The gastrointestinal system is the primary gateway by which the external environment interacts with the body.
It continuously works to distinguish between beneficial and harmful influences. Even with small aberration in its function, we can have problematic results
. Problems with digestion and absorption may occur mechanically, in functions such as mastication, motility or permeability, and often originate from genetic changes or enzyme changes.
Loss of digestion and absorption efficiency may lead to gas, bloating, diarrhea, pain, constipation, all indicating that the system is irritable.
Gut irritability left untreated may lead to leaky gut and development of food allergies, bacterial or yeast overgrowth, and the production of toxins.
Toxins may accelerate the irritation and leakiness resulting in toxic molecules entering the portal and systemic circulation.
This creates stress on systemic defenses leading to immune, hormonal and inflammatory balances. If the system is left unchecked, and eventually outstrips the body’s adaption, adrenal insufficiency may occur.
SYMPTOMS AND CONDITIONS:
Gastrointestinal disorders to be discussed include celiac disease, Crohn’s, ulcerative colitis, and irritable bowel. There is a complex interaction between enzymatic function which starts in the mouth and continues in the stomach and small intestine, with final elimination through the colon and rectum.
FOOD AS TRIGGERS; ALLERGY AND SENSITIVITY:
The complex mechanism of sorting out nutrients from non-nutrients at the level of the gut mucosa are very complex. The following is a list of food-illness interactions.
- Although most cases are associated with an increase attributed to airborne rather than food allergies, the role of dietary factors has been investigated and several studies link food to asthma. Change in diet, along with fish oils and inhibitation of inflammation has shown improvement.Inflammation reduction – it is very important to optimize inflammation in the gut. I feel that it is best to have anti-inflammatory foods, herbs, as well as spices.
- Clearly, essential fatty acids play a role as with glutamine and others. Curcumin, cats claw, green tea, and cruciferous vegetables also lower inflammation.
- Atopic dermatitis, childhood migraines, gluten, and dairy also have been associated with systemic food insult. The antigliadin antibody set is essential.
- I perform allergy testing as well as an elimination diet in my office. Several different laboratories are used, using different procedures. I have had them on myself and found them to be very effective.
- Gut permeability
- – leaky gut or intestinal hyperpermeability is a common clinical syndrome implicated in a wide array of conditions. Arabinogalactan, large fiber, butyrate and glutamine as well as beneficial flora are effective in treatments.
- Heavy metals –
- heavy metal accumulation may also play a part in poor digestion, due to its association with degraded enzyme function, dysbiosis, and bacterial or fungal overgrowth.
- The primary site of metal poisoning is the level of the metalloenzymes, the site of catalytic function within the enzymes. In the simplest term, the heavy metal displaces the mineral at the metalloenzyme site, resulting in degraded or absent enzyme function. This impedes digestion and increases leaky gut.
Laboratory testing and gastrointestinal disease – fat absorption is important to test.
If secretions from the pancreas and liver are adequate, absorption of dietary fat is almost complete. To assess for adequacy of digestion absorption of fat, a fecal fat analysis can be done. When the patient has large, greasy, foul-smelling stool, this is called steatorrhea and can cause digestive disorders such as failure of the pancreas and other systems.
Other testing that I perform evaluates enzyme function, which is needed for digestion. Microbiology testing is important to look at pathogens such as abnormal bacteria, fungus and parasites, as well as Bifidobacterium species. Measurements of inflammation include eosinophil protein X.
EPX is elevated inflammatory bowel disease, and can be useful for evaluating disease activity and predicting relapse. Calprotectin, when elevated, can help distinguish irritable bowel syndrome from inflammatory bowel syndrome, and is also seen in bowel cancer and polyp disease.
Intestinal permeability is performed using a mannitol lactulose test where leaky gut can be diagnosed.
Direct visualization is through an esophagogastroduodenoscopy (EGD) or colonoscopy.
The diet is very important.
Adequate amount of high-quality protein as well as good fats is recommended.
Carbohydrates should be minimized and include low-glycemic ones. Allergy testing will also help the patient heal faster, as well as heavy metal testing.
Reduction of inflammation is extremely important, and I use a balanced anti-inflammatory medical food. Optimization is also used, using pancreatic enzymes and hydrochloric acid when needed. I feel that gut flora including probiotics and prebiotics is very important. The most common probiotic bacteria are Bifidobacterium, lactobacillus and Saccharomyces Boulardii.
A glutamine and other anti-inflammatories, and gut repair are performed as needed.
My treatment of ulcerative colitis, Crohn’s and irritable bowel focuses on the primary cause.
I use both prescription and natural treatments
. A complete stool study looking at the level of inflammation, digestion, and the need for pancreatic enzymes as well as hydrochloric acid is evaluated. The tests include markers for inflammation as well as evaluation of parasites, fungus, and bad bacteria. The level of probiotics is ascertained.
I feel that allergy testing is mandatory, and other autoimmune tests might also be added.
At times, heavy metals as well as mold evaluation are instituted.
Depending on the patient’s symptoms, a complete evaluation of the patient’s vitamins, minerals, fatty acids and organic acids are performed.
Based on these results along with testing for gluten, a personalized program is developed for each patient. I can work with you and your gastroenterologist and believe that at times prescription drugs are indicated, although I feel it best to use the approach initially as described above.
If you feel you have some of these problems, and wish to arrange a consultation please call the office.