The number of people who have reached out to me and shared how the podcast has changed their practice, understanding, and life seriously can't be understated. Unfortunately, after three years and so many personal changes, I've decided to put the podcast on a hiatus. I feel so many mixed emotions about this, and given my personality, it's hard to take a step back but I look forward to bringing you more amazing content in the future.

I talk about:

1) How nutrition science is rarely sensational or extreme. As well as the importance of doing what feels good for your body - without making it dogmatic.

2) The value in trying to eat as many plant foods as you can each and every day. The importance of choosing a variety of foods that are acceptable to your palate, culture, budget, and lifestyle.

3) The value of having a member on your health care team that advocates for you, whether that's your dietitian, pharmacist, doctor, or physio. If you're struggling to advocate for yourself and your medical needs, it is important to find an allied health provider that can get the best care possible for you.

Connect with me on my website at www.andreahardyrd.com, my clinic website at ignitenutrition.ca, on Instagram @andreahardyrd, or Twitter or Facebook here as well!

Pain is a predominant feature in the majority of functional gut disorders. The higher risk of anxiety and depression when coping with any chronic illness, including GI disorders, as well as anxiety and depression impacting symptoms and symptom perception in many GI conditions are all very important aspect of medical care.

This week I interview Dr. Katia Tonkin on the role that cannabis plays in medical care – including in the treatment of anxiety, depression, and pain.

Dr. Tonkin is a medical oncologist who worked at The Cross Cancer Institute in Edmonton Alberta Canada for 20 years and in London, Ontario Canada for 6 years prior to that. She became interested in medical cannabis in 2016 as many patients started asking about cannabis. After researching into it, Dr. Tonkin felt cannabis was likely to help many patients with a wide variety of problems. She started treating patients in April 2017 and wants to contribute to clinical research to further medical knowledge into appropriate uses of medical cannabis, as well as educating health care providers on the proper use of cannabis. She works out of Optimum Wellness Center as well as other clinics as a medical prescriber.

We talk about:

• Tonkin's background as a clinician and how they became interested in the role cannabis plays in medical care.
• What cannabis is.
• The components of the plant that have therapeutic impacts.
• The role of a medical prescriber.
• How cannabis, that is medically prescribed, differs from cannabis you might find in stores and why 'self medicating' is not the best strategy to realize the benefits of cannabis
• The conditions we have evidence for using cannabis with (including anxiety, depression and pain)
• How these overlaps with gastrointestinal disorders.
• How to find a medical prescriber.

Connect with Dr. Katia Tonkin at Optimum Wellness Centres in Edmonton, Alberta.

Long-COVID is defined by The National Health Service as having symptoms that develop during or after a COVID infection which continue for more than 12 weeks. This week I interview Marlee Coldwell, RD on how long COVID presents and ways that it can be managed in our patients.

Marlee has been working with patients who have complex digestive health issues and food intolerances for the past 5 years. Marlee specializes in providing nutritional support for digestive disorders including IBS, IBD, SIBO, fatty liver disease, and much more. Marlee is the team lead dietitian for Ignite Nutrition, one of Canada's top digestive health nutrition practices. With her specialized knowledge of gastrointestinal health, she also helps to train and support other dietitians to work with those who have unique and complex food intolerances and GI disorders.

In 2019, Marlee also wrote a cookbook called 'Insulin Resistance Diet for Beginners', which showcases her other great passion, women's health and PCOS management.

We talk about:

· What long COVID is

· How many people experience it

· What the symptoms are

· How we see it influencing our IBS patients and how nutrition can help

· The influence of COVID on the GI tract

· The taste and smell changes, how they influence people's nutrition, and if there is anything to help

· The inflammatory immune-mediated symptoms like rashes, brain fog, joint pain, chronic fatigue, gut pain, and diarrhea

· Why people have been curious about a low histamine diet when it comes to long COVID

· The overlap between MCAS and long covid, and why people are being managed like MCAS patients

· If using a MCAS approach can ´fix´ long COVID

Connect with Coldwell on at ignitenutrition.ca on Instagram here @ignite.nutrition.inc

Hypermobility spectrum disorders are estimated to be among 3% of the general population. So, every GI practitioner should be aware of hypermobility and the symptoms, because whether we recognize it or not, we're seeing these patients all the time.This week I interview Cheryl Harris, RD on the overlap between hypermobility and GI disorders to help guide practitioners towards recognizing it in their digestive health patients.

Cheryl Harris, MPH RD has been a dietitian for 20 years and has specializing in digestive disorders for 15 years. She was recognized as one of the top nutritionists in the DC metro area by the Washingtonian and was selected as the "Emerging Dietetics Leader of the Year" for Virginia. She has presented and written widely on digestive concerns and was honored to teach part of the AND Certificate of Training in Gluten-related disorders. She is honored to serve on the International Consortium for Ehlers-Danlos and Hypermobility Spectrum Disorders Diet and Nutrition Working Group.

We talk about:

• how Cheryl started working in GI
• What EDS is
• How digestion is impacted by EDS
• How EDS is currently managed
• Some important nutritional considerations in the management of EDS
• Conditions that overlap with EDS including POTS and MCAS
• What POTS is
• Why these conditions overlap and how the presentation of multiple lesser-recognized conditions complicate management for patients
• How nutrition plays a role in POTS
• How dietitians & other health care providers can better screen for, recognize and refer to ensure patients get a more timely diagnosis. What some of the red-flags are and who should they refer to.

Connect with Cheryl on her website at harriswholehealth.com on her email at cheryl(at)harriswholehealth(dot)com or on Twitter or on her Facebook here as well!

Nutrition is central to a functioning immune system. It impacts our ability to fight precancerous cells, ward off pathogens, heal injuries, and support our bodies through disease. This week I interview Doug Cook, RD on the role that nutrition plays in our immune function.

Doug Cook is a registered dietitian with over 21 years of experience. With a Master of Health Science in Nutrition, he specializes in functional and integrative nutrition. Doug dives deep into the research on nutrition and science to provide his patients, and the public expert up-to-date information, questioning the way that we've 'always done it' through his blog www.dougcookrd.com and on his podcast Pursuit of Health. I always personally learn so much from him - especially in the way of brain health, and micronutrients. I appreciate that perspective because a lot of times when I'm looking at patients I'm strictly focusing on digestive symptoms. So, it's nice to kind of take a step back and learn from colleges who actually do their research.

We talk about:

• How Cook decide to become a dietitian
• The importance of critically reviewing the up-to-date research instead of trusting the way that things have always been done
• How nutrition plays a role in immune function
• What a functioning immune system means in contrast to the idea of people wanting to 'boost' their immune system
• Some of the key nutrients we should be aware of and why
• Some of the gaps often seen in people's diets in regards to nutrition & immune function
• How the gut plays a role in immune function and where nutrition fits in
• What gut permeability/leaky gut is, why is it so trendy right now, and what the science actually says
• Some nutrition basics for improving gut permeability and supporting good immune function

Connect with Cook on his website at www.dougcookrd.com on his podcast Pursuit of Health on Instagram @your.nutrition.education on Twitter or on his Facebook here as well!

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease where fat accumulates in the liver, and can progress to inflammation (non-alcoholic steatohepatitis or NASH), and hardening of the liver (cirrhosis). It is a silent disease, often completely symptomless, however, trying to catch it early is important due to its progressive nature.

This week I interview RD Neha Shah on what NAFLD is, how it may be reversed and the overlap between gut issues and NAFLD.

Neha has been specializing in gastroenterology and hepatology for the past 16 years. She initially began her career as an inpatient dietitian at Stanford Health Care, counseling patients by bedside recovering from gastrointestinal surgery. She later came into the Digestive Health Center there to inaugurate and build Nutrition Services for all programs within the GI and Liver Clinics. She is now at UCSF, specializing in GI, IBD, and intestinal rehabilitation. Neha also owns a GI and liver nutrition private practice, Neha Shah Nutrition, with the intent to bring specialized GI and liver nutrition care to the community.

In addition to patient care, Neha has authored over 20 articles in reputable journals related to GI nutrition. She is co-founder and is Director of Operations of the international South Asian IBD Alliance and is a member of the Crohn's and Colitis Medical Advisory Committee of Northern California. Her goal is to continue to be involved with GI initiatives to advance nutrition care to improve outcomes.

We talk about:

• How she got involved as a dietitian in gastroenterology
• What NAFLD is
• How NAFLD develops and how prevalent NAFLD is
• What some of the risk factors are for developing NAFLD
• What the standard treatment is for NAFLD
• What the gut-liver axis is and how it relates to NAFLD
• If probiotics or prebiotics play a role in NAFLD management
• Why NAFLD often overlaps with other gut conditions - and how to manage both at the same time

Connect with Shah on her website at www.nehanutrition.com on Instagram @Nehagastrord or on her Twitter here as well!

Two previous guest of our Let's Gut Real Podcast, Dr. Drossman and Johannah Ruddy, join us again today to talk about their newly released book. Gut Feelings: The Patient's Story Personal Accounts of the Illness Journey A Guide for Patients and Doctors Gut Feelings: A Patient's Story. Now available on Amazon.

Dr. Drossman received his M.D. degree at Albert Einstein College of Medicine and subspecialized in biopsychosocial medicine and Gastroenterology. He received his gastroenterology training at the University of North Carolina where he founded the UNC for Functional GI and Motility Disorders. Currently he is Professor Emeritus of Medicine and Psychiatry in Gastroenterology at UNC. He is a Fellow of the American College of Physicians, a Master of the American College of Gastroenterology, Past-President of the American Psychosomatic Society (1997) and Founder and President of the Rome Foundation for 29 years. In addition, he founded the Drossman Center for the Education and Practice of Biopsychosocial Care as an entity to help train physicians in relationship-centered biopsychosocial care with an emphasis on communication skills and enhancing the patient-doctor relationship.

Dr. Drossman is joined today by co-author Johannah Ruddy who is a national expert, researcher, and writer on teaching communications skills to patients and providers. Johannah currently serves as the Executive Director of the Rome Foundation. She has 22 years of executive leadership experience working with a variety of non-profit organizations nationwide and a strong background in writing for patients as well as a speaker at GI practices, medical centers, and conferences in the area of provider communication and patient advocacy. She holds a Bachelor of science degree from the University of New Mexico in Political Science, a Masters of Education from New Mexico Highlands University and is a doctoral student at Campbell University. She lives in Wake Forest, North Carolina with her husband of 21 years and their two sons.

Dr. Drossman, Johannah Ruddy and I talk about:

- Dr. Drossman's and Mrs. Ruddy's backgrounds and how they came to work together

- Disorders of gut brain interaction

- Typical patient experiences with these diagnoses and the reasons why they hold so much stigma

- Each of their biggest learnings as practitioner and patient in doing these interviews

- Common mistakes/pitfalls practitioners experience in working with patients and how this may be a disservice to our patients

- The key things clinicians can take away from this book, with a focus on patient centred care.

- How patients advocate for themselves to feel heard in their journey

You can find their new book: Gut Feelings: The Patient's Story Personal Accounts of the Illness Journey A Guide for Patients and Doctors Gut Feelings: A Patient's Story

which is also available on Amazon: https://romedross.video/patient-story

You can find their previous book: Gut Feelings- Disorders of Gut-Brain Interactions, A Guide for Patients and Doctors which is available on Amazon: https://romedross.video/GutFeelingsWebsite

Check out the video version of the audio recording excerpt featured in this presentation: https://romedross.video/LesleyGutFeelings4X

Connect with Johannah on Instagram @johannahruddy on Twitter @JohannahRuddy or on LinkedIn.

Learn more about the Theromefoundation.org or here: https://romeonline.org

Did you know that it is more common to have anxiety and depressive symptoms if you have IBS compared to if you don't have IBS?

This week I interview dietitian Heidi Staudacher to discuss how patients can often end up in a vicious cycle where they have gastrointestinal symptoms that lead to mental health problems and then that further leads to more gut symptoms.

Heidi Staudacher is an accredited practising dietitian and has had extensive experience in the clinical management of people with clinically functional gastrointestinal disorders. Heidi completed her PhD at King's College London in 2016 in which she investigated the use of the low FODMAP diet in irritable bowel syndrome and its impact on symptoms, the microbiota and diet quality. Her research interests include understanding the effect of different dietary components on gut microbiota, and therapeutic diets for gut disorders and their influence on gut microbial composition. She is passionate about conducting high quality research in the field of diet and gut health.

We talk about:

• How Staudacher became interested in the area of functional gut disorders and mental health
• The prevalence of mental health disorders in IBS
• How IBS impacts mental health
• Whether or not developing IBS predisposes individuals to developing mental health issues
• How it is the chicken or the egg when it comes to mental health and IBS
• How so many patients have heard the phrase 'it's all in your head' and how the onus is placed on patients to 'fix' their IBS and how distressing that can be
• How patients have often felt like it's their own fault through challenges with their mental health that they have IBS
• How nutrition influences mental health in IBS
• Some interventions for IBS that have been shown to improve mental health
• Whether or not changing the gut microbiota might influence mental health and IBS.
• The role of probiotic, prebiotics, and dietary changes in order to change the gut microbiota
• The influence of diet on mental health in IBS. Including the impact of disordered eating and eating disorders
• The big take aways clinicians need to know regarding the intersection of mental health in functional gut disorders

Connect with Staudacher on Twitter or on her website at foodandmoodcentre.com.au as well!

Although the etiology of primary sclerosing cholangitis (PSC) is poorly understood it is a progressive disease characterized by inflammation of the bile ducts.

This week I interview RD Brittany Roman-Green and we discuss primary sclerosing cholangitis, its relationship to ulcerative colitis and what the current research says about it.

Brittany Roman-Green is the founder of Romanwell and is an IBD focused registered dietitian nutritionist, certified personal trainer, and behavior change specialist. Brittany's the national coleader of the diet and nutrition national scientific advisory committee for the Crohn's and Colitis Foundation and the national leader of the registered dietitians in IBD practice group for the Academy of Nutrition and Dietetics. Brittany has lived with ulcerative colitis for over 20 years and also has IBS and PSC.

We talk about:

• What is primary sclerosing cholangitis (PSC)
• What are the symptoms of PSC?
• Why do people with IBD develop PSC?
• Does nutrition influence PSC management?
• Nutrition management of IBD, including a discussion about inflammatory foods
• The use of restrictive diets and their potential side effects
• The 2020 International Organization for the study of IBD guidelines

Connect with Roman-Green on her website at romanwell.com on Instagram @weareromanwell or on her Facebook here as well! You can also checkout their IBD starter kit that's full of tips for advocating for oneself when you have IBD.

Enzymes are important for any living organism and play a huge part in the day-to-day operations of the human body. Enzymes provide a number of very vital processes – not only for digestion but for the nervous system, muscles, and many other important bodily functions.

This week I interview Anjie Liu and David Hachuel creators of FODZYME® to discuss how digestive enzymes can specifically help with IBS symptoms.

Co-founded by Anjie Liu and David Hachuel, MPH, Kiwi Biosciences is a human-centered biotech company developing elegant scientific solutions for extraordinary gut relief. FODZYME® was developed with a group of world-class experts in enzymology, biotechnology, medicine, and nutrition, FODZYME® was released to the world in Spring 2021. On a mission to make more foods painless, the team is working on a novel polyol-targeting enzyme to address the polyol group of the FODMAP family in development. The new solution will be transforming polyols like sorbitol and mannitol into sorbose and mannose that are more readily absorbed in the gut.

We talk about:

• What enzymes are, and how they work in the body
• Why certain enzymes are beneficial in IBS
• Why FODMAPs cause symptoms
• What enzymes are found in FODZYME® (including information about alpha galactosidase, lactase, and inulinase) and what their research has found
• How FODZYME® and its unique delivery system works to improve patient symptoms
• How the production of fructose occurs with inulinase, and when this may or may not be problematic
• Glucose isomerase - is it beneficial to fructose malabsorption? Why or why not
• Next steps in novel enzyme development

Connect with FODZYME® on their website at fodzyme.com on Instagram @fodzyme or on Twitter or on their Facebook here as well!