The statistics of gastrointestinal (GI) disorders paint a bleak picture, with around 11 percent of the global population affected by symptoms of Irritable Bowel Syndrome (IBS). That being said, from my experience, many people who suffer from GI issues think they are in perfect health.
You may think you’re doing great, except for the antacids you take most nights before you goes to sleep. Or you can’t understand why you are constipated most of the time, but don’t worry about it too much. These stories are commonplace, and invariably most people have experienced troublesome gastrointestinal (GI) symptoms at some point in their life.
Even in larger populations like the US, more than three-quarters of the country suffers from one or more chronic digestive ailments, but most don’t report them to their doctor because they dismiss them as “normal”.
In the past, we thought of the digestive system like a constantly active boiler, where you could add food at any time and it would metabolize to create energy. We now know that not to be the case. More than 2,000 years ago, Hippocrates said, “All disease begins in the gut.” Only now are we beginning to understand that the gastrointestinal system is a key adaptive interface that mediates many functions and is thus central to health and disease.
Every time we eat, we are subjecting our internal environment to a constant stream of antigenic insults — an antigen is a foreign substance that triggers an immune reaction. That’s why achieving optimal health requires a healthy gut barrier function that produces a well-regulated neurological and immune system. If you’re experiencing gut-related symptoms — such as bloating, gas, indigestion, pain, and a change in bowels — it may be time to take a closer look at your GI health.
How You Eat Matters
Our relationship with food has changed. It is no longer seen as a necessity to fulfill our most basic need. Especially in the westernized world, food is often associated with pleasure.
Another notable change that was brought about by modernization is the move away from habits like eating with our hands or with older tools, like chopsticks. In fact, these habits offered multiple benefits for the gut. For instance, the surface of your hands contain bacteria, which transfer to your gut and contribute towards the diversity of the gut microbiome.
Using your hands or chopsticks is also likely to prevent over-eating due to a slower and more mindful eating pace, which provides more time for digestive juice production and signals of fullness. The use of cutlery has been linked with faster eating, which in turn may increase the risk of a metabolic syndrome, such a type 2 diabetes.
Listen to Your Reflux
To many people, the experience of stomach acid, or reflux and heartburn, is thought of as unnecessary and annoying. Instead of prompting a deeper investigation into their health, most will simply turn to popular methods of reducing acid production, like Gaviscon or Nexium).
However, the common misconception here is that your reflux or heartburn is caused by an excessive production of stomach acid, when in fact what is happening is that your stomach does not produce enough acid to break down what you’ve just eaten.
Low stomach acid causes carbohydrate fermentation in the stomach, which produces hydrogen gas. This then puts pressure on the stomach — forcing undigested food back up towards the esophagus — thus causing pain.
This can also promote the growth of a bacteria called H. Pylori, which can suppress gastric acid secretion and compound the problem even more. Therefore, ironically, many of the perceived symptoms of too much acid are actually the result of low acid production. For some people, supplementing with acid often relieves their heartburn symptoms and improves their digestion.
The Issue of Gut Permeability
Gut permeability, a term describing the control of material passing from inside the gastrointestinal tract through the cells lining the gut wall into the rest of the body, is a key defense mechanism. When it increases, external factors like viruses, bacteria, toxins, microbial metabolites, undigested foods, and other antigens are able to enter your blood stream. The immune system swiftly reacts by recruiting inflammatory proteins as a defense mechanism, which can cause systemic inflammation and, later, sustained intestinal permeability.
Conditions such as allergies, autism, IBS, celiac disease, dermatitis, rheumatoid arthritis, obesity, and insulin resistance have all been correlated with intestinal permeability, or “leaky gut”. In fact, intestinal hyperpermeability is now regarded as a precondition to developing inflammatory autoimmune conditions.
If good nutrition is the key to optimally fueling our body, then the gut is the gateway through which nutrition influences the rest of our body. If the gut barrier is compromised, you may experience reduced absorption of any specific nutrient or mineral, leading to the disruption of multiple bodily systems.
The Effect of Stress on Your Gut
Disrupted motility (dysmotility), or the ability of organisms and fluid to move or get around, contributes to a number of conditions, such as reflux, constipation, and diarrhea. This is commonly caused by stress and the subsequent activation of the “fight or flight” stress response, leading to signs and symptoms throughout the GI tract — difficulty swallowing, reflux, nausea, vomiting, and SIBO (small intestinal bacterial overgrowth) — which commonly lead to bloating, flatulence, diarrhea, constipation, and abdominal pain.
In fact, various environmental factors can significantly influence the balance of bacteria in the gut. Poor digestion — including low stomach acid — may predispose you to higher numbers of pathogenic bacteria. Additionally, prolonged physical or mental stress can increase your risk of low stomach acid, while high levels of cortisol are associated with reduced immune function and protective mucus, which then further weakens your immune defenses. Low dietary fiber can also play a role.
Tips to Improve the Health of Your GI Tract
- Keep to a mealtime routine — mindfully eat with others at a table away from distractions.
- If stress is an issue, engage in deep breathing exercises before eating. This will stimulate the vagus nerve, which promotes a relaxed state in the body, and facilitate proper digestion.
- Chew your food properly. Avoid large amounts of liquid with meals as this will dilute your stomach acid.
- Leave a gap of four hours between eating and going to bed. Eating disrupts sleep signaling and interferes with rest and repair.
- Eat a wide range of fiber sources and reduce your consumption of any heavily processed foods or chemicals.
Dr. Nas Al-Jafari BMBS BMedSci (Hons) MRCGP DPD DFSRH DOccMed is a Functional Medicine Practitioner, a Family Medicine Consultant, and the Medical Director at DNA Health Corp.