Dear Doctor: My big New Year’s resolution was to get my gut into better shape. I’m not talking about a flat stomach -- after having three kids, that ship has sailed -- but about the gut microbiome. Do I need to take probiotics?

Dear Reader: Considering the abundance of foods and drinks with which many of us celebrate the weeks between Thanksgiving and Jan. 1, the new year is a logical and appropriate time for a gut reset. And, yes, we’re talking about the gut microbiome here, which is the collection of trillions of microorganisms that call our digestive tracts home. These include the vast and varied colonies of bacteria, fungi, protozoa, friendly viruses and other microbes that interact with our bodies and, in many cases, help to keep us healthy. Research into the microbiome continues to uncover the many ways in which gut health plays a role in general health, including how it affects processes as varied as the immune system, blood sugar regulation, the cardiovascular system, cholesterol, weight and even mental health.

The good news is that, with several simple lifestyle choices, you can improve your gut health. To understand how, we should define two important terms -- the probiotics that you mention and another equally important piece of the gut microbiome puzzle, prebiotics. Probiotics is the word we use to describe the good microbes living in our guts. A wide variety of types and strains of probiotics are now available as dietary supplements, and in food sources such as yogurt, kefir and naturally fermented foods and drinks. The jury is still out as to whether or not probiotic supplements are actually helpful in achieving and maintaining gut health.

Perhaps more important are prebiotics. These are a type of indigestible carbohydrate that are found in fiber-rich foods, including fruits, vegetables, seeds, beans and legumes. Prebiotics pass through the digestive system and arrive in the colon largely intact. There, they provide a food supply for the all-important probiotics living in our gut. In order to support your microbiome, it’s important to eat a wide range of fresh fruit, vegetables and other prebiotics.

In addition to what you do eat, gut health depends on steering clear of certain foods. Unfortunately for those of us with a sweet tooth, recent studies have shown that a high intake of simple carbohydrates in the diet can tip the balance of gut bacteria to specific types of microbes associated with low-grade inflammation. That’s pretty much the opposite of what you’re trying to achieve. The occasional sweet treat won’t wreak havoc on the gut, but people who regularly eat a lot of sugar or highly processed foods need to rethink their diets.

Gut health isn’t all about food. Studies have found that, just like our hearts, bones, muscles and mood, the denizens of our gut microbiomes respond positively to exercise. A study published in 2017 found a link between exercise and the bacteria that support weight loss. Add in adequate sleep and managing stress, and you’re on your way to a healthier gut in 2021.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Is it true that grief can make you get physically sick? My mom passed away just before Thanksgiving, and I’ve been struggling with my health. I’m having headaches, I’ve had an eczema flare and I caught the first cold I’ve had in three years.

Dear Reader: We have only to look to language to see how closely grief and bereavement are associated with physical pain. Heartsore, heartsick, heartache, brokenhearted -- each word draws a direct line between the emotion of grief and its profound effect on the human body. People who are grieving talk about feeling empty and numb, of being sick with grief. And small wonder. Research shows that, in addition to being an emotional challenge, grief and grieving can indeed take a physical toll on the human body. The sense of loss and longing that are a part of grief often manifest themselves as physical sensations, including a tightness in the throat and chest; a hollow feeling in the solar plexus; physical weakness; aches and pains; lack of energy; and changes to appetite and sleep patterns.

Research into the physical effects of grief suggests that the immune system gets involved by mounting an inflammatory response. A study of older adults who were grieving found the effectiveness of certain white blood cells, which fight off infection, to be measurably reduced. A different study, published in the journal Circulation, found that the day after a significant death, a grieving survivor’s risk of having a heart attack was 21 times higher than normal. A week later, the risk was 6 times as great. The psychological pain of grief can put your physical health in jeopardy.

Another reason grief can be so difficult to endure is that, in addition to being a state of body and of mind, it also is a process. The famous “five stages of grief” theory, which includes denial, anger, bargaining, depression and acceptance, suggests an orderly and linear progression. However, reality is far more complex. People can find themselves experiencing multiple stages of grief at one time and revisit them repeatedly.

Grief is classified into two distinct types, acute and persistent. Most people experience the former, which lasts about a year and gradually resolves. In persistent grief, the feelings and symptoms last far longer. Although there’s no quick way out of the physical and emotional pain of mourning a loss, research suggests specific steps can help make it bearable. First, do your best to maintain a healthy diet and get adequate sleep. Physical exercise, including mind-body practices such as yoga, tai chi and qi gong, is important. It can be hard to get motivated, so consider joining an exercise group or taking regular classes.

Be sure to reach out to your social circle. Grief is an isolating experience, and even one social interaction per day can lift your spirits. And consider a support group. The participants will understand what you’re going through. A support group can both show you a way forward and give you a chance to lend someone else a hand when you are able.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I would appreciate if you would talk a bit about eyelash mites. What are they, and how does someone get them? What is the best treatment to get rid of them?

Dear Reader: Eyelash mites, also known as Demodex mites, are a type of eight-legged parasite. They live in or near the hair follicles on the face and eyes and are found primarily near the eyelashes and the eyebrows. They have a short life cycle, about 14 to 18 days, during which they feed on the oils and dead cells that are found on the surface of the skin. At about three-tenths of a millimeter in size, Demodex mites are invisible to the naked eye. Under a microscope, however, you would see a semi-transparent body shaped somewhat like a cigar. Their eight legs are arranged in four pairs, which makes it easier for them to grasp tubular structures like an eyelash or an eyebrow hair.

It may be unsettling, but we all have a small number of these mites living in the folds and along the edges of our eyelids. They stay hidden in the hair follicles during the day and emerge at night to eat, lay eggs and excrete waste. The mites are part of our body’s natural microbiome, and by cleaning up dead skin cells and excess oils, they’re actually doing us a service.

As long as their numbers stay low, Demodex mites are harmless. But certain conditions, such as a blocked oil gland, which gives them an abundance of food, can cause the mites to reproduce in great numbers. Their populations also tend to increase as people age. When too many of these tiny parasites are present, they can lead to eye and skin problems. The most common is an inflammation of the eyelids known as blepharitis, or, more specifically, anterior blepharitis. When caused by mites, the condition occurs at the front edge of the eyelid, where the eyelashes emerge. Symptoms include red or dry eyes, swollen eyelids, sticky lashes, itching, burning or stinging, grittiness in the eyes and crustiness around the outer edge of the eyelid. An infestation of mites can also cause dry and itchy skin, and it can even damage the oil glands at the edges of the eyelids and the lashes.

To determine if blepharitis is being caused by eyelash mites, your health care provider will use a special magnifying instrument to examine the eyelid. They may also take a skin, oil or eyelash sample to examine under a microscope. Treatment of anterior blepharitis due to eyelash mites includes gentle and careful soaking and cleaning of the affected area, done several times per day. You may also be prescribed a medicated cream that will trap the mites and prevent them from mating. Throw away any eye makeup you may have used during the infestation. And, since they can spread from person to person, it’s important to never share eye makeup, particularly mascara. Infestations of eyelash mites can recur, so remain vigilant about eye hygiene in the future.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)