Three Critical Don’ts for Digestive Health, According to a Leading Gastroenterologist
Digestive wellness isn’t just about what you do—it’s equally important to know what you should avoid. Dr. Joseph Salhab, a widely followed gastroenterologist known as “thestomachdoc,” recently highlighted three practices he avoids in his own life and urges patients to consider as well. His guidance aligns with current research on constipation relief, NSAID use, and swallowing difficulties, all of which can impact long-term digestive health.
Don’t rely on Colace for constipation relief
One of the most talked-about takeaways from Dr. Salhab’s message is to avoid Colace, a laxative whose active ingredient is docusate sodium. He notes that studies have shown Colace performs no better than a placebo in softening stool or easing constipation for many people. For those struggling with regularity, experts increasingly emphasize approaches with clearer evidence of benefit—such as increasing dietary fiber, hydration, and physical activity. Foods rich in soluble fiber, including kiwi, can support softer stools naturally. Psyllium husk, a well-studied fiber supplement, is often recommended as a first-line option when dietary changes aren’t enough. If constipation persists, a clinician can tailor a plan based on symptoms and underlying causes rather than relying on a laxative with limited proven advantage over placebo.
Limit long-term NSAID use (Ibuprofen, Naproxen)
The second caution from Dr. Salhab focuses on long-term NSAID use, such as ibuprofen and naproxen. While these medications are effective for pain relief, they carry well-documented risks to the digestive tract. NSAIDs can irritate the stomach lining and contribute to ulcers, bleeding, and even perforation in severe cases. They also have blood-thinning effects that can complicate gastrointestinal health, especially in individuals with preexisting conditions. If chronic pain management is needed, discussing alternatives and a plan with a healthcare provider is essential. Options may include acetaminophen, topical treatments, or other non-NSAID strategies, depending on the individual’s health profile. Regular review of medication lists with a clinician can help minimize unnecessary digestive risk while maintaining quality of life.
Never ignore swallowing problems
The third warning is clear: swallowing difficulties should not be ignored. Persistent trouble swallowing food or pills can signal underlying issues that merit investigation. Dr. Salhab recommends pursuing diagnostic testing when swallowing symptoms arise, with an Upper Endoscopy (esophagogastroduodenoscopy) being a commonly used tool to visualize the esophagus, stomach, and the first part of the small intestine. Early identification of problems such as structural narrowings, motility disorders, or ulcers can prevent complications and guide effective treatment. If you notice symptoms like coughing during meals, frequent choking, or a sense that a food bolus “gets stuck,” seek medical evaluation promptly rather than waiting for symptoms to worsen.
What the science says
These recommendations echo findings from major studies. For instance, reviews in gastroenterology literature have questioned the efficacy of certain laxatives like docusate for constipation relief, highlighting a lack of superiority over placebo in many patients. Separately, research on NSAIDs consistently demonstrates potential gastrointestinal risks, reinforcing the importance of cautious use and alternative therapies when possible. Regarding swallowing difficulties, evidence-based practice supports timely endoscopic assessment when alarm symptoms or persistent dysphagia are present, as early intervention often improves outcomes.
Practical takeaways for daily life
To support digestive health without relying on uncertain shortcuts, consider these practical steps:
– Increase fiber intake through fruits, vegetables, and whole grains; add psyllium if advised by your clinician.
– Stay hydrated and engage in regular physical activity to promote bowel regularity.
– Use NSAIDs sparingly and under medical guidance; explore safer alternatives for chronic pain management.
– If you experience swallowing difficulties, schedule an evaluation, and discuss endoscopic testing as appropriate.
– Talk with a healthcare provider about personalized strategies, especially if you have a history of ulcers, bleeding disorders, or other digestive health concerns.
In a landscape saturated with quick fixes, Dr. Salhab’s three don’ts offer a thoughtful framework for protecting your digestive system—grounded in patient safety and current medical evidence.
