend? How do you – is there something that I should say to help get the conversation started in a way that doesn't feel really, you know, frightening to me? 

Donna Monthei: I don't know. I just, so I just suggest that people be honest if you're dealing with something. You're not the only one by far. You are not the only one and you are not the only one in that person's practice that is dealing with whatever it is.

You know, it's really funny because we as humans tend to normalize our symptoms. You know, I'll hear people say all the time, “Well, this is just something that runs in my family,” or “This – we all have got problems,” or “Yeah, we all have abdominal pain,” or “We all have, you know, this urgent diarrhea. We all have whatever it is.”

And it's just like, well, maybe you all have the same issue going on and it's not a genetic thing and it's not something that you can't fix. And so I think for people, if they're just honest about what they're dealing with, that can definitely help them get, you know, get help faster. If it's somebody that's dealing with me, I just put people's minds at ease that, that very first call that I have with them is usually just a, like a meet-and-greet sort-of thing.

Like, “Hey, is there something I can do to help you? What are you dealing with?” And once I get people talking – and I think that this is probably pretty common across practitioners – once you get people talking and they realize that there's not any judgment there, they just speak freely. 

Bruce Kassover: So I get through the gatekeeper. I've made my first appointment with you. What is the relationship like? What is a typical appointment? Like, how does that go down? 

Donna Monthei: So, once we decided that we're a good fit, that the potential patient is dealing with something that I can help, because there's some things that I can't – I don't work with people that have physical obstructions or anything like that. That's something for them to manage with an MD. But once we determine, okay, this is sounds like a good approach, and you know, we want to move forward, the rest of it is super easy. It's just a matter of pooping in the french fry container. So I just send them the test kit that. Arrives to their house so they can, you know, provide their sample in their privacy of their own home.

It really is a french fry container that you provide your sample in and gather up some different sections there and put it in the little vial, just send it right back to the lab. 

I always tease people and say, you know, “Yep, they're putting their hazmat suit on and they're digging into your sample right now, figuring out what's going on.” But it's not really that. It's amazing technology. They provide the actual number of the organisms in your gut, whether that's the parasites, the viruses, the bacteria, and the fungus. It's just a super-simple, at-home, stool-based test that you just do your thing, send it back to the lab, and then roughly, I think their turnaround time is about 10 to 12 business days. And then you get your report and it's got, you know, the list of the organisms and the reference range and where you are. So you get an actual number for that organism, for each organism. And then, you know, kind of what's going on there from there, I take that and I prepare an analysis in writing for my patients, I want people to really thoroughly understand exactly what's going on in their gut. And so that takes some interpretation. That's part of my specialty. I started out my professional adult life as a computer programmer. And so I do have that, that analysis side of things. And so I use that in helping people to understand their current status.

You know, what does their test show and what the heck do we do about it? How do we get you back to. A balanced gut with a perfect environment and optimal digestion so that you don't deal with these symptoms. 

Bruce Kassover: So then you work with them, you give them a game plan. And how often do you guys, would you meet and confer?

Donna Monthei: So I meet with them once a month via Zoom so that, you know, we have eyes on each other, we can go through whatever, but I also offer, for every single person that I work with, the ability to text me or email me as often as need it. If that's all day, every day when they get started, then that's what it takes. 

And this is for lots of things. This for compliance. It's for, “Hey, is this, what I'm feeling, normal? Should I be experiencing this? How many times – I'm confused on my plan – how many times should I be taking this certain supplement or whatever it is?” I am available for my patients to have someone to ask those questions. 

You know, a lot of times they'll go to their doctor and they'll get their plan and they'll be sent home and they say, “Okay, come back in a month.” Well, sometimes a month is too long. You know, if you've got questions, you need to ask those questions. And so, I am here for that. And that's part of the benefit of working with someone like me, that I do address the issues or the, you know, whatever it is, when they are occurring instead of waiting for the next monthly appointment.

It's funny, I get positive feedback as well as negative feedback. You know, what-do-I-do-here-is-this-normal kind-of things. People will just text me and say, “I had a brown poop today.” Okay, here we are moving forward with some positive steps here. And so, yeah, I'm really, I know what it feels like to be dealing with symptoms and feel like you're alone and that nobody can help you, or that you have this diagnosis, that's a lifelong thing that you just have to learn how to manage.

And I really intimately understand that. And so I am very invested in my patients not feeling like that, not feeling like they're alone, like they're just like, “Okay, here's just another practitioner that's like giving me some stuff to do, giving me some stuff to swallow and says, you know, ‘Good luck’ and sends them on the way.” That's not at all my approach. I don't want people to feel like that at all because it doesn't feel good.

Bruce Kassover: And from what you were just saying, it sounds like this is a – or at least you practice this as a – complimentary modality to whatever the patient is already doing with their other physicians and healthcare providers.

Donna Monthei: Yes. 100%. Yes. I am not here to say, “Stop taking this med.” If they want to get off of, for example, that a lot of people come to me and they want to get off of the PPIs, those acid reducers. I do work with them to be able to do that. But, yes, I do work in conjunction with either their functional medicine doc, their GI doc, whoever that is.

I'm not there to say, “You know, that doctor's wrong,” or “stop doing whatever they said.” I go based on what the patient is wanting, what their goals are. 

Bruce Kassover: That's outstanding. So if I am listening now, and this really sounds like something I'd be interested in taking advantage of, how do I get ahold of you? 

Donna Monthei: So you can find me, I have a website, it's evervitalnutrition.com. On that website, you can click to book a free gut assessment. That's where we chat about, you know, what's going on with you and see if my approach is something that sounds good to you. You can also, there's a contact form on my website that you can reach out there. If you would just prefer to email me, you can do that: donna@evervitalnutrition.com. And I'm also on Instagram and there's a lot of free information about gut health on my profile there. And I am just about to start a YouTube channel where there will be a ton of info as well. 

Bruce Kassover: That's awesome. We're going to put links to all of these in the show notes, so if anybody wants to be able to just click on it, take a look at the show notes and that should direct you there as well.

And it's my - am I correct in saying, in saying that you, you are a sole practitioner? If somebody is dealing with you, they're going to deal with you directly. Is that correct? 

Donna Monthei: Correct. I do have assistants, but I deal with everybody myself. I don't, it's not a student, coach, it's not anybody else. It's me and my level of experience and expertise, yes. 

Bruce Kassover: You know, I do have one other question. And this is just to clear up my own confusion because as you know, my earlier question, I watch enough TV and I see commercials for prebiotics and probiotics and other biotics. What is all that stuff? 

Donna Monthei: That is a really good question. I know that the probiotic people have done an amazing marketing job because everybody knows what that is. And they almost allude to the fact that you can just solve your problems with a probiotic. 

So, a probiotic, that contains actual strains of bacteria. Now, the question is whether they, those strains, make it alive through the digestive stomach acid, the digestive process, so that they end up in the colon where they are needed. Don't know. I think the answer is, some of them do and others of them don't. So the probiotics themselves are those beneficial strains. 

Prebiotics are food for the beneficial strains, whether they come through a probiotic or whether they come, they're already in your gut. So prebiotic is the food for the probiotic.

Postbiotic is the substance, the metabolite that our beneficial bacteria create for us that are inherently beneficial to us. So prebiotic is the food, probiotic is the strain, postbiotic is the thing produced that's beneficial to us. 

Bruce Kassover: Well that actually makes sense. I appreciate you clearing that up. So Donna, as you know, this is Life Without Leaks, and even though we haven't been talking a lot about leaks, we've been talking a lot about digestive health, and I'm wondering if you could share with us, if you have one tip or hint or strategy for people to live a life with better digestive health, what might that be?

Donna Monthei: So my tip for better digestive health is fiber, fiber, fiber. Those are my three tips right there. And I'm kidding, but the takeaway for your listeners is fiber. I recommend to my patients 30-plus different fruits and vegetables, herbs, nuts, seeds per week. And that's kind of a good way, once we think about, okay, am I always eating the same green beans? Am I always eating the same carrots or the same, whatever, we want a nice variety of fruits and vegetables, seeds, nuts, plants in our gut for the widest variety of beneficial bacteria to grow. What we eat feeds those beneficial bacteria and we want a nice, diverse, strong population, and eating a variety of fruits and vegetables and plant materials will do that.

And so that's kind of the big takeaway. Think about what you're eating and don't just set it on repeat – you know, green beans on Monday, green peas on Tuesday, carrots on Wednesday, repeat. Go to the store, look at what weird things are in there. There's something called broccoli Romanesco – I like to throw that in every now and then. It's, it looks like broccoli and cauliflower had a baby. Find those weird things like broccoli romanesco and other things that you don't eat on a regular basis and toss them into your diet. Let those gut bugs have something to eat. 

Bruce Kassover: That is a delicious way to end things. So thank you, Donna. I really appreciate it – I appreciate you sharing all of this information.

I hope that anybody who's listening, who thinks that they might be able to benefit, reaches out and certainly, you know, does what they can to recognize when they have gut issues and really, you know, take proactive steps to take care of them. Thank you for joining us. 

Donna Monthei: You are so welcome. I'm happy to be here.

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continence. Our music is rainbows by Kevin McLeod. More information about NAFC is available online at NAFC.org.