Gut Health Matters

So why a talk about the gut?

Next to the common cold, digestive problems are the most common reason people seek medical attention. In fact, two of every three people have had a digestive problem in the past three months.

Modern science has found that the majority of our body’s immune system originates in the digestive system — 60-70% according to some estimates. The problem is that colonic and immune functions decline with age, contributing to disease throughout the body.

So what exactly is the gut?

The word gut is usually referring to the small and large intestine which is a part of our digestive system. Understanding how the gut works can help us keep things running more smoothly.

The Digestive System consists of the following:

  1. The mouth – breaks food down into manageable pieces and starts the digestive process
  2. The esophagus – here, powerful, rhythmic muscular contractions push food down to the stomach
  3. The stomach – the food mixes with gastric juices for a few hours. Enzymes break down most of the proteins and acid kills off the majority of bacteria. The resulting thick liquid passes slowly into the small intestine.
  4. The small intestine – food particles move along this intricate tubing (about 6 meters long) and are broken down into simpler molecules, of carbohydrate, protein and fat. These are then absorbed into the blood stream.
  5. The large intestine – the remaining food particles spend 12-48 hours here. Here, water and minerals are absorbed while bacteria break down undigested food particles.
  6. The pancreas – not strictly part of the digestive system but secretes an alkaline juice which neutralizes stomach acid, and enzymes that break down protein, fat and carbohydrates.
  7. The liver – the chemical factory and warehouse of the body. Receives nutrients from the gut via the blood.
  8. The gall bladder – concentrates bile and squeezes it into the small intestine, where it helps to digest fat.

How do you know if your gut is in need of help? Do you have any of these symptoms? Remember symptoms are the roadmap to the origin or cause of disease.

  • Abdominal cramping or pain
  • Diarrhea, constipation or
    alternating bouts of both
  • Bloating
  • Gas
  • Mucus in the stool
  • Indigestion
  • Fatigue
  • Chronic skin conditions

Digestive problems contribute to the following disorders:

  • Irritable bowel syndrome
  • Gastroesophageal reflux (heartburn)
  • Crohns disease
  • Ulcerative colitis
  • Allergies/Sinusitis
  • Cancer
  • Rheumatoid arthritis
  • Psoriasis
  • Eczema
  • Lupus
  • Scleroderma
  • Autoimmune disease
  • Fibromyalgia

Our bowel movements tell us a lot about our overall health:

The color, consistency, and smell of stools say a lot about our health, and, of course, our diet.

What is constipation?

Constipation equals infrequent or difficult bowel movements, usually characterized by small, hard, dry stools that are difficult to pass. There may also be straining during elimination, abdominal discomfort or pain, bloating and an uncomfortable sensation of a full bowel.

Four most common causes of constipation and what to do about them.

Problem 1: Dehydration.

The large intestine plays a primary role in water balance and excretion. As food makes its way through the large intestine, the intestine absorbs water from it and stools form. By the time the stool reaches the rectum, most of the water has been absorbed and the stool becomes harder.

Solution: Make water your beverage of choice. Water is the most healthful beverage, Talk with your Physician about how much water is right for you.

Problem 2: Inadequate fiber intake.

Fiber is the part of grains and produce that the body cannot digest. It adds bulk to stool and keeps it soft, making stools easier to pass. Fiber also stimulates the production of healthy flora in the gut, moves food efficiently through the digestive tract, and binds and transports bile acids and cholesterol for excretion out of the body.

Most of us do not get enough fiber in our diets. The average American consumes 5 to 14 grams of fiber a day, even though experts recommend 20 to 35 grams.

Solution: Increase fiber intake.

Eat a well-balanced, high-fiber diet with plenty of complex carbohydrates.

When you need extra help…

Oat bran (which increases the bulk of stool and softens the stool).
Glucomannan (which absorbs and binds components within the bowel movement).

Problem 3: Inadequate peristalsis.

Peristalsis consists of a series of smooth muscle contractions in the digestive tract.These contracting waves move food along through the large intestine. Inadequate levels of calcium and magnesium can lead to inadequate peristalsis and consequent constipation.

Solution: Take magnesium and calcium supplements, which support the lining of the gastrointestinal tract, allowing for optimal absorption of nutrients. This also helps maintain a balanced microbial population in the gut. A lack of bulk from low fiber can also lead to inadequate peristalsis since the bulk stimulates natural contractions.

Problem 4: A salt imbalance.

People on low-sodium diets can have problems with constipation, Sodium is an important mineral that helps regulate the body's fluid balance.

Solution: Adjust your salt intake. Discuss with your physician what your salt intake should be.

What not to do:

Most people with constipation don't need strong medication. Over time, laxatives become habit-forming, as the body comes to rely on them in order to have a bowel movement.

Other causes of constipation to consider:

May occur as a side effect of medications. Symptom of a disease such as a neurological disorder (multiple sclerosis) or metabolic or endocrine condition (diabetes or hypothyroidism). Not exercising enough can lead to constipation.

Diarrhea

Everyday things such as food, medication, or stress can cause diarrhea. However, diarrhea sometimes may signal an underlying medical condition.

Will fiber help my diarrhea?

Fiber is your friend. If you're battling chronic diarrhea, constipation, or both, you need plenty of high-fiber foods. Fiber is a stool regulator and a stool normalizer. Like a sponge, fiber works by soaking up water. Fiber also adds bulk to the stool.

Soluble vs. Insoluble Fiber

Soluble fiber dissolves in water. Insoluble fiber does not. Soluble fibers attract water and form a gel, which slows down digestion. Soluble fiber delays the emptying of your stomach and makes you feel full, which helps control weight. Slower stomach emptying may also affect blood sugar levels and have a beneficial effect on insulin sensitivity, which may help control diabetes. Soluble fibers can also help lower LDL (“bad”) blood cholesterol by interfering with the absorption of dietary cholesterol.

Sources of soluble fiber: oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran, strawberries, nuts, flaxseeds, beans, dried peas, blueberries, psyllium, cucumbers, celery, and carrots.

Insoluble fibers are considered gut-healthy fiber because they have a laxative effect and add bulk to the diet, helping prevent constipation. These fibers do not dissolve in water, so they pass through the gastrointestinal tract relatively intact, and speed up the passage of food and waste through your gut.

Sources of insoluble fiber: whole wheat, whole grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, zucchini, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, green beans, dark leafy vegetables, raisins, grapes, fruit, and root vegetable skins.

Are floating stools healthy?

According to the National Institutes of Health, healthy stools typically sink. However, floating stools do not necessarily mean that there is a problem. Usually, floating stools result from nutrient malabsorption that can lead to excess flatus (a.k.a. gas), which makes the stool less dense and thus allows it to float. Nutrient malabsorption occurs when the body does not completely digest and absorb nutrients from the gastrointestinal (GI) tract. When more food is digested by bacteria in the lower intestine, more gas is produced that needs to find a way out either via farting or via floating stools.

Having diarrhea and floating stools for more than two weeks may be a sign of nutrient malabsorption. Alternative explanations for floating stools include a change in diet, diarrhea, acute GI infections, and diseases such as celiac disease.

What is IBS exactly?

Unlike more serious intestinal diseases such as ulcerative colitis and Crohn's disease, IBS does not increase the risk of colorectal cancer, and in most people the symptoms are mild. The primary characteristic is a gastrointestinal disturbance. Everyone has digestive disturbances at times. Do all you can to moderate your dietary habits to support good digestion... but, if IBS symptoms are a chronic problem, see a trained medical professional to help you resolve it.

Even if you are already working with a Gastroenterologist you may want to consider adding a Naturopathic Doctor to your treatment team, as there are a number of safe, natural and effective steps your ND can recommend to get your system moving in the right direction again.

Common symptoms of IBS include...

  • Abdominal cramping or pain
  • Diarrhea, constipation or alternating bouts of both
  • Bloating
  • Gas
  • Mucus in the stool

These sorts of intestinal symptoms have been labeled IBS, this doesn't mean medication is the best or the only answer. In fact, taking pills may cause a need for other ones, because they so often generate side effects.

It's worth noting that the medications specifically approved for IBS, Alosetron Hydrochloride for diarrhea and Tegaserod Maleate for constipation, have serious side effects, including even more severe constipation or diarrhea and decreased blood flow to the colon. This may lead to even more digestive problems and diseases. Sometimes medication may prove necessary, but often you'll do better to identify and address the underlying causes of the digestive problem.

The proper functioning of your digestive system has an awful lot to do with what you put in your mouth, what happens to it before it reaches the large intestine, and whether you have the appropriate balance of bacteria in your large intestine.

Suggestion to Help with IBS:

Be picky about what you eat and drink. Avoid sodas and other sugary treats, caffeine, alcohol and fried or processed foods, all of which impede digestion. Try to eat more whole foods, healthy fats (e.g., found in salmon, olive oil, avocado, nuts and seeds) and complex carbohydrates, such as whole grains and steamed veggies.

Monitor food combinations, as these directly influence how quickly and efficiently food is digested. For example, don't combine "white" foods (such as white sugar, white flour, white bread, white potatoes, etc.) with saturated fats (for example, red meat or dairy products). Taken together, these can require as long as two to three hours to digest, during which time microorganisms in the food can colonize the stomach lining and cause digestive disturbances.

Keep fluids with meals to a minimum, and chew food thoroughly. The natural process by which saliva is added to food as it is chewed, to break it down thoroughly in the mouth, sets the rest of the digestive process in motion. Washing down food with water or other beverages turns out to be counter-productive. Fluids may also dilute stomach acid, making digestion less efficient.

Digestive Enzymes may be needed.

If you are 35 or older, consider taking supplemental digestive enzymes. Since aging tends to diminish our digestive enzymes, taking them as a supplement helps the body break down foods into compounds that make nutrients easier to digest, and also work to decrease the number of colonized microorganisms in the stomach.

Consider HCL or Hydrochloric acid supplements to aid digestion and nutrient absorption. Try the Apple cider vinegar test at home to assess need.

Probiotics and Their Role in Gut Health

The word probiotic tells us what these supplements do. Pro means for, and bios means life. Probiotic literally means “For Life”, a very apt description of what these friendly bacteria do for us.

Do probiotics treat dysbiosis?

Yes, dysbiosis is a term used to describe an unfavorable balance of good bacteria to bad bacteria. In addition to the symptoms already mentioned, frequent cold and flus can be an indication of an unhappy gut or dysbiosis.

Our immune systems are supposed to prevent disease-causing microbes (bacteria, viruses, parasites, and fungi) from invading our bodies. When microbes manage to get inside, the immune system is responsible for hunting them down and destroying them.

We also depend on our immune systems to protect us from illnesses that begin inside us, from either single cells (cancer) or mixed up messages (allergies and autoimmune disease).

We need our immune systems to support robust colonies of the friendly bacteria Lactobacillus and Bifidobacterium to help protect us from staph infections, colds, cancer, and allergies.

Wait a minute doesn’t bacteria cause disease?

All bacteria (there are at least 1,000,000 species!) are one-celled organisms that live in huge groups called colonies. Some bacteria, like Group A Streptococcus, are well-known for their ability to make us sick. These are the bacteria that cause impetigo, rheumatic fever, and those dreaded and painful strep throat infections.

The overwhelming majority of bacteria, however, are harmless to humans and some are exceedingly beneficial. Lactobacillus acidophilus, Lactobacillus plantarum, Bifidobacterium longum, and Bifidobacterium lactis are some of the best known and most effective friendly bacteria.

What exactly do the friendly bacteria do?

The probiotics Lactobacillus acidophilus and Bifidobacterium longum act like school teachers. An important part of their day is spent making sure that the colonies of friendly bacteria in the intestinal tract do their best to stay strong, stable, and balanced.

L. acidophilus and B. longum remove the disease causing bacterium that are living in the colonies and allow the friendly bacteria to thrive. Certain strains of probiotics can increase our White Blood cell counts, which helps us to ward off disease. Studies have shown that L. acidophilus and B. longum can reduce cold symptoms and in lab studies, they are able to shrink cancerous tumors.

They also prevent the diarrhea that is common when taking prescribed antibiotics for an infection. Probiotics must be taken 3-4 hours away from any antibiotic! The frequent use of antibiotics has dramatically increased the incidence of Clostridium difficile, a microbe responsible for a serious infection of the lower intestinal tract.

What is lactoferrin and why is it in my probiotic formula?

When we break down the word lactoferrin it provides us with an excellent understanding of what it can do for our health. From the Latin lacto, or milk, and ferrin, which means iron - we get lactoferrin, an iron-binding protein that is found in milk. Lactoferrin has a unique affinity to iron, allowing it to bind to the nutrient. Numerous strains of pathogens need an iron-rich environment to reproduce. Lactoferrin limits the availability of iron to bacteria in the intestines.

Breast milk is an excellent source of lactoferrin with about 125 mg per cup. However, human colostrum, or first milk, is rich in lactoferrin with a whopping 875mg per half cup. Colostrum is the thick yellow fluid that comes in before breast milk and rapidly activates the immune systems of newborn babies to get them revved up and running well. Lactoferrin is also present in other bodily fluids, including tears, nasal secretions, saliva, bronchial mucus, gastrointestinal juices, vaginal mucus, and semen.

When taken together, lactoferrin and the probiotics provide a synergistic effect (synergism occurs when two or more nutrients work together to create a more powerful effect than they could alone) to the immune system. However, in order for the probiotics and lactoferrin to reach the small intestine (where nutrients are digested and released into the bloodstream), they must be able to survive the trip through the harsh stomach fluids.

What should I look for in a probiotic supplement?

Make sure they haven’t been exposed to air, sunshine, artificial light, or moisture. In addition, probiotic bacteria and lactoferrin need to be protected from the digestive juices and enzymes in the stomach.

Read the label: Try to determine what type of delivery system the manufacturer is using. Reputable probiotic supplement makers will guarantee that the bacteria will reach the intestines alive, vibrant, and raring-to-go. On the label, look for “cfu units guaranteed per capsule through expiration.”

Multi-strain: It’s important to have at least two Lactobacillus and two Bifidobacterium strains in the probiotic you take. You need to take a multi-strain, high potency, acid-proof probiotic that contains specific prebiotics. Lactobacilli colonize the small intestine while Bifidobacteria do best in the colon. Having both types assures that the entire intestinal tract gets covered.

High Potency: It’s important to get at least 10 billion CFU (colony forming units) per dose in the probiotic you take. More is better and 20 billion CFU is a particularly effective dose.

Acid-Proof: It’s critical that probiotics survive passage through the acidic stomach and make it into the intestinal tract alive. Sodium alginate is a safer coating than most enteric acid coatings which contain a polymer of acrylic acid, a synthetic chemical. High potency means nothing without stomach acid protection – up to 99.99% of unprotected probiotics are killed after 60 minutes in stomach acid.

Do I need prebiotics?

Prebiotics complement the action of probiotics. They are a class of nutrients that help immune-supporting bacteria to proliferate in the colon. Prebiotics are either long chain carbohydates that only probiotics utilize or special nutrients and growth regulators that give probiotics a selective advantage. Scientists have found that complex carbohydrate molecules rank among the most effective of pre-biotic nutrients.

Prebiotics Include:

  • Inulin
  • FOS: fructooligosaccharides
  • mannosoligosaccharides
  • arabinogalactans
  • Guar gum

Lactoferrin is another type of prebiotic that gives probiotics a select advantage by working synergistically with probiotics.

Research is revealing more and more about specific indications of probiotic strains and types:

Bacillus Coagulans actually produces spores which are amazingly proving to have some interesting health benefits. Typically spore-forming bacteria are something to avoid at all cost. For example, Clostridium botulinum (the organism that causes botulism) can cause food poisoning and death. But instead of damaging health, recent research suggests Bacillus coagulans can reduce cholesterol.

In a published clinical trial, hyperlipidemic adults who supplemented with Bacillus coagulans for three months experienced reductions in total cholesterol and low-density lipoprotein (LDL), along with increases in beneficial high-density lipoprotein (HDL).

Recently, Bacillus coagulans has been recommended by Mehmet Oz, MD, and Michael Roizen, MD, in their book YOU: The Owner’s Manual, Updated and Expanded Edition. Their probiotic of choice: a daily dose of 2 billion cells Bacillus coagulans (the amount found in a typical capsule).

What if gas or constipation worsens once starting a probiotic?

Remember this: Every individual has a unique microflora within their intestinal tract, some gastroenterologists believe it can be as discerning as a fingerprint.It should not be surprising that finding the perfect probiotic dose program may take a bit of trial and error.

Most of these reactions are versions of what doctors call the Herxheimer reaction. When a high potency probiotic is taken for the first time it may cause rapid die off of undesirable microorganisms such as Candida which the body needs time to eliminate. Usually Herxheimer symptoms clear up in several days and the intestinal tract gets back to a healthy balance with probiotics in control.

Remember, probiotic products that are not protected from stomach acid rarely cause any reactions since they are essentially dead by the time they enter the intestinal tract. 99 - 99.99% of unprotected probiotics are killed after 60 minutes in pH 1.6 stomach acid!

Do I have Food Sensitivities?

Food allergies are more common than most people think, and can cause of a host of health complaints. It is estimated that up to 20% of the population have adverse reactions to foods.

The most common types of food sensitivities include: dairy, wheat, gluten, eggs, soy, corn, and sugar. You’re probably most familiar with a peanut or shellfish allergy, which triggers a specific type of allergic reaction called an IgE antibody reaction. This reaction can trigger anaphylactic shock, a life threatening reaction where the airways swell shut.

Doctors diagnose the IgE allergies with a blood test or scratch testing. In the world of food sensitivities, we are working with IgG reactions. IgG reactions can also occur where a person reacts to a food anywhere between 4-72 hours after ingestion.

Typical food sensitivity reactions:

  • Asthma
  • Eczema,
  • Constant runny nose (allergic rhinitis)
  • Hives
  • Digestive symptoms like vomiting, abdominal pain. diarrhea, or flatulence
  • Joint pain
  • Fatigue
  • Headaches
  • Difficulty concentrating
  • Moodiness or behavior extremes
  • Obesity

What is an elimination diet?

Some physicians do elimination/challenge testing, where you stop eating all the most common allergens for at least three weeks, and then add them back one at a time to see if symptoms occur. Each common food sensitivity is re-introduced three times in one day, while avoiding all of the other common food sensitivities. Symptoms are then watched for four days.

This can work well if you are allergic to the things that were eliminated. But if you just have a rare allergy, the elimination test isn’t effective, and only a blood test will likely pick it up.

Celiacs Disease – A Range of Symptoms.

Foods can also trigger different immune systems in different ways, causing many different symptoms and making them difficult to diagnose. For instance, celiac disease is often thought to be a food allergy to gluten, which is a protein found in wheat, rye and barley. Celiac is actually a genetic autoimmune disease, and is an IgA and IgG antibody reaction to food.

The National Institutes of Health estimates that around two million people in the United States have celiac disease, or about one in every 133 people, and more than 95 percent of people with the disease remain undiagnosed.

The possible symptoms of celiac disease range from none (asymptomatic celiacs), to diarrhea, weight loss, weakness, and fatigue (also called classic celiac disease). All forms of celiac cause damage to the lining of your intestines. They can also cause liver damage, anemia, and osteoporosis, all of which can be subtle enough that you don’t actually feel them.

There is also atypical celiac, which is the most common form of the disease. Atypical celiac can have a range of symptoms, and is therefore much more likely to go undiagnosed. The symptoms of this can vary from migraines to constipation, but is usually affects the immune system, digestive system or nervous system.

Celiacs can also cause Dermatitis Herpetiformis, an itchy skin rash that can affect any part of the body. For some it looks like facial acne and for others it can look like eczema.

There are three parts to the diagnosis of celiac disease:

  1. Blood work, which includes Tissue transglutaminase IgA, anti endomysial IgG, anti gliaden IgA and IgG and total IgA.
  2. Small intestinal biopsy.
  3. The response to the gluten free diet.

The treatment for celiacs disease, a Gluten free diet, has to be strictly followed for life. Treatment also involves reversing any nutritional deficiencies that may have developed as a result of the damage to the small intestine, which is where we absorb nutrients from our food.

What is a leaky gut?

When the digestive system degrades to a certain point, it is called “leaky gut.” A leaky gut is usually diagnosed if a person tests for multiple food sensitivities. A leaky gut is a breakdown of the lining in the intestine which leads to increased permeability.

Leaky gut is associated with so many health problems: allergies, multiple chemical sensitivities, delayed food sensitivities (not Type I anaphylactic allergies that close airways), chronic fatigue, fibromyalgia, joint pain, headaches, foggy mindedness, eczema, acne… ect. Treatment revolves around avoiding offending foods and repairing the gut:

  • Glutamine supplementation
  • Mineral Support: Zinc, Calcium and Magnesium

In conclusion, remember that your gut is as unique as your fingerprint and that there is no one size fits all in medicine. Always trust your gut instinct while exploring your path to wellness!