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Settling Your Stomach

DaVinci Laboratories

Digestive health can be achieved through dietary changes and supplements.

Digestive disorders encompass a wide range of both chronic and acute conditions, but one common factor unites all of them: when a digestive issue strikes, that is a recipe for misery, as it can impact one’s daily life.

Digestive complaints account for 8 million visits annually to the emergency room, according to the Centers for Disease Control and Prevention (CDC).

“The main digestive health concerns include heartburn, acid reflux (GERD), stomach aches, IBS (irritable bowel syndrome), IBD (inflammatory bowel disease), bloating, diarrhea and constipation,” said Laurel Sterling, MA, RD, CDN, national educator for Carlson Labs, an Illinois-based manufacturer.

“According to the American College of Gastroenterology, 60 million Americans suffer from heartburn at least once a month. While it’s a common issue for older people, it’s now become a growing problem for younger adults. Millennials and younger people, particularly those ages 18-24, are reporting increased bouts of indigestion and upset stomach, nausea and anxious stomach,” added Deborah Kelly, director of public relations for Boiron USA, a Pennsylvania-based manufacturer.

The typical Western diet is not conducive to optimal gut health, with its abundance of processed foods, saturated fats, sugars, etc., noted Tom Bayne, president of Microbiome Labs, a Florida-based manufacturer. “Furthermore, excessive use of antibiotics, NSAIDs (nonsteroidal anti-inflammatory drugs), and proton pump inhibitors (PPIs) can cause gut dysbiosis, and this also concerns people. People want to know more about the ingredients that are in their food and how certain medications will affect their gut and overall health,” he said.

Causes of Indigestion

More research today is focusing on the gut microbiome and how it interacts with other systems in the body, and many natural practitioners tend to focus on this vital piece of the puzzle in diagnosing and treating digestive disorders. Lifestyle changes can help immensely, and, in conjunction with this, some practitioners recommend supplements or homeopathic remedies.

“There is evidence that many chronic metabolic diseases do, in fact, begin in the gut. This association has a lot to do with the different gut bacteria residing in one’s digestive tracts, as well as the integrity of the gut lining,” said Hank Cheatham, vice president, marketing and sales, Daiwa Health Development, Inc., a manufacturer based in California. Leaky gut can, in turn, result in a chronic inflammatory response.

Mei Wei Wong, marketing director at Sovereign Laboratories, an Arizona-based manufacturer, agreed. “The integrity of the bowel wall and the health of the gut microbiome are the two factors that are most important for most people. Inflammation in the gut can lead to chronic and long-term injury, but changes in lifestyle and dietary habits can go a long way to restoring the health of the digestive tract.”

Many natural practitioners recognize that digestive health is intricately connected to overall health. “Our bodies are extremely fine-tuned machines. Once we are familiar with doing what is ‘right,’ including eating properly and exercising regularly, we will have a positive impact on our digestive health (and vice versa),” said Terrence Tormey, CEO of Kibow Biotech, a manufacturer based in Pennsylvania.

“Many factors contribute to indigestion, including eating too fast or too much, smoking and lying down after a meal. Certain foods like citrus, spices, fatty food and alcoholic or caffeinated beverages can trigger symptoms,” said Kelly.

A diet low in soluble and insoluble fiber also contributes to digestive issues, as does stress, certain medications and lack of mobility, added Sterling.

Leah Linder, ND, science and education manager with SFI USA/Klaire Labs, a Nevada-based manufacturer, agreed that lack of fiber is a major contributor to digestive-related disorders. “Only 5 percent of people in the U.S. meet the Institute of Medicine’s recommended daily target of 25 grams for women and 38 grams for men. That amounts to a population-wide deficiency,” she said, adding that a fiber-rich diet is associated with better gastrointestinal health as well as a reduced risk of inflammatory disorders.

She continued, “Additionally, while the research is still relatively nascent, fiber’s role in nourishing our gut microbiome is likely its main health benefit. So, in that sense, fiber is one of our greatest super-nutrients.”

Conventional Medications and Treatments

Many Americans take prescription medications, such as PPIs, promotility agents and histamine-2 blockers for chronic heartburn and reflux, and many others take occasional over-the-counter medications for acute episodes. For GERD alone, there were more than 64 million people taking prescription medication in 2004, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

However, some of these medications can cause side effects or may have negative effects, long term. “In recent months, the Food and Drug Administration (FDA) issued a statement that some of the leading heartburn medicines contained a probable human carcinogen. Now that the products in question have been voluntarily removed from store shelves, consumers are looking for safer, more natural alternatives to treat their heartburn,” said Kelly.

Often in conventional medicine there is a disconnect between symptom management versus root-cause healing, said Dr. Linder.

Many consumers also take antibiotics or laxatives but these can “…throw our digestive system out of balance,” said Bayne, as antibiotics can kill off good bacteria and create an environment where antibiotic-resistant pathogens can grow.

Natural Approaches

Because many practitioners understand the gut’s association with general health, a holistic approach is generally warranted when treating patients who have digestive concerns. An improvement in dietary and lifestyle habits, though not an overnight fix, is, for many patients, the most effective means to heal the gut microbiome.

“The microbiome is a key factor for good health throughout life, and serves many functions. It is the seat of our immune system—more than 70 percent of our immune system resides in the gut. We want to help feed the microbiome the ingredients that it needs to do its job the right way,” said Wong.

Dr. Andrew Rubman, a naturopath in Connecticut with a special interest in gastroenterology, said he always advises patients who have digestive concerns to chew slowly. “The idea is to break up the food into smaller particles so that it can be more easily digested,” he said, adding that this process will stimulate the vagus nerve.

He does not believe in suppressing acid with drugs. “The stomach needs to have concentrated hydrochloric acid to digest food,” he said, adding that if you neutralize stomach acid with medication, you’re doing a disservice to your body. Dr. Rubman also advises against drinking too much liquid with meals.

“If you chew very thoroughly and don’t water your meal down with a lot of beverages, avoid antacids and let your stomach develop a very strong acidic environment, that will trigger a cascade of events that will allow for digestion of food and uptake of nutrients. That is three-quarters of the problem that people with digestive issues face. If they do these things, [they] will find themselves doing better and their system functioning better,” he advised.

If GERD symptoms persist after a meal is digested, he recommends dissolving a couple of teaspoons of baking soda in 6 oz. of water. He also prescribes botanicals, his favorite being slippery elm bark, best used in a very warm tea. He said he also prescribes probiotics, but not as a first intervention, though he did say that they do tend to help most people. Kelly said that homeopathic medicines are often an ideal choice for a first line of treatment. “Improvements are usually seen quite rapidly, particularly in acute conditions and when treatment is started at the onset of symptoms. Chronic conditions will require the attention of a practitioner knowledgeable in homeopathy and may require more time for improvement,” she said. She said that homeopathic medicines have no known interaction with other medications, herbs and supplements, have a very low risk of side effects, and will not exacerbate pre-existing conditions.

Other lines of defense include supplements such as omega-3s, prebiotics, probiotics and digestive enzymes, noted Dr. Linder. All three have their unique properties. For example, said Dr. Linder, many people turn to probiotics to aid in digestion and to promote healthy ecology within the GI (gastrointestinal) tract. And digestive enzymes support the ability to digest food and assimilate nutrients by breaking down larger molecules and make them easier to absorb.

And then there are prebiotics.

“Rapidly increased awareness of the influence the gut microbiome has on our health has caused researchers to look into new ‘prebiotic fibers’ for their benefits. Prebiotics are fibers, which are used by the good bacteria living in your gut. Prebiotics allow the growth of good bacteria residing in your gut to outcompete the pathogenic microbes, thus leading to a more balanced gut microbiome,” said Tormey.

“Chiropractic, massage, yoga, acupuncture, exercise, a proper diet and drinking enough water all assist with digestive health. Some of the best natural remedies include fiber, probiotics, digestive enzymes, aloe, magnesium, chamomile, ginger, omega-3s, lavender and peppermint,” said Sterling.

When a food sensitivity is suspected as the root cause of a digestive issue, often practitioners will prescribe elimination diets or order stool tests, said Bayne.

Natural Supplements for the Practitioner Market

Boiron, a homeopathic medicine manufacturer, offers several homeopathic multi-symptom medicines that address such digestive issues as heartburn, indigestion, gas, bloating and diarrhea. For example, Acidil melt-away tablets target heartburn, stomach pain and bloating, and can be taken with or without food. “It has no known drug interactions and will not slow down the absorption of other medications or micronutrients,” said Kelly. She explained that the active ingredients are Abies nigra (black spruce resin), Carbo vegetabilis (activated charcoal/wood charcoal), Nux vomica (poison nut), and Robinia pseudoacacia (black locust bark).

Two other products by Boiron are Gasalia, which helps the whole digestive track, and the new Diaralia for diarrhea relief.

Kibow offers three products: Kibow Renadyl, for kidney health; Kibow Fortis, a fiber product comprised of seven functional prebiotic fibers; and Kibow Flora, a blend of six strains of probiotic bacteria. Of Kibor Renadyl, Tormey said that it is “…the first and only use of probiotics for those with serious kidney illness” and that the patented formula is used by nephrologists, dialysis centers and patients around the world.

Carlson Labs has 10 products related to digestive health. The latest are the Kid’s Probiotics Stix, Ginger ALL and Natural Digestive Enzymes; others include Aloe Vera Gel, Golden Aloe, Nutra Support Digestion and Serrapeptase. All of these include natural ingredients, such as the inner gel of the aloe vera leaf in the Aloe Vera Gel and Gingever, a concentrated high-potency extract in Ginger ALL. “Ginger has been widely used since ancient times for its digestive effects, and we still use it today to help maintain healthy gut flora, aid in digestion and soothe the digestive tract,” said Sterling.

Colostrum is the key ingredient in the three digestion products manufactured by Sovereign Laboratories, including PRO Colostrum-LD; PRO Daily G.I. Complete; and GastroDefense Stomach Armor. “Bovine colostrum has historically played a role in maintaining health in the face of epidemics and the spread of viral infections. The use of colostrum can be effective especially in situations where there is no specific treatment protocol,” said Wong, adding “Our proprietary liposomal delivery ensures that colostrum’s bioactive components are able to be absorbed where they are needed.”

Microbiome Labs offers about 12 total supplements designed to target the gut, including probiotics and enzymes.

MegaOmega, a gut-specific fish oil, is Microbiome Labs’ recent product launch. “Essentially, we have altered the omega-3 ratios in this fish oil so that it is higher in EPA (eicosapentaenoic acid) and DPA (docosapentaenoic acid) than most DHA(docosahexaenoic acid)-prominent fish oil that are more suited for brain and heart health. This supplement also has pro-resolving mediators within it that improve tissue repair and regeneration,” said Bayne.

The company has also released a stool test called BiomeFx that uses whole genome DNA sequencing and “…provides more insight into precise diet, lifestyle and supplement recommendations,” he added.

ChildLife Essentials, a manufacturer headquartered in California, recently launched ChildLife Clinicals Digestive Health, a diverse array of digestive enzymes formulated specifically for use by children to help facilitate digestion and nutrient absorption; it can be mixed into a child’s drink. “Children need digestive support because their growing bodies and minds are highly sensitive to nutrient deficiencies and digestive dysregulation. Issues which present during the critical periods of growth in a child’s life can manifest in untold ways later in life. In addition, digestive issues can oftentimes lead to a child having a negative relationship with food or cause a reduction in diversity of food types consumed, both of which are unfavorable to proper health and wellness,” said Adam Sutter, quality director.

Klaire Labs focuses on the microbiome and has a vast portfolio of prebiotics, probiotics and digestive enzymes, including its Ther-Biotic line, SIBB-Zymes to support people with maldigestion, and their Vital-Zymes multi-enzyme formulation. Ther-Biotic Complete is the company’s bestselling probiotic and was the first multi-strain dairy-free probiotic offered in the healthcare practitioner channel. A recent release is Ther-Biotic Synbiotic, which combines seven strain-specific probiotics with SunFiber, designed to support microbiome health. Another new SKU is Functional Plant Protein, available in two flavors, which also contains prebiotic fibers.

The active ingredient in Daiwa Gastro Health is IgY Max: antibodies, derived from chicken eggs, that are designed to help the body eliminate only the harmful bacteria and leave the good microbes intact.

State of the Natural Market

With greater consumer awareness and education about the gut microbiome and its importance in regulating overall health, the natural market for digestive products is doing quite well, and additional growth is anticipated.

In “Opportunities in Digestive Health,” the Natural Marketing Institute/Nielsen’s reported that gastrointestinal health is a $65 billion market in this country, with 37 percent of consumers managing a digestive health issue. “Popular ingredients such as probiotics, prebiotics and digestive enzymes make up a significant portion of the market,” said Cheatham. “While it’s not a new concept that consumers follow specific diets to aid digestive health, the products themselves are becoming more visible and abundant, and product labels are becoming more detailed for the health-conscious individual,” he added. “The awareness of the importance of digestive health has driven innovations in the market and I believe created an entire category of not just dietary supplements but functional foods as well.”

Also, the media has been highlighting digestion and digestive solutions as of late, which helps give the market a boost.

Though microbiome research is in its early stages, new discoveries are being made. “This forces nutraceutical manufacturers to continue to research and develop innovative solutions,” said Dr. Linder.

Practitioner Tidbits

Ideally, practitioners should take an integrative approach to digestive concerns to address the root causes, as gut health and a balanced microbiome has long thought to be integral to general health and wellbeing. “This huge paradigm shift toward treating the whole patient, rather than treating their symptoms, is welcomed by many health care practitioners,” said Bayne.

Sterling advised that practitioners discuss the lifestyle issues that could be driving their patients’ digestive problems and recommend natural remedies as a first line therapy for digestion. “I feel that practitioners can best serve their patients by offering other more natural options and remedies, and to look beyond traditional testing measures and beyond just issues with their patient’s digestive health,” she said.

Many practitioners will suggest supplements for their patients as part of an overall wellness care plan, particularly when diet modifications are not sufficient to resolve digestive complaints.

“Practitioners can incorporate natural digestive products into their practice by educating their patients on the importance of maintaining a healthy gut to avoid devastating diseases and the need for natural, digestive supplements because the typical diet is deficient in digestive enzymes,” said Cheatham.

Bayne suggested that practitioners should always ask patients about their gut. “Some good questions would include frequency and consistency of stool, their dietary patterns, abdominal pain and discomfort, constipation etc. However, some less obvious questions may help practitioners understand if gut health is an underlying issue in other conditions. For example, irritability, food cravings, brain fog and joint pain may also be clues that a patient is experiencing leaky gut. So, just be aware that some symptoms may be extraintestinal, but they could still be stemming from the GI tract,” he said.

Because of the complexity of microbiome science, people are turning to their practitioners for expert advice on optimal treatments for their specific health needs, said Dr. Linder. “Having the ability to test, and the knowledge to recommend, the right prebiotics and probiotic strains in proper combination is extremely valuable to patients today. With so many options available to consumers, they need support from their practitioner to help them make the best decision for their individual needs.”

“My advice,” said Dr. Rubman, “is to try to find a properly, nutritionally informed physician. We try to educate you to the degree that you want as to what is actually happening in your system, and to what it is you’re putting in your mouth so that you can make better informed choices about what to eat and when to eat it. I can’t overemphasize enough the importance of consciously choosing your food, processing it properly, and being observant of what is going on with that, so you can live a longer and healthier life and avoid drugs and surgery.”

Healthy Take Aways:

• Practitioners should take an integrative approach to treating digestive issues.
• Dietary and lifestyle changes are often the first line of defense against digestive problems.
• Natural supplements, such as enzymes, probiotics and prebiotics, can be helpful in restoring the gut microbiome.

For More Information:

Boiron USA, www.boironusa.com
ChildLife Essentials, https://childlifenutrition.com
Daiwa Health Development, https://dhdusa.net
Kibow Biotech, https://kibowbiotech.com
Klaire Labs, https://klaire.com
Microbiome Labs. https://microbiomelabs.com
Sovereign Laboratories, www.sovereignlaboratories.com