Download Digestion is fundamentally a three stage process that begins with

Digestion is fundamentally a three stage process that
begins with the initial breakdown of food in the mouth and
stomach. It continues through the small intestine where foods
are broken down into minute particles and simultaneously
absorbed. The process is completed in the large intestine with
the re-absorption of water and the elimination of feces. Any
dysfunction in any of these three stages decreases our intake
of nutrients, compromises other systems of the body and can
affect the intestinal environment seriously enough to foster
more serious problems.
This mechanical and enzymatic process of breaking foods
down and absorbing their nutrients yields waste products and
toxins. The integrity of the digestive tract tissue must be intact
to prevent these toxins from entering the blood stream. If the
strength of the intestinal tissue is
compromised, toxins are able to filter
into the bloodstream. Over time, this
weakens the body and makes it
conducive for many illnesses.
Breakdowns in the digestive process
and protective barrier of the intestinal
tract are responsible for the vast majority
of today’s health problems including
cancer, arthritis, autoimmune diseases,
allergies, asthma, eczema, chronic fatigue
and recurring infections, especially in
children.
How does one know if this is relative to
them? Even the mildest of digestive
symptoms which we accept as “normal”
may be reflective of digestive
imbalances. For example, any form of
bloating or distension within 30 minutes
or 2 hours of eating signals an incomplete or imbalanced
digestive process. Other signs may include malodorous stools,
undigested food, mucous or blood in the stool, flatulence, bad
breath, coating on your tongue, light-colored or green stools,
constipation (inability to move your bowels 1-2 times daily)
and/or incomplete evacuation. Chronic inflammation is almost
always an indicator of bowel dysfunction.
These symptoms may be reflective of minor imbalances that
require changes in ones diet or possibly an adjustment in
combining the proper foods together. The removal of certain
foods that elicit allergic or hypersensitive reactions may be
warranted. In more serious situations it may signal a decrease
in your body’s ability to produce adequate levels of digestion
chemicals, the possibility of pathogens such as parasites or a
condition known as candidiasis (fungal overgrowth),
malabsorption or an inflammatory state of the bowel (quite
often, several of these conditions are found together).
Phase 1:
Digestion begins in the mouth. The mechanical action of
chewing serves several functions. It tears the food into small
pieces, thereby increasing its surface area. This gives the acids
and enzymes greater access to work more effectively on the
food. Simultaneously, it releases enzymes that start the
digestive process immediately. The saliva secreted serves as a
lubricant and makes it easy to swallow the food. Finally, there
is the cephalic response. This is a brain signaling mechanism
that prepares the body for food. It is involved with the quality
and quantity of saliva produced, thermogenesis, insulin and
glucagons response (see article on insulin for its importance)
and the full spectrum of digestion, absorption and utilization.
Once the food enters the stomach it signals for the release of
Hydrochloric acid (HCl) and a protein
digesting enzyme called pepsin. The
acid kills harmful microbes (viruses,
bacteria etc.) and churns the food into a
liquid-like substance termed 'chyme'.
There is also a mechanical-type
contraction of the stomach that assists in
this phase and subsequently passes the
chyme into the small intestine for phase
2 of digestion.
If there is a deficiency in the chemical
production of the stomach, it will
diminish the efficacy of the entire
digestive process because phase 2 is
dependent upon the acidic nature of the
chyme. It is the acid content of the
chyme that sends signals to the gall
bladder and the pancreas to perform the
next phase.
When HCl production is decreased, it compromises the rest
of digestion. This is noted by gas, bloating or indigestion
within 30 minutes of eating, bad breath, a coated tongue, acid
reflux possibly and the sense of hyperacidity (Hyperacidity is
not common. It usually results from long term hypoacidity
and irritation to the mucosal lining of the stomach due to poor
mucous production. Without this mucosal protection, any
amount of acid can create irritation.). HCl is also necessary
for vitamin B-12 and iron absorption. Decreased levels may
lead to anemia. Some other signs may include constipation,
ridged fingernails, undigested food particles in the stool,
allergies, arthritis, and sinus problems.
Influences on HCl production include the bacteria H. pylori
(often involved with gastric ulcers), hypoglycemia,
malabsorption syndrome, adrenal and thyroid dysfunction and
deficiencies in vitamin B6 and zinc. Correction of these
conditions should be done before the use of HCl becomes
apart of anyone’s regular program.
It is important to recognize our ability to produce HCl
decreases as we get older. This is one of the contributing
factors why digestive problems get worse with age.
Supplementation with the various forms of HCl can be of
benefit. Temporary use of HCl may be part of the solution, but
for younger people, it should not be part of any permanent
regimen if possible. For the elderly, it may be in their best
interest to make it a regular part of their nutrition program.
However, it is better to establish healthy eating habits and
correct any form of bowel dysfunction than to rely on HCl
supplementation.
Phase 2:
As the chyme enters the small intestine, numerous signals
are sent off simultaneously.
The pancreas is stimulated to perform two digestive functions.
First, it produces and releases bicarbonate into the small
intestine. This helps to protect the small intestine by making
the pH level more alkaline and neutralizing the acid content of
the chyme.
The second job of the pancreas is to produce and release
digestive enzymes into the small intestine. These substances
continue the digestive process and break down the fats,
proteins and carbohydrates into tiny particles to be absorbed
through the intestinal lining and into the blood and lymph
vessels. These substances will go through scores of
biochemical changes before they are eventually used by the
cells of the body.
These pancreatic enzymes are most effective when the pH is
at the proper alkaline level. If the pancreas is unable to
produce the necessary bicarbonate level or if it is not properly
stimulated because of a deficiency of HCl production from the
previous stage, then the enzymes will be unable to fulfill their
function efficiently.
Typically, those with decreased enzyme function will
develop bloating, gas, and/or abdominal distension within 45
minutes to two hours after eating. They may have undigested
food in their stool, constipation, diarrhea, fatigue, food
allergies or sensitivities, skin conditions, and floating stools.
Usually, the use of a plant derived, broad spectrum enzyme
formula proves effective. It is believed that overeating and
poor food choices contribute to poor enzyme production.
Assisting the pancreas during this phase is the gall bladder.
The gall bladder is the storage area for bile. Bile is produced
by the liver and serves two basic functions. When acid or fat
enters the small intestine, it signals the production of a
chemical called cholecystokonin (CCK) that signals the gall
bladder to release its bile. Upon release, the bile enters the
small intestine and helps the bicarbonate create an alkaline
environment for the enzymes. At the same time, the bile also
emulsifies the fats. This breaks the fats into small particles,
allowing the fat-digesting enzymes (known as lipases) better
access to them, increasing enzyme efficacy and fat digestion.
The second function of the gall bladder involves
detoxification. As toxins are neutralized by the liver, they are
excreted in the bile. When the bile is released in the digestive
process the toxins are excreted with it and removed in the
feces. Any compromise in the liver’s ability to produce bile or
the gall bladder’s function to release the bile increases the
toxicity of the body and increases the risk of many illnesses.
The traditional warning signs that determine who is in the
high risk category for gall bladder problems are the four Fs:
female, fat, fertile and over forty. A main reason for these
factors is their relationship to estrogen metabolism problems,
i.e. PMS, fibroids, endometriosis, ovarian and breast cysts etc.
Obesity (fat) (Obesity primarily results from insulin
dysfunction-see articles on blood sugar regulation and stress)
is involved because the extra body fat now becomes a second
sight that produces estrogen (female & fertile). This excess
estrogen, along with the imbalances created by bad food
selection, increases the toxic load for the liver and gall
bladder. As we get older (over 40), our poor life-style habits
catch up with us. Eventually, the liver is depleted of its
reserves and can no longer detoxify adequately. The bile
becomes viscous and becomes more difficult to excrete. This
may pre-dispose a person to form gall stones. Toxins also
remain in the system too long and place an increased burden
on this already overworked process, hindering it even further.
Other contributing risk factors to gall bladder dysfunction
appear to be a diet containing high levels of fats, low fiber
intake and refined carbohydrates and stress.
Important signs of a gall bladder problem include light or
clay-colored stools, headaches, usually above the eyebrows
along the frontal sinuses, an inability to handle greasy foods,
pain along the right shoulder blade area, tenderness to the
right thumb web area when palpated firmly, possible
discomfort under the right rib cage area, skin conditions,
hemorrhoids, bowel dysfunction and jaundice.
A common ailment previously mentioned is gall stones. If
left unattended, they can lead to serious problems including
pancreatitis. However, surgery is usually not the best way to
remedy the situation. Many alternative practitioners have
developed expertise it “flushing out” the stones through
specific programs. That remedy is beyond the scope of this
article and should never be tried without being under the
supervision of an experienced practitioner. Any flushing
program needs to be accompanied with lifestyle changes
regarding diet, exercise and stress management. However, the
use of phosphatidyl choline, have been utilized to keep the
bile thin, allowing it to exit the gall bladder more easily and
perform its function. Other remedies include vitamin C,
taurine, beet root concentrate, pancreatic enzymes,
specifically lipases, dandelion and milk thistle. Dietary
changes are critical and a decrease in dietary fats and refined
carbohydrates, accompanied by an increase in quality fiber is
the first step.
Those who have had their gall bladder removed need to
keep their bile thin and possibly take bile salts. The inability
to produce these salts places the individual at a higher risk for
colon cancer. Before supplementing yourself, please check
with your practitioner.
Phase 3
After the small intestine completes its job of breaking down
the food and absorbing the nutrients, it passes the remaining
chyme to the large intestine through a sphincter termed the
ileocecal valve (ICV). Proper function of this sphincter is
critical to the well-being of the digestive tract because it
regulates the chyme entry into the colon and protects the small
intestine from the backwash of bacteria from the large
intestine.
As the chyme passes through the large intestine, the body
reabsorbs water from this mass (up to 2 liters/day) and stores
the fecal material in the distal part of the colon until the signal
to defecate is given.
The large intestine is colonized by bacteria collectively
termed microflora (MF) (MF lives throughout the entire
digestive tract, but it is predominant in the large intestine.). A
healthy adult’s gut will contain approximately between 5 to 15
pounds of MF. There are over 400 different forms of these
bacterial microorganisms, both friendly and harmful, and
there numbers total in the trillions. The symbiotic balance
between these groups of bacteria is critical to one’s health.
Stool is largely comprised of these bacteria.
The MF breaks down the fiber in our foods and produces
short-chain fatty (SCFA) acids as part of its metabolism.
SCFA are the fuel supplied to the colon cells to keep them
functioning. This is one of the reasons fiber is so critical to
our health. It provides the
substrate by which
nourishment for the colon
cells is provided. This in
turn creates a healthy
environment for the MF to
flourish. Though this
feedback mechanism may
appear simple, it is highly
regulated and influenced by
the previous stages of
digestion, diet, stress, food
quality, environmental
factors, toxicity etc. It is
critically important because
research has shown that
individuals who develop
serious bowel ailments, i.e.
colitis and colon cancer,
have a markedly decreased
level of these SCFA in their
systems.
The MF is also
responsible for the
production of certain B
vitamins i.e. pantethine, choline and vitamin K. Imbalances in
the MF colonies can lead to nutrient deficiencies and affect
many biochemical pathways that utilize these nutrients. Other
benefits of MF are its ability to limit the numbers of unhealthy
microbes, support the immune system and reduce the harmful
effects of cholesterol.
Disturbance in the ecological balance of these MF colonies
is called dysbiosis. It is reflective of and a contributor to a
compromised immune system. In addition to the above
mentioned functions being impaired, dysbiosis is involved in
many of today’s serious illnesses including cancer,
autoimmune diseases, allergies, asthma, IBS, chronic fatigue
syndrome, recurring infections, and learning disorders in
children. Though gut ecology is overlooked by mainstream
health care professionals, its integrity can not be emphasized
enough.
Dysbiosis results from any one or combination of
influences. Starting with poor dietary habits and the overconsumption of refined foods, many of the contributing
factors include too much alcohol, stress, laxatives, NSAIDS,
birth control pills, poor digestion, metal toxicity, formula fed
babies, and acquired food sensitivities and allergies from all
the above stressors.
In infants and children, cow’s milk, dairy and refined
carbohydrates are the main culprits. Also, giving infants solid
foods prematurely, especially animal proteins and grains, can
disrupt the developing intestinal tract. Sanitary and
environmental conditions, trauma, infections, radiation,
chemotherapy, age, and genetics may also contribute to this
malaise.
But the most common denominator causing dysbiosis is
antibiotics. When antibiotics are given to attack any invasive
bacteria, it can not discriminate between the beneficial
bacteria of the body (MF) and the invading pathogen. It will
eliminate any form it comes in contact with. This diminishes
the colon’s functional
capacity. It is especially
harmful in children because
the function of the GI
system is not fully
developed and is much
more susceptible to insults.
And what is so critical is
that approximately 60% of
our immune system resides
in the gut. This aspect of the
digestive tract is known as
the GALT: gut-associated
lymphoid tissue.
GALT
The GALT consists of
specialized cells and
lymphatic tissue in the gut
lining. These specialized
cells produce antibodies and
are our first line of defense.
These antibodies, known as
Secretory IgA (SIgA), exist
wherever there is mucosal
tissue, including the mouth.
SigA will attack anything it perceives as a potential threat. In
conjunction with other specialized cells in the gut lining and
blood, the GALT determines which food nutrients are allowed
to pass through the gut wall into the body. Simultaneously, it
neutralizes and removes invading pathogens and food
particles too large to cross the intestinal barrier.
When this capability is diminished, pathogens can pass
through the intestinal barrier and different types of reactions
can occur. If the immune system overreacts, food allergies and
asthma are possible consequences. Sometimes, the immune
system can not recognize the difference between the body’s
tissues and the invading pathogen. In turn, it attacks the tissue
it believes to be the pathogen i.e. the myelin sheaths of nerves
are destroyed in multiple sclerosis, intestinal tissue in Crohns,
etc. And when the immune system is too weak to defend the
body properly, it can not protect against illnesses such as
cancer.
Healthy development of the GALT starts at the moment of
birth. In utero, the baby’s digestive tract contains no MF and
is sterile. As the baby exits the vaginal canal, it is exposed to
the bacteria of the mother’s vagina and the rectum. This
stimulates the infant’s immune system to start producing its
own MF, primarily bifidobacterium. This process is carried on
via breast feeding (There is evidence that shows formula-fed
babies have a greater susceptibility to infections from
microbes causing diarrhea.). Breast milk contains peptides,
immune factors, fats, and nutrients necessary for the infant’s
development, including the maturation of the digestive
system. As the child is weaned from breast milk and starts to
eat solid foods, a different form of flora, typical for an adult,
develops. This is of the lactobacillus variety.
Maintenance of the GALT does not end with infancy or
childhood. Our lifestyle choices have a direct impact on its
integrity. Diets consisting of large quantities of vegetables and
moderate amounts of whole grains and fruits will provide a
good source of fiber for the MF and assure
It was mentioned that antibiotics are the most common
disruptive force to the MF and GALT. This is most clearly
seen with children suffering from recurrent ear infections.
With each episode, they are given a course of antibiotics.
Though the medication temporarily knocks out the infection,
the child’s digestive and immune system are actually
weakened by the antibiotics. This sets up an environment
more conducive for the next infection to take hold. And with
each subsequent infection and round of antibiotics, these
systems function at a diminished capacity, making the child
even more susceptible to get sick. It becomes a vicious,
negative feedback cycle. These individuals are the most likely
candidates for digestive and chronic illnesses during
childhood and as an adult.
Some children have received so much antibiotic therapy
their body no longer responds to treatment because there
immune systems have been too highly compromised by the
overmedication. Too often the bacteria have developed a
resistance. These are the children who end up with surgery to
place tubes in their ears to provide drainage and hopefully
stop further infections. Yet this never addresses the original
problem of a weakened digestive-immune system and further
cripples it by not correcting the damage inflicted by the
antibiotics.
To further elaborate on this relationship between antibiotics,
the digestive system and health, the Journal of the American
Medical Association recently released their findings of a study
conducted with a Seattle-based health plan that enrolled more
than 10,000 women over a 17 year period. They found that the
higher the antibiotic use, the higher the risk of breast cancer.
Newsday reports, “One explanation for the increased cancer
risk could be that antibiotics can alter bacteria in the
digestive system, possibly interfering with the metabolism of
foods that fights diseases”.
Anytime antibiotics are used, the eliminated MF must be
replaced. The most common replacement is lactobacillus
acidophilus and bifidobacteria. If there is diarrhea associated
with the antibiotic regimen, S. boulardii works well. These
should be taken on an empty stomach (30 minutes prior to
eating or 2-plus hours after eating; some prefer before bed and
upon arising) for a minimum of two weeks. Increased fiber
intake should accompany MF replacement. Many products
come with FOS orinulin to provide nourishment for the MF.
At first, FOS may produce gas. If so, reduce the amount and
slowly build up over a few weeks. Eventually the gas
subsides. If not, it may indicate a more severe dysbiosis and
need further examination. Long term antibiotic therapy may
require more than MF replacement. The integrity of the
intestinal lining may be highly compromised and require more
serious, individualized attention.
Leaky Gut Syndrome
When the lining of the gut has been compromised
sufficiently, it becomes porous, allowing toxic particles to
enter the blood stream. At this point, the SigA and GALT can
no longer keep up with the toxic load. This leads to
inflammation of the intestinal wall, exacerbating the condition
and further permitting more toxins and large food particles
entrance into the blood. This is quite often the scenario in
food allergies and sensitivities and can be the trigger for
autoimmune problems.
The increased toxic burden is handled by the liver (see
article in detoxification). As the liver cleans up the overload,
toxic by-products are produced. Normally, these substances
are neutralized by the reserves of the liver. With the excess of
toxins demanding attention, these reserves can become
depleted and the normal detoxification process hampered.
This can lead to local problems such as gall stones or set the
stage for systemic illnesses including cardiovascular disease,
arthritis and cancer.
As the gut inflammation increases, malabsorption is a
natural consequence. The vital nutrients for maintaining a
healthy gut wall are limited. This accelerates the gut lining
destruction, increases the leaky gut phenomena and deprives
the rest of the body from some of its basic nutritional needs.
Other conditions associated with leaky gut are chronic fatigue,
eczema, chemical sensitivity, joint pains, emotional symptoms
and ADD.
Since there is a strong overlap between dysbiosis and a
leaky gut, many of the same causes and symptoms are shared.
A good way to differentiate is through laboratory testing.
Leaky gut is verified by a lactulose/mannitol test. After
fasting, you drink a solution containing two different types of
sugar molecules, one larger than the other. Urine is then
collected for the next six hours. In a healthy gut, the large
molecule (lactulose) is not absorbed and excreted in the urine.
Mannitol (small molecule) should be absorbed and show up
low in the urine. The ratio of the two sugars is examined.
If it is skewed towards the lactulose, leaky gut is confirmed.
There are also tests for dysbiosis. This is usually done
through stool analysis. Quite often both problems are present.
Candidiasis
One common form of dysbiosis is the overgrowth of the
microorganism Candida albicans. Candida competes with the
lactobacillus and bifidobacteria for space on the intestinal
wall. Their numbers are small so usually there is no harm.
When the MF is destroyed by antibiotics or any of the other
stressors, candida will make the most of the opportunity and
expand its colonies. An overgrowth occurs and when the
numbers become large enough many symptoms arise,
complicating ones health and diagnostic picture.
Diagnosis can be difficult in some cases. Stool tests are not
one hundred percent reliable. Sometimes a urinary indican test
will pick up candida when a stool test can not.
There are times when both are insufficient and the practitioner
must use their clinical experience to interpret the individual’s
symptoms.
There are many remedies on the market to combat
candidiasis. Most individuals require more than one and need
to be monitored for efficacy. Symptom reduction is not
enough. There are times when the remedies can contain or
control further growth of the organism. This allows you to feel
better but is not necessarily corrective. After a certain period
of time re-testing is necessary to determine the microorganism
status. As a reduction in candida is indicated, intestinal repair
must be done to restore integrity to the intestinal tract. This
needs to be accompanied by MF replacement. How this is
accomplished can vary widely from individual to individual.
During this time dietary measures must be followed.
Candida thrives on sugars. All refined foods must be
eliminated. The vast majority of fruits should be avoided. In
severe cases no fruits
should be consumed.
Small amounts of legumes
and whole grains (avoid
gluten foods) are allowed
with proteins and
vegetables. If severe,
grains should also be
eliminated and legumes
monitored. Avoid dairy.
Treating candida is not
as simple as it sounds.
Remember, there are
usually multiple problems
occurring simultaneously.
One further complication can be parasites.
Parasites
Parasites are microorganisms that can trigger any of the
aforementioned problems. If all the therapeutic attention is
directed at eliminating these ailments, correction may be
somewhat palliative but will fall far short of any lasting
corrections. The parasites will continue to harbor in the
intestinal tract preventing any remedies from being effective.
Diagnostic testing involves stool and saliva samples.
Microscopic stool examination searches for the actual
organism. This is not one hundred percent reliable due to
collection techniques, laboratory methodology and location of
parasitic infestation. The saliva test reveals antibody
production in response to the organism. It can be a more
sensitive test. Even if the stool inspection is negative, if the
antibody test is positive, it indicates the presence of a parasite.
Parasites can also be detected through blood and urinary
organic acids.
Parasite infections have been on the rise. Factors that place
you at a higher risk are:
• Eat out often
• Eat at salad bars for meals
• Drink from well water
• Have pets
• Eat sushi
• Travel to other countries i.e., tropical islands
• Past history of food poisoning
• Use of public swimming pools
• Any form of anal sex
Parasites often require strong herbal remedies and sometimes
antibiotics. All antibiotic therapies must be followed with MF
replacement (this holds true for herbs too). Dietary protocol is
not as limiting as the candida restrictions (unless candida is
also present), but dairy is totally forbidden. Remain off all
refined foods. Whole grains, fruits and legumes are
permissible.
Gluten/Gliadin Intolerance
Gluten is a protein found in a variety of grains including
wheat and oats. It will create inflammation of the intestinal
tract and cause malabsorption. If it is left undetected, it can
lead to very serious health issues. Symptoms are similar to
those previously mentioned and include weight loss, failure to
thrive and a chronic sensitivity to the smallest amount of food
with gluten. Approximately
ten percent of those afflicted
develop a bumpy, itchy skin
rash. This condition is not
correctable. Foods with
gluten must be avoided
permanently. Removal of
these foods will allow the
body to repair when given
the proper therapeutic
modalities.
Gliadin is a tri-peptide
molecule within the gluten
protein. Its ramifications
may not always be as severe but it does cause inflammation,
disrupt the intestinal tract and lead to the same dysfunctions.
Generally, once the imbalances caused by thegliadin
sensitivity are corrected, these foods can be re-introduced into
the diet in small quantities without causing any further
problems. Those with gluten intolerance are not so fortunate.
Gluten foods should be eliminated permanently.
With any ongoing digestive disturbance you should be
tested for both sensitivities.
Hopefully this gives you an idea of the inner workings and
complexities of the digestive system. Before starting any
program, try to educate yourself in regards to eating healthy,
stress reduction and developing a sound exercise regimen.
Make small incremental changes and set reasonable short term
goals with a long term goal in mind. Many times our
complaints will decrease by some basic changes. If you find
the results you are getting are not satisfactory, seek out help.
Support groups and the referrals of friends can be a valuable
source of information and guidance.
If you are on any medications and make changes, please
inform your doctor.