The gastrointestinal tract is responsible for many slightly panicked visits—here’s how to help calm the issues.
Digestive issues seem more prevalent than ever. Part of this is because they are, and another is that there is so much more awareness due to marketing of OTCs (over-the-counters) and pharmaceuticals aimed at upper and lower digestive symptom relief.
Daina Parent, ND, naturopathic liaison for Wisconsin-based Standard Process, observed that GI (gastrointestinal) issues are among the top reasons for scheduling a visit with a naturopath. Abdominal pain or discomfort related to gas/bloating, acid reflux, indigestion and bowel movement changes (such as diarrhea and constipation) are common complaints.
According to the American College of Gastroenterology, adults commonly experience GI symptoms, such as heartburn, indigestion, bloating, excess gas, nausea, constipation and diarrhea, pointed out Vicky Mak, technical writer, ChildLife Essentials, California. In children, the most common GI complaints include acid reflux, constipation, stomach aches/cramps, bloating or diarrhea.
Christophe Merville, DPharm, director of Education & Pharmacy Development, Boiron USA, Pennsylvania, cited research from Mintel and Sloan-Hutt, which has shown that gas and bloating and acid indigestion and heartburn are the top two gastrointestinal conditions experienced by consumers. Diarrhea and constipation are also very common complaints. “Traditionally, digestive issues tended to increase with age due to the aging digestive tract and the side effects of medications. More recently, the younger demographic is experiencing digestive complaints at higher rate mostly the result of stress, on-the-go lifestyles, erratic eating schedules and diet fads like keto or paleo,” he commented.
Merville added that younger adults today tend to want quick relief and are not willing to give up their trigger foods. But good news for naturopaths: “There is also a strong preference for more natural options that will fit into their wellness lifestyles especially if they are worried about the long-term effects of traditional over-the-counter medications.”
There often seems to be a common culprit whether it’s an upper GI tract dysfunction or a lower GI issue. According to Hank Cheatham, vice president, California-based Daiwa Health Development, recent research suggests that that the typical Western diet—high fat, high sugar, low fiber intake—has altered the diversity of the gut microbiome, creating dysbiosis, which is a shift in the microbiota composition resulting in a reduction in the number of beneficial microbes and an increase of harmful microbes in the intestinal tract.
“Diet-induced dysbiosis is thought to contribute to many diseases including metabolic syndrome, diabetes, inflammatory conditions, neurological pathologies and psychiatric disorders,” he said. “These changes not only occur over the long-term intake of such a diet but can occur in a single day.”
Dysbiosis and other GI issues may be pernicious in that other affected symptoms may be the reason for your client’s visit. Cheatham explained, “Some related areas of health affected by impaired digestion that naturopaths should tie into are gut-brain health, hemorrhoids, diabetes, kidney stones and other kidney disorders, and metabolic syndrome. Symptoms of food intolerance would include bloating, cramps, diarrhea, headache, heartburn and irritability.”
Stress is a well-known generator of dysbiosis and dyspepsia, among other GI woes. Even before the pandemic, Merville noted, eight out of 10 Americans were already experiencing some digestive issues, with the top three being heartburn/acid indigestion, gas and bloating, and diarrhea. Those who tried to improve their moods by indulging in high-carb, high-fat, high-sugar comfort foods and alcohol are experiencing altered GI function, presenting with symptoms that may be new or intensified.
One previously obscure connection, the gut-brain-axis (GBA), is now much more clearly understood by gasteroenterologists. Even clients get it—feeling stressed out, scared, depressed, creates all sorts of “stomach troubles,” including pain, gas and constipation or diarrhea.
Pamela Wirth, founder and principal of HelloHealth, Arizona, pointed to gut microbes and the immune system as being intimately involved in the GBA. The resident 100 trillion or so microbes in the gut produce SCFAs (short-chain fatty acids), such as propionate butyrate and acetate, by digesting fiber that is consumed. SCFAs are found in high levels in people with healthy guts, and affect brain function in several ways, including appetite, blood sugar control and mental health changes. SCFAs have been shown to increase serotonin in the brain, facilitate food breakdown for absorption, regulate blood sugar in the brain and protect against overgrowth.
“The immune system is another essential connector of the gut-brain axis,” she explained. Gut bacteria communicate with the immune system by emitting signals to regulate its activities, and they also produce substances that influence immune response negatively. Examples include lipopolysaccharides that induce sickness by binding to receptors on cells of the immune system, and the pro-inflammatory prostaglandin E2, produced by gut bacteria that can act as a messenger to signal the immune system. “Inflammation and all these substances are associated with many brain disorders, including motor skills, vocal skills, severe depression, anxiety, dementia and schizophrenia,” she commented.
“Recent advances in research have illuminated the important connection between the gut microbiome and the brain,” emphasized Nancy Morrow, MS, nutrition support manager, Standard Process. “This bi-directional signaling can result from multiple bacterial metabolites, one being short-chain fatty acids such as butyrate. Butyrate has been shown to strongly influence the brain’s immune environment, and directly affect serotonin and gut hormone release to elicit endocrine signaling, impacting brain function.”
Around the GI Horn
Stress, poor diet, sudden drastic dietary changes, new medications and anxiety all impact digestion and appetite. Natural solutions abound, which will help you home in on what’s going on with your client and how you can help him or her restore healthy gut balance and function.
Hello Health’s Belly Great is, described Wirth, a unique blend of 15 probiotics and two prebiotics for the gut-brain axis as well as ImmunoStrong Mighty Might for its unique blend of botanicals on bacterial, viral and fungal support in the gut. “The simplest way the gut-brain axis was described to us by doctors was the need to only put helpful bacteria into the gut but also use plants to detox and remove toxins from the gut for optimal support. We have received great feedback on the Organic Sea Moss+ product as well,” she said.
ChildLife Essentials offers Pure DHA, a berry-flavored chewable soft gel supplement containing essential omega-3 PUFAs that interact with the gut-brain axis, influencing both intellectual development and gut microbial composition, according to Mak. Several studies among infants and children have consistently demonstrated that supplementation with omega-3 PUFAs, especially DHA, can improve cognitive measures and visual function. Consuming both DHA and EPA can directly alter and balance gut microbiota, potentially improving intestinal health and function.
According to Morrow, Standard Process’ GI Stability contains the human milk oligosaccharide, 2’-Fucosyllactose, which acts as a prebiotic contributing to production of short chain fatty acids. The 2’FL in GI Stability has been enzymatically fermented to be bio-identical to the 2’-Fucosyllactose found in human breast milk. “This product combines the latest research of 2’-FL with Collinsonia root, which has been used historically to support normal elimination and digestive health,” she said.
Gut Microbiome Management
ChildLife Essentials offers two products to help manage the gut microbiome in infants and children. ChildBiotics Probiotics with Colostrum is an orange-flavored probiotic powder dietary supplement for young children aged 1 year and older. It combines clinically studied probiotic strains (Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABla-12) with bovine colostrum and prebiotic fructooligosaccharides (FOS) to support healthy digestion and the immune system. DDS-1, alone or with UABla-12, can modulate gut microbiota by increasing the relative abundance of beneficial bacteria and reducing levels of opportunistic bacteria. Bovine colostrum contains specific immunoglobulins that binds to intestinal bacteria, modifies microbiota composition and maintains healthy immune responses toward bacteria in the gut. As a soluble dietary fiber, FOS serves as a nutrient for the gut microbiome, maintaining intestinal bacterial populations and supporting overall gastrointestinal health.
ChildLife Essentials’ LiveBiotics Immune & Digestive Support chewable tablets are a proprietary probiotic blend of Lactobacillus acidophilus DDS-1, Bifidobacterium lactis UABla-12, Bifidobacterium bifidum UABb-10, and Bifidobacterium longum UABl-14 to maintain immune and digestive health in children aged one year and older. In a 2019 randomized, double-blind, placebo-controlled multi-center study, researchers investigated the effects of this multi-strain probiotic within healthy adults with functional constipation. Compared to the placebo group, those who ingested the probiotic displayed a significant increase in the relative abundance of the bacterial family Ruminococcaceae. Increased Ruminococcaceae abundance was shown to have beneficial implications for the human gut, being positively correlated with improved stool consistency and faster intestinal transit.
Promoting Bowel Regularity
Stephanie Seitz, ND, MT (ASCP), MPH, who practices at Natural Kid Doc, Scottsdale, AZ, said that for both constipation and diarrhea, “rule out” hypothyroidism and hyperthyroidism, respectively. Clients who complain of frequent constipation should review how much fiber they are normally eating and make a point to add more. For those who are prone to episodes of diarrhea, the BRAT (bananas, rice, applesauce, toast) diet along with probiotics.”
Along with supporting a healthy microbial environment in the gut, Standard Process’ GI Stability contains organic beet and okra for added fiber and phytonutrients, and the herbal component collinsonia root, traditionally used to support healthy elimination, Morrow noted.
GI Adsorb, also from Standard Process, contains a mineral adsorbent/binder known as clinoptilolite, which Morrow described as a zeolite mineral formed from ancient volcanic ash after contact with seawater. She explained, “Clinoptilolite (as G-PUR) has the capacity to trap certain substances to its surface and within its pores. Heavy metals, mycotoxins and cholesterol are among these. This binding ability helps to prevent their absorption and ushers them out through elimination. GI Adsorb also contains cracked cell wall chlorella. Along with adsorbent properties of its own, chlorella contains chlorophyll that plays a role in detoxification support.”
The active ingredient in Daiwa’s Gast4ro Health is IgY Max, which Cheatham described as an innovative element utilizing passive immunity. IgY Max is a polyvalent antigen specific IgY product from specifically immunized eggs that target 26 of the most common human-relevant pathogens. It supports the role of prebiotics by aiding in immune system function and by decreasing “bad” bacteria while leaving the good intact. “Daiwa Gastro Health’s IgY Max promotes GI health by strengthening gut wall integrity, improving bowel function and reducing non-beneficial bacteria adherence,” he pointed out. “Due to its mechanism of action IgY Max in Daiwa Gastro Health is an effective tool to address issues caused by dysbiosis, which can induce irregular bowel function.”
The key ingredients in ChildLife Essentials ChildBiotics Probiotics with Colostrum are clinically researched effects on bowel regularity, according to Mak. In a 2020 RCT of 330 adults with IBS (irritable bowel syndrome), those who consumed DDS-1 and UABla-12 experienced reduced levels of abdominal discomfort and encouraged normal bowel consistency. Specifically, there was a significant reduction in constipation and diarrhea related stool types and a corresponding increase in normal stool types.
The probiotics in ChildLife’s LiveBiotics Immune & Digestive Support also have demonstrated positive clinical outcomes for supporting bowel regularity, according to Mak. In a 2019 randomized, double-blind, placebo-controlled trial, researchers observed that the multi-strain probiotic helped modulate bowel function earlier than the placebo in participants with functional constipation. Compared with the placebo group, the probiotic group showed a faster normalization of stool frequency and consistency.
For young children and infants, ChildLife’s InfantBiotics Probiotic Drops provide proprietary probiotics L. rhamnosus LGG and B. animalis subsp. lactis BB-12 to reduce duration of loose stools in infants and children. Children who consumed LGG demonstrated fewer incidences and shorter episodes of loose and watery stool and normal bowel habits. BB-12 was shown to be associated with softer and more frequent bowel movements, shorter and fewer episodes of loose stools, and overall regularity.
Resolving Nausea & Stomach Turbulence
Clients complaining of upper digestive symptoms, should first be instructed to “Remove offending food and use demulcent herbs to soothe the esophagus,” advised Dr. Seitz. For nausea and belching, she likes to recommend ginger tea.
“One of the most common causes of upper digestive disturbances is an impaired ability to break down macronutrients from food,” said Morrow. “An acidic pH and secretion of enzymes is foundational for this process.”
Standard Process’ Enzycore combines digestive enzymes that act at different pH levels. It provides support for breaking down fiber from legumes and lactose from dairy, as well as full spectrum macronutrient digestion. It also contains l-glutamine to support the gut lining. Morrow commented, “It supports both gastric and intestinal phases of digestion and provides glutamine for supporting the mucosal lining. Further, Enzycore is gluten, dairy, soy and grain free and vegetarian.”
Homeopathy has several remedies your clients may find suitable for upper digestive complaints. According to Merville, several homeopathic medicines, such as Nux vomica and Lycopodium, work not only on the local symptoms such as gas, acid reflux and cramps, but also relieve general and behavioral symptoms, such as irritability, which has a major influence on digestion.
“Boiron’s NauseaCalm is an option for upper digestive disturbances as it relieves nausea and vomiting from everyday causes, including stomach flu,” he said. “It also works for motion sickness nausea. Boiron’s Diaralia can help with lower digestive disturbances like nausea, vomiting and intense fatigue associated with diarrhea or traveler’s diarrhea. And Boiron’s Acidil meltaway tablets relieve occasional heartburn, acid indigestion, bloating and upset stomach.”
You may likely continue to see clients who present with symptoms of GI imbalance, and for those whose primary purpose of consultation with you is a GI dysfunction, addressing stress and anxiety along with diet renovation, adding exercise and supplementation, can help restore the balance and maintain it for the long-term.
Healthy Take Aways
• According to the American College of Gastroenterology, adults commonly experience GI symptoms, such as heartburn, indigestion, bloating, excess gas, nausea, constipation and diarrhea.
• Eight out of 10 Americans were already experiencing some digestive issues, with the top three being heartburn/acid indigestion, gas and bloating, and diarrhea.
• SCFAs have been shown to increase serotonin in the brain, facilitate food breakdown for absorption, regulate blood sugar in the brain, and protect against overgrowth.
• One of the most common causes of upper digestive disturbances is an impaired ability to break down macronutrients from food.