by Dr. Joseph Debé
Belching, bloating, abdominal pain, flatulence, constipation and diarrhea most often are not associated with life threatening conditions. Nonetheless, the presence of these uncomfortable symptoms signifies altered metabolic processes that slowly erode health and eventually manifest in more serious conditions. These symptoms can have a multitude of causes, and therefore, thorough investigation is necessary to allow for targeted treatment.
The first cause of chronic gastrointestinal symptoms that needs to be ruled out is the presence of toxic organisms. Parasites, yeast and toxic bacteria can all be checked for with laboratory testing. A surprisingly large percentage of the population is infected with these "bugs". You do not have to travel to third world countries to contract a parasite. They are commonly ingested in food that has been prepared by an infected cook. When these pathogens are found, treatment usually involves some combination of herbs, medication and dietary changes. One laboratory I commonly use performs a "Sensitivity Test" on the toxic organisms isolated from stool samples. This involves exposing the "bug" to varying concentrations of different herbs and medication. The purpose is to see which compounds are most effective in killing the organism. In this way, treatment becomes customized and more effective. It is important to realize that most of these problem organisms are only toxic when they exist in excessive numbers in the intestinal tract. When they co-exist in proper balance with the approximately 400 other species of bacteria, there is no problem. Many bacteria and yeast are opportunistic. If given the chance, they will over-proliferate. When this happens, the reason for it must be sought. A weakened immune system, secondary to stress, toxicity, or malnutrition, is often the predisposing factor that allows for dysbiosis (imbalanced gastrointestinal flora). Insufficient numbers of the beneficial protective strains of bacteria, such as bifidobacteria and lactobacillus acidophilus, can also set the stage for overgrowth with more toxic strains of bacteria and yeast. Antibiotic usage and consumption of a high-meat, high-sugar, low-fiber diet predispose to overgrowth of yeast and toxic bacteria and death of the protective species. Lactobacillus acidophilus and bifidobacteria are available in supplement form but most brands are worthless. Based on my review of the literature, I feel that the NCFM strain of acidophilus, sold by a company called "Metagenics," is the best available. Incidentally, yogurt is not an acceptable substitute. Although yogurt has a reputation for being a source of acidophilus, the strain found in yogurt is not native to humans and will not colonize the intestinal tract as a good human strain acidophilus supplement will. Laboratory tests can measure the status of the intestinal immune system and the numbers of acidophilus and bifidobacteria as well.
Another common cause of gastrointestinal symptoms is maldigestion. The digestive process actually begins with our mental state before we eat. If we are relaxed and looking forward to an enjoyable meal, there is a very different effect on our physiology than if we are stressed out and have to eat in a rush. The body does not digest food well when under stress. Stress causes an activation of the sympathetic nervous system, which is responsible for the "fight or flight reaction". When the sympathetic nervous system is activated, digestive secretions slow, blood flow is diverted away from the gastrointestinal organs, and the speed at which food moves through the system is altered. (The speed at which food moves through the system can be investigated by eating corn, recording the date and time, and then looking at each subsequent bowel movement and recording the date and time when the corn first appears. A "transit time" of less than 20 or more than 30 hours is abnormal and is associated with maldigestion and malabsorption. The individual consuming the food does not benefit from its nutrients but toxic organisms, that get to feed upon it, do!) Many relaxation techniques are effective in reducing stress. Techniques developed by a non-profit organization called "The Institute of Heart Math" have been proven to normalize sympathetic nervous system activity, boost immune system function, and balance stress hormones. Chiropractic also influences sympathetic nervous system activity, and I have seen first-hand the benefits for gastrointestinal symptoms. To aid relaxation at mealtime, before you start to eat, take a deep breath and exhale. Avoid stressful environments and conversation when you eat. Pay attention to your food - don't watch television or read while eating.
The next step in the digestive process is chewing food, which produces greater surface area for digestive enzymes to work on. Food should be chewed thoroughly. Do not drink too much with your food as this can dilute digestive fluids. If you have significant gastrointestinal symptoms, you should consider "food combining". By not eating too many different types of food at one meal, your body can more efficiently digest food to completion. Fruit should be eaten alone. Proteins and high carbohydrate foods should not be eaten together. Under these guidelines, protein is eaten with low starch vegetables and carbohydrates are also eaten only with low starch vegetables. Most meals should be the protein-vegetable combination, especially if you have any disorder of carbohydrate metabolism.
The lack of proper production of digestive secretions can also cause gastrointestinal symptoms. Insufficiency of stomach acid secretion is particularly common, especially with age. Stress, bacterial infection, and deficiencies of zinc and vitamin B1 can result in reduction of stomach acid output. Patients are often prescribed acid blocking or antacid medications for symptoms that are actually secondary to inadequate hydrochloric acid! This only compounds the problem. Without adequate stomach acid, food is not properly digested, many nutrients are not properly absorbed, toxic organisms that contaminate our food are not destroyed, and the next step in the digestive process, the release of digestive enzymes by the pancreas, is not activated. The undigested food continues through the intestinal tract and becomes a food supply for toxic bacteria and yeast, fostering their overgrowth. Stomach acid adequacy can be measured with invasive tests. A simple, non-invasive way to gauge stomach acid sufficiency is to challenge it with a base-sodium bicarbonate or baking soda. What you do is, first thing in the morning, before eating, mix 1/4 teaspoon of fresh baking soda into eight ounces of water and drink it. Time how long it takes you to belch. As the baking soda reacts with the stomach acid, carbon dioxide gas is formed and belched. It is normal to belch within two to three minutes. Not belching within five minutes is a crude indication of hypochlorhydria - insufficient stomach acid. This condition necessitates hydrochloric acid supplementation.
There are several other important aspects to the digestive process. Laboratory testing can investigate these and lead to appropriate treatment.
Another common cause of gastrointestinal problems is food intolerance or sensitivity. There are many different ways in which food can produce adverse reactions within the body. Which food is a problem varies from person to person. Immediate-type food allergies can be determined by IgE (antibody) blood testing. Delayed-type immune reactions to food are probably best identified by IgG4 levels. The ALCAT test is another popular assessment for delayed food and chemical reactions.
Another type of food reaction is the toxicity reaction of the lining of the intestinal tract to gluten, a protein found in many grains. This is an inherited trait, found more commonly in those of Northern European descent. Gluten toxicity can be identified most easily by measurement of antibodies in saliva samples. The most definitive test is a comprehensive blood antibody analysis offered by Cyrex Labs.
Lactose intolerance results from lack of the enzyme lactase, which digests the sugar lactose, found in cow's milk. Lactose intolerance is both inherited and produced by damage to the intestinal wall, which commonly results from parasites and gluten toxicity. Lactose intolerance occurs more commonly in certain races and tends to increase with age. It can be determined by laboratory testing, if necessary.
Other types of food intolerance are produced by the food serving as fuel for toxic organisms within the intestinal tract. Examples of this are simple sugars contributing to yeast overgrowth and certain starches feeding toxic bacteria. An inexpensive, but effort-intensive way to most accurately determine which foods are contributing to your gastrointestinal symptoms is to go on an elimination-provocation program. First, you eliminate the most common allergens from your diet - wheat, yeast, corn, citrus fruits, eggs, dairy products, and shellfish. In its strictest form, an elimination diet may consist of nothing but lamb and pears. After following a restricted menu of hypoallergenic foods for 3 weeks or so, you reintroduce one new food to your diet every two days and record your symptoms. In this way, you can pinpoint which foods are problematic. Incidentally, during the elimination (restricted menu) phase, you should start feeling much better overall. Whatever method is used to determine food intolerances, the problem food needs to be avoided, at least temporarily.
In summary, after careful investigation, the treatment of most gastrointestinal symptoms will involve some combination of:
1. Herbs, medications, and dietary changes to eradicate toxic organisms.
2. Stress reduction.
3. Immune system enhancement.
4. Supplementation with beneficial bacteria.
5. Replacement (supplementation) of lacking digestive enzymes.
6. Adopting proper eating habits.
7. Food combining.
8. Correction of nutrient deficiencies.
9. Avoidance of problematic foods