Dr. Saurabh Sethi MD MPH

Harvard & Stanford-trained Gastroenterologist • 4M+ Community • No Med Advice

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Gut doctor here

The gut-liver axis is real

and

What you eat at dinner tonight affects your liver by morning

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Liver doctor here

GLP-1 medications are showing real promise for fatty liver

and

Diet and fiber still do the heavy lifting long-term

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Gut doctor here

Colon cancer is one of the most preventable cancers

and

A simple screening test can catch it before it starts

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Liver doctor here

You can have fatty liver without drinking any alcohol

and

Ultra-processed food is now the leading driver

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Gastroenterologist here

Constipation is not just about drinking more water

and

Low fiber intake is the root cause in most cases

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Hi. Liver doctor here

Fatty liver has no symptoms in the early stages

and

By the time you feel it, damage is already done

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

⁠Hi. Gut doctor here

Bloating after every meal is not normal

and

It’s usually a sign your gut microbiome needs attention

Agree?

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Your bloating isn’t from ‘low stomach acid’ - this is a popular wellness claim with almost no clinical basis; most bloating is motility or fermentation-related, not acid-related.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Bloating after every meal isn’t ‘just IBS’- persistent post-meal bloating gets dismissed as IBS when it’s sometimes SIBO, gastroparesis, or pancreatic insufficiency - distinct conditions with different treatments.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Think gluten is the problem?

It might be fructans.

They're found in wheat, garlic, and onions—and can cause the same bloating.

Still bloated after going gluten-free? Check your garlic and onion intake.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Healthy meal. Bloated 30 minutes later?

It may not be the food.

Fast fermentation higher in the gut can cause gas and bloating.

The fix isn't less fiber - it's slower fermentation.

Think: smaller portions, cooked foods, acacia, or PHGG.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Pancreatic cancer used to be an older person’s disease.

Cases are now rising in younger adults - especially women - driven by obesity, diabetes, and smoking. 

Know your risk. Modify what you can. Catch it early.

That’s the only path to better outcomes.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Pancreatic cancer kills because it looks like everything else.

What gets missed:
Jaundice
Unexplained weight loss
Back and abdominal pain
New-onset diabetes
Light-colored stools 

New diabetes after 50 + weight loss = imaging. No exceptions.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Pancreatic cancer has a 13% five-year survival rate.

It’s the only major cancer still below 20%.

Here’s why - and what needs to change.

Most people are diagnosed too late for surgery.

Catch it early? Survival jumps to 46%. 

That gap is the whole story.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

70,000 Americans are diagnosed with pancreatic cancer each year. Most learn too late.

This week at ASCO, a daily pill nearly doubled survival for advanced patients.

For a cancer with almost no good options, that’s huge.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Pancreatic cancer has a ~3% 5-year survival rate once it spreads.

Now a daily pill, daraxonrasib, cut the risk of death by 60% in metastatic disease.

Median survival: 13.2 vs 6.7 months.

Not a cure. But real progress against one of medicine’s toughest cancers.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Breaking: Daraxonrasib just became the first pill to double survival in advanced pancreatic cancer. 13 months vs. 6 on chemo. Not a cure - but the biggest leap this disease has ever seen.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Chia seeds don’t get enough credit for what they do in your gut.

The fiber ferments slowly.

That’s exactly what your microbiome wants.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Everyone is optimizing breakfast for protein.

Nobody is optimizing it for fiber.

Your gut is still waiting.

[Dr. Saurabh Sethi MD MPH @doctorsethimd]

Yogurt for breakfast sounds like a gut health win.

Check the sugar content first.

Most commercial yogurts have more sugar than a candy bar.