Digestive Conditions

The old adage “what goes in, must come out” is the typical view from people of the digestive tract, thinking of it simply as a tube that takes in food and expels wastes. Rarely do people recognise that the digestive system is made up of multiple functional layers responsible for its successful operation. Like the layers of a cake or the levels of a building, the functional layers of the gut rely on one another for support, structure and function, whereby a disturbance in one, can impact the others (refer to Figure One). Of these layers, diet, barrier integrity and bacterial balance are foundational components to address in any patient suffering from digestive symptoms. Irrespective of the specific diagnosed condition, formulating a treatment strategy that effectively targets all of these layers can offer significant benefit to your patient’s presenting with gut disorders.

Diet is often a priority in the acute treatment of any digestive disorder, which makes sense when you consider that the gut is assaulted with approximately half a tonne of food every year. The foods you may be continuously exposing yourself to, directly influences all of the functional layers of the digestive tract. Consumption of particular foods may elicit both a local and systemic immune response in sensitive individuals. The resultant inflammatory reaction causes damage to what may already be a disturbed and permeable gut, further exacerbating your symptoms. This constant irritation can be especially painful in conditions such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) which are characterised by visceral hypersensitivity. Further to this, it is well established that diet can rapidly and significantly alter the composition of the gut microflora. (Turnbaugh PJ, et al. The effect of diet on the human gut microbiome: a metagenomic analysis in humanized gnotobiotic mice. Sci Transl Med. 2009;1(6):6ra14).

While dietary modifications will benefit everyone, the extent of this will be determined by ensuring the most appropriate dietary program is recommended.

Dietary strategies are an invaluable facet of treating digestive symptoms, however, simply removing an offending food is seldom enough. Using coeliac disease as an example, following the removal of gluten, it is likely a patient will subsequently present with leaky gut and require continued effort to heal the intestinal barrier. The barrier layer of the gut is comprised of three different, but interdependent components- the epithelium, mucosal barrier and secretory immunoglobulin A (sIgA). The mucus layer plays a pivotal role in separating host tissue from making direct contact with the microbiome. Within the mucosa is sIgA, an antibody that is pertinent to mucosal immunity through the entrapment and removal of pathogenic bacteria, viruses and toxins. These actions are highly relevant in a range of conditions including IBS, IBD and coeliac disease.

Further affecting the health of the intestinal barrier, is the intestinal microbiota. Comprising over 1,000 species with a combined weight of approximately one to two kilograms, these ‘bugs’ play a dominant role in not only maintaining the health of the digestive tract but have also proven to influence various chronic diseases. Daily probiotics can help to improve all of the functional layers within the digestive tract, with best results seen when using targeted probiotic strains with demonstrated efficacy.

Naturopaths view the digestive system, not just as a pathway for carrying food in and out of the body, but as individual functional layers that when addressed holistically can help to alleviate any form of gut dysfunction. Introducing dietary modifications, repairing a damaged intestinal barrier and restoring a healthy microbiome are just three, of the multiple functional layers of the gut pivotal to treatment success. At our finger-tips are effective herbal and nutrient combinations to address all of these functional layers of the digestive system.

Reflux

Reflux and indigestion affects millions of people’s lives every day with one in ten adults experiencing reflux every week. For some, the symptoms of reflux and indigestion may only be mild with only a slightly uncomfortable sensation in the stomach or the occasional regurgitation. For others the pain can be more severe and quite disruptive. Although the symptoms may be mild, your body may still be suffering damage.

When you swallow, food passes down a long tube between your mouth and your stomach called the oesophagus. Your digestive system has mechanisms for allowing food and drink to pass into your stomach, and prevent it from coming back up. When these mechanisms don’t work properly, your stomach contents can squeeze out of your stomach and back up into your oesophagus. When this happens, the acid and other secretions that normally digest your food actually burn and begin to digest the lining of your oesophagus; this is what causes the burning sensation that is so irritating for people with reflux. If this happens often enough, the tissue may become so damaged that it becomes ulcerated.

Many things can cause reflux or make it worse. These include eating too fast or overeating, eating spicy or fatty foods, stress, anxiety and emotional trauma, smoking, drinking excessive coffee, cola drinks or alcohol. Reflux may also occur as a symptom of more serious conditions which we can discuss at your next consultation if you are concerned.

There are many things that you can do to reduce your chance of suffering reflux such as:

  • Eating smaller meals more frequently.
  • Taking time to relax and enjoy a leisurely meal time.
  • Managing stress effectively (I have some stress management techniques that I can share with you).
  • Reducing the amount of caffeine you have by cutting back on coffee, tea and cola drinks.
  • Have a break from alcohol for a while or at least reduce your intake.
  • Avoid taking aspirin and anti-inflammatory drugs if possible as these increase your risk of ulcer. If these were specifically prescribed for you, discuss your requirements before you stop using them. You can also talk to me about effective alternative anti-inflammatories that are gentle on your digestive system.
  • Naturally soothing and healing remedies that hit the nail on the head!

Imagine getting lasting relief from the irritating discomfort or pain from reflux and indigestion! While natural medicine takes a wholistic approach, it is interesting to find that subtle differences amongst nutrients and how they are prepared dramatically improve their benefits. For example, zinc is a mineral that is important for wound healing, but when it is given in the particular form it specifically adheres to inflamed wounds or ulcers in the digestive system.

This provides more targeted healing for gastric ulceration than other forms of zinc. Specific types of zinc also differs from other forms of zinc in that it actually inhibits Helicobacter pylori, the bacteria that is associated with gastric ulcers. Other forms of zinc do not have these specific benefits.

Another example is soy protein. We have known for years that soy may assist in the management and prevention of a number of diseases including cardiovascular disease, menopausal symptoms and osteoporosis. Yet when soy protein is prepared in a particular way, by fermentation with L. delbruekii, it takes on remarkable new properties for gastric healing! This type of fermented soy protein can heal the gastric lining giving fast relief from heartburn, nausea, bloating and most symptoms of gastric ulcer.

As your Natural Healthcare Practitioner I can support you in making simple dietary and lifestyle changes that will address reflux and indigestion. I can also provide you with a simple new supplement that has been designed using the above ingredients to specifically treat reflux and indigestion. This product can give relief from reflux and indigestion within 10 minutes of taking it.

Constipation in Adults

Constipation is a condition in which a person has difficult or infrequent passage of faeces. Constipation may be a symptom of underlying pathology or an ongoing problem in itself, lasting days, months, or years. Normal bowel movements occur from two to three times a day to three times per week. Constipation may occur at any age, and most people will experience constipation sometime in life, but it is more frequent in infancy and old age. Most cases result from changes in diet or physical inactivity and inadequate fluid intake. Psychological factors, particularly depression, may affect bowel motility and cause constipation. Chronic abuse of laxatives or cathartics can also lead to chronic constipation.

Defining constipation requires broad questioning. The Rome II diagnostic criteria is a useful guide for assessing functional constipation.

Constipation includes 2 or more of the following:

  1. Straining during at least 25% of defecations
  2. Lumpy or hard stools in at least 25% of defecations
  3. Sensation of incomplete evacuation for at least 25% of defecations
  4. Sensation of ano-rectal obstruction/blockage for at least 25% of defecations
  5. Manual maneuvers to facilitate at least 25% of defecations per week
  6. Fewer than 3 defecations per week

Loose stools are rarely present without the use of laxatives

This criteria is fulfilled for the previous 3 months, with symptom onset at least 6 months prior to diagnosis.

Aetiology / Risk factors
  • Decrease in exercise or activity, often occurring with illness and travel
  • Dietary changes
  • Use of many medications, such as diuretics and some antidepressants
  • Low fibre diet
  • Stress
  • Hypothyroidism
  • Anorectal fissures or thrombosed haemorrhoids
  • Strictures
  • Tumours
  • Pregnancy
Signs and Symptoms
  • Infrequent, difficult passage of stools (less than three times a week)
  • Sudden and significant decrease in frequency of bowel movements
  • Stools harder than normal, possibly impacted
  • Sensation of incomplete bowel emptying
  • Bloated sensation

Constipation in Children

Constipation is a common problem in children. It occurs in up to 10%, although only 3% of parents actually seek advice from a health care practitioner. Constipation is generally described as infrequent bowel movements or the passage of hard stools. Any definition of constipation depends on how often the child normally passes stools and the normal consistency of his or her stools. Most children with constipation have no underlying medical condition. They often are labelled as having functional constipation or acquired megacolon. In most cases, childhood constipation develops when the child begins to associate pain with defecation, and the child withholds stools in an attempt to avoid discomfort. As stool withholding continues, the rectum gradually accommodates and the normal urge to defecate gradually disappears. The infrequent passage of very large and hard stools reinforces the child's association of pain with defecation, resulting in worsening stool retention and progressively more abnormal defecation dynamics with anal sphincter spasm. Chronic rectal distension ultimately results in both loss of rectal sensitivity, and loss of urge to defecate, which can lead to faecal incontinence (i.e., encopresis).

Initially, most constipation occurs as a result of changes in diet or physical activity, including inadequate fluid intake. In infants, normal bowel function varies dramatically, with breast fed infants usually using their bowels move at least daily, while bottle fed infants may use their bowels as infrequently as once per week. Once solids are introduced, both groups become more similar.

Aetiology / Risk factors
  • Avoidance of bathroom due to playing, concerns about cleanliness or a painful previous experience
  • Diet high in sugar and refined cereal products
  • Fever, infections, extended bed rest or dehydration
  • Hirschsprung disease, a congenital lack of innervation to the bowel
  • Lead poisoning leads to chronic constipation in children
  • Depression, coercive toilet training and sexual abuse are less common but significant causes
Signs and Symptoms
  • Infrequent, difficult passage of stools (less than three times a week)
  • Stools harder than normal, possibly impacted
  • Bloated sensation
  • Abdominal pain
  • Abdominal exam may indicate distension and hard faecal mass
  • Rectal exam may show hard, impacted stool in the rectum
  • Infants may straighten legs and clench buttocks to prevent stool passage if there is discomfort

Diagram 1

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