Gastrointestinal Tract Function (GI Tract)
The gastrointestinal tract (GI Tract) is an organ system responsible for turning food into small molecules that our cells can use for energy, maintenance, growth, repair and waste products. Optimal function of these processes is the basis for good health. We assess the GI Tract function through history, physical examination and laboratory testing. The intensity of laboratory testing is driven by the person’s symptoms and health background.
“All disease begins in the gut”- Hippocrates
The human gut contains 10 times more bacteria than all human cells in the entire body. It is home to 100 trillion microorganisms, with colonies of bacteria found on all human surfaces such as the skin, the sinus cavities and the gums. A healthy gastrointestinal tract is important because it is the home to the “Enteric Nervous System (ENS)” commonly referred to as the “second brain.” The ENS manufactures 95% of the serotonin and 50% of the dopamine found in your body. These neurotransmitters have a profound impact on our mood and emotions. It is also home to the GALT (gut associated lymphoid tissue), which is considered to be the immune system of the gut. Two thirds of our immune system resides in our intestines. The GALT is responsible for regulating inflammation, infection and allergic reactions by determining what is friend and what is foe.
Dysbiosis occurs when the relationship between the microbe and host are impaired. Dysbiosis was coined by Dr. Elie Metchnikoff. It comes from dys-, which means “not,” and symbiosis, which means “living together in harmony.” Dysbiosis can be caused by medications like antibiotics or proton pump inhibitors, toxin exposure, endotoxins, poor diet such as excess fructose, food sensitivities and chronic stress. When the immune system is chronically activated because of dysbiosis, it weakens our ability to protect ourselves from disease promoting microbes and adversely alters our microbiome. There can be an overgrowth of unfriendly bacteria, fungi/yeast, or parasites that cause symptoms related to the GI tract.
Symptoms and Signs of Dysbiosis:
The classical symptoms are abdominal bloating, abdominal discomfort, and bowel pattern irregularity. As mentioned before, dysbiosis can contribute to health problems related to any system in the body.
• Psychological symptoms may include depression, Attention Deficit Disorder and hyperirritability.
• Neurological symptoms may include headache, dizziness and cognitive dysfunction (poor memory and or brain fog).
• Respiratory symptoms may include chronic rhinitis, chronic sinusitis, and asthma. Cardiovascular problems may include palpitations, arteriosclerosis and heart attack (the chronic inflammatory response may contribute to narrowing of the arteries or arteriosclerosis).
• Gastrointestinal (GI Tract) symptoms and diseases such as stomach ulcers, ulcerative colitis and Crohn’s disease are often associated with dysbiosis. When dysbiosis is not the direct cause of a disease, it can be a contributing factor in symptom severity and disease persistence.
• Female health problems include PMS, menstrual irregularity and infertility. There is a possibility that chronic yeast overgrowth contributes to problems such as endometriosis and fibroids. Chronic interstitial cystitis is often improved by normalizing the bowel flora.
• Male health problems such as chronic prostatitis. Abnormal growth of bacteria in the stomach may lead to stomach cancer. Abnormal patterns of bacteria in the colon may increase the risk to colon cancer, particularly if the healthy bacteria that produce a gut nutrient called butyric acid are diminished.
• Allergic illnesses such as eczema can be associated with dysbiosis.
• Musculo-skeletal problems such as arthritis, chronic myofascial pain syndrome and fibromyalgia are associated with dysbiosis.
In my clinical experience more than two thirds of people with chronic health conditions have dysbiosis and intestinal permeability disorders contributing to their problems. We can re-balance our microbiome by removing the undesirable organisms and restoring the desirable bacteria while supplying nutrients to optimize the barrier function. At an appropriate time during treatment we recommend supplementation with healthy bacteria (probiotics) and the food that feeds the bacteria (prebiotics).
• Remove all undesirable organisms. This may include an adverse food, parasite, or disproportionate growth of the wrong types of bacteria. This may require prescription medications or herbal products.
• Assess exposure to toxins (heavy metals such as mercury, pesticides, and herbicides) and attempt to reduce the toxic load. This results in a restoration of immune function.
• Review glucose insulin metabolism. Abnormal glucose/insulin metabolism, also termed Metabolic Syndrome, is a common contributing factor to dysbiosis.
• Assess hormonal imbalance. An estrogen dominant state can predispose to yeast overgrowth.
• Identify food intolerances, allergies or toxicities. By removing the food from the diet we can improve immune function and facilitate the resolution of dysbiosis. Adherence to the proper diet is critically important to a successful outcome. While a bacterial or parasitic infection can be treated with appropriate medication and herbal products, a yeast infection requires dietary change to be treated effectively.
Table I Factors Effecting the Microbiome and GI Tract Barrier
Table II Probiotics, Prebiotics, Symbiotic
Live microorganisms. You can take them in capsule form or by eating cultured and fermented foods
Examples: Water Kefir, Kombucha, raw apple cider vinegar Prebiotics
Non-digestible foods that promote growth of bacteria
Examples: raw garlic, raw/ cooked onion, jicama, raw asparagus, raw Jerusalem artichokes, leeks, radishes Symbiotic
Combinations of prebiotics and probiotics that are found in the same food
Examples: Kimchi, sauerkraut, pickles, dairy kefir
Tests that look for dysbiosis:
• Cultures of the stool: These tests look for parasites, abnormal bacteria and overgrowth of fungi or yeast. When abnormal organisms are identified, sensitivity testing to determine the most effective treatment can be done. The Comprehensive Digestive Stool Analysis, (CDSA, Genova Labs) is a commonly used test.
• Breath Testing: The Hydrogen Breath Test is used as a clinical medical diagnosis for people with gastrointestinal symptoms suggesting Irritable Bowel syndrome and common food intolerances. This test can look for intolerances to Lactose and or Fructose. It can also help diagnose Small Intestinal Bacterial Overgrowth (SIBO).
The small intestine plays a critical role in digesting proteins, starches and fat. The intestinal tract lining is as large as a tennis court and as thin as your eyelid, only one cell thick. The lining of the intestinal tract has a selective barrier to prevent undesirable substances from entering the body, such as large undigested molecules, foreign substances and pathogens. Properly deconstructed nutrients can pass through the barrier to be assimilated and utilized by the body for energy. A breach in the intestinal barrier from irritants such as excess refined carbohydrates, alcohol, medications, chemical toxins and chronic stress increases intestinal permeability (see Table I). This is known as “Leaky Gut Syndrome”. This can cause symptoms of illness, provoke immune activation, and lead to disease processes.
Factors that Suggest Leaky Gut Syndrome
Factors that may raise the suspicion of Leaky Gut Syndrome include a history of major trauma or burns, gastrointestinal infections, chronic stress, over consumption of alcoholic beverages, low fiber and highly processed diets, dysbiosis, food and environmental contaminants and medications, specifically NSAIDS. NSAIDs are the anti-inflammatory medications that include aspirin, ibuprofen, and naproxyn. A history of food allergy or sensitivity should also alert one to the possibility of Leaky Gut Syndrome in the Tract.
Leaky Gut Syndrome can be associated with a variety of illnesses and chronic health problems inn GI Tract including:
• Attention Deficit Disorder
• Autistic Spectrum Disorders
• Chronic Fatigue Syndrome
• Food allergies and intolerances
• Inflammatory Bowel Disease & Irritable Bowel Syndrome
• Parasitic infection
• Mood and cognitive disorders
• Skin conditions
• Autoimmune Disease
• Chemotherapy and radiation
Symptoms and Signs of Leaky Gut Syndrome:
There are a variety of non-specific symptoms that may be associated with Leaky Gut: fatigue, malaise, abdominal pain, abdominal discomfort, bloating, diarrhea, cognitive dysfunction, joint pains and generalized weakness.
Tests that look for Leaky Gut Syndrome:
Zonulin is a protein that is found in blood tests. Elevation suggests intestinal permeability. It can be used in diagnosis and as a retestable therapy marker.
4 R Treatment for Leaky Gut Syndrome:
1. REMOVE stimulants that cause dysfunction such as offending foods, abnormal organism, medication and/or supplements.
2. REPLACE processed and adverse foods with whole foods. Hydrochloric acid and enzymes (protease, lipase, amylase and DDP IV) are necessary support for proper digestion.
3. REPOPULATE the microbiome with beneficial prebiotics, such as fructoolgiosaccharides (FOS) and probiotic bacteria.
4. REPAIR the intestinal barrier by eating foods and taking supplements that support the healing process. Food sources to reduce inflammation and promote healing include turmeric, quercetin and butyrate, aloe vera, cabbage juice, okra, slippery elm and bone broth.
1. Metagenics Ultra-Flora Control is a new probiotic that has been shown to improve Zonulin levels and by inference, intestinal permeability. 1
2. Metagenics Ultra GI Replenish formula features a prebiotic blend of natural-identical human milk oligosaccharide (HMO), as PreBiome 2’FL and isomalto-olgiosaccahries (IMOs). These two prebiotics are non-digestible carbohydrates that act as food for beneficial microbe. 2
3. Supplements like glutamine and zinc carnosine restore the barrier integrity.
*Please come in for your free trial bottle of Metagenics Ultra Flora Control while supplies last. (GI Tract, GI Tract. GI Tract)
To optimize your health through diet and nutritional support or for more assistance, please contact Integrative Medicine at Crossroads to inquire about a consultation with our nutritionists Keri Connell, MS, CNS, LDN or Sara Cooper, MS, CNS, LDN, CSCS.
In addition, please visit www.crossroadsteachingkitchen.com to learn more about our nutrition classes.
Integrative Medicine at Crossroads410-997-5191
References (GI Tract)
1) Stennman, L., Lehtinen, M., Meland, N., et al. (2016). Probiotic with or without fiber controls body fat mass, associated with serum zonulin, in overweight and obese adults. EBioMedicine, 190-200