Using the analogy of a misbehaving child, your gut will misbehave when you give in to its every whim. If you shower your gut with riches (i.e. rich food), it may eventually become spoiled.
You need to know what buttons to push to keep your gut in line. You have to pay attention to your gut so you know what it likes and what it does not.
Similar to a parent/child relationship, your gut takes it cues from the host, and will exhibit symptoms accordingly. Perpetually ignoring a problem with band-aid therapies will stunt the gut's ability to be independent.
Enough of the analogies. Now the data:
Intestinal Permeability
The intestinal wall is the most important barrier against the external environment. It is modulated by the immune system. When the wall begins to crumble, it allows external stressors to invade our bodies unopposed. Our immune system then goes into overdrive, which creates inflammation, compromises our ability to properly absorb nutrients, and causes us to the feel the adverse symptoms that lead to numerous gastrointestinal disorders.
A review in the July issue of American Academy of Allergy and Immunology names intestinal barrier dysfunction as the major factor contributing to predisposition for inflammatory diseases, including food allergy, inflammatory bowel disease, and celiac. AAAI lists several factors that contribute to weakening of the intestinal wall:
Remove
Discover what the is creating the problem and remove it completely.
Replace
Present your gut with compatible macro and micronutrients.
Repopulate
In most cases, when removing gut irritants, health microflora (probiotics) is absent. Infusing your gastrointestinal tract with probiotics is essential for healing.
Repair
When the gut is presented with the proper tools, it heals itself. While it can be a long road, we have clients who find relief almost instantaneously.
Testing
An allergist can diagnose any IgE (true) allergy through R.A.S.T. blood test or scratch/intradermal tests. Many allergists do not test for IgG food intolerances. We use a very reliable lab (Biotrition) that tests blood for over 200 foods and spices. An elimination diet with challenges is also an option, especially for gluten intolerance, in which a challenge is the gold standard. A proficient gastroenterologist should diagnose most gut disorders including Celiac disease, IBD, IBS, Ulcerative Colitis. A licensed dietitian nutritionist like myself can help you with dietary and lifestyle implementation.
Natural Alternatives
In some cases, medication may be required short-term to calm the gut to allow healing. Probiotics, Zinc Carnosine (Zinlori), and Digestive Enzymes are three common natural therapies to accelerate healing. In addition, a host of vitamins, minerals, and herbs are extremely effective. However, these substances need to be individualized by a licensed health professional.
GERD and Reflux
Rare Form of Reflux
While exhibiting the same symptoms as the more popular acid reflux, bile reflux is a backup of digestive fluid (bile). Bile is an alkaline fluid released from the gallbladder that aids the small intestine in the digestion of fats. For those who get no or only partial relief from acid reflux medication, your doctor should rule out bile reflux. If not treated, it can create bleeding ulcers, Barrett's esophagus, and esophageal cancer. Bile reflux can occur after gallbladder or gastric bypass surgery, from scar tissue or peptic ulcer blocking its normal path, and of course, poor dietary choices.
You need to know what buttons to push to keep your gut in line. You have to pay attention to your gut so you know what it likes and what it does not.
Similar to a parent/child relationship, your gut takes it cues from the host, and will exhibit symptoms accordingly. Perpetually ignoring a problem with band-aid therapies will stunt the gut's ability to be independent.
Enough of the analogies. Now the data:
Intestinal Permeability
The intestinal wall is the most important barrier against the external environment. It is modulated by the immune system. When the wall begins to crumble, it allows external stressors to invade our bodies unopposed. Our immune system then goes into overdrive, which creates inflammation, compromises our ability to properly absorb nutrients, and causes us to the feel the adverse symptoms that lead to numerous gastrointestinal disorders.
A review in the July issue of American Academy of Allergy and Immunology names intestinal barrier dysfunction as the major factor contributing to predisposition for inflammatory diseases, including food allergy, inflammatory bowel disease, and celiac. AAAI lists several factors that contribute to weakening of the intestinal wall:
- Chronic alcohol consumption (moderate to copious consumption);
- Nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, which brings a high incidence of gastrointestinal side effects, including intestinal permeability, ulcers, perforation, hemorrhage, hypermotility, and IBD;
- Presence of pathogens such as E. coli and clostridium difficile, along with a lack of healthy microflora (i.e. probiotics);
- Psychological and physical stress;
- Incompatible diet.
- Food Intolerance and Allergy
The level of intestinal barrier dysfunction correlates with the severity of symptoms. Mismanaging symptoms leads to gastrointestinal diseases such as Crohn's and Eosinophilic Esophigitis, - Inflammatory Bowel Disease
In patients with IBD, it occurs in 10-25% of their healthy first generation relatives. - Celiac Disease
- Gliadin crosses the intestinal barrier and activates the immune system. Not surprisingly, healthy first degree relatives of celiac suffers also have increased risk of permeability.
- A Mayo Clinic study that appears in Gastroenterology states that undiagnosed celiac disease in the U.S. is increasing in prevalence (1 in 100, up from 1 in 133 ten years ago) and is linked to a nearly fourfold increased mortality.
- A study in British Medical Journal says that a minority of patients with recurrent mouth sores have celiac disease. In this five percent of celiac disease patients, recurrent mouth sores may be the sole manifestation of the disease. All patients showed significant improvement in sores after 2 to 6 months on a gluten-free diet.
- Every cell lining the small intestine bristles with thousands of tightly packed microvilli that project into the gut lumen, forming a brush border that absorbs nutrients and protects the body from intestinal bacteria. In the June issue of the Journal of Cell Biology, researchers now find that microvilli emit gut enzymes to get a head start on breaking down food and could also be an important defense mechanism against intestinal pathogens. This is a very important discovery because when the intestinal wall is compromised, villi are destroyed This is why it is so critical to diagnose a gluten issue so that proper nutrient absorption persists.
- Type 1 Diabetes
Destruction of insulin-producing pancreatic cells. - Irritable Bowel Syndrome
Psychological and/or physical stress and diet are the main causes. According to a study in the July issue of the Journal of the American Dietetic Association, IBS symptoms in one quarter of patients may be caused or exacerbated by one or more dietary components. The study targets certain sugars and insoluble fiber as a few of the foods that may worsen symptoms. A modified exclusion diet and stepwise reintroduction of foods or trials of eliminating classes of food is useful. - Ulcerative Colitis
Due mainly to psychological and/or physical stress.
Remove
Discover what the is creating the problem and remove it completely.
Replace
Present your gut with compatible macro and micronutrients.
Repopulate
In most cases, when removing gut irritants, health microflora (probiotics) is absent. Infusing your gastrointestinal tract with probiotics is essential for healing.
Repair
When the gut is presented with the proper tools, it heals itself. While it can be a long road, we have clients who find relief almost instantaneously.
Testing
An allergist can diagnose any IgE (true) allergy through R.A.S.T. blood test or scratch/intradermal tests. Many allergists do not test for IgG food intolerances. We use a very reliable lab (Biotrition) that tests blood for over 200 foods and spices. An elimination diet with challenges is also an option, especially for gluten intolerance, in which a challenge is the gold standard. A proficient gastroenterologist should diagnose most gut disorders including Celiac disease, IBD, IBS, Ulcerative Colitis. A licensed dietitian nutritionist like myself can help you with dietary and lifestyle implementation.
Natural Alternatives
In some cases, medication may be required short-term to calm the gut to allow healing. Probiotics, Zinc Carnosine (Zinlori), and Digestive Enzymes are three common natural therapies to accelerate healing. In addition, a host of vitamins, minerals, and herbs are extremely effective. However, these substances need to be individualized by a licensed health professional.
GERD and Reflux
Rare Form of Reflux
While exhibiting the same symptoms as the more popular acid reflux, bile reflux is a backup of digestive fluid (bile). Bile is an alkaline fluid released from the gallbladder that aids the small intestine in the digestion of fats. For those who get no or only partial relief from acid reflux medication, your doctor should rule out bile reflux. If not treated, it can create bleeding ulcers, Barrett's esophagus, and esophageal cancer. Bile reflux can occur after gallbladder or gastric bypass surgery, from scar tissue or peptic ulcer blocking its normal path, and of course, poor dietary choices.
Acid Reducing Meds May Lead to Dependency
Treatment with proton pump inhibitors (PPIs) for eight weeks induces acid-related symptoms like heartburn, acid regurgitation and dyspepsia once treatment is withdrawn in healthy individuals, according to a new study in Gastroenterology.
"The observation that more than 40 percent of healthy volunteers, who have never been bothered by heartburn, acid regurgitation or dyspepsia, develop such symptoms in the weeks after cessation of PPIs is remarkable and has potentially important clinical and economic implications," said Christina Reimer, MD, of Copenhagen University and lead author of the study. " This study indicates unrecognized aspects of PPI withdrawal and is a very strong indication of a clinically significant acid rebound phenomenon that needs to be investigated in proper patient populations."
The use of PPIs for acid-related symptoms and disorders is extensive and rapidly escalating. While the incidence of new patients being treated with PPIs remains stable, the prevalence of long-term treatment is rising, the reasons for which are not fully known. Studies have shown that up to 33 percent of patients who initiate PPI treatment continue to refill their prescriptions without an obvious indication for maintenance therapy.
Rebound acid hypersecretion, defined as an increase in gastric acid secretion above pre-treatment levels following antisecretory therapy, is observed within two weeks after withdrawal of treatment and could theoretically lead to acid-related symptoms such as heartburn, acid regurgitation or dyspepsia that might result in resumption of therapy.
When you continually block the production of stomach acid, your body becomes more efficient in producing it. So when you stop the PPI, you will overproduce acid for a period of time. This is why people who want to stop PPIs must SLOWLY wean off them.
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