Imagine “little pets living inside your intestinal tract.” That’s how Cleveland Clinic microbiome expert Gail Cresci describes the trillions of microbes in your gut. Those microbes not only impact your gut health and break down food but also affect your overall well-being, as they support your immunity, regulate inflammation in the body, and even produce vital compounds like vitamins and hormones.

Knowing how crucial your gut health is to your overall health, it’s important to pay attention when it gives you signs that it may be struggling. Cresci says there are things you can do to restore your microbiome’s health. 

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Signs of an unhealthy gut to watch out for 

“If you’re bloated or you have lots of gas, you may have a disrupted composition and function of the gut microbiome,” Cresci said, adding that the only way to know for sure is to have it measured.

Other signs of an unhealthy gut may include:

• Vomiting or an upset stomach
• Fatigue
• Trouble sleeping
• Food intolerance
• Skin irritation or problems

Research has linked skin issues like acne and psoriasis to the gut. Studies are also looking into how the gut biome impacts reproductive health and hormone levels. 

How to keep your gut healthy

It’s important to see a doctor to determine the root cause of your health concern and rule out other conditions. Making changes to your diet or routine that may improve your gut and overall health is a good first step. 

Cresci also said that there’s no exact standard for the perfectly healthy gut microbiome since everyone’s composition is so different. Bearing that in mind, here are four things you can do to help keep it on the right track. 

1. Eat gut-friendly foods

The gut microbiome prefers foods we can’t digest. This includes foods with a lot of fiber, such as fresh fruits, vegetables, whole grains, legumes, seeds and nuts; foods we already know we should eat for their nutritional properties.

According to Cresci, foods high in sugar and fat and low in fiber should be removed from your gut or eaten in lower amounts. “These are all associated with the consumption of a Western diet, which is also associated with a disrupted microbiome,” she said. 

Beyond a gut-healthy diet, which not-so-coincidentally coincides with a heart-healthy diet, eating fermented foods can help replace the good microbes and their metabolites. Cresci lists yogurt, kombucha and kefir as examples. 

2. Make note of the medications you’re taking

It’s a well-known fact that taking antibiotics disrupts, at least temporarily, the family of “good” bacteria thriving in your body. Some common side effects of taking antibiotics include nausea, diarrhea and developing yeast infections. If you’re prescribed an antibiotic or have recurring infections that have you taking antibiotics often, ask your doctor about what you can do to help minimize the disruption to your microbiome.

Other medications that can disrupt our microbiomes, Cresci says, include those that alter the pH of the stomach and take away acid. Examples include proton pump inhibitors, aka PPIs, and histamine H2-receptor antagonists or H2 blockers, which are used to reduce acid reflux symptoms and might be available over the counter. 

By keeping track of the medications you’re taking, you can help pinpoint the cause of your symptoms and (with sign-off from your doctor) take the appropriate steps or substitutions if gut health is an issue.

3. Find the right probiotics or supplements 

In addition to incorporating more yogurt or fermented foods into their diet, some people may seek a probiotic in hopes of balancing their gut, as they’re designed to mimic an intact microbiota. If you’re considering taking a supplement, including probiotics, Cresci told CNET it’s important to know that probiotics are strain-specific, and “each strain has its own method of action.” 

For example, some probiotics are designed to help people with antibiotic-induced diarrhea, but that won’t work for a person taking them for bowel regularity. 

“You want to take the one that has been studied for whatever it is your problem is,” she said. 

Also, keep in mind that probiotics will not completely override what you eat. 

“If you have a bad diet, and you want to keep eating a bad diet but want to improve your microbiome, a probiotic isn’t gonna help you,” Cresci said. “You have to do the other part too.” 

4. Move your body every day and prioritize sleep 

“Get better sleep” or “exercise more” might sound like tired advice, but improving your sleep hygiene and squeezing in more physical activity are tried and true ways to improve your health, including your gut health. 

Exercise may help your gut in different ways, including by improving your circulation, helping your metabolism and aiding your digestive muscles, according to the Cleveland Clinic. If you dread running or don’t have time to go to the gym, don’t worry: There are small ways you can get your body in the habit of moving every day or at least more frequently. 

Getting good sleep is another general piece of wellness advice tied directly to the health of our guts. According to Cresci, our microbiome adheres to the circadian rhythm, too. So, if we eat when our gut microbiome isn’t ready, we won’t be set up to process the nutrients of our food properly. 

Lacking sleep also triggers an increase in stress and cortisol, which have negative mental and physical impacts. 

“There’s a lot going on with the gut-brain interaction, so that signals back to the microbiome, and vice versa,” Cresci said. 

Perhaps most fundamental is the fact that when we’re exhausted, we don’t have the energy to check off many of the things that keep us healthy, including exercising or finding a nutritious meal — both of which impact our gut health. 

“When you’re sleepy, tired, exhausted, you tend not to do the things we know are good for microbiomes,” Cresci said. “So it kind of perpetuates itself.”