Held on 28th November 2021, the National Foundation for Digestive Diseases (NFDD) organized a public symposium titled ‘COVID-19 & Digestive Health’ during the 31st NFDD Day, with Miraco Nutripharm as the supporting partner. To accommodate a wider audience, the symposium was held in both English and Chinese languages. It was an exciting event with 501 participants joining the English session and 202 participants at the Chinese session. Miraco Nutripharm also helped with the publicity of the event by putting up social media advertisements, providing Pro-GutTM probiotic samples to the registrants and sharing about the event with our partners on our social media platforms.
The public health symposium kicked off with a welcome speech from the NFDD Chairman, Clinical Associate Professor George Goh. He introduced the National Foundation for Digestive Diseases (NFDD) as a Singaporean organization dedicated to promoting education, advocacy and support about digestive health to the general public. Clinical Associate Professor George Goh went on to raise the issue of the exacerbation of digestive problems during the COVID-19 pandemic outbreak and shared that the relevant topics lined up for the symposium would help to strengthen the public’s knowledge on gut health.
The health talk started off with Professor Gwee Kok Ann, a Gastroenterologist from Gleneagles Hospital, who shared about how the COVID-19 virus affects the gut and liver. He stated that close to 20% of COVID-19 patients develop digestive symptoms such as diarrhea, loss of appetite, nausea, vomiting and abdominal pain. Professor Gwee added that COVID-19 can also worsen symptoms of Irritable Bowel Syndrome (IBS). Due to the boom of home-baking trend in Singapore due to the pandemic, Professor Gwee mentioned that the baked goods containing certain wheat and fruits are high in Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs). FODMAPs have been linked to worsening digestive symptoms of IBS such as bloating, diarrhea and abdominal pain as they are poorly absorbed by the small intestine.
Professor Gwee moved on to how COVID-19 can affect the liver. He stated that fatty liver is a risk factor for severe COVID-19 infections due to the other metabolic disorders that usually come with it such as obesity, diabetes and hypertension. Professor Gwee also acknowledged the negative effects of working from home and home-based learning on the physical and mental health of the public because of reduced physical activity as well as increased screen time. Professor Gwee encourages the public to be vaccinated against COVID-19 by explaining that the side effects from the vaccinations are mild compared to the symptoms of getting the actual virus.
The next speaker, Dr Jonathan Lee, Consultant from the Gastroenterology and Hepatology Department in National University Hospital (NUH), shared about the role of gut microbiome in gut and liver disease. He explained that the human microbiome are microscopic living organisms largely found in our gut and work in a mutually beneficial relationship with our body. Dr Jonathan Lee went on to add that the microbiome is important to our bodies’ metabolism, mood and behavior as well as immunity. Dr Jonathan Lee emphasized the phrase ‘You are what you eat’ and proceeded to elaborate that our diet can alter the microbiome in our body. A bad diet can lead to a less than ideal microbiome which may cause more harm than good. Dr Jonathan Lee added that it is also important to include live bacteria (available in fermented foods and probiotics) in our diet on top of high fiber foods to improve our gut microbial composition and functions.
Dr Jonathan Lee also said that poor dietary choices can contribute to a leaky gut. This is because the microbiome that lacks good nutrients may start to digest the important mucus lining of the intestine, which may then lead to NonAlcoholic Fatty Liver Disease (NAFLD). NAFLD is a condition where fat builds up in the liver, in people who drink little or no alcohol. Aside from that, Dr Jonathan Lee talked about how the microbiome plays an important role in our mood and behaviors. Did you know that 90% of the body’s serotonin or ‘happy hormones’ actually come from the gut? Thus, having a healthy gut helps to maintain healthy levels of serotonin. Lastly, he shared about a research where severe COVID-19 patients have missing key gut microbes, which leads to the conclusion that a healthy gut microflora may be important in helping with our immune systems. Dr Jonathan Lee ended his presentation by saying that we can improve our bodies’ microbiome through exercising, having a good diet, and also taking probiotics and prebiotics.
The third speaker, Ms Hazel Yeong, Senior Dietician from Khoo Teck Puat Hospital (KTPH), talked about the importance of healthy food for the gut and liver. She stated that good nutrition helps to maintain a healthy weight, delays ageing, provides protection from chronic diseases, strengthens the immune system and supports good well-being. One of the important nutrients is probiotics, which are live bacteria that are beneficial for the body. She mentioned that the key benefits of probiotics include improving gut health, restoring a healthy microbiome, preventing gut infection and reducing gut inflammation. She added that probiotics also aid in food digestion, produce essential nutrients, eliminate harmful toxins and help prevent growth of bad bacteria.
Ms Hazel Yeong stressed that if you want to take probiotic supplements, it is important to look for a product that has live cultures and multiple bacteria strains to be effective. She also spoke about prebiotics which are essential food for gut microbes. Prebiotics help to promote growth of good bacteria and produce useful nutrients. She added that wholegrains, vegetables and fruits are also part of a healthy diet. Aside from that, Ms Hazel Yeong talked about the fatty liver and how it can lead to further liver damage. To prevent that, she advised participants to maintain a healthy weight, avoid alcohol, cut down on sugar and avoid fatty foods. Ms Hazel Yeong concluded her talk by giving tips for a healthy diet that include buying fresh produce, using less oil and salt in cooking plus keeping hydrated.
Ms Michelle Shi, Senior Clinical Psychologist from Singapore General Hospital (SGH), who was the last speaker, presented about stress and the gut. She explained that stress can lead to many symptoms which include gastric issues. Echoing what Dr Jonathan Lee from NUH shared, Ms Michelle Shi elaborated that the gut and brain interact very closely which is why it is important to maintain a healthy mental state for a healthy gut. She provided useful tips on stress management such as doing regular exercises, engaging in hobbies and practicing relaxation techniques. During the talk, Ms Michelle demonstrated an interesting relaxation technique - diaphragmatic breathing, which involves fully engaging the stomach, abdominal muscles, and diaphragm when breathing.
During the Chinese session, Professor Lee Yuan Kun from NUS Yong Loo Lin School of Medicine (YLLSoM), shared about how the gut microflora affects gut health. He started by talking about how the microbiome of a child at birth originates from the mother. He also added that there is a 2-year window from birth where probiotics can help to modulate the gut microbiome which can lead to health benefits such as preventing allergic diseases in infants. He continued on to say that the good bacteria in our digestive system helps protect from the bad bacteria through competition and advised the audience to take probiotic supplements to replenish their gut microflora if needed.
Next up was Dr Kewin Siah, Consultant Gastroenterologist from National University Hospital (NUH) and organizing chairman of this 31st NFDD day. Dr Kewin Siah shared about stress during COVID-19 and Irritable Bowel Syndrome (IBS). He stated that IBS affects 1 in 5 adults and is prevalent in all ages. Since we have established that the brain and gut are closely related, he said that stress can actually worsen IBS symptoms especially when most of us are working from home right now due to the pandemic. He used the gut-brain connection to further explain why some people may feel nauseous or experience abdominal discomfort when they are nervous, for example, before interviews or exams. He suggested useful ways to reduce stress by practicing diaphragmatic breathing or by engaging in hobbies you enjoy.
As the final speaker, Dr Frances Lim, a Colorectal Surgeon from Mount Elizabeth Novena Hospital, presented on the gastrointestinal symptoms of COVID-19. Aside from the usual respiratory symptoms, COVID-19 patients may also experience nausea or vomiting, anorexia, diarrhea and abdominal pain. Sometimes, gastrointestinal complications like liver injury, gallbladder inflammation and feeding intolerance may also occur. She then showed an alarming statistic that 1 in 10 COVID-19 patients in Singapore suffers from persistent symptoms even 6 months after infection. Dr Frances Lim stated that the pandemic has worsened digestive symptoms especially when we are less active and more stressed out. She urged everyone to keep healthy by eating well and exercising. She also added that you may approach your healthcare professionals for advice on diet therapies and stress management.
It was exciting to collaborate with NFDD on this online public symposium and even more so to share valuable knowledge on gut health with the community. We also learnt a lot about how COVID-19 affects our gut and liver, tips to cope with stress and ways to maintain a healthy gut. A big thank you to the specialist doctors, professor, dietician and psychologist for the informative sharing on these interesting topics that are especially relevant to the current COVID-19 pandemic.
Miraco Nutripharm is glad to be the supporting partner of this meaningful event related to gut health. We hope to promote health and wellness in the general public via health education and also through Pro-Gut™, our flagship brand of clinically developed probiotics containing 8 live probiotic strains and a prebiotic. Look out for more of our educational webinars and let us take charge of our health together.