“When in doubt treat the gut” is one of the most basic tenets of holistic medicine. For many people with chronic health concerns this is clearly true, and they know this because they have symptoms of poor digestion or their main health concerns are worse before, after or during meals. Gut dysfunction can also be the missing causal link in understanding many other conditions which, on the surface, do not seem related to digestion.
Digestion takes place in multiple phases and poor function in any phase can contribute to other problems. The location of the dysfunction often correlates with certain symptom pictures.
The first phase of digestion takes place in the mouth, where the act of chewing releases salivary enzymes. Food broken apart in the mouth travels easily down the esophagus, through the upper esophageal sphincter and into the stomach. Often stress, habit and time constraints lead to rapid eating without proper chewing. This can cause symptoms of heartburn and acid reflux, as well as set the scene for incomplete digestion and other downstream difficulties.
Once in the stomach, food should be churned up with hydrochloric acid (HCl) to break it down into molecules. Stress, rapid eating, poor nutrition, age, certain medications (esp. acid blockers), and certain infectious organisms, and can severely lowers acid levels which hijacks the entire digestive process. This can cause indigestion, as well as fatigue after meals, vitamin and mineral depletion, and of course harms the rest of the digestive process.
The third phase is really a two step process. Well digested food is received into the upper small intestines and is further broken down into its’ most basic forms using enzymes and those particles are then absorbed into the body. The small intestines will become inflamed if the food is not properly broken down by the stomach and the mouth. The inflammation damages the intestinal lining and reduces its’ absorptive and barrier functions. Improperly digested food ferments in the small intestine creating gas, bloating and pain. When you have undigested food particles that can now slip through the damaged barrier of the gut lining then the immune system will see those food particles that have entered the body as foreign and mount an attack. This is how food allergies are born.
In the lower small intestine the fourth and last phase of digestion takes place. Here the absorption process continues and vitamins and minerals are activated by beneficial bacteria. When the gut environment is altered due to undigested food, gas, medications (such as antibiotics, steroids, proton pump inhibitors, etc.), heavy metal toxicity, yeast/bacteria/parasites it the proper metabolism of nutrients does not occur.
The large intestine or colon is the last part of the picture and is mainly responsible for elimination. Elimination of byproducts from detoxification, chemical reactions and other waste. Low fiber in the diet can reduce stool quality and passage. Stress, certain medications, aging, surgery, Celiac disease, diverticulosis and scleroderma are some things that can negatively affect the gut motility or stool passage. Anything that slows the elimination of waste can exacerbate the overall damage to the gut environment as well as lead to reabsorption and recirculation of those wastes.
Gut health is the key player in our immune health as well as our only pathway to assimilate what we need to survive and heal. When the proper function of the gut has been challenged, the effects can initially be subtle, but over time become profound. They say we are what we eat, but more accurately, we are what we can digest and absorb.