Practitioners can help patients tackle their digestive issues by getting to the root of the problem.
The eyes may be the windows to the soul, but the gut is the key to overall health. According to NYU Langone Health’s Division of Gastroenterology, the gastrointestinal (GI) system serves essential roles in protecting and sustaining the overall health and wellness of the human body, starting with the intake and absorption of nutrients. “Our gut plays a major role, not only in our gastrointestinal health, but in the health and well-being of the entire body,” explained Dr. Lisa Ganjhu, clinical assistant professor of medicine at NYU Langone Medical Center, adding that it is this digestive process that provides the building blocks the body needs to live, to function and to stay healthy.
Often referred to as the body’s “second brain,” the gut is connected to the immune system (approximately 70 percent of the immune system resides in the digestive tract), and can even have an effect on our mood or state of mind. “There is increasing awareness of the link between digestive health and mood, via the gut-brain-axis,” said Hannah Braye, nutritional therapist and technical advisor at Florida-based Bio-Kult (Protexin).
Because the GI system is so involved with a number of the body’s functions, it is quite concerning that so many people today are having digestive issues. Ross Pelton, RPh, PhD, CCN, scientific director for Texas-based Essential Formulas noted that digestive issues are one of the most common reasons people visit doctors. “A 2009 report from the National Institutes of Health (NIH) stated that 60 to 70 million Americans are affected each year by digestive diseases, at a cost exceeding $100 billion and accounting for 105 million visits to doctor’s offices; 10 percent of hospitalizations and 15 percent of in-patient hospital procedures are related to treatment for digestive diseases,” he said.
As for common digestive issues, Serena Goldstein, ND and Natural Practitioner advisory board member, listed GERD, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), such as Crohn’s or ulcerative colitis (UC), diverticulosis, celiac disease, gallstones and hemorrhoids. Dr. Goldstein added that other common issues that may be a trigger include Candida, H. Pylori (overgrowth is strongly linked to peptic ulcer disease), and small intestinal bacterial overgrowth (SIBO), usually associated with GERD. Ryan Sensenbrenner, senior marketing manager for Enzyme Science, Inc. in Florida, added that occasional heartburn is also a major factor in the category.
But what is causing so many digestive issues? Dr. Pelton noted that driving forces within the digestive health category include unhealthy lifestyle trends such as a poor diet, sedentary work and leisure habits and increased levels of stress in daily life are having a detrimental impact on digestive health.
Dr. Goldstein agreed, adding that stress is a driving force behind digestive distress, because it will further alter gut bacteria and the ability to absorb food, as well as the capacity for regular bowel movements. “Stress management is a huge factor, as when we’re stressed out, our body thinks we’re running from a bear (primitive brain)—so it won’t prioritize resources to our digestion and reproduction organs. Without proper resources nourishing our gut, it can lead to ‘leaky gut’ (separation of tight junctions that hold food and other particles in, that then get into our body,” she explained.
For years, conventional OTC and prescriptions drugs, such as proton pump inhibitors (PPIs) and antacids, have been the go-to for digestive distress. “The current OTC market for digestive issues is dominated by drugs that inhibits the production of stomach acids or neutralizes the acid in the stomach,” said Jason Edwards, president and CEO of Indiana-based Rebel Herbs. “This is a massive industry, antacids alone are more than $10 billion annually.”
In addition, these conventional methods often only treat the symptoms of the issue and aren’t dealing with what is at the core of the symptoms. “The best approaches involve uncovering the root cause of the condition,” noted Jessica Brandes, ND, with Nevada-based Klaire Labs/SFI-USA. “That often involves the removal of exacerbating agents, i.e. allergens, foods environmental contributors, eradicating infectious agents, and then improving the integrity of the gut lining and replenishing a healthy microbiome.”
However, as Americans are taking more control of their health, they are learning that many of the conventional remedies are not only just masking the problem, but also may be doing more harm than good. “Research is emerging that points to serious health issues for people that use these OTC or even prescription medications for digestive disorders (liver cancer, and bone loss for example)—this is pushing the public to consider herbal options,” Edwards said.
“Frequent heartburn medications have come under fire from numerous studies linking them to things like dementia and heart disease,” added Sensenbrenner. “These medications are intended to be taken for a short amount of time for severe sufferers, yet those with occasional mild indigestion often take them as well.”
Diet & Lifestyle Changes
In order to fix their digestive issues, people often look to their health care practitioners to help the get back on track, and often, a lifestyle change is in order. “Dietary and lifestyle changes are some of the most important changes one can make and often mean a reduction or discontinuation of conventional medications,” explained Jeremy Appleton, ND with Klaire Labs/SFI-USA. “These changes alone can be incredibly effective.”
Braye agreed that improving the diet is the first step to addressing digestive issues. “Eating foods which are high in dietary fiber and resistant starches will not only keep our bowel movements regular, helping to eliminate toxins from the body, but will also help to feed beneficial bacteria within the gut, she said. “I encourage clients to aim to eat two portions of fruit and at least five portions of vegetables (a rainbow of different colors) a day and to switch to wholegrain varieties of bread, pasta, rice etc. in order to increase fiber intake.” Braye also recommends prebiotic foods, naturally fermented foods and good-quality protein.
Sensenbrenner added that a food allergy or intolerance might be the reason for digestive distress. “When faced with an occasional digestive challenge, we encourage individuals to first look at their diet to determine if the problem could be caused by a specific food or food group,” he said. “Many practitioners work with their patients on elimination diets to identify food intolerances. Once the challenge has been identified, supplemental digestive enzymes, when taken with a meal, can support the digestion of many of these problem-foods.”
While making improvements to their diet, getting enough exercise and sleep are all major factors in improving gut health, supplementation is often an option to not only help repair the gut, but maintain its health once it is back in working order. “A wide range of products exists to help manage digestive complaints, said Dr. Brandes. “Among them, nutritional supplements to help repair the gut lining, followed by pre-and probiotics to help replenish the microbiome and digestive enzymes to assist individuals who may have reduced enzyme production.”
Dr. Goldstein added that the remedy might vary depending on the condition. She noted that magnesium is commonly given for constipation, deglycyrrhizinated licorice (DGL) can be taken before meals to soothe reflux, digestive enzymes are more of a go-to when there’s indigestion, gas, bloating or constipation, apple cider vinegar can help stimulate acid production to promote healthy digestion, while herbs like chamomile, peppermint and fennel help with improved blood flow to the digestive system by calming the system and absorbing gases.
Probiotics & Digestive Enzymes
On the supplement front, probiotics may be one of the most well-known products for digestive health, after gaining notoriety from Activia yogurt commercials that starred Jamie Lee Curtis. According to Dr. Pelton, probiotics help regulate digestion, absorption assimilation and elimination—essentially, everything “works better” when the microbiome is healthy, meaning a wide range of different strains of probiotic bacteria.
“Probiotics are a category of products that are commonly used to help treat and correct digestive issues,” he said. “Scientists now understand that compounds created by probiotic bacteria in the GI tract are responsible for regulating many functions related to human health. We refer to these compounds as post-biotic metabolites. It’s not the actual bacteria, but rather the compounds they produce that regulate digestion, absorption, cell signaling, detoxification, gut-brain communication, our immune system and much more.”
Essential Formulas’ Dr. Ohhira’s Probiotics delivers a complete microbiome system with each capsule containing probiotics, prebiotics and post-biotic metabolites, according to the company. “Dr. Ohhira’s Probiotics is revolutionary in that it is actually a fermented food product that contains probiotic bacteria … as do all fermented foods,” explained Dr. Pelton.
Braye added that, “multi-strain probiotics have been shown to be more effective at inhibiting pathogens and exert their positive effects across more areas of the gastrointestinal tract, therefore potentially helping a more diverse range of digestive disorders.”
Bio-Kult’s probiotic range includes Bio-Kult Advanced multi-strain formula, a unique multi-strain probiotic with 14 strains of beneficial bacteria; Bio-Kult Candéa, which contains seven strains of probiotic bacteria to reinforce the gut microflora, helping to prevent the yeast Candida albicans from finding binding sites in the gut to grow; and Bio-Kult Pro-Cyan, a scientifically developed triple action probiotic formula that works with the body to help maintain normal levels of bacteria in the gut and a healthy urinary tract. The company’s newest addition, Bio-Kult Infantis, is a scientifically developed advanced probiotic formula for babies, toddlers and young children.
“The main benefits of the Bio-Kult product range are that they are multi-strain probiotics providing a wide range of benefits, do not need to be refrigerated, have a guaranteed two-year shelf life, are proven to survive the stomach acidity and reach the intestine intact and are backed with a growing portfolio of research,” Braye noted.
According to Sensenbrenner, probiotics and digestive enzymes are a perfect match, working together to deal with digestion issues. “So often, we see individuals who immediately go to probiotics when faced with a digestive challenge,” he said. “At Enzyme Science, we’re big believers in probiotics as a supplement with enzymes. Probiotics provide fantastic foundational support to set the GI tract up for efficient digestion, but enzymes can be more efficient in that they actively work to break down food. Together, they go hand-in-hand to create solutions for occasional digestive distress.”
Enzyme Science offers a number of natural digestive formulas. The company’s flagship product, Critical Digestion, provides a combination of enzymes and probiotics to break down all of the most common building blocks of foods, such as fats, fiber, proteins and carbohydrates. For food intolerances, Intolerance Complex covers all of the major food intolerances in one, including gluten, casein, lactose and phenols. In addition, Acid Calm provides a natural alternative for those with occasional heartburn. Sensenbrenner explained that it provides not only digestive enzymes, but also soothing herbs and zinc carnosine, which has been shown to support the mucosal lining of the GI tract.
Klaire Labs also offers a number of products that address digestive health. According to Dr. Appleton, some of the company’s most well-known products in the category include the Ther-Biotic line of probiotics (e.g., Ther-Biotic Complete capsules and powder, Ther-Biotic Children’s Chewable, Ther-Biotic for Infants, Ther-Biotic Women’s Formula, etc.), Vital-Zymes Complete and Vital-Zymes Chewable (digestive enzymes), Interfase and Interfase Plus (enzyme preparations designed to interrupt dysbiotic biofilms), LactoPrime Plus (probiotic), Sequest-AC (formerly Nuvexa, featuring a fat-complexing functional fiber known as alpha-cyclodextrin), Saccharomyces boulardii, ABx Support (a probiotic for people recovering from antibiotic therapy), among others.
Ginger Many people remember their mothers giving them ginger ale when they were young to settle an upset stomach, which it turns out, isn’t an “old wives’ tale.” According to Edwards, ginger extract is well known to improve digestion and reduce nausea. “We deliver it as a single herb powder that will dissolve in water or other beverage and can be used whenever the consumer has an upset stomach of irritated digestive tract,” he said.
In addition to offering ginger as a single herb powder, Rebel Herbs offers #76 Digestade, a broad formula that stimulates the digestive processes to improve the entire operation of digestion. Ingredients in #76 Digestade include fennel see, Embelia ribes, Plumbato zeylanica, Aegle marmelos (bael fruit) and Holarrhena antidysenterica.
Having a healthy digestive system is vitally important for health in general and natural practitioners can help their patients implement the proper diet and lifestyle changes that get on a path to having a healthy gut. Braye noted that practitioners could better serve their patients with digestive issues by encouraging holistic changes, which focus on all aspects of both physical and mental health. “All too often, people fall into the trap of taking a ‘pill for an ill,’” she said. “However, to see significant and lasting improvements in digestive health, supplementation should be used to complement concurrent changes to diet and stress-reducing lifestyle modifications. Protocols should be tailored to meet the individual needs of the client.”
“Digestive health is really at the core of overall health,” concluded Dr. Appleton. “Hippocrates of Kos famously said that all disease begins in the gut. As our understanding of the human microbiome expands, and inter-relations between that system and other body systems become increasingly evident, the words of the father of modern medicine will ring even truer today than they did when they were spoken more than 2,000 years ago.”
Healthy Take Aways:
• Approximately 70 percent of the immune system resides in the digestive tract.
• According to NIH, 60 to 70 million Americans are affected each year by digestive diseases.
• Food allergies or intolerances can be the reason behind digestive distress.
• Ginger extract is well known to improve digestion and reduce nausea.
For More Information:
Bio-Kult (Protexin), www.bio-kult.com
Enzyme Science, Inc., www.enzyscience.com
Essential Formulas Inc., www.essentialformulas.com
Klarie Labs/SFI-USA, www.klaire.com
Rebel Herbs, www.rebelherbs.com