Digestive Disorders

images-1Anatomy of the GUT

Perhaps the most common source of problems, the gut, is also the most important. It is required for digestion of food, absorption of essential proteins, carbohydrates and fats as well as vitamins, minerals and trace elements.

It contains a living ecology of billions of bacteria performing essential functions. Disorders of this environment alone can cause major health problems. In fact the gut its been estimated, to contain up to 10x more microbes than the total of our own human cells! This microbiome is the largest growing area of research. Interactions between microbes and the human host are far reaching. Our immune system, brain function, nutrient supplies, protection from ingress of toxins yet allow required molecules – its complexity is mind boggling. There is interchange of DNA – swapping information, imprinting, virus to bacterial to human…….it makes taking a simple probiotic seem so inconsequential when considering the scope.

wheatBut more sobering is the harms to this massively important ecosystem from what we put into it – processed foods, toxic chemicals in foods, in the environment, antibiotics in foods as growth stimulators, widespread use of herbicides. Diet change can alter the microbiome structure in days.

Obesity can be induced in animals by changing gut flora (microbiome). The jigsaw pieces start to make more sense.

Importantly, the internal gut environment because of its exposure to invasion by unfriendly microbes requires an exceptionally vigilant and powerful protection system. No wonder that 80% of the body’s immune system is positioned in and around the walls of the entire alimentary tract.

 

 

intesthealthThe diagram shows a healthy intestinal lining on the left with millions of good bacteria, tight cell junctions and the villi (like a carpet pile) are thick and pink. On the right, the villi are sparse, cell junctions loose (permeable) and good bacteria are fewer whilst pathogenic (harmful) microbes are predominant. Toxins, partially digested food molecules, microbes can easily penetrate through this ‘leaky gut’ and cause local and widespread immune problems. Many of the 81 auto-immune diseases are initiated in the gut. Auto-immune means that the body’s own defence system has been ‘tricked’ or inadvertently turned on its own tissues causing serious damage. Examples are Coeliac disease, rheumatic fever, rheumatoid arthritis, thyroid and other gland disease and so on.

Attention to the GUT health should be the first area of attention. Its the one that many are afraid to do for many live to eat – rather than the opposite.

The effects of disorders and diseases of the gut can be very localised or have general effects throughout the whole   body and can affect almost any organ or tissue system. Skin disorders, arthritis, autoimmune diseases, brain, behavioural, fatigue, brain fog,  mental health issues and so on. This is why it is so vital to have an OPTIMAL digestive system.

Management

Disorders of the intestinal tract are numerous, some examples are:

  • Inflammation, ulceration (IBD – Inflammatory Bowel Disease like Ulcerative Colitis, Crohn’s Disease.
  • Cancers – Colorectal cancer is very common. Poor bowel conditions can predispose along with genetic factors.
  • Infections – bacterial, parasitic, viral
  • Dysbiosis – disturbed flora composition
  • Obstructions
  • Disordered digestion or absorption – reduced enzyme production, damaged intestinal lining
  • Motility disorders
  • Food intolerances/Allergies
    • Coeliac
    • Wheat Allergy
    • Non-Coeliac Gluten Sensitivity NCGS
  • Autoimmune Disorders – Coeliac and others

GUT disorders expanded

Click to expand a fuller pdf  Gastro-Intestinal Disorder chart. This forms the basis for my patient workup with digestive symptoms. Its a big chart – you can zoom in.

Common Symptoms

  • “irritable bowel syndrome’
  • pain
  • bloating
  • loose stools
  • constipation
  • blood or mucus in stools
  • wind – gas
  • indigestion
  • food sensitivities
  • skin conditions
  • joint pains
  • breath issues
  • mind functional problems
  • children behavioural problems

The clinic workup:

  1. establish a good medical history of events, a time line, associated symptoms
  2. dietary evaluation
  3. relevant examination
  4. investigations

Investigations – are chosen relevant to each case  – ensuring the test is cost-effective.

  1. Full blood workup
    1. include Coeliac testing
  2. Routine Stool analysis – pathogens
  3. Elimination – Challenge diet
  4. Food allergy testing – blood test for 96 foods by IgG and IgE antibody assays.
  5. Gut Permeability test
  6. Liver Detoxification Profile
  7. CDSA (Complete Diagnostic Stool Analysis)
  8. Bioscreen stool sample (Melbourne lab) – live analysis
  9. SIBO – Small Intestinal Bowel Overgrowth
  10. Ultrasound imaging
  11. Gastroscopy (specialist)
  12. Colonoscopy (specialist)
  13. Intestinal Camera (specialist)

gluten free dietWhy are we seeing more gluten free foods!! Why are more people going GF? Is it a fad?No!!

 

Firstly lets define contemporary gluten disorders –

  1. Coeliac Disease – an Auto-immune disease, genetically linked
  2. Wheat allergy – true IgG antibody driven allergy
  3. NCGS – Non-coeliac gluten sensitivity – not allergic
  4. Non specific stages of above.

Gluten-Sensitivity-Hydra-Pic-1024x713Coeliac disease is a well defined typical auto-immune disorder – in fact one could say the ‘poster child’ for AIDs. A specific part of the gliaden protein (in gluten) which is regarded by human surveillance immune cells as a threat. The response is to produce a defence – ie antibodies, which will attack the threat – which happens to be gluten. However, the antibody, anti-tG2  – attacks an enzyme in the intestinal wall leading to inflammation and eventual destruction.

imagesA leading GUT researcher in the world, Prof Alessio Fasano has taken the understanding to new levels.

What is less appreciated, is that other anti-TG Human TGsantibodies will attack other parts of the body, leading to many possible diseases. Research is occurring rapidly to confirm the role in even schizophrenia, ataxia and other brain diseases. Some bgrain brainbelieve it may have a role on dementia as well (Dr Perlmutter). Dr Chris Reading, 20 years ago,  in Australia found many cases of profound depression caused by gluten. Getting them totally GF resulted in complete cure.

Why?

Dr Davis and Dr Perlmutter have written books Dr Davisthat go a long way to explain this. Gluten is added to so many foods. Never in human history have we gorged gliadenso much on refined flour. Moreover, the new wheat is the Dwarf hybrid  -which has a far more complex gluten/gliaden molecular structure than the old traditional wheats prior to 60 years ago. It appears to be reacting more and more, and perhaps worse with each generation. Different groups in gliaden (from gluten) protein (coloured in diagram) can react with the immune system causing the wide spectrum of disease patterns.

Fasano_Gluten-Causes-Leaky-Gut-In-EveryoneDr Fasano’s research has led him to realise that EVERYONE gets some degree of leaky gut by eating gluten! Its a matter of how ill do you want to be OR GET.

Treatment Strategies

Treatment

Treatment will be based on diagnosis. The objectives are to move towards a functional intestinal tract.