The gastro-intestinal system is a complex, intriguing and wondrous organ: it has components that have not only evolved with us throughout history but that we now understand play an integral role in well-being and health in many ways.
No one takes pleasure in discussing matters of the bowels. For laymen and scientists alike, the brain and heart are organs that harness much more allure and importance. After all, the heart is the intrinsic pump of life and the brain is the seat of conscious thought. No poet would dedicate a sonnet to the lowly bowel. But when things do go wrong, the experience can be most distressing, accounting for up to 40% of all complaints in the physician’s office.
A SUPER-ABSORPTIVE MACHINE
The gut is the fundamental organ of digestion, enabling us to break down food and absorb vital nutrients into our bloodstream which ultimately nourish our cells and keep us alive. It also helps us eliminate toxins which can then be excreted in our faeces.
A DEFENSIVE BARRIER
The walls of the gut protect us from toxins and potentially harmful organisms that we may ingest from food and which may enter the bloodstream and cause infection. In addition to this we also have an entourage of ‘good’ bacteria that form a protective army, a front line of defence that further prevents any foreign bacteria from penetrating the gut wall.
A FASCINATING MICROBIOME
The healthy functioning of the gut depends on maintaining the correct balance of ‘good’ and ‘bad’ intestinal bacteria. The collective metabolic activity of the gut’s micro-organisms is equivalent to an organ within an organ – they not only keep harmful bacteria at bay, but also help us digest food and contribute to the production of certain vitamins (folate, B12 and K) and proteins, which keep the cells of the gut energised and healthy. Researchers are just beginning to unravel the mysteries of how changes in the normal composition of gut bacteria may influence health and trigger disease in genetically susceptible individuals.
THE SEAT OF ALL HEALTH – REGULATING THE IMMUNE SYSTEM
The gut itself has, in a sense, its own immune system which exists as pockets of lymph tissue (containing fighter immune cells) throughout the digestive system. A healthy composition of intestinal bacteria often begins in infancy – breastfed children have healthier diversity of their gut bacteria than formula fed infants and research is showing that this can affect the health of the immune, nervous and hormone systems later on in life. A disruption in this delicately balanced bacterial ecosystem may give rise to a number of health conditions within the bowel including food intolerances, allergies and inflammatory bowel conditions. The role of imbalanced gut flora in diseases outside of the gut is also being explored with possible links to chronic fatigue syndrome and certain autoimmune diseases like rheumatoid arthritis, ankylosing spondylitis (a form of spinal arthritis) and multiple sclerosis.
A MIND OF ITS OWN?
The gut is the only organ containing its own intrinsic nervous system. Known as the enteric nervous system, it can mediate reflexes independently from brain or spinal cord input. The enteric nervous system contains not only nerve cells but is also a warehouse of neuro-chemicals that help different cells communicate with one another. Curiously, these chemicals are the same as those found in the brain, for example, serotonin. Whilst it is indeed true that the brain can affect the function of the bowel and that the gut can function quite independently from cognitive thought, a perplexing thought that intrigue scientists: Can the health of the gut also affect the brain? Can it influence our mental health and emotional well-being? The significance of a gut-brain axis has been well researched and restoring the correct balance of intestinal bacteria could influence pain, mood, behaviour and even weight. This certainly adds a whole new dimension to the term ‘gut feelings.’
DIGESTIVE UPSETS – INFLAMED OR IRRITABLE?
When our guts misbehave, giving rise to symptoms such as heartburn, constipation, diarrhoea or cramps, the experience can be intensely uncomfortable and embarrassing.
Crohn’s disease and ulcerative colitis are collectively known as Inflammatory Bowel Diseases (IBD) since they are associated with specific inflammation of the gut lining. Crohn’s disease can affect any part of the gut from mouth to anus whereas ulcerative colitis is typically limited to the rectum and colon. Symptoms may include:
- blood in the stool
- diarrhoea
- abdominal pain and/or cramping
- mucous or pus in the stool
- fatigue
- weight loss
Irritable Bowel Syndrome (IBS) is associated with digestive symptoms in the absence of specific inflammation in the gut. Patients experience abdominal pain and changes in bowel habits, normally with either constipation or diarrhoea predominating in a given patient. IBS is a disorder of the motion of the gut and whilst psychological factors influence this, the exact cause is not fully understood. Genetics, infection, the role of the gut flora and inflammation are increasingly recognised as causal but the specific contribution of each remains elusive.
DIETARY AND LIFESTYLE TRIGGERS
Psychological stress, dietary and lifestyle factors can all trigger digestive symptoms. Nicotine from cigarette smoking and alcohol influence the motility and internal environment of the gut. Highly refined carbohydrates including sugars (particularly fructose) and gluten as well as dairy products can trigger the symptoms of IBS. One study recently showed significant improvement of IBS symptoms in patients following a low carbohydrate diet. Coffee and acidic foods such as tomatoes are well-known heartburn culprits. Studies have shown that regular exercise both directly and via stress-lowering effects improved digestive complaints in IBS sufferers.
TREATMENT OPTIONS
Traditional
Inflammatory bowel diseases should be managed by a gastroenterologist. Medications given during severe flare-ups can include steroids to reduce inflammation, immune-modifying drugs and antibiotics. IBS is treated according to what bowel pattern predominates: antispasmodics and antidiarrhoeal medications in diarrhoea-predominant cases and fibre combined with laxatives in constipation-predominant cases. Anti-depressants and medications targeting serotonin receptors are also sometimes used.
Non-pharmaceutical treatments
Restoring and maintaining a healthy gut is based on the rule of the 4 ‘Rs’:
- Remove harmful organisms including yeasts, bacteria, viruses or parasites.
- Repair the cells of the gut wall lining with essential nutrients. Good protein intake is essential for proper immune functioning. A recent study showed that specific amino acids (building blocks of protein) like glutamine in addition to a diet rich in protein helped to maintain healthy intestinal cells, gut flora and gut barrier function as well as normalising the immune functions of the gut. Omega-3 fatty acids may be useful for their anti-inflammatory effects.
- Replace normal gut flora populations with probiotics, particularly lactobacillus and bifidobacteria strains.
- Restore and maintain gut balance with digestive enzymes, dietary modifications and exercise. Some patients experience soothing effects with remedies like peppermint oil.
CONCLUSION
New insights into the gastro-intestinal system reveal that the gut is far more than just an excretory organ. It plays a pivotal role in overall health as a key modulator of the immune system. Whilst we know it interacts in curious ways with our hormonal, metabolic and nervous systems, the significance of these connections is still being unravelled by the scientific community. Changes in the delicately balanced microenvironment of the bowel have been linked to a number of diseases both inside and outside of the intestines paving the way for new and novel treatments to be explored. Look after your digestive system with a healthy diet and it will look after you. After all, didn’t your mother ever tell you to listen to your gut?
Editor's note: Since the publication of this article, it has come to light that supplementing with a specific short chain fatty acid (SCFA), Butyric Acid, help rebuild the colon cells and prevent further leaky gut symptoms. Butyric acid, or butyrate, is an SCFA produced by probiotic fermentation of fibre in the lower intestinal tract. Supplementing with butyric acid is an emerging approach to not only tighten the junction proteins that seal the gut barrier, but also strengthen the gut microbiome. Butyric acid is the primary source of energy for our colon cells, and it repairs, strengthens and protects the gut lining.
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