The GI system is fundamental to health and wellbeing. There has been an explosion of research into the microbiome (gut bacteria), which has increased our understanding of how important the relationship between commensal bacteria and health is. 

The main functions of the intestinal tract is to breakdown foods we eat so that we are able to absorb the nutrients, water & electrolytes needed to sustain life.

If we take a brief walk through the digestive tract and cover the various parts involved:

-      Mouth –this where the digestion process starts. Saliva released from glands in the mouth contains amylase, which starts the break down of starch and sugars. Saliva also contains immune cells, the most abundant of these is SIgA (Secretory Immunoglobulin A) which provide a first line of defence against pathogens. As well as providing lubrication to the food bolus as you swallow, saliva has numerous roles in dental health. In addition to saliva the action of chewing also start the digestion process but breaking food into smaller particle making it easier to swallow but also aids digestion further along the digestive tract. Chewing also has an effect through neurological pathways to stimulate the production of digestive enzymes further along the gastrointestinal tract.

-      Stomach  - When the food arrives in the stomach is enters into a highly acidic environment caused by the release of gastric juice from glands in the stomach lining. Gastric juice contains digestive enzymes, hydrochloric acid, mucus and bicarbonate. The extreme acidity of the stomach is important for aiding pepsin with the break down of proteins, and to kill off any bacteria.  Enzymes like intrinsic factor are needed to absorb B12 and other important nutrients. In addition to the release of acid and enzymes the glands produces mucus & bicarbonate, which lines the stomach and protects it from the acidic environment. The stomach also contracts and expands to mix the food with the gastric juice and help it breakdown further before it is released in batches into the small intestine.

-      Small Intestine – Once in the small intestine the acidity of the food mixed with gastric juice prompts the lining of the small intestine to produce bicarbonate, which neutralizes the acidity at the mucosal surface. Hormones are also released, which prompt the gall bladder to release bile and the pancreas to produce further digestive enzymes. The walls of the small intestines have numerous folds, which gives a very large surface area so that nutrients and electolytes can be absorbed. This membrane contains huge amount of immune cells to make sure that pathogens are removed before they enter the blood stream. There are also numerous commensal bacteria living in the gut, which are essential.

-      Large intestine -  In this part of the bowel the majority of water and electrolytes are removed. Bacteria also play a role in fermenting certain foods that are then absorbed. What remains is faeces.

-      Commensal Bacteria – It is being recognized that commensal bacteria play an important role in our immune systems ability to function and adapt to ever changing challenges from pathogens. They also breakdown certain foods such as fibre in vegetables to SCFA (Short chain fatty acids) such as butyrate. These SCFA are essential for cells in the gut to survive). If you are wondering what commensal means it is just that these bacteria are good for us and, it is a way to differentiate the role that these bacteria play in health from bacterial pathogens which are detrimental.

-      ENS (Enteric nervous system) – You may have heard the expression “gut brain” - The gut is so large and complex it also has its own nervous system. The ENS is large, complex and uniquely able to orchestrate gastrointestinal behaviour independently of the central nervous system (CNS). An intact ENS is essential for life and ENS dysfunction is often linked to digestive disorders. There is evidence that the ENS can also play a part in systemic neurological disorders.

GI Disorders

Gut problems are common and range from the level of discomfort to serious pain and disease with autoimmune conditions such as Ulcerative Colitis and Chrons disease.

Here is a list of common symptoms related to gut problems

-      Diarrhea

-      Constipaion

-      Alternating Diarrhea & Constipation

-      Bloating and excess gas

-      Stomach aches and pain

-      Abdominal Tenderness

-      Heartburn

-      Nausea

If these symptoms are present and persistant it is important to rule out any serious illness that may be causing them and your GP should be consulted. If there is blood in your stool or if your stool become black and tarry consult your GP immediately.

Many people find that even though they have been given the all clear they still suffer with gut problems.

In Functional medicine we are interested in treating minor issues that can go on to cause bigger problems. This approach means that changes to diet and lifestyle can have a positive effect and also help reduce the risk of complications as we age.

As described the gastrointestinal tract is extremely complicated and there are a huge number of books on the subject, not to mention research papers. In order to make some sense of gastrointestinal problems it is easier to think about the problems in 3 stages.

Stage 1 - Dysbiosis

Dysbiosis is a term that refers to an imbalance in bacteria with in the gut lumen.

Stage 2 – Organ Problems

Various organs are required to function properly to aid digestion, the stomach needs to produce adequate acid, the liver and gall baldder need to release bile, the pancreas has to release digestive enzymes. Additionally the gut itself produces hormones and other excretions to aid digestion as well as moving through the gut via peristalsis.

Stage 3 – Pathogens Present

The presence of unwanted bacteria in the gut can cause low-level chronic infection. This is often due to a bacterial infection of species that are not helpful. These bacteria can produce by products, which are toxic and can cause inflammation and problems with the gut lining which can lead to leaky gut. Once the gut has become leaky these toxic by products can enter the blood stream and cause serious systemic effects.

It is possible to have just one of these problems, without the others, or all three together.

By looking at gastrointestinal problems in this way it is possible to devise protocols and diets using natural products to restore good gut function health and vitality.

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