4 Easy Ways to Improve Your Colon Health - Dr. Michael Ruscio, DC

Does your gut need a reset?

Yes, I'm Ready

Do you want to start feeling better?

Yes, Where Do I Start?

Do you want to start feeling better?

Yes, Where Do I Start?

4 Easy Ways to Improve Your Colon Health

Your “How-To” Guide For Giving Your Colon The Attention It Deserves

Key Takeaways

  • The core foundations of better colon health are a whole-foods, anti-inflammatory diet, healthy gut bacteria, regular exercise, and low stress. 
  • Paleo and low FODMAP diets can help lower intestinal inflammation, restore the gut microbiome, and can reduce symptoms of poor colon health. 
  • Probiotic supplements are a safe, easy, and effective way to reduce symptoms of an unhealthy colon.
  • Changes in bowel habits, abdominal pain, gas and bloating, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) are all signs that your colon health needs some work.

The colon plays a much more influential role in our well-being than we give it credit for. The large intestine is home to trillions of bacteria that help regulate our immune system and digestion, and even help produce essential vitamins like biotin and vitamin K [1, 2]. Working on your colon health and keeping your gut bacteria happy is a great way to jump-start your journey to better health. 

If you’ve been dealing with stool changes, gas and bloating, or abdominal pain, this may be a sign that your colon deserves more attention. And if you’ve been diagnosed with a chronic gut condition like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) this is especially true.

Fortunately, a whole-foods, anti-inflammatory diet, proper rest and exercise, and keeping your stress levels low are great, natural ways to boost your colon health. The Paleo and low FODMAP diets may be particularly effective at lowering gut inflammation, reducing symptoms of an irritated colon, and promoting better overall digestive health. 

For extra support, probiotic supplements contain billions of healthy bacteria that are excellent for reducing inflammation, restoring gut bacteria, and keeping the lining of your colon healthy.  

This article will help you get to the bottom of self-care for colon health and leave you with several research-backed tools for improving your gut. 

Signs Your Colon Health Needs Help

You may be wondering if your colon even needs support, so we are here to break it down for you. For some, it may be obvious, especially if you have been diagnosed with a condition like Crohn’s disease or ulcerative colitis. However, your colon health can still be less than optimal, even if you don’t have a diagnosis.

While it’s less prone to bacterial imbalances than the small intestine, the colon can become inflamed and unwell due to various stressors. If you have a history of the following risk factors for poor colon health, you may want to take a deeper look at your large intestine:

  • Blood sugar imbalances [3]
  • A diet high in processed foods [3]
  • Low fruit and vegetable intake [3]
  • A sedentary lifestyle [3]
  • Tobacco use [3]
  • Obesity [4]
  • Excessive alcohol use [4]
  • Excessive NSAID use [5]
  • Leaky gut [6, 7]
  • Gut infections [8]
  • Small intestine bacterial overgrowth (SIBO) [9]
  • A personal or family history of colon cancer, IBD, or polyps [10]

Irritable bowel syndrome (IBS) is an extremely common condition that affects both the small and large intestine and can cause gas and bloating, diarrhea, constipation, and abdominal pain [11]. IBS is linked to chronic conditions that can affect the large intestine, like IBD [12], and the above symptoms are a big sign you may want to focus on your colon health.

Other red flags that indicate you may have a problem with your colon include [10]:

  • Blood or mucous in your stool [5, 8]
  • Anemia [8]
  • Pain in the rectum [5, 8]
  • Nausea and vomiting [13]
  • Weakness and fatigue [5]
  • Fever [5]
  • Unexplained weight loss [5]
  • Loss of appetite [8]

If you experience any of the above symptoms regularly, it’s important that you get in to see your healthcare provider, as it could be a sign that you are dealing with a more serious condition like IBD, diverticulitis, or colorectal cancer.

However, whether you’re struggling with mild bloating and constipation or IBD, there are safe, natural, and effective ways to heal your colon and get back to living a full, symptom-free life.

How To Get Your Colon Health Back on Track

Below is a straightforward guide with natural, safe, and effective treatments for better colon health. We’ve tried to make it as simple and easy as possible for you to take your digestive health into your own hands, but reach out to our functional medicine center at any step along the way if you need additional assistance. 

You can also sign up for our newsletter for updates on ways to keep your gut healthy.

Change Up Your Diet 

You can’t address colon health without first tackling your diet. A healthy diet is the foundation of all digestive health, and if the food you eat is causing you problems, changing your diet is the best place to start. But did you know that even if you eat a relatively healthy diet, you still may be dealing with an unhealthy gut? 

That’s because everyone’s dietary needs are unique, and many seemingly healthy foods can be a personal trigger for gut inflammation. We recommend trying a whole-foods, anti-inflammatory elimination diet — like the Paleo diet — to remove these potential allergens.

The Paleo Diet

The Paleo diet is a nutrient-packed diet that calms inflammation in the colon by reducing your exposure to common problem foods that can trigger an immune response [14, 15]. Removing potentially inflammatory foods like dairy, sugar, corn, unhealthy fats, and gluten-containing whole grains heals the intestinal environment, helps restore the normal gut flora, and reduces inflammation in the GI tract [16, 17, 18, 19].

A more strict version of the Paleo diet, autoimmune Paleo (AIP), has been shown to improve IBD, as do low-carb diets [20, 21]. However, you may not need to get as restrictive as AIP right off the bat. Try simple Paleo first for 2-3 weeks to see if you experience any symptom relief. If you don’t get the results you’re looking for, it may be time to try AIP or the low FODMAP diet.

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A Low FODMAP Diet 

The low FODMAP diet is a great option for those whose poor colon health is linked to a gut bacteria imbalance. This diet eliminates foods that feed an overgrowth of gut bacteria in the intestines and can help reduce inflammation and leaky gut. 

Research shows that a low FODMAP diet can successfully restore the microbiome in those with IBS, making it an excellent option for improving colon health [22]. This diet is also effective at reducing symptoms of gas and bloating, abdominal pain, diarrhea, and constipation, especially in those with IBS and IBD [23, 24, 25]. A low FODMAP diet appears to show even more benefit when used in combination with probiotics, which is why we promote a holistic approach when it comes to healing the gut [26].

Whatever diet you go with, make sure it’s packed with fresh fruits, veggies, and fatty fish that are high in nutrients like magnesium, folate, and vitamin D and can reduce your colon cancer risk [4]. Lastly, if you’re not sensitive to caffeine, consider drinking a cup of coffee a few days a week (try and forgo the sugar and cream) for an extra colon health boost [4].

For more information on how to successfully shift your diet to be more low FODMAP or Paleo-friendly, check out one of our many articles on gut-healing diets

Introduce Beneficial Bacteria

Once you get your diet dialed in, the next step is to introduce more healthy bacteria into the gut. While there are probiotic foods that can help do this (think kefir, yogurt, and sauerkraut), the fastest, easiest, and most effective way is to take probiotic supplements.

Probiotics contain billions of beneficial bacteria that help regulate the immune response in the gut, lower inflammation levels, heal the gut lining, and restore the gut flora [27, 28, 29, 30, 31, 32]. This makes them a great tool for healing the colon from dysbiosis (a gut bacteria imbalance), intestinal permeability, and chronic inflammation.

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Probiotics for Colon Disease

It’s likely that probiotics’ powerful effects on the immune response in the digestive tract is what makes them so beneficial in treating inflammatory conditions of the colon. There is a large body of research that supports the use of probiotics in IBD, and they may improve remission rates and prevent relapse [33, 34, 35, 36].

While there is some mixed evidence on the effectiveness of probiotics in preventing IBD flares [36], the benefits of probiotics on gut health are undeniable, making them a great option for those dealing with active or controlled IBD. 

Probiotics may also be helpful for those with diverticulosis — a condition where small pouches develop in the colon, becoming susceptible to infection. A 2018 systematic review of 13 clinical trials showed that probiotic supplements were effective in all stages of diverticular disease, including both asymptomatic and symptomatic presentations [37, 38].

There is even some preliminary evidence that probiotics can be helpful in reducing post-surgical complications in colon cancer patients [39, 40, 41].

Probiotics for IBS

Perhaps the strongest evidence for the benefits of probiotics on intestinal heath is regarding their use in irritable bowel syndrome (IBS). A 2008 meta-analysis looked at 20 clinical trials that involved a total of 1,404 participants and found that probiotics effectively improved global IBS symptoms including constipation, diarrhea, gas and bloating, and abdominal pain [42].

Similar to probiotic use in IBD [43], it appears that multi-strain probiotics pack the biggest punch when it comes to healing IBS symptoms, as several types of probiotic bacteria showed benefits [44]. This is why we recommend taking a supplement from each category of probiotic when healing the digestive system. Check out our probiotics starter guide for more information on how to use probiotics for gut health. 

To sum it up, probiotics appear to have a strong influence on the gut’s immune system, barrier integrity, and microbiota and can be exceedingly helpful for improving colon health in a variety of conditions.

Other Supplements to Consider for Colon Health

Probiotics aren’t the only supplement that can restore colon health. If changing up your diet and trying probiotics don’t seem to do the trick in completely resolving your symptoms, it may be worthwhile to give the following a try:

  • L-Glutamine: Research shows that this amino acid can help reduce leaky gut in those with Crohn’s disease [45].
  • Digestive Enzymes: When taken with mesalamine (an anti-inflammatory drug), digestive enzymes reduced abdominal pain, cramping, gas, and bloating in those with IBD [46].
  • Dietary Fiber: Soluble fiber, like psyllium husk (Metamucil), can improve IBS symptoms, particularly constipation [47, 48, 49, 50]. It may also promote regular bowel movements in those with diverticular disease [51].
  • Omega-3 Fatty Acids: These healthy fats have been shown to improve survival rates amongst colon cancer patients [52].

The overall benefits of these supplements on colon health make them a great option for both those dealing with a serious digestive condition and/or general symptoms of a distressed colon. Of course, if you do have a serious underlying medical condition, it’s always good to have your doctor on board when adding new dietary supplements into your routine.

Get Moving

Getting in some regular physical activity is one of the best ways you can protect and heal your colon [2, 53, 54, 55, 56, 57]. High levels of physical activity can reduce the risk of colon cancer and colorectal cancer, suggesting a protective effect of exercise against digestive cancers [53, 55].

Exercise also appears to be beneficial in treating IBS symptoms and is considered a primary treatment in those with constipation-type IBS (IBS-C) [58].

The data is still early, but it appears that some of the protective benefits of exercise on colon health may be due to its positive influence on the gut microbiome [56]. While more research is needed on the direct effects of exercise on gut bacteria, the wide array of health benefits that come from regular physical activity make it a great option for keeping your colon in check.

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Find Ways to Stress Less

If you’ve read about the mind-gut connection, then you know the influence that stress can have on your digestive health. Stress is a common trigger for IBS symptoms, and managing your stressors can have a huge impact on your gastrointestinal health. 

Research shows that stress-reduction techniques like meditation can significantly reduce the severity of symptoms in those with IBS [59]. If meditation isn’t your thing (we understand — quieting your mind can take a lot of practice), consider trying cognitive behavioral therapy (CBT), hypnotherapy, or yoga, as they all show benefit in resolving digestive upset [60, 61, 62, 63, 64].

Breathing techniques are another great (and free) way to reduce stress, so consider giving something like box breathing a try. To try out this method, follow the below steps: 

  1. To start, inhale for a count of 4 seconds.
  2. Hold your breath at the top of the inhale for another count of 4.
  3. Then release your exhale slowly over 4 seconds. 
  4. Lastly, hold the bottom of the exhale for 4 final seconds to complete the cycle. 
  5. Repeat this set as many times as you need until you feel more calm. 

There’s really no one right method when it comes to relieving your stress to improve gut health. Do whatever works for you and try to make it a regular part of your daily routine.

Keep Your Colon Happy

Keeping your colon in tip-top shape doesn’t have to be hard. Whether you’re working with bothersome symptoms of gas, bloating, and stool changes, or a more serious condition like IBD, there are simple steps you can take to improve your colon health. 

An elimination diet that removes inflammatory foods, like the Paleo diet, is a great way to start your journey. And if that doesn’t give you relief, research shows that a low FODMAP diet can be very beneficial for colon health. Add in healthy bacteria through probiotics, get some exercise, and work on your stress management and you’ll be soon on your way to a happy, healthy colon. 

If you’re looking for more in-depth help, my book Healthy Gut, Healthy You offers a step-by-step guide on how to heal your body by addressing your digestive health. You can also reach out to the Ruscio Institute for Functional Medicine to meet with one of our highly qualified clinicians to assess your health needs.

The Ruscio Institute has developed a range of high-quality formulations, including high-quality probiotic supplements, to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References
  1. Healthy Gut Healthy You [Internet]. Available from: https://drruscio.com/gutbook/
  2. Azzouz LL, Sharma S. Physiology, Large Intestine. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 29939634.
  3. O’Sullivan DE, Sutherland RL, Town S, Chow K, Fan J, Forbes N, et al. Risk Factors for Early-Onset Colorectal Cancer: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022 Jun;20(6):1229-1240.e5. DOI: 10.1016/j.cgh.2021.01.037. PMID: 33524598.
  4. Recio-Boiles A, Cagir B. Colon Cancer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 29262132.
  5. Lynch WD, Hsu R. Ulcerative Colitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 29083748.
  6. Leech B, McIntyre E, Steel A, Sibbritt D. Risk factors associated with intestinal permeability in an adult population: A systematic review. Int J Clin Pract. 2019 Oct;73(10):e13385. DOI: 10.1111/ijcp.13385. PMID: 31243854.
  7. Honzawa Y, Nakase H, Matsuura M, Chiba T. Clinical significance of serum diamine oxidase activity in inflammatory bowel disease: Importance of evaluation of small intestinal permeability. Inflamm Bowel Dis. 2011 Feb;17(2):E23-5. DOI: 10.1002/ibd.21588. PMID: 21225906.
  8. Ranasinghe IR, Hsu R. Crohn Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 28613792.
  9. Shah A, Morrison M, Burger D, Martin N, Rich J, Jones M, et al. Systematic review with meta-analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease. Aliment Pharmacol Ther. 2019 Mar;49(6):624–35. DOI: 10.1111/apt.15133. PMID: 30735254.
  10. Meseeha M, Attia M. Colon Polyps. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 28613512.
  11. Patel N, Shackelford K. Irritable Bowel Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 30521231.
  12. Halpin SJ, Ford AC. Prevalence of symptoms meeting criteria for irritable bowel syndrome in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol. 2012 Oct;107(10):1474–82. DOI: 10.1038/ajg.2012.260. PMID: 22929759.
  13. Ischemic colitis – Symptoms and causes – Mayo Clinic [Internet]. Available from: https://www.mayoclinic.org/diseases-conditions/ischemic-colitis/symptoms-causes/syc-20374001
  14. Whalen KA, McCullough ML, Flanders WD, Hartman TJ, Judd S, Bostick RM. Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults. J Nutr. 2016 Jun;146(6):1217–26. DOI: 10.3945/jn.115.224048. PMID: 27099230. PMCID: PMC4877627.
  15. Olendzki BC, Silverstein TD, Persuitte GM, Ma Y, Baldwin KR, Cave D. An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report. Nutr J. 2014 Jan 16;13:5. DOI: 10.1186/1475-2891-13-5. PMID: 24428901. PMCID: PMC3896778.
  16. Lupp C, Robertson ML, Wickham ME, Sekirov I, Champion OL, Gaynor EC, et al. Host-mediated inflammation disrupts the intestinal microbiota and promotes the overgrowth of Enterobacteriaceae. Cell Host Microbe. 2007 Aug 16;2(2):119–29. DOI: 10.1016/j.chom.2007.06.010. PMID: 18005726.
  17. Nistal E, Caminero A, Herrán AR, Arias L, Vivas S, de Morales JMR, et al. Differences of small intestinal bacteria populations in adults and children with/without celiac disease: effect of age, gluten diet, and disease. Inflamm Bowel Dis. 2012 Apr;18(4):649–56. DOI: 10.1002/ibd.21830. PMID: 21826768.
  18. Hakansson A, Molin G. Gut microbiota and inflammation. Nutrients. 2011 Jun 3;3(6):637–82. DOI: 10.3390/nu3060637. PMID: 22254115. PMCID: PMC3257638.
  19. Lobionda S, Sittipo P, Kwon HY, Lee YK. The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors. Microorganisms. 2019 Aug 19;7(8). DOI: 10.3390/microorganisms7080271. PMID: 31430948. PMCID: PMC6722800.
  20. Konijeti GG, Kim N, Lewis JD, Groven S, Chandrasekaran A, Grandhe S, et al. Efficacy of the autoimmune protocol diet for inflammatory bowel disease. Inflamm Bowel Dis. 2017 Nov;23(11):2054–60. DOI: 10.1097/MIB.0000000000001221. PMID: 28858071. PMCID: PMC5647120.
  21. Britto S, Kellermayer R. Carbohydrate monotony as protection and treatment for inflammatory bowel disease. J Crohns Colitis. 2019 Jul 25;13(7):942–8. DOI: 10.1093/ecco-jcc/jjz011. PMID: 30715243.
  22. Vervier K, Moss S, Kumar N, Adoum A, Barne M, Browne H, et al. Two microbiota subtypes identified in irritable bowel syndrome with distinct responses to the low FODMAP diet. Gut. 2021 Nov 22; DOI: 10.1136/gutjnl-2021-325177. PMID: 34810234.
  23. Altobelli E, Del Negro V, Angeletti PM, Latella G. Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients. 2017 Aug 26;9(9). DOI: 10.3390/nu9090940. PMID: 28846594. PMCID: PMC5622700.
  24. Hahn J, Choi J, Chang MJ. Effect of Low FODMAPs Diet on Irritable Bowel Syndromes: A Systematic Review and Meta-Analysis of Clinical Trials. Nutrients. 2021 Jul 19;13(7). DOI: 10.3390/nu13072460. PMID: 34371973. PMCID: PMC8308820.
  25. Zhan Y, Zhan Y-A, Dai S-X. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clin Nutr. 2018 Feb;37(1):123–9. DOI: 10.1016/j.clnu.2017.05.019. PMID: 28587774.
  26. Abhari K, Saadati S, Hosseini-Oskouiee F, Yari Z, Hosseini H, Sohrab G, et al. Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management? Eur J Nutr. 2020 Aug;59(5):2111–7. DOI: 10.1007/s00394-019-02060-y. PMID: 31327047.
  27. Leblhuber F, Steiner K, Schuetz B, Fuchs D, Gostner JM. Probiotic Supplementation in Patients with Alzheimer’s Dementia – An Explorative Intervention Study. Curr Alzheimer Res. 2018;15(12):1106–13. DOI: 10.2174/1389200219666180813144834. PMID: 30101706. PMCID: PMC6340155.
  28. Toribio-Mateas M. Harnessing the power of microbiome assessment tools as part of neuroprotective nutrition and lifestyle medicine interventions. Microorganisms. 2018 Apr 25;6(2). DOI: 10.3390/microorganisms6020035. PMID: 29693607. PMCID: PMC6027349.
  29. Stenman LK, Lehtinen MJ, Meland N, Christensen JE, Yeung N, Saarinen MT, et al. Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial. EBioMedicine. 2016 Nov;13:190–200. DOI: 10.1016/j.ebiom.2016.10.036. PMID: 27810310. PMCID: PMC5264483.
  30. Mujagic Z, de Vos P, Boekschoten MV, Govers C, Pieters H-JHM, de Wit NJW, et al. The effects of Lactobacillus plantarum on small intestinal barrier function and mucosal gene transcription; a randomized double-blind placebo controlled trial. Sci Rep. 2017 Jan 3;7:40128. DOI: 10.1038/srep40128. PMID: 28045137. PMCID: PMC5206730.
  31. Sindhu KNC, Sowmyanarayanan TV, Paul A, Babji S, Ajjampur SSR, Priyadarshini S, et al. Immune response and intestinal permeability in children with acute gastroenteritis treated with Lactobacillus rhamnosus GG: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2014 Apr;58(8):1107–15. DOI: 10.1093/cid/ciu065. PMID: 24501384. PMCID: PMC3967829.
  32. Lamprecht M, Bogner S, Schippinger G, Steinbauer K, Fankhauser F, Hallstroem S, et al. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. 2012 Sep 20;9(1):45. DOI: 10.1186/1550-2783-9-45. PMID: 22992437. PMCID: PMC3465223.
  33. Pabón-Carrasco M, Ramirez-Baena L, Vilar-Palomo S, Castro-Méndez A, Martos-García R, Rodríguez-Gallego I. Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults-A Meta-Analytical Study. Nutrients. 2020 Aug 28;12(9). DOI: 10.3390/nu12092628. PMID: 32872272. PMCID: PMC7551006.
  34. Losurdo G, Iannone A, Contaldo A, Ierardi E, Di Leo A, Principi M. Escherichia coli Nissle 1917 in Ulcerative Colitis Treatment: Systematic Review and Meta-analysis. J Gastrointestin Liver Dis. 2015 Dec;24(4):499–505. DOI: 10.15403/jgld.2014.1121.244.ecn. PMID: 26697577.
  35. Avalueva EB, Uspenskiĭ IP, Tkachenko EI, Sitkin SI. [Use of Saccharomyces boulardii in treating patients inflammatory bowel diseases (clinical trial)]. Eksp Klin Gastroenterol. 2010;(7):103–11. PMID: 21033091.
  36. Naidoo K, Gordon M, Fagbemi AO, Thomas AG, Akobeng AK. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD007443. DOI: 10.1002/14651858.CD007443.pub2. PMID: 22161412.
  37. Ojetti V, Petruzziello C, Cardone S, Saviano L, Migneco A, Santarelli L, et al. The use of probiotics in different phases of diverticular disease. Rev Recent Clin Trials. 2018;13(2):89–96. DOI: 10.2174/1574887113666180402143140. PMID: 29607785.
  38. Ojetti V, Saviano A, Brigida M, Petruzziello C, Caronna M, Gayani G, et al. Randomized control trial on the efficacy of Limosilactobacillus reuteri ATCC PTA 4659 in reducing inflammatory markers in acute uncomplicated diverticulitis. Eur J Gastroenterol Hepatol. 2022 May 1;34(5):496–502. DOI: 10.1097/MEG.0000000000002342. PMID: 35045564.
  39. Chen Y, Qi A, Teng D, Li S, Yan Y, Hu S, et al. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis. Tech Coloproctol. 2022 Jun;26(6):425–36. DOI: 10.1007/s10151-022-02585-1. PMID: 35348943.
  40. Wu X-D, Xu W, Liu M-M, Hu K-J, Sun Y-Y, Yang X-F, et al. Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta-analysis of randomized controlled trials. J Surg Oncol. 2018 Jun;117(7):1394–404. DOI: 10.1002/jso.25038. PMID: 29572838.
  41. Liu D, Jiang X-Y, Zhou L-S, Song J-H, Zhang X. Effects of Probiotics on Intestinal Mucosa Barrier in Patients With Colorectal Cancer after Operation: Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2016 Apr;95(15):e3342. DOI: 10.1097/MD.0000000000003342. PMID: 27082589. PMCID: PMC4839833.
  42. Martoni CJ, Srivastava S, Leyer GJ. Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABla-12 Improve Abdominal Pain Severity and Symptomology in Irritable Bowel Syndrome: Randomized Controlled Trial. Nutrients. 2020 Jan 30;12(2). DOI: 10.3390/nu12020363. PMID: 32019158. PMCID: PMC7071206.
  43. Zhang X-F, Guan X-X, Tang Y-J, Sun J-F, Wang X-K, Wang W-D, et al. Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis. Eur J Nutr. 2021 Aug;60(5):2855–75. DOI: 10.1007/s00394-021-02503-5. PMID: 33555375.
  44. Zhang T, Zhang C, Zhang J, Sun F, Duan L. Efficacy of Probiotics for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis. Front Cell Infect Microbiol. 2022 Apr 1;12:859967. DOI: 10.3389/fcimb.2022.859967. PMID: 35433498. PMCID: PMC9010660.
  45. Benjamin J, Makharia G, Ahuja V, Anand Rajan KD, Kalaivani M, Gupta SD, et al. Glutamine and whey protein improve intestinal permeability and morphology in patients with Crohn’s disease: a randomized controlled trial. Dig Dis Sci. 2012 Apr;57(4):1000–12. DOI: 10.1007/s10620-011-1947-9. PMID: 22038507.
  46. Spagnuolo R, Cosco C, Mancina RM, Ruggiero G, Garieri P, Cosco V, et al. Beta-glucan, inositol and digestive enzymes improve quality of life of patients with inflammatory bowel disease and irritable bowel syndrome. Eur Rev Med Pharmacol Sci. 2017 Jun;21(2 Suppl):102–7. PMID: 28724171.
  47. El-Salhy M, Ystad SO, Mazzawi T, Gundersen D. Dietary fiber in irritable bowel syndrome (Review). Int J Mol Med. 2017 Sep;40(3):607–13. DOI: 10.3892/ijmm.2017.3072. PMID: 28731144. PMCID: PMC5548066.
  48. Moayyedi P, Quigley EMM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2014 Sep;109(9):1367–74. DOI: 10.1038/ajg.2014.195. PMID: 25070054.
  49. Furnari M, de Bortoli N, Martinucci I, Bodini G, Revelli M, Marabotto E, et al. Optimal management of constipation associated with irritable bowel syndrome. Ther Clin Risk Manag. 2015 May 30;11:691–703. DOI: 10.2147/TCRM.S54298. PMID: 26028974. PMCID: PMC4425337.
  50. Bellini M, Gambaccini D, Salvadori S, Tosetti C, Urbano MT, Costa F, et al. Management of chronic constipation in general practice. Tech Coloproctol. 2014 Jun;18(6):543–9. DOI: 10.1007/s10151-013-1093-9. PMID: 24272606.
  51. Eberhardt F, Crichton M, Dahl C, Nucera R, Jenkins J, Marx W, et al. Role of dietary fibre in older adults with asymptomatic (AS) or symptomatic uncomplicated diverticular disease (SUDD): Systematic review and meta-analysis. Maturitas. 2019 Dec;130:57–67. DOI: 10.1016/j.maturitas.2019.10.006. PMID: 31706437.
  52. Song M, Ou F-S, Zemla TJ, Hull MA, Shi Q, Limburg PJ, et al. Marine omega-3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance). Int J Cancer. 2019 Jul 15;145(2):380–9. DOI: 10.1002/ijc.32113. PMID: 30623420. PMCID: PMC6525069.
  53. Xie F, You Y, Huang J, Guan C, Chen Z, Fang M, et al. Association between physical activity and digestive-system cancer: An updated systematic review and meta-analysis. J Sport Health Sci. 2021 Jan;10(1):4–13. DOI: 10.1016/j.jshs.2020.09.009. PMID: 33010525. PMCID: PMC7856558.
  54. Wang J, Huang L, Gao Y, Wang Y, Chen S, Huang J, et al. Physically active individuals have a 23% lower risk of any colorectal neoplasia and a 27% lower risk of advanced colorectal neoplasia than their non-active counterparts: systematic review and meta-analysis of observational studies. Br J Sports Med. 2020 May;54(10):582–91. DOI: 10.1136/bjsports-2018-100350. PMID: 31296585.
  55. Hidayat K, Zhou H-J, Shi B-M. Influence of physical activity at a young age and lifetime physical activity on the risks of 3 obesity-related cancers: systematic review and meta-analysis of observational studies. Nutr Rev. 2020 Jan 1;78(1):1–18. DOI: 10.1093/nutrit/nuz024. PMID: 31393566.
  56. Cook MD, Allen JM, Pence BD, Wallig MA, Gaskins HR, White BA, et al. Exercise and gut immune function: evidence of alterations in colon immune cell homeostasis and microbiome characteristics with exercise training. Immunol Cell Biol. 2016 Feb;94(2):158–63. DOI: 10.1038/icb.2015.108. PMID: 26626721.
  57. PDQ Screening and Prevention Editorial Board. Colorectal cancer prevention (PDQ®): health professional version. In: PDQ cancer information summaries. Bethesda (MD): National Cancer Institute (US); 2002. PMID: 26389222.
  58. Dumitrascu DL, Baban A, Bancila I, Barboi O, Bataga S, Chira A, et al. Romanian guidelines for nonpharmacological therapy of IBS. J Gastrointestin Liver Dis. 2021 Jun 18;30(2):291–306. DOI: 10.15403/jgld-3581. PMID: 33951120.
  59. Jandaghi G, Zia-Tohidi A, Firoozi M. Psychological Interventions for Irritable Bowel Syndrome: A Meta-Analysis of Iranian Randomized Trials. Arch Iran Med. 2021 Jun 1;24(6):496–504. DOI: 10.34172/aim.2021.71. PMID: 34488313.
  60. Zhao S-R, Ni X-M, Zhang X-A, Tian H. Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients. World J Clin Cases. 2019 Nov 6;7(21):3446–62. DOI: 10.12998/wjcc.v7.i21.3446. PMID: 31750328. PMCID: PMC6854400.
  61. Lackner JM, Jaccard J, Keefer L, Brenner DM, Firth RS, Gudleski GD, et al. Improvement in gastrointestinal symptoms after cognitive behavior therapy for refractory irritable bowel syndrome. Gastroenterology. 2018 Jul;155(1):47–57. DOI: 10.1053/j.gastro.2018.03.063. PMID: 29702118. PMCID: PMC6035059.
  62. Peters SL, Muir JG, Gibson PR. Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease. Aliment Pharmacol Ther. 2015 Jun;41(11):1104–15. DOI: 10.1111/apt.13202. PMID: 25858661.
  63. Miller V, Carruthers HR, Morris J, Hasan SS, Archbold S, Whorwell PJ. Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients. Aliment Pharmacol Ther. 2015 May;41(9):844–55. DOI: 10.1111/apt.13145. PMID: 25736234.
  64. Kavuri V, Raghuram N, Malamud A, Selvan SR. Irritable bowel syndrome: yoga as remedial therapy. Evid Based Complement Alternat Med. 2015 May 6;2015:398156. DOI: 10.1155/2015/398156. PMID: 26064164. PMCID: PMC4438173.

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