Gut Health: A Functional Approach

Gut Dysfunction Matrix ™

If you are having digestive problems, you are not alone. A GI survey of American adults in 2015 found that 61% of the over 71,000 respondents in the US had at least one digestive complaint in the past week. That year, GI complaints in the US accounted for 105 million ambulatory care visits, 14 million hospital admissions, 236,000 deaths, and $142 billion in total costs.

Click here to take Dr. Morris’s Functional Gut Health Questionnaire.

Burden of Gastrointestinal Symptoms in the United States: Am J Gastroenterol. 2018 Nov; 113(11): 1701–1710.

Digestive diseases account for over 100 million ambulatory care visits annually in the U.S. Many more do not seek care at all. We can do better than this.

The human GI tract is an impressive 20-25 feet long. When completely flattened out, our GI tracts have 300 square meters of surface area—more than a tennis court and 200x more than our skin.

Microbiome: Far from being barren, our guts host about 100 trillion microorganisms. A typical microbiome has 1000 different species. When we pick up pathogenic “unfriendly” microbes (bacteria, yeast & parasites), the result is often chronic inflammation, leaky gut, and decreased gut surface area. Chronic gut dysbiosis is often the start of major problems. A simple way to address or prevent cases of GI distress is taking a probiotic of “friendly” bacteria to crowd out and outcompete the bad actors. I often recommend Jarro-Dophilus EPS Gut Rescue Probiotics 50 Billion CFU.

STRESS: Modern diets and stressors are highly disruptive to our digestion. Stress causes the body to divert energy away from producing the metabolically expensive hydrochloric acid (HCl) and digestive enzymes  (protease, amylase, lipase) we need to break down our food into safe, bioavailable molecules. Stress is somewhat unavoidable, but we can support our digestion by taking extra HCl and digestive enzymes.

PROCESSED FOOD: It may be everywhere, but its a mistake to assume that human digestive tracts are well-adapted to a grain-based diet. Homo sapiens originated about 315,000 years ago. The first evidence of humans eating grains comes from western Asia ~75,000 years ago where people ate wild ancient wheat that grew on riverbanks. Many years later in the fertile crescent, humans first cultivated barley in what would become Jordan ~11,000 years ago.

As grains and processed foods were entering the food supply, humanity also advanced in sanitation, treating injuries and infections. It’s also likely no coincidence that along with longer life spans, humanity also developed the “modern epidemics” like obesity, diabetes, heart disease, cancers, Alzheimer’s, Parkinson’s, ADD, IBS, IBD, fatigue, a host of cancers and autoimmune diseases. These modern epidemics have become so pervasive that conventional medicine seems to consider them a normal or inevitable part of life and aging.

The problem with a grain based diet is that plants engaged in a form of chemical warfare to protect themselves from being eaten. Lectins are found in most plants, particularly seeds such as grains, beans, and nuts. They are also found in mushrooms, and potatoes. Glycoalkaloids are found in the Solanaceae family that includes potatoes, tomatoes, peppers, eggplant. Cyanogenic glycosides are found in cassava, sorghum, flaxseed and apple and apricot fruits. One of the primary jobs of our liver is to detoxify these myriad plant toxins. As the modern diet has drifted toward processed grain-based foods, our caloric intake has increased along with our exposure to these harmful plant toxins. At the same time, human intake of protective fibers and nutrients has decreased. The best solution is to reduce grain based and processed food intake. Soaking or sprouting grains can reduce some of the toxin load, as can hulling, but this also decreases the protective fiber and vitamin content.

GERD: About 30% of Americans report heartburn (or “gastro-esophogeal reflux disease”) every week. Conventional doctors frequently prescribe acid blocking drugs proton pump inhibitors (Prilosec, Prevacid and Nexium) or H2-blockers (e.g. Zantac, Pepcid and Tagamet) for GERD. Unfortunately, these drugs just cover up symptoms and often make the underlying problem of insufficient digestion worse. Many cases of GERD actually respond well to increasing digestion of with lemon water or bitters before meals, and one can always take supplemental HCl and enzymes in pill form.

LEAKY GUT: Is the loss of tight junction integrity between the epithelial cells lining our GI tract, and it causes further problems When partially digested food enters through a leaky gut, our immune systems attack the food and the cells around them. Prolonged GI immune activation contributes to symptoms of bloating, constipation, common with Irritable bowel disease (IBS). Left unattended, gut inflammation lead to inflammatory bowel disease (IBD) like Crohn’s and ulcerative colitis. It is also widely believed that poor digestion and gut inflammation along with genetic susceptibility plays a key role in the development of many autoimmune diseases (like rheumatoid arthritis, lupus, MS, psoriasis, Hashimotos).

There are specific nutrients that help soothe and repair our vital gut lining. My first-line suggestions are often DGL lozenges and Aloe Vera Gel that soothe esophagus, stomach and duodenum. Zinc, Mastic gum, and slippery elm are three other agents that can soothe repair damage from gut inflammation and maldigestion. L-Glutamine is an amino acid in blood plays a vital role in the maintenance of gut integrity. Glutamine is rapidly consumed in the cells lining your gut–especially if there is some trauma, inflammation, stress, or infection. For anyone experiencing IBD, IBS, food allergies, or food sensitivities, autoimmune diseases it is well worth trying a course of 5g doses of L-glutamine powder taken before or between meals costs about $0.25 per serving. Other effective combination products are available for severe cases that need short-term concentrated support. Vital Nutrients GI Repair Powder has: zinc, L-glutamine, colostrum, N-Acetyl Glucosamine (NAG), slippery elm, MSM, and Aloe Vera. GI Revive from Designs for Health is another well designed product that has glutamine, NAG, MSM, DGL, slippery elm, marshmallow, chamomile, okra, and quercetin.

A growing group of Functional and Naturopathic clinicians are promoting a return to a natural, whole-foods diet. Although taking this step will be a drastic shift for many people, it is really a return to our true nature. Whole-30 diets can be a good place to start.

Elimination Diets involve removing foods that are likely potentially contributing to an individual patient’s state of disease for 4-5 weeks, and then reintroducing them one at a time while watching for flareups. Elimination diets can be tailored to a patient based on their symptoms and typical diet. Foods I often recommend avoiding include dairy, gluten, eggs, soy, corn, added sugars, nightshades, and artificial ingredients). A “full” elimination diet involves reducing food options to a short list of whole foods considered least likely to be problematic before a careful reintroduction.

Adverse Food Reactions (ARFs) include allergies, sensitivities and intolerances. Allergy to food is mediated by IgE immunoglobulins, and these are often fairly obvious and severe. Food “sensitivities include other reactions mediated by the less perilous IgG immunoglobulin, and other more difficult to detect immune reactions. Serum IgG testing is an easy way to survey your blood for 90+ foods at once for ~$200. Many patients find this a excellent way to target a trial of an elimination diet.

Here’s how it works: Do eliminate the suspected foods for 4-12 weeks and then sequentially “challenge” the eliminated foods one at a time for a few days each while watching for a return or exacerbation of symptoms such as: headache, brain fog, joint pain, acne, skin rash, acid reflux, loose stools, IBS, anxiety, disturbed sleep, etc. These conditions are all exacerbated by an over-activated immune system caused by the foreign proteins and chemicals in grains and processed foods.

Back to the bugs. One of the other primary interventions I use with patients is Gut probiotics and fermented foods. I am especially likely to recommend probiotics and fermented foods to patients that have more serious gut dysfunction, systemic inflammation, autoimmunity, a weak immune system, a history of a standard American diet (SAD) or taking frequent courses of antibiotics.

For patients with concerted GI issues, I may order a specialized stool test called a Complete Stool Analysis & Parasitology (CSAP). For ~$320, you can learn an awesome amount about your many aspects of digestion and the community of microbes (both good and bad) living inside your amazing and vitally important GI tract. A more economical option that focusses on identifying problematic viruses, bacteria yeast/fungus and parasites Culture, PCR + Parasitology for $170.

The take-home point is that lots of things can harm your gut function, but if we eat appropriate foods, treat infections, ensure good digestion and make sure your microbiome is optimal, we can prevent and reverse many if not most health problems today. I you are having gut symptoms, don’t wait. Contact us with your questions or make an appointment.