修复你的肠道：医生的四步方案，告别腹胀、提升精力，即刻感受更佳状态

是的。

Yes.

好的。

Okay.

那怎么才能快速消除腹胀呢？

So how do you stop bloating fast?

首先，马上吃消化酶。

First thing, take digestive enzymes right away.

基本上，它的作用就是分解你的食物。

Basically, what it does, it's gonna break down your food.

所以如果你觉得腹胀不舒服，就吃一两粒，看看感觉怎么样。

So if you're bloated and you're uncomfortable, go ahead and take one or two of those and see how you feel.

它会开始分解食物。

What it's gonna do is start breaking down the food.

大约半小时到一小时内，你就会感觉腹胀消下去了。

And within thirty minutes to an hour, you should feel that bloating go down.

哇。

Wow.

对。

Yes.

还有什么别的办法吗？

What's another thing you can do?

第二件事是吃点促进肠胃蠕动的药，比如姜和朝鲜蓟的胶囊，吃一到两粒，这样能启动肠胃的清理蠕动，把气泡往下推，让你能把气排出来，而不是堵在肚子里。

The second thing is take that prokinetic, that ginger artichoke pill, take one or two of those, and it's gonna start getting those cleaning waves going so that it moves the gas bubbles downward so you can actually pass those bubbles so they're not stuck inside of you.

这是第二点。

So that's the second thing.

第三点呢，就是刚才提到的，每天晚上补充镁，这样就不会出现排便不畅的问题。

And the third thing is kind of what we touched on, taking that magnesium every night so that you never run into a problem where things are backed up.

我很欣赏

What I love about

这条建议的地方在于，你反复强调的都是同样的推荐。

this advice is you keep coming back to the same recommendations.

对，很简单。

Oh yeah, it's very simple.

谢谢你把它讲得这么简单。

Thank you for simplifying it.

你也可以去散散步。

You can also go for a little walk.

好的。

Okay.

散步怎么

How does a

会有帮助呢？

walk help?

散步自然能促进肠道蠕动。

So walk naturally activates the motility in the gut.

所以如果你觉得胀气，最糟糕的就是一直坐在办公桌前不动。

So the worst thing you can do if you're bloated is to just sit there at your desk.

所以哪怕你只是稍微走动一下，在办公室里转转，爬几层楼梯，都能促进肠道蠕动。

So even if you can just get around, walk around the office, go up a flight of stairs, that gets that motility going.

所以这是任何人都能轻松尝试的方法。

So that's an easy thing that anyone can try.

我很喜欢这个建议。

I love that.

对。

Yeah.

医生。

Doctor.

拉杰斯里医生，我已经从你这里学到了很多，但很抱歉，我得先暂停一下，因为我想给我们的赞助商一个机会说几句话，但请别走开。

Rajsree, I am already learning so much from you, and I hate to do this, but I gotta hit the pause button real quick because I wanna give our sponsors a chance to share a few words, but don't go anywhere.

接下来我们要聊的内容非常多，现在只是用花园打个基础。

There is a ridiculous amount we are gonna unpack here, and we are just laying the foundation with the garden.

接下来，医生。

Coming up, Doctor.

Rajsree会教大家如何开始打造更健康的肠道，包括最适合肠道健康的饮食方案，以及五个能立刻让你感觉好起来的重要日常习惯。

Rajsree is gonna show you how to start building a healthier gut, including the best diet for gut health and the five most important daily habits that will really help you start feeling better right away.

你有没有找到过真正好喝的蛋白饮？

Have you ever found a protein drink that you actually like?

那种喝下去不会让你觉得胀气的蛋白饮。

A protein drink that when you drink it, you don't feel bloated.

而且没有那种奇怪的、像粉笔一样的余味。

It doesn't have that weird, chalky aftertaste.

我从来没遇到过这种东西。

I've never found anything like that.

后来有个朋友给我看了个东西，彻底改变了我的想法。

And then a friend showed me something that changed everything.

他从口袋里掏出一个小瓶子，我简直不敢相信。

They pulled out this little shot from their pocket, and I couldn't believe it.

他说，梅尔，这玩意儿里有23克蛋白质。

They said, Mel, there's 23 grams of protein in this thing.

我尝了一口。

I took a sip.

天哪。

Holy cow.

这是我喝过最好喝的蛋白饮。

It was the best protein I'd ever had.

不胀气。

No bloat.

味道很好。

Delicious.

没有人工香精。

No artificial flavor.

无糖。

Sugar free.

零脂肪。

Fat free.

你确定这是23克优质蛋白质吗？

Are you sure this is 23 grams of high quality protein?

当然确定，因为我是联合创始人。

You better believe I'm sure because I'm a co founder.

我每天早上锻炼前都会先喝一瓶。

I have one first thing in the morning before I work out.

搞定。

Boom.

23克优质蛋白质轻松搞定。

23 grams of high quality protein handled.

在PureGenius Protein下单时使用优惠码MEL10，首单可享9折优惠。

Use code MEL10 at PureGenius Protein for 10% off your first order.

3秒钟摄入23克蛋白质，每瓶不到3美元。

23 grams of protein in three seconds for under $3 a shot.

欢迎回来。

Welcome back.

我是你的朋友梅尔·罗宾斯。

It's your friend Mel Robbins.

今天我们有医生。

And today we have Doctor.

拉杰斯里医生教你关于肠道健康的一切，如何修复肠道，如何缓解腹胀、肠易激综合征引起的便秘等等。

Rajsree teaching you all about gut health, how to heal your gut, how to relieve bloating, IBS constipation, and more.

这是我的

Here's my

下一个问题。

next question.

医生。

Doctor.

拉杰斯里，什么是肠易激综合征？

Rajsree, what is IBS?

肠易激综合征，就是肠道易激惹综合征，实际上影响着百分之十到十五的人口。

So IBS, it's irritable bowel syndrome, and it actually affects ten to fifteen percent of the population.

这么常见啊。

It's that common.

哇。

Wow.

那什么是肠易激综合征？

What what is it?

有哪些症状？

What are the symptoms?

要诊断肠易激综合征，基本上需要满足三个条件。

So to have IBS, you just basically need three things.

首先要有腹痛或腹部不适。

You need to have abdominal pain or discomfort.

其次排便习惯要有改变。

You need to have an alteration in your bowel habits.

也就是说，要么便秘，要么腹泻，或者两者交替出现。

So either constipation or diarrhea or a combination of both.

而且你还会注意到，排便之后，你的症状和疼痛会有所缓解。

And you need to notice that when you have a bowel movement, your symptoms and your pain improves.

所以很多人都符合肠易激综合征的标准。

So many people fit the criteria for IBS.

你希望我们怎么看待肠易激综合征呢？

How would you like us to think about IBS?

肠易激综合征只是你症状的一个标签，但它并不是引起症状的真正原因。

IBS is just a label for your symptoms, but it's not what's really causing the symptoms.

所以，如果你被告知患有肠易激综合征，其实还有很多可以进一步检查的。

And so if you've been told you have IBS, there's so much more investigation that can be done.

好的。

Okay.

我们现在知道，百分之七十的肠易激综合征实际上是由小肠细菌过度生长引起的。

What we now know is that seventy percent of IBS is actually caused by SIBO.

哇。

Wow.

是的。

Yeah.

但如果是肠易激综合征，嗯。

But if it's IBS Mhmm.

那你会怎么处理呢？

What do you do about it?

所以如果病人来找我，我有条件做那些进一步的检查。

So if a person is coming to see me, I have the luxury of doing all that further investigation.

所以我们总是会检测小肠细菌过度生长。

So we always test for SIBO.

我们会检测食物过敏。

We test for food allergies.

大多数时候，小肠细菌过度生长的检测结果会是阳性的。

And most of the time the SIBO test will be positive.

如果由于某种原因是阴性，那我们就会继续进行肠道微生物组检测。

If for some reason it's negative, then we move on to a gut microbiome test.

所以再说一次，关键总是要找到那个根本原因并解决它。

So again, it's always about figuring out what that root cause is and fixing it.

如果你只是有肠易激综合征，不知道从哪里开始，你可以从肠道花园的前两个系统入手，也就是促进肠道蠕动，确保排便完全顺畅，可以借助镁和夜间使用的肠道动力激活剂，同时改善食物的消化。

Now, if you're just someone with IBS and you don't know where to start, you can start with the first two systems of the gut garden, which is promoting motility, making sure your bowels are a 100% and complete with the help of magnesium and motility activator at night, and improving your digestion of food.

试试一些消化酶。

Try some digestive enzymes.

这是一种成本很低的干预措施。

It's a low cost intervention.

它可能会对你帮助很大。

It might help you tremendously.

看看效果如何。

And see where that takes you.

什么是SIBO？

What is SIBO?

小肠细菌过度生长。

Small intestine bacterial overgrowth.

所以SIBO基本上就是细菌倒流了。

So SIBO is basically when bacteria back up.

它们现在跑到了不该待的地方。

So now they're in the wrong place.

正常情况下，我们的小肠里细菌并不多。

So normally, our small intestine does not have much bacteria.

小肠的职责是从食物中吸收营养。

The job of the small intestine is to absorb nutrients from your food.

那数万亿的细菌，它们都住在结肠里。

The trillions of bacteria, they're located in the colon.

那里才是你主要的微生物群所在。

That's where your primary microbiome is.

但如果有什么原因让这些细菌倒流回小肠，它们不该出现在那里，就会过早地开始发酵你的食物。

But if something causes those bacteria to back up into your small intestine where they're not supposed to be, they start fermenting your food too early.

所以每次你吃东西，就会感到难受的胀气和腹胀，还可能改变你的排便习惯。

So every time you eat, you get this miserable gas and bloating, and it can alter your bowel habits.

所以现在它看起来就像肠易激综合征，你可能被诊断为肠易激综合征了。

Hence, now it resembles IBS, and maybe you've been labeled with IBS.

它还会引起反酸和恶心。

It can also cause acid reflux and nausea.

它会让你有那种我们说的早饱感，就是吃不了多少就觉得饱了，因为肚子里全是压力。

It gives you that feeling of what we call early satiety where you can't really eat that much because you've got all this pressure in your abdomen.

对。

Yeah.

它甚至会影响营养吸收。

And it can even interfere with your nutrient absorption.

然后你就会缺乏维生素B12、维生素D和铁。

So then you get deficiencies in b twelve and vitamin d and iron.

而且SIBO甚至会影响胃肠道以外的部位。

And SIBO can even have effects outside the GI tract.

所以有SIBO的人会变得非常焦虑。

So people with SIBO get really anxious.

他们还会出现脑雾、疲劳、关节疼痛，还有很多其他症状。

They get brain fog, fatigue, joint pain, and so much more.

哇。

Wow.

对。

Yeah.

我看到你旁边有一个人体模型，里面都是内脏。

I I see that you have a model next to you of a human being and it's all the insides.

就像你在医学院看到的那种，是的。

It's like something you would see at a medical school, Yes.

我……

I

这个人模型上的这些小贴纸就是结肠里的细菌。

And this human model is these little stickers are the bacteria in your colon.

好的。

Okay.

如果你在听的话，她在大肠周围贴了那些花里胡哨的贴纸。

If you're listening, she's got these, like, splashy stickers around the colon.

就是这样。

That's it.

就是代表那些细菌。

Just representing that's the bacteria.

好的。

Okay.

想象一下，如果我们把这些细菌移到它们不该待的小肠里，会发生什么。

Imagine what would happen if we take these bacteria and we move them to your small intestine where they're not supposed to be.

天哪。

Oh my goodness.

这会对你的消化造成很大的破坏。

This is gonna cause so much havoc to your digestion.

看起来她像是在你的小肠上放了一堆小爆炸。

It looks like she's putting little, like explosions all over your small intestines.

对。

Yes.

我看着这个模型，感觉我自己都胀气了。

I'm just looking at this model, and it feels like I'm getting bloated.

没错，这些细菌在错误的地方发酵你的食物，还会干扰你消化食物。

That's exactly what it Those bacteria, they start fermenting your food in the wrong place, and they interfere with your digestion of food.

那SIBO怎么诊断呢？

How do you diagnose SIBO?

很简单，做个呼气测试，就是喝一种溶液。

So it's a simple breath test, and it's a test where you drink the solution

嗯。

Uh-huh.

乳果糖溶液。

Of lactulose.

乳果糖是什么？

What is lactulose?

这是一种你的身体无法吸收的糖，所以它会留在你的肠道里。

It's a type of sugar that your body cannot absorb, so it stays in your intestines.

如果你有SIBO，这些细菌就会把它发酵成气体。

And if you have SIBO, the bacteria, they're going to ferment it into gas.

然后你每隔二十到三十分钟吹一次气，收集你的呼吸样本，持续整整三个小时。

And then you actually blow and collect your breath at twenty to thirty minute intervals for a full three hours.

你把管子寄回去，他们会根据你呼吸中产生的物质绘制图表。

And you mail back the tubes and they're gonna graph out what's being produced in your breath.

不会吧。

No way.

是的。

Yes.

这太不可思议了。

That's insane.

那你是怎么治疗SIBO的？

So how did you treat SIBO?

你做的第一件事是什么，是为了确认这就是这个病，还是直接说，你知道吗？

What was the first thing that you did to either confirm that this was what this was or to just go, You know what?

我感觉就是这个病。

I have a feeling this is what this is.

那你是怎么治疗这个病的呢？

And so, what do you do to treat this?

所以，治疗SIBO的传统方法是服用抗生素。

So, the conventional treatment for SIBO is to take an antibiotic.

什么？

What?

是的。

Yes.

嗯，不幸的是，传统治疗方法效果不太好。

Well, the conventional treatment unfortunately doesn't work well.

它的失败率和复发率都非常高。

It has a very high failure rate and a very high relapse rate.

所以我治疗SIBO的时候，会把它看作一个完整的肠道生态系统问题。

So when I treat SIBO, I look at this as a full garden ecosystem problem.

好的。

Okay.

我们必须修复肠道的蠕动功能。

We have to fix the motility in the gut.

我们必须修复你对食物的消化分解。

We have to fix your breakdown of food.

基础阶段就是我们把一切都准备好，以便杀死细菌。

The foundational steps is where we get everything ready to kill the bacteria.

我们直到治疗的第四个也是最后一个阶段才会杀死细菌。

We don't kill the bacteria until the fourth and final phase of treatment.

哦。

Oh.

所以第一阶段是促进蠕动。

So phase one is promoting motility.

那就是镁和促进肠道蠕动的激活剂。

That's the magnesium and the motility activator.

我们得先把这些弄好。

We gotta get that all going first.

第二阶段是消化酶。

Phase two is the digestive enzymes.

有些人需要额外的甜菜碱和胃蛋白酶，不是所有人都需要，但有些人胃酸偏低，这可能会带来很大的改变。

Some people need that extra betaine and pepsin, not everybody, but some people have low stomach acid, and that can be a game changer.

所以这就是那些授粉者。

So that's the pollinators.

我们正在让它们发挥作用。

We're getting that going.

第三阶段是，肠道里可能因为这些细菌而有炎症。

Phase three is there's probably inflammation in the gut from all these bacteria.

所以我让患者开始服用含有免疫球蛋白的孢子益生菌，来修复肠道炎症。

So I start patients on a spore probiotic that has immunoglobulins to heal the inflammation in their gut.

这就是第三阶段。

That's phase three.

这些是基础步骤，先把一切调理好，然后才能在第四阶段用草药抗菌剂真正杀死细菌。

So those are the foundational steps to get everything in order before we can actually kill the bacteria in phase four with the herbal antimicrobials.

我们用的草药抗菌剂叫小檗碱。

The ones we use are called berberine.

它来自小檗碱植物的根部。

It comes from the root of a berberine plant.

还有牛至油，你可能比较熟悉。第三种是阿利辛。

Oregano oil, so you're probably familiar with And the third one is alacidin.

它来自大蒜。

It comes from garlic.

医生，您在临床实践中以及您自己身上看到了什么效果？

Now, what have you seen in your clinical practice and in yourself, Doctor.

拉杰斯里，当您和您的患者按照这个方案执行时，如果有人SIBO检测呈阳性，您会怎么做？

Rajsree, when you follow this protocol with your patients and with yourself when somebody comes in and has a positive SIBO test?

所以这个方案，我觉得成功率非常高。

So this protocol, I would say is incredibly successful.

对我自己和我的几百个病人来说都是这样，我们看到了非常显著的效果，因为我觉得我的方案确实解决了恢复肠道生态系统的四个关键方面。

It was for me and for hundreds of my patients, but we see incredible results because, again, I think that my protocol really addresses the four systems of restoring the gut ecosystem.

所以到最后，你不仅清除了SIBO，你的肠道菌群也更健康了。

So at the end of it, not only have you cleared SIBO, you have a healthier gut microbiome.

而且我们还有一套完整的预防复发的策略。

And then we have this whole strategy for prevention of relapse.

这对SIBO来说非常关键，因为如果没有策略，百分之五十的患者会在九个月内复发。

That is so critical in SIBO because fifty percent of patients will relapse in nine months if you don't have a strategy.

太厉害了。

Incredible.

我想提醒你，在收听的时候，我们为每一集都准备了全面的指南，包括节目笔记和链接。

I just wanna remind you as you're listening that we have a comprehensive guide to every episode with show notes, with links that we prepare for every episode.

所以如果你像我一样，还有医生……

So if you're like me and as Doctor.

拉杰斯里在讲话，你正试着记笔记。

Rajsree is talking, you're trying to take mental notes.

好，她刚才说了什么？

Okay, what did she just say?

因为我得把这个发出去。

Because I gotta send this.

你可以去看节目笔记，所有内容都在那里。

You can go to the show notes and it's all gonna be right there for you.

所以你只管专心听，我们会帮你搞定。

So you can just lean in and listen, and we got you.

我们来聊聊肠漏吧。

Let's talk about leaky gut.

好的。

Sure.

什么是肠漏？

What is leaky gut?

所以，肠漏的医学术语叫做肠道通透性增加。

So the medical term for leaky gut is increased intestinal permeability.

这基本上就是肠道花园里第三套系统，也就是土壤，出了问题。

So it's basically a problem with that third system of the gut garden, the garden soil.

想象一下，你的花园土壤出现了大裂缝。

Imagine your garden soil having big cracks in it.

正常情况下，我们的小肠是由许多微小的细胞组成的，我这里有个小模型。

So, normally, our small intestine is made up of tiny little cells, which I have a little example here.

她拿了一个黄色的瑜伽盒子。

She's got yellow yoga box.

如果你在听的话，我来给你描述一下。

I'm gonna narrate this for you if you're listening.

这些微小的细胞叫做肠上皮细胞，就是小肠内壁上的那些小细胞。

And these tiny little cells are what we call enterocytes, the little tiny cells on the lining of your small intestine.

好的。

Okay.

这些就是排列在肠壁上的东西。

So these are the things that line the wall.

好的。

Okay.

这些微小的细胞通过紧密连接结合在一起。

Now these tiny cells, they're bound together by tight junctions that hold them together.

嗯。

K.

这些细胞的工作就是吸收你食物中的营养。

And the job of these cells is to just absorb nutrients from your food.

嗯。

K.

但如果有什么东西破坏了这些细胞之间的微小连接，把它们撑开，那可能是多种原因造成的。

But if something disrupts these tiny junctions between these cells and pops them open, now it could be a variety of things.

可能是典型的美国饮食，里面充满了防腐剂、乳化剂和添加剂。

It could be the standard American diet, which is full of preservatives and emulsifiers and additives.

好。

K.

可能是抗生素。

It could be antibiotics.

也可能是非甾体抗炎药，比如空腹吃很多布洛芬。

It could be NSAIDs, like if you're taking a lot of ibuprofen on an empty stomach.

或者如果你喝酒很厉害的话。

It could be if you're a heavy drinker.

所以这些都是对肠道的伤害。

So all of these are insults to the gut.

我们之前说的细菌也可能是原因吗？

Can the bacteria we talked about also be?

好的。

Okay.

太好了。

Great.

当然。

Absolutely.

所以SIBO是肠漏的一个大根源，因为细菌再次干扰酶，在肠道里引发炎症。

So SIBO is a big root cause of leaky gut because of the bacteria, again, interfering with the enzymes, creating inflammation in the gut.

这就是肠漏的样子。

So this is what leaky gut looks like.

现在你的小肠里那些微小的细胞之间出现了缝隙。

Now you've got openings between these tiny cells in your small intestine.

哦，所以不是一根管子，而是像网一样。

Oh, so instead of having a tube, you have mesh.

没错。

Exactly.

现在你的肠道上有了小洞。

You have little holes in your gut now.

这是个问题，因为本来应该在肠道内部的细菌和食物，现在不是通过细胞被正常吸收，而是有了一个开放的窗口进入你的血液。

This is a problem because bacteria and food that are normally on the inside of your gut, instead of getting properly absorbed through these cells, they now have an open window to enter your bloodstream.

哎呀。

Uh-oh.

哎呀。

Uh-oh.

就像这样。

Like this.

这个小

This little

她是个乒乓球，然后她直接把它塞进了墙里。

She's a ping pong ball, and she just shoved it through the wall.

对。

Yeah.

所以现在它就在我身体里到处飘了？

So now it's floating around in my body?

它已经进入你的血液了。

It's entered your bloodstream.

你猜这边是什么？

And guess what's over on this side?

是我身体的其他部分。

The rest of me.

对，还有你70%的免疫细胞。

Yeah, and 70% of your immune cells.

它们就在这些微小细胞的另一边。

They're sitting right there on the other side of these tiny cells

哦，你的

in Oh, your

所以在这边

so on the

里面有一层内壁，负责吸收营养，而且正常情况下，它应该把所有的食物、细菌和垃圾都留在管道里。

inside, you've got this lining that's absorbing nutrients, and that's also, when working correctly, is supposed to keep all the food, bacteria and crap on the tube.

没错。

Exactly.

但如果你吃一堆不健康的超加工垃圾食品，或者吃太多布洛芬，或者吃抗生素，或者你有细菌感染或者小肠细菌过度生长或者其他问题，肠道内壁就会开始被撑开，里面的东西就会漏过去，进入血液，而血液里最先接触肠道外壁的就是免疫细胞。

But if you're eating a bunch of unhealthy ultra processed crap or doing too much ibuprofen or taking antibiotics, or you got bacterial or SIBO or other stuff, it starts to stretch the lining and now all the stuff on the inside is scooting through and now it's in your bloodstream, but the first thing in your bloodstream on the outside of your intestinal walls is the immune cells.

没错。

Exactly.

那会发生什么？

So what happens?

这会迷惑免疫系统，引发一连串的炎症反应。

So it confuses your immune system and it creates this whole entire inflammatory cascade.

所以现在肠道的情况会影响全身，而且不同的人表现可能不一样。

And so now what's happening in your gut affects the rest of your body, and it can present in different ways in different people.

那怎么修复肠漏呢？

So how do you heal a leaky gut?

修复肠漏，

So we heal leaky gut.

首先得调整饮食。

First, we've got to clean up the diet.

所以，我们得把这些引发炎症的因素去掉。

So we've gotta get rid of those inflammatory triggers.

我们必须戒掉酒精、麸质和乳制品，因为这些都可能引发炎症，至少在治疗肠漏期间是这样。

We have to remove alcohol, gluten, and dairy because those are potentially inflammatory triggers, at least while we're treating leaky gut.

之后我们可能可以慢慢把它们重新加回来。

We may be able to reintroduce those later.

我们还要避免加工食品，把那些添加剂和乳化剂都清掉。

We also cut out processed foods to get rid of all those additives and emulsifiers.

针对肠漏症，我们常用的两种疗法中，第一种是L-谷氨酰胺粉。

And then the two treatments we use for leaky gut, the first is L glutamine powder.

它其实就是一种氨基酸，恰好能作为这些肠上皮细胞的营养来源。

So it's just an amino acid and it happens to be food for these little enterocytes.

它能给细胞提供养分，滋养它们，并帮助封闭细胞之间的紧密连接。

So it feeds these cells, and it nourishes these cells and seals up these tight junctions between the cells.

不过这个过程需要时间。

It does take time.

这不是一蹴而就的过程。

It's not an overnight process.

你需要花多长时间来做这件事？

How long do you need to dedicate to do this?

至少三个月。

Three months for sure.

有时候需要六个月。

Sometimes up to six months.

好的。

Okay.

这就是我们用的第一种治疗方法。

So that's the first treatment we use.

好的。

Okay.

我们用的第二种治疗方法是免疫球蛋白，也叫IgG抗体。

The second treatment we use is immunoglobulins, also known as IgG antibodies.

它们跟初乳有点像。

They're kind of similar to colostrum.

你了解初乳吗？

Are you familiar with colostrum?

那是从奶里来的，对吧？

That's from milk, isn't it?

对。

Yes.

这就好比初乳，里面含有各种抗体，能滋养婴儿的肠道和免疫系统。

It's like the mother's first milk that has all the antibodies to nourish the infant's gut and immune system.

所以牛初乳的问题在于它含有乳制品蛋白。

So the issue with colostrum is it has dairy proteins.

而免疫球蛋白是完全不含乳制品成分的。

So immunoglobulins are completely dairy free.

它们不含乳制品蛋白，是从牛血清中提取的，通常做成胶囊形式。

So there's no dairy proteins and they're derived from bovine serum and they just come in capsules.

所以这两种是我们治疗肠漏的主要方法，但肠漏通常不会单独发生。

And so these two are the primary treatments that we have for leaky gut, but leaky gut does not usually happen in isolation.

所以我们又回到了那个花园的比喻。

So we're back to that garden metaphor.

现在我发现了一种新的细菌，在很多人的肠道里都缺失，它叫作无色杆菌。

And now there's this new bacteria that I'm noticing that's missing in a lot of people's gut, and it's called achromanacea.

无色杆菌的全名是无色杆菌黏液嗜菌，但它生活在肠道的黏液层中。

Achromanacea, the full name is achromanacea mucinphilia, but it lives in the mucus layer of the gut.

它就住在这里，紧挨着这些肠上皮细胞，然后产生那种保护性的黏液，你知道的，能防止肠道渗漏。

So it lives right here next to these enterocytes, and it creates that protective mucus that, you know, prevents leaky gut.

但如果你缺少这种制造黏液的关键细菌，那你患肠道渗漏的风险肯定会更高。

But if you're missing this critical bacteria that's making the mucus, well, you're definitely higher risk of leaky gut.

所以如果缺了它，我们也会补充这种毛螺菌。

So if you're missing that, we will also replenish that achromanxia.

最后一点是，如果这边长满了杂草，也就是我们之前提到的那些细菌，比如小肠细菌过度生长、菌群失调或者念珠菌感染，我们也得把这些清理干净。

And then the final thing is if you've got a bunch of weeds on this side, the bacteria like we talked about, SIBO or dysbiosis or candida, we've got to clean that up as well.

这就是草药抗菌剂发挥作用的地方。

That's where the herbal antimicrobials come in.

医生，

Dr.

Rajsree医生，对肠道健康最好的饮食是什么？

Rajsree, what is the best diet for gut health?

医生，

Dr.

每个人的肠道花园都不一样。

So everyone has a different gut garden.

有趣的是，同样的饮食可能对每个人并不都有效。

So the interesting thing is that the same diet might not work for everyone.

哦，我明白了。

Oh, I see.

我本来想要一个简单的答案。

I wanted a simple answer.

好，我给你举个例子。

Well, let me give you an example.

我有一些朋友是素食主义者，他们吃高纤维的纯素饮食，而且状态非常好，这很棒。

I have some friends who are vegan and they eat a vegan diet incredibly high in fiber, and they're thriving on that, which is wonderful.

但如果同样的饮食给到别人，他们可能会腹胀、难受。

But if that same diet was given to someone else, they probably get bloated and miserable.

所以有些人在地中海饮食上效果不错。

So some people do good on a Mediterranean diet.

有些人在原始人饮食上效果不错，但有一些关键原则是我对所有人都推荐的。

Some people do good on a paleo diet, but there are some key principles that I recommend across the board.

首先，要吃天然食物。

The first is that you wanna eat whole foods.

所以尽量少吃加工食品。

So you wanna avoid processed foods as much as you can.

完全正确。

Absolutely.

第二点就是尽量让盘子里的食物颜色丰富多样。

The second is that you wanna have as many colors on your plate as possible.

也就是说，你要吃些浆果、紫色的土豆或者紫甘蓝、胡萝卜之类的，因为不同的颜色意味着你能摄取到抗氧化剂和植物营养素。

So that means, you know, having some berries or colorful purple potatoes or purple cabbage, carrots, because colors is when you're gonna get the antioxidants and the phytonutrients.

所以尽量尝试摄入各种颜色的食物。

So try your best to eat a diverse array of colors.

第三点是倾听身体的反馈，找出哪些纤维适合你。

The third thing is to listen to your gut and figure out which fibers agree with you.

那你怎么知道呢？

Now how do you know?

所以这得靠一点点试错。

So it's a little bit of trial and error.

好。

K.

但假设你吃了芝麻菜。

But let's say you eat arugula.

芝麻菜通常很容易消化，因为它不含任何可发酵的碳水化合物。

Arugula is usually well tolerated because it doesn't have any fermentable carbohydrate.

所以如果你吃芝麻菜配柠檬汁和橄榄油，感觉很好，那这就是一种很好的纤维，可以继续吃；但如果你吃豆子会胀气，那可能就不适合你。

So if you eat arugula with lemon juice and olive oil and you feel good eating that, that's a great fiber to keep in your diet versus if you eat beans and you get bloated, maybe that doesn't agree with you.

所以纤维是好的，但你可能需要反复试验，找出哪些纤维适合你的肠胃，然后把它们留在你的饮食中。

So fiber is good, but you may have to do trial and error to figure out what fibers agree with your gut and keep those in your diet.

第四点也是最后一点，就是尽量让你的饮食多样化。

And the fourth and final thing is to try to diversify your diet as much as possible.

这意味着，不要每天晚上只吃西兰花，也许可以试试四季豆或芦笋，或者更好的是，把各种蔬菜一起炒。

So what that means is that instead of just having, like, broccoli every night, maybe try green beans or asparagus or better yet, stir fry a bunch of vegetables together.

因为你的饮食越多样化，你的肠道微生物组就越强大、越有韧性。

Because the more diverse your diet, the more robust and resilient your gut microbiome.

这样你的肠道花园里会长出更多的植物，让它更健壮，杂草就不会再长出来了。

So you're gonna get more plants growing in your gut garden, and that's gonna make it more strong so that the weeds don't come back.

纤维对你的肠道有什么作用？

What does fiber do for your gut?

说到纤维，我们通常会想到它能增加粪便体积，让排便更规律。

So when we think about fiber, usually we think of it as bulking up your stool, keeping your bowels flowing regularly.

对。

Mhmm.

但纤维对肠道的作用远不止这些。

But it does so much more for your gut.

实际上，纤维是肠道中有益细菌的食物。

So fiber is actually food for the good bacteria in your gut.

当你摄入纤维时，就像给肠道花园施肥一样。

So when you're eating fiber, it's like putting fertilizer into your gut garden.

这样会有更多的花朵绽放，有益细菌利用纤维产生关键的后生元，这些后生元对健康至关重要。

So you're gonna have more flowers popping up and the good bacteria use the fiber to then produce critical postbiotics that are critical for your health.

这些后生元会影响免疫系统、新陈代谢、皮肤，以及更多方面。

I mean, these postbiotics influence your immune system, your metabolism, your skin, and so much more.

你建议你的病人每天摄入多少纤维？

How much fiber do you recommend to your patients that they try to get every day?

那你有没有自己最喜欢的纤维来源？

And do you have your favorite forms of it?

这个问题问得好。

So that's a great question.

对很多肠胃病人来说，纤维就像一把双刃剑。

Fiber for a lot of my gut patients can be like a double edged sword.

我的很多肠胃病人属于那种对纤维比较敏感的类型。

A lot of my gut patients are what I call fiber sensitive.

所以，虽然理论上纤维对肠道很好，但我不能直接让病人按推荐量吃，比如女性25克、男性38克。

So even though fiber in theory is so good for your gut, I can't just tell patients to take the recommended twenty five grams for a woman or thirty eight grams for a man.

那样很可能会给他们带来很多问题。

That'll probably cause them a lot of problems.

我通常建议从绿叶蔬菜开始。

Usually what I recommend is start with the leafy greens.

比如芝麻菜、菠菜、甜菜叶，如果喜欢的话，可以先吃煮熟的。

That's like the arugula, the spinach, the chard, and start with the cooked form if you prefer.

煮熟的蔬菜总是比生的更容易消化。

Cooked vegetables are always easier to tolerate than the raw.

但这些绿叶蔬菜的好处是它们不含可发酵的碳水化合物，所以通常不会引起腹胀。

But the nice thing about these leafy greens is they don't have any fermentable carbohydrate, so they usually don't cause bloating.

所以如果你对纤维敏感，可以试试先炒一大把菠菜。

So if you're someone who's fiber sensitive, try sauteing a bunch of spinach first.

确保炒得熟透。

Make sure it's well cooked.

所以通常要循序渐进，从煮得很熟的蔬菜开始，找出适合自己的，然后再尝试新的食物。

So usually it's about taking baby steps, starting with really well cooked, figuring out what agrees with you, and then trying new things in your diet.

然后，那些对你有效的食物，就继续保留在饮食中，并尽量多样化。

And then whatever does work for you, keep that in your diet and try to diversify.

每个人的情况都不一样。

So everyone is kind of unique.

你需要不断尝试和调整，同时倾听自己身体的反应。

You have to do a lot of trial and error and listening to your gut.

医生。

Doctor.

Rajsree，非常感谢你这样的解释。

Rajsree, thank you so much for explaining it that way.

我们稍作停顿，先听一下赞助商的广告。

Let's say a quick pause so we can hear a word from our sponsors.

回来后，她会讲一个她在网上最受欢迎的话题之一——组胺不耐受。

When we come back, she's gonna down one of her most popular topics online, which is histamine intolerance.

你可能从来没听说过，但听她讲的时候，你会想，哦，等等。

You may have never heard of it, but when you hear her discuss this, you're gonna go, oh, wait a minute.

我觉得那说的就是我，或者我认识的某个人，她会告诉你具体该怎么做。

I think that's me or maybe somebody I know, and she's gonna tell you exactly what to do about it.

请继续收听。

Stay with me.

我们马上回来。

We'll be right back.

欢迎回来。

Welcome back.

我是你的朋友梅尔。

It's your friend Mel.

今天，你和我一起请到了医生。

And today, you and I are here with Doctor.

拉杰斯里。

Rajsree.

她会教我们关于肠道健康的所有知识，以及她修复肠道的简单方案。

And she is teaching us all about gut health and her simple protocol for healing your gut.

所以，医生。

So Doctor.

拉杰斯里，我接下来有个问题。

Rajsree, here's the next question I've got.

保持肠道健康，最重要的五个日常习惯是什么？

What are the five most important daily habits for having a healthy gut?

我很喜欢这个问题，因为我觉得我们太关注吃什么了，但其实怎么吃和什么时候吃也非常重要。

I love this question because I think we pay so much attention to what we eat, but how we eat and when we eat are so important.

所以我给所有病人推荐的第一件事就是控制进餐间隔。

So the first thing I recommend to all my patients is to practice meal spacing.

进餐间隔？

Meal spacing?

对。

Yep.

进餐间隔其实就是说两餐之间不要吃零食。

So meal spacing essentially means no snacking between meals.

也就是说每餐之间要间隔四到五个小时。

So that's having four to five hours between your meals.

这样做能激活肠道的清洁波，真的能减少腹胀。

And what that does is it activates the cleaning waves in your gut so it really reduces bloating.

所以这真的非常有用。

So that really, really is helpful.

我推荐的第二件事是练习正念饮食。

The second thing I recommend is to practice mindful eating.

我觉得我们很多人都是在压力很大的情况下吃饭的。

So I think so many of us are eating under very stressful circumstances.

你知道，工作上的压力就不少。

You know, we've got stress from work.

我们可能一边赶路一边吃，或者一边工作一边吃，或者一边刷着让人焦虑的邮件或新闻一边吃。

We may be eating on the go, you know, or while doing work or scrolling through stressful emails or news.

这种压力会让我们的身体进入战斗或逃跑的状态。

And that stress puts us into a state of fight or flight.

所以吃饭的时候，你要激活副交感神经系统，它能帮助你休息和消化。

So when you're eating, you want to activate the parasympathetic nervous system, which helps you rest and digest.

最简单的方法之一就是把所有电子设备收起来，给自己一点时间，做几次深呼吸，这样就能激活迷走神经。

So one of the easiest things you can do is put away all your devices, take a few moments for yourself, take a few deep breaths, and that's gonna activate that vagus nerve.

迷走神经会告诉你的胃分泌胃酸，告诉你的胰腺分泌胰酶，还能促进肠道蠕动。

And that vagus nerve is what tells your stomach to make stomach acid, your pancreas to make pancreatic enzymes, and it gets that motility going.

这样你的消化会好很多。

So your digestion will be so much better.

吃东西的时候，你真的要享受每一口。

And when you eat, you really wanna enjoy every bite.

你知道，花时间咀嚼食物，品尝食物。

You know, take the time to chew your food, taste your food.

第三点就是只在真正饿的时候才吃。

The third thing would be to only eat when you are truly hungry.

当你真正饿的时候，胃酸最强，胰酶也最强，肠道蠕动会启动，消化也会好很多。

So when you are truly hungry, that's when your stomach acid's gonna be strongest, your pancreatic enzymes are gonna be strongest, your motility is gonna be activating and your digestion's just gonna be so much better.

第四点就是白天要保持活动。

So the fourth thing is to stay active throughout the day.

吃完饭后，如果能去散散步，同样能自然促进肠道蠕动。

So after eating, if you can go for a little walk, again, you're gonna naturally activate the motility in the gut.

如果白天能穿插一些活动，这对消化的帮助会大得多。

So if you can work in a little bit of movement throughout the day, that's gonna help your digestion so much more.

再说，一直坐着不动，老待在办公桌前，可能是对消化最不好的事情了。

Again, being stagnant and just sitting at your desk is probably the worst thing you can do for your digestion.

第五点就是，吃饭的时候尽量别喝太多水。

And the fifth thing is to try not to drink too much water with your meals.

真的吗？

Really?

对。

Yeah.

为什么？

Why?

水当然对补水很重要，但如果你吃饭时喝很多水，实际上会稀释胃酸和胰酶。

So water obviously is important for hydration, but when you drink a ton of it with your meals, you're actually diluting your stomach acid and your pancreatic enzymes.

所以，根据我对病人和自己的观察，我吃饭时如果需要就抿几口水，但大部分水我会留到大约四十五分钟后再喝。

So what I've observed with my patients and with myself is when I eat my meal, I'll take a few sips of water if needed, but I'll save the bulk of my water for, like, forty five minutes later.

这样做之后，我需要的消化支持就少多了。

And by doing that, I need far less digestive support.

就是说，我不需要吃那么多消化酶了，因为我自身的胃酸和酶浓度够了。

Like, I don't need to take as much digestive enzymes because my natural acid and enzymes are concentrated.

那我们换个话题吧。

So I'd love to switch gears.

什么是组胺不耐受？

What is histamine intolerance?

组胺不耐受是食物敏感的一种极端表现。

So histamine intolerance is another extreme form of food sensitivity.

基本上，有组胺不耐受的人会突然觉得自己对什么都过敏。

And basically, a person with histamine intolerance suddenly feels like they're allergic to everything.

不幸的是，很多我们认为对肠道有益的健康食品，其实组胺含量很高。

And the unfortunate part is a lot of really healthy foods that we think are good for our gut are loaded in histamines.

比如发酵食品，像泡菜、酸菜、康普茶，还有骨头汤。

So that's the fermented foods like the kimchi, sauerkraut, kombucha, and the bone broth.

什么是组胺？

What is a histamine?

组胺是我们免疫系统产生的一种化合物，当我们出现过敏反应时，它会自然释放出来。

So histamine is a compound that's made by our immune system, and it's naturally released when we're having an allergic reaction.

比如你打喷嚏或者对环境过敏时，免疫细胞就会释放组胺，导致鼻塞。

So if you're having a sneezing attack or environmental allergies, your immune cells are releasing that histamine and that's causing the nasal congestion.

但组胺会影响身体里的多个器官。

But histamines can affect multiple organs in your body.

在大脑里，它可能引起焦虑、失眠和头痛。

So in your brain, it can create anxiety, insomnia, headaches.

在皮肤上，它可能导致皮疹和荨麻疹。

In your skin, it can cause rashes and hives.

在心脏，它可能引起心悸。

In your heart, it can cause palpitations.

在胃里，它可能导致胃酸反流。

And in your stomach, it can cause acid reflux.

在肠道里，它可能引起腹胀和腹泻。

And in your gut, it can cause bloating and diarrhea.

所以它真的会影响你全身。

So it can really affect your whole body.

就像我刚才说的，组胺也存在于那些发酵食品中。

And histamines are found, like I said, in those fermented foods.

它也存在于陈年食品里。

It's also found in aged foods.

比如酱油、陈醋、陈年奶酪和酒精饮料里都有。

So it's found in soy sauce and aged vinegars, aged cheeses, and alcohol.

你能给我讲讲组胺是怎么在体内堆积的吗？

Can you show me how histamine builds up in the body?

当然可以。

Absolutely.

我先拿个例子来说明一下。

So let me get an example over here.

好的。

Okay.

她有一个玻璃花瓶，里面装着乒乓球，有白色的和蓝色的。

She's got a glass like vase that has ping pong balls in it, white and blue.

中间有一条红线，标记着半满的位置。

And there's a red line halfway up to mark halfway up.

然后这里还有一些乒乓球。

And then you've got some more ping pong balls here.

对。

Yeah.

好的。

Okay.

这些球代表组胺。

So these balls represent the histamines.

好的。

Okay.

接下来，我给你讲一个我病人的故事，描述他的一天以及他的组胺水平的变化。

So to I'm gonna give you a story of one of my patients and describe his day and what happens with his histamine levels.

好的。

Okay.

我有个病人，就叫他约翰吧。

So one of my patients, let's just call him John.

他45岁，来找我看病，基本上对什么都过敏。

He's a 45 year old man, and he comes to see me, and he's basically reacting to everything.

他吃什么都不舒服。

Everything he eats is making him feel sick.

他老是腹胀。

He's bloated all the time.

还拉肚子。

He's got diarrhea.

现在又头疼。

He's got headaches now.

他特别焦虑，晚上睡不着，皮肤还一直长东西。

He's super anxious, and he can't sleep at night, and his skin is breaking out.

那可真不少。

That's a lot.

那我来说说约翰的情况吧。

So let me describe what's happening to John.

比如说他早上起来，想吃得健康一点。

So let's say he wakes up in the morning, and he's trying to be healthy.

他就吃了酸面包配牛油果，加一片番茄和一个鸡蛋。

So he has his sourdough toast with avocado, a slice of tomato, and an egg.

听起来挺健康的。

That sounds healthy.

听起来是挺健康的。

It sounds healthy.

但他没意识到，牛油果和番茄里都含有组胺。

But little does he realize that avocado and the tomato have histamines.

这样一来，他体内的组胺就更多了。

So now his body's got more histamines.

然后到了晚餐时间，他和妻子去了他最喜欢的日本餐厅，喝了几杯葡萄酒，而葡萄酒里也含有组胺。

And then for dinner, he goes out to dinner with his wife to his favorite Japanese restaurant, and he has a couple glasses of wine, which again have histamines.

哎呀。

Oops.

然后他吃了最喜欢的寿司，还蘸了很多酱油。

And then he has his favorite sushi with a bunch of soy sauce.

酱油里组胺含量特别高。

Soy sauce is loaded in histamines.

那你猜那天晚上约翰会怎么样？

So guess what happens to John that night?

他回到家。

He comes home.

头疼得厉害。

He has a horrible headache.

而且特别焦虑。

He's super anxious.

他整晚都睡不着。

He can't sleep the whole night.

他的皮肤开始长东西。

His skin is breaking out.

痒得不行。

It's itching.

他难受得要命。

He's absolutely miserable.

所以基本上，他跨过了组胺桶的临界点。

So he basically crossed the threshold of his histamine bucket.

组胺在他体内泛滥成灾。

It's overflowing in his system.

那为什么会这样呢？

So why did this happen?

因为就在六个月前，他吃同样的东西可能一点事都没有。

Because literally six months ago, he could have eaten the exact same foods and been fine.

是的。

Yes.

嗯，这归根结底是他的肠道菌群发生了什么变化。

Well, it comes down to what's happened in his microbiome.

菌群发生了改变，就像花园里杂草丛生一样。

There's been a shift, and there's an overgrowth of weeds in his garden.

好。

K.

这些细菌现在产生更多的组胺，并且消耗掉一种关键的酶，这种酶通常负责分解组胺。

These bacteria are now producing more histamines, and they're eating up a critical enzyme that normally breaks down histamines.

这种酶叫做DAO，也就是二胺氧化酶。

And that enzyme is called DAO, diamine oxidase.

好。

K.

所以我给约翰做的检查是，让他做了SIBO呼气测试和粪便菌群测试。

So what I did for John is I had him do the SIBO breath test and the stool microbiome test.

我们发现他有很严重的小肠细菌过度生长，两种类型都有，而且他还存在肠漏的问题。

And we found that he had very significant SIBO, both types, and he had leaky gut.

所以他是雪上加霜，情况很糟糕。

So he had the perfect storm.

他的肠道里长了一堆不该长的杂草。

He had a bunch of weeds in the wrong place in his gut.

因为肠漏，他的免疫系统现在处于混乱状态，反应过度了。

And because of the leaky gut, his immune system was now confused, overreacting.

所以我 basically 给他制定了一个修复小肠细菌过度生长和肠漏的方案。

So I basically treated him by putting him on a protocol to heal the SIBO and the leaky gut.

这个方案持续了三个月，用到了我们今天讨论过的所有方法。

So it was a three month protocol doing everything we talked about today.

为了帮他缓解这段时间的症状，我让他采用了低组胺饮食。

And to help with his symptoms during that time, I put him on a low histamine diet.

很多人在这儿容易搞混，以为治疗组胺不耐受就是吃低组胺饮食。

Now, this is where a lot of people get confused, and they think that the treatment for histamine intolerance is a low histamine diet.

那组胺不耐受的治疗方法是什么呢？

What's the treatment for a histamine intolerance then?

治疗的关键在于找到根本原因，清理那些有害的东西。

The treatment is really getting to that root cause, cleaning up those weeds.

所以这和我们一直反复讨论的让肠道环境恢复健康的方案是一样的。

So it's like the same protocol we've been talking about over and over to get the gut environment healthy again.

为了帮助恢复，你只是降低自己的组胺摄入，给肠道一个恢复健康的机会。没错。

And in order to help it, you're just lowering your own histamine intake to give your gut a chance to get healthy Exactly.

因为我觉得有一点很重要，就是你不是在说这些食物不健康。

Because one of the things that I think is important to say is you're not saying these foods are unhealthy.

你是说，根据你的肠道系统以及肠道可能出问题的四种方式，即使是很健康的食物也可能造成大问题，因为你的肠道环境……所以当你推荐低组胺饮食时，并不是因为其他食物不健康。

You're saying that based on your gut system and what's off in those four ways your gut can be off, foods that are really healthy can wreak havoc because your And gut environment's so when you recommended a low histamine diet, it's not because the other stuff was unhealthy.

而是因为他的肠道无法耐受，因为肠道本身不健康。

Because his gut couldn't tolerate it because the gut was unhealthy.

没错。

Exactly.

明白了。

Got it.

好的。

Okay.

医生。

Doctor.

Rajsree，你的甲状腺和肠道是怎么关联的呢？

Rajsree, how are your thyroid and gut connected?

我们的甲状腺是脖子上那个蝴蝶形状的器官。

So our thyroid is that butterfly shaped organ in our neck.

它基本上通过肠-甲状腺轴和你的肠道连接在一起。

And it's basically connected to your gut through the gut thyroid axis.

所以甲状腺会影响肠道，肠道也会影响甲状腺。

So your thyroid can affect your gut and your gut can affect your thyroid.

那我们来聊聊甲状腺影响肠道的方式有哪些。

So let's talk about the ways that the thyroid can affect the gut.