Ep. 653 Estrogen, Progesterone, and Gut Health with Dr. Kumkum Patel | Gut Health, Constipation, Estrogen, Progesterone

Cynthia Thurlow (0:00)

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Welcome to Everyday Wellness Podcast. I'm your host, nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, the honor of connecting with the truly infectious Kumkum Patel who is a double board certified gastroenterologist and neuro gastroenterologist who specializes in the connection between gut, brain, and pelvic floor. Today, we spoke about IBS and stress in midlife, the impact of the enteric nervous system, as well as key risk rates for colorectal cancer, especially in millennials, how stress hits differently in perimenopause and menopause, the influence of proton pump inhibitors, and specific sequelae that she sees, the influence of bile acid diarrhea, especially after cholecystectomy or removal of the gallbladder, how our microbiome changes through the menopausal transition, and specific things that she looks for, clues to see if the astroblom is optimized, visceral hypersensitivity, the influence of motility, pelvic floor dysfunction, and constipation, and why constipation should not be normalized, how she addresses tears, hemorrhoids, and fissures, what to do when standard approaches stop working, and specific nutritional interventions that she likes to concentrate on with her patients, and how she utilizes microbiome testing, and how this influences conversations with her patients. You'll love Dr. Patel. Her enthusiasm is truly infectious, and I anticipate this will be the first of many other conversations. Dr. Patel, I've been so looking forward to our conversation. Welcome to Everyday Wellness.

Kumkum Patel (2:41)

Thank you so much. I've been looking forward to this. I've been a big fan of yours. I absolutely love what you're doing, and your work is exactly what we need in this space, and having more people talk about it.

Cynthia Thurlow (2:51)

Oh, I received that wonderful compliment, and thank you for carving time out of your early end of the spectrum and on Pacific Coast time. You know, before we were recording, we were talking about the influence of stress, and I think certainly as a gastroenterologist, as a woman, as a mom, as a wife, you know, you have a lot of responsibilities.

When you're looking at your female patients, not necessarily, doesn't necessarily have to be the midlife women, talk to us about the interrelationship of stress and that gut-brain access that so many of us kind of really take for granted.

Kumkum Patel (3:27)

Yeah, I cannot emphasize enough the fact that stress affects not only the way the brain works, but the way the gut responds as a result, right? Because you think about the gut as the second brain and, right, the enteric nervous system is ready to respond and the gut is like, is going to do what the brain says. So let's say you're having some type of stress, whether it's external stress, you're about to go run away from a tiger in a forest, or you're about to go give a presentation in front of 10,000 people, or you're about to go get into a fight with your spouse, your brain can't tell the difference, right? Your brain's like, okay, let's get into it, let's prepare, and it's going to prepare for all three at the same time. It cannot really differentiate between the tiger and the spousal fight. So it's like, okay, we're going to be going into low-dose fight or flight mode. And because of that, the gut can't poop, it can't do anything right now, right? So in some people, they get a holding, right? They get a death grip on their colon and the body's like, okay, well, if you're going to go run away from a tiger in a forest, you don't have time to stop and poop, right? So in those people, they accommodate, and then they get constipated for days and days and days, right? And so you think about the people who get stressed out when they travel or stressed out when they go give a talk and they're constipated, that's what happens. They're in a low-dose fight or flight mode, and the body's like, okay, we're not going to poop until you're done fighting this fight. And other people, they have the opposite response, right? And some people, their bodies are like, well, if you're going to run away from a tiger in the forest, you don't have time to stop and poop or pee or do anything. So let's just empty out your entire GI tract now before it happens, right? So right before you go give that talk, right before you get on stage, right before you go have that major fight or whatever, you may have nausea, you may have vomiting, you may have loose stools, you may have stomach rumbling, you may have distension, you may have cramping. And all of those are because the enteric nerves, the nerves that are surrounding the gut, are receiving messages from the brain going down the vagus nerve saying, okay, we're going to have the opposite response, we're going to empty out everything. So a lot of people have that visceral response.