Maintaining Digestive Health

To a large extent our digestive systems dictate our quality of life.

It can be as simple as that, given that we literally become what we eat, digest and assimilate. If the process goes wrong anywhere from intake to elimination, particularly if a chronic condition develops, normal everyday life is affected significantly. 

Digestive disturbances should be addressed early, that way they’re much easier to treat – whether this be bloating, Candida, gastro-oesophageal reflux disease (GERD), ulcerative colitis, Crohn’s disease, colon cancer or anything in between. Improvement in digestive health will impact profoundly on the health of the individual. It’s important to obtain a proper diagnosis if you think you may have a digestive disorder in order to treat it appropriately. Because the scope of this subject is so enormous, for the purpose of this article only a few aspects of digestive health can be covered.

‘I have finally come to the conclusion that a reliable set of bowels is worth more to a man than any quantity of brains.’ (Josh Billings – pseudonym for Henry Wheeler Shaw, 1818 – 1885)

HEALTH BENEFITS OF FIBRE

One of the first things we automatically think of when discussing digestive health is increasing fibre intake.  Fibre is an essential macronutrient in the human diet; unfortunately Western nations are reported to consume less than 50% of their daily recommended quota. Oatmeal for breakfast is an excellent way to include healthy fibre in the diet, unless you suffer from coeliac disease (an intolerance to gluten), which means that wheat, oats, barley and rye are forbidden owing to their gluten content. Whole grains, vegetables, berries and fruit, seeds and nuts are all rich in fibre and are known to prevent a variety of ills including several types of cancer including colon cancer, constipation, ulcerative colitis, Crohn’s disease, diverticulitis, and many other conditions including obesity, type 2 diabetes, high cholesterol and cardiovascular disease.

Fibre improves the absorption of the minerals calcium and magnesium, both of which are needed for a healthy digestive system. Fibre also helps to stabilise sugar levels as it lowers the glycaemic index of food eaten, which in turn improves immunity thus improving overall health. Most sources recommend around 30 g of fibre a day in the average adult diet, but closer to 50 g a day is ideal for diabetics. Fibre needs to pass through to the large intestine, attracting water along the way, where it undergoes fermentation by the colonic bacteria.

‘Fermentation’ is a normal healthy biological process which many people never consider when they eat healthy foods like fresh berries or vegetables. Fermentation is simply the breakdown of soluble, resistant starch comprised mainly of carbohydrate molecules in the large intestine, yielding gases and further useful chemicals like short-chain fatty acids which are the primary form of nutrition for the epithelial cells lining the intestine. A typical property of soluble fibre is to bind with water forming a viscous gel providing numerous health benefits during passage through the digestive system. Fibre products sometimes cause minor gastric discomfort when the user has not previously had sufficient fibre in their diet – the way around this is to introduce it very slowly over the course of a month, increasing water intake proportionately.

Insoluble fibres do not undergo fermentation, but are nevertheless valuable for their water-attracting properties that aid bowel regularity. They also provide a healthy environment for the good bacteria to flourish providing them with ‘food’. Soluble fibres include pectins found in berries, fruit and legumes; cellulose from brans or husks of grains and many vegetables; beta-glucans in whole oats and barley and fructo-oligosaccharides found in a variety of vegetables like artichokes, mushrooms and chicory. Another insoluble fibre is xanthan gum, very useful in gluten-free baking for both its binding and rising properties.

FIBRE FERMENTATION AND PREBIOTICS

The process of intestinal fermentation involves action by natural bacteria, sometimes called flora, residing in our large intestine (primarily the colon). These bacteria require soluble fibre as fuel and as sources for fermentation to produce valuable chemicals and health benefits. Since the fibre serves as food for the bacteria already in the intestine, this is called a ‘prebiotic’, meaning that before the bacteria can serve their main purpose in digestion (producing enzymes that digest food) they must be fed with a substrate they prefer (i.e. fermentable fibres). Although humans have over 400 strains of bacteria in their gastro-intestinal tracts, the predominant resident intestinal flora are bifidobacteria and lactobacilli which are essential to digestive health.

Prebiotics are dietary supplements containing non-digestible and non-assimilable (by the human body) food components that selectively stimulate the growth and activity of probiotic micro-organisms.

PROBIOTICS

It goes without saying that the most important part of good digestive function is a healthy body supported by good-quality, healthy food. However, once your health is compromised through poor eating habits, antibiotics or stress, often the first sign of strain manifests in some sort of digestive problem. At this stage targeted nutrients are needed to restore health. Probiotics are arguably the most important element in the digestive health equation, no matter what the condition. The word probiotic means ‘for life’, and while probiotics work by killing pathogenic bacteria, destroying toxins, boosting antibodies and preventing bacterial and fungal overgrowth, they produce health and life in the intestines in the form of healthy bacteria. After a course of antibiotics it is essential to take a probiotic for some time in order to do damage control, as antibiotics kill off a lot of beneficial bacteria.

Probiotic preparations are usually defined as: ‘Live micro-organisms, indigenous to the human intestinal tract, which when consumed in adequate quantities improve the intestinal microbial balance and positively affect the functioning of the human intestinal tract and general health.’¹

According to Dr Ela Johannsen, these are the required properties of probiotic products:

Safety aspects:

• Should not possess virulence characteristics
• Should not be capable of transferring antibiotic/drug resistance to pathogens.

Micro-organisms contained in probiotic products:

• Should be of human origin
• Should colonise the small and large intestines
• Should be acid and bile resistant
• Should have anti-microbial properties (to eliminate pathogens)
• Should modulate the immune system.

DIGESTIVE ENZYMES

By facilitating the digestion of undigested food in the stomach (which is a common cause of heartburn), digestive enzymes can be very helpful for the entire digestive process. The main ones to look for need to have the following types of enzymes present: amylase to digest polysaccharides, cellulase to digest cellulose, lipases which digest dietary fats, proteolytic enzymes to digest dietary proteins, and if no ulcer is present, then hydrochloric acid.

If you suffer from heartburn, a Goldenseal capsule can sometimes help sufficiently, but the best and safest home remedy which is really successful is taking a probiotic and enzyme supplement before you go to bed. Use a digestive enzyme supplement here that does not contain hydrochloric acid – reserve that one for when you are eating a meal.

FATTY ACIDS

Fatty acids are important in maintaining colon health as they raise acidity levels which improve nutrient absorption, lower the risk of colon cancer, and act as anti-inflammatory mediators. They stimulate immune protection through an array of intermediate effects within the intestinal system, including cytokine production, and appear to inhibit appetite, leading to reduced calorie intake and weight loss. As we get an overwhelming amount of omega-6 fatty acids in our diet, it is recommended that just omega-3 pharmaceutical-grade fish oil be supplemented daily (at a dose of around 3 g a day), or eat fatty fish at least four times a week.

RECOMMENDED SUPPLEMENTS

• Choose one of the new synbiotic range, with strains of carefully chosen beneficial bacteria mixed with a prebiotic to encourage colonisation.
• Choose a product that contains prebiotic fructo-oligosaccharides (FOS) to enhance implantation of healthy bacteria.
• Magnesium citrate, which is important for digestive function, helps to prevent constipation and improves general colon health. Taken with zinc it helps to avoid heartburn.
• A fibre supplement either in the form of oat bran added to your food or a psyllium supplement in powder or capsule form, taken with a glass of water or added to food.
• Fish oil to regulate possible digestive tract inflammation (I personally recommend a fish oil with an 80% active triglyceride form.
• Glutamine powder or capsules (3 g a day) to encourage healing of the walls of the digestive tract if ulcers, GERD, Candida or leaky gut are present.
• If longstanding proton-pump inhibitors have been used for acidity, then a vitamin B₁₂ supplement and/or injections would be helpful for a while.
• Vitamin C (preferably Ester C if gastric over-acidity or an ulcer is present) due to its ability to heal, its antioxidant activity and powerful ability to boost overall immunity.

Many other nutrients can be taken, but using all or some of these major ones together with a healthy diet should produce a swift result. Having said that, remember that if this is something you have had for a long time, don’t give up – you will need to be patient before seeing results.

TOO MUCH OR TOO LITTLE STOMACH ACID?

Sometimes the symptoms of having too much stomach acid are the same as having too little. Test yourself by adding vinegar to your diet and monitoring your symptoms. Vinegar has a low pH, which means that it is similar to your stomach acid. Add a tablespoon of apple cider vinegar to your meal and if your symptoms of indigestion decrease, it is likely that you have low stomach acid. If they increase, you have too much.

Without zinc the body cannot produce sufficient hydrochloric acid (HCL), and without HCL, zinc is not adequately absorbed. If you have too little stomach acid, take a zinc supplement and a hydrochloric acid supplement for a while, and once you find your stomach burning from the HCL, discontinue this and carry on with a 22 mg zinc supplement daily, which will restore optimal levels of HCL.

QUICK TIPS FOR COMMON DIGESTIVE COMPLAINTS

Constipation

Increase dietary fibre, increase fluids (especially water) and supplement with a good probiotic or symbiotic.

Diarrhoea

Investigate the possibility of coeliac disease, avoid very hot or cold liquids, stimulants, fizzy drinks and junk fats hidden in baked goods. Avoid fried foods and take a good probiotic supplement.

Abdominal pain/bloating

Consider that you may be wheat or dairy intolerant – cut these out for one month, cut out sugar, avoid processed food and take a probiotic. Eat small regular meals, and do not wear tight clothing around your waist.

Oral thrush

Often after an antibiotic or a time of stress there is a coating on the surface of the tongue, or a metallic taste in the mouth. Accompanying this can be a feeling of anxiety and a dry-mouth sensation which no amount of water seems to satisfy. Open a good probiotic capsule into your mouth with a little water, and slosh it around for a few minutes, ending up by gargling with it and then swallowing it.  Within a day you should feel relief.

Gastro-Oesophageal Reflux Disease (GERD)

A common complaint, this is often due to poor cardiac sphincter tone, the ring muscle at the end of the oesophagus, and increased abdominal pressure (obesity, pregnancy). Eat small, regular meals, avoid fizzy drinks and take digestive enzymes with each meal. Don’t lie down for three hours after eating your evening meal, and don’t bend to pick up things if your stomach is full. The following simple and inexpensive tip can be exceptionally helpful and in fact most upper gastrointestinal symptoms may be improved with the same approach – by trying it you have nothing to lose but your symptoms. Use a thumb-sized piece of fresh ginger root, run it through a good juicer (not a blender), save the juice in a jar in the fridge and take a teaspoon every morning on rising (you will soon get used to the sensation). Do this daily for three weeks. Symptoms maydisappear before that, but if you stop short of three weeks you may have a relapse if this is a longstanding problem. Deglycyrrhised liquorice is also a very helpful and supportive herb to take if you have GERD.

It’s worth mentioning here that something as simple as cutting out wheat or bread can significantly reduce the symptoms of GERD, heartburn, bloating and a host of other digestive woes. The three main culprits of digestive distress appear to be wheat (or gluten in some cases), dairy products and sugar (especially fructose which exacerbates irritable bowel syndrome). Avoiding these often gives relief for as long as they are avoided. Reintroduce them if you wish to after 4 to 6 weeks on a rotational basis, one at a time, and keep a journal to see which are causing your problem.

DIETARY CONSIDERATIONS

There is no magic bullet for digestive health but by avoiding certain foods, and including others, there is a strong chance of noticing a huge improvement within a couple of weeks. The table below gives an indication of a few things to include, and things to avoid that may help.

Eating smaller, more frequent meals tends to agree with most people with digestive problems. Aim for around 30% protein, 20% complex carbohydrates such as basmati rice, quinoa, etc., and the rest of the plate could be vegetables, salads and a little healthy fat such as olive oil in a salad dressing. A diet that is too low in fat can spell problems for the digestive tract – fat is not the enemy, only bad fat is. Healthy fats in the form of fish oil, avocado, raw nuts and seeds (not their oils) and coconut oil help to lubricate the digestive tract promoting a state of health, and reducing inflammation.

Editor's note: Detoxification has been used for centuries to remove toxic waste from the body. It is a safe and proven way to increase energy levels, fitness and weight loss. Dr Jason Malia answers questions on how to Detox your Digestive System.

Reference

1. Joint FAO/WHO Expert Consultation on evaluation of health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Report, Cordoba, Argentina 1-4 October 2001.