The Health Pyramid-Level 2- Gut Health

GUT HEALTH

Your Gut Is So Much More Than Digestion

For years, I thought gut health basically meant whether or not your stomach hurt, whether you were bloated, and whether you were going to the bathroom regularly. It wasn’t until I started dealing with my own health issues and was told I had what is commonly referred to as a “leaky gut” that I started learning just how complicated this system actually is.

The more I learned, the more I realized that the gut isn’t operating in its own little corner of the body. It is communicating with the immune system, the nervous system and even the brain all day long. That is exactly why gut health belongs in Level 2 of my Health Pyramid.

What Does “Leaky Gut” Actually Mean?

Our intestines are supposed to be selectively permeable. The intestinal lining allows water and nutrients to be absorbed while also acting as a barrier that helps keep bacteria and other potentially harmful substances where they belong. When that barrier becomes more permeable than it should be, the medical term is increased intestinal permeability.

You will hear the phrase “leaky gut” used constantly in the wellness world. Increased intestinal permeability is a real biological phenomenon and has been documented in certain gastrointestinal diseases. However, “leaky gut syndrome” is not currently recognized as a stand-alone medical diagnosis. That distinction matters because I never want this series to turn into diagnosing ourselves based on a list of symptoms.

In my own health journey, being told I had a leaky gut made me start asking questions. What was affecting my intestinal barrier? What was happening with digestion? What was I eating? What role could stress, medications or other health issues be playing? Most importantly, what could I realistically change?

Meet Your Microbiome

Inside the gastrointestinal tract lives an enormous community of microorganisms, including bacteria and other microbes, collectively called the gut microbiome. We are still learning an incredible amount about it, but we know these organisms interact with digestion, metabolism, the intestinal barrier and the immune system.

There is no single “perfect” microbiome that everyone should be trying to create. That is another place where wellness marketing can get ahead of the science. What researchers are increasingly interested in is how the composition and function of the microbiome relate to diet, medications, illness, environment and overall health.

The Gut-Brain Connection

This may be my favorite part of the gut-health conversation because it completely changes the idea that digestive health is only about digestion.

The gut and brain communicate through what is called the gut-brain axis. It is a two-way communication network involving the enteric nervous system, the central nervous system, the immune system, hormones, microbial metabolites and the vagus nerve. In other words, your brain talks to your gut, and your gut talks back.

If you have ever felt butterflies before something exciting, suddenly lost your appetite when you were upset, or felt your stomach turn during a stressful situation, you have experienced this connection in real life.

The vagus nerve is one of the major pathways carrying information between the gastrointestinal system and the brain. The microbiome can also influence signaling through substances produced when microbes metabolize components of our food. Researchers are studying how all of these pathways may relate to stress, mood, cognition and neurological health.

Serotonin is another fascinating part of this story. Much of the body’s serotonin is produced in the gastrointestinal tract, where it has important roles in intestinal function and motility. That does not mean that gut serotonin simply travels into the brain and makes us happy. The biology is much more complicated than that. It does, however, show how deeply interconnected these systems are.

The relationship also works in the opposite direction. Stress and signals from the brain can change gastrointestinal movement, sensitivity and secretion and can influence the gut environment. This is one reason someone can have very real digestive symptoms that become worse during periods of stress. It is not “all in their head.” The brain and gut are physically communicating.

Inflammation, Immunity and the Intestinal Barrier

The intestinal lining is also part of our immune defense. Our digestive tract has the complicated job of interacting with food and an enormous microbial community while helping the immune system distinguish between what should be tolerated and what may represent a threat.

This is another reason I think it is a mistake to look at every symptom separately. Digestion, immune signaling, inflammation, the microbiome and the intestinal barrier influence one another. Researchers are still working out exactly what is cause, effect or both in many diseases, so this is an area where we need curiosity without turning early research into certainty.

Regularity Is Information

We also need to talk about bowel movements because somehow we have made one of the most normal biological functions something people are embarrassed to discuss. How often you go, stool consistency, persistent constipation, diarrhea, pain, blood, major changes in your normal pattern and other symptoms can all provide useful information.

There is a wide range of normal, but persistent or concerning changes deserve attention rather than being automatically blamed on “gut health” and treated with another supplement.

So What Can We Actually Do for Our Gut?

This is where I want to stay away from the idea that there is a magical gut cleanse or a supplement that repairs everyone’s intestinal lining. Supporting gut health usually looks much less glamorous, and much more like the foundational habits we have already been talking about.

• Eat a varied diet built around whole and minimally processed foods when possible. Different plant foods provide different types of fiber and compounds that gut microbes can use.

• Get enough fiber, but increase it gradually. Fiber supports bowel regularity and certain fibers are fermented by gut microbes into compounds such as short-chain fatty acids. If you have significant gastrointestinal symptoms, suddenly adding huge amounts of fiber may make you feel worse, so individual tolerance matters.

• Learn the difference between prebiotics and probiotics. Prebiotics are substances used by beneficial microbes, while probiotics are live microorganisms that may provide a health benefit in specific circumstances. Not every probiotic product does the same thing, and more strains or a bigger number on the bottle does not automatically mean better.

• Consider fermented foods if you tolerate them. Foods such as yogurt with live cultures, kefir, kimchi and sauerkraut can be part of a varied diet, but they are not required for everyone and they are not a cure for intestinal disease.

• Stay hydrated. Your gut does not suddenly stop caring about the layer we just discussed. Adequate fluid is important for normal digestive function and bowel regularity.

• Move your body. Physical activity can support gastrointestinal motility and is associated with changes in the gut microbiome, giving us another example of how the layers of the Health Pyramid overlap.

• Pay attention to sleep and stress. The gut-brain relationship means that caring for your nervous system belongs in a gut-health conversation too.

• Be thoughtful about medications and supplements. Some medications can affect the gastrointestinal tract or microbiome. That does not mean you should stop prescribed medication. It means persistent symptoms are worth discussing with your healthcare provider instead of making medication changes on your own.

• Treat the underlying problem. If increased intestinal permeability or digestive symptoms are related to something such as celiac disease, inflammatory bowel disease, an infection or another medical condition, treating the actual condition matters more than buying products marketed to “seal” the gut.

When Gut Symptoms Deserve More Than a Wellness Fix

Bloating once in a while is one thing. Ongoing or severe symptoms are different. Persistent abdominal pain, unexplained weight loss, blood in the stool, black stools, ongoing vomiting, fever, difficulty swallowing, persistent diarrhea or constipation, anemia, or a major unexplained change in bowel habits are reasons to seek medical evaluation.

I think this is particularly important in the wellness space because we can become so focused on fixing ourselves that we accidentally normalize symptoms that deserve an actual diagnosis.

Start by Paying Attention

You do not need an expensive microbiome test and a cabinet full of supplements to begin thinking about your gut. Start by noticing what is already happening.

• What does your digestion normally feel like?

• Are your bowel habits regular for you?

• Are you getting fiber from a variety of foods?

• How much of your diet is made up of highly processed foods?

• Do certain foods consistently trigger symptoms?

• Do your digestive symptoms change when you are stressed?

• Are you sleeping enough and moving regularly?

• Have you been living with digestive symptoms for so long that you have started considering them normal?

One of the biggest things I learned from my own experience was that my gut was not a separate problem to solve. It was another part of a much bigger system. The foods I ate mattered. Stress mattered. Sleep mattered. Movement mattered. My health history mattered. And the goal was not to chase a perfect microbiome. It was to understand what my body was telling me and support it in ways that made sense.

That is really the point of the Health Pyramid. The further we move through it, the more obvious it becomes that none of these layers truly stand alone.

Sources & Further Reading

• Cleveland Clinic — The Gut-Brain Connection.

• Cleveland Clinic — Leaky Gut Syndrome: Symptoms, Diet, Tests & Treatment.

• Hwang YK, Oh JS. Interaction of the Vagus Nerve and Serotonin in the Gut-Brain Axis. International Journal of Molecular Sciences. 2025.

• Ohara TE, Hsiao EY. Microbiota-neuroepithelial signalling across the gut-brain axis. Nature Reviews Microbiology. 2025.

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