You may only think of your gut when you are hungry, but your gut is more important than you think. Your gut includes your stomach and your mouth, esophagus (the pipe connecting your mouth and stomach together), intestines, and colon. The gut has many important roles, including digestion and absorption, but it also makes up 70% of your immune system and helps detoxify. This explains why your health can take a serious knock if your gut health is poor. This article will take a closer look at GI dysfunction, the different types and causes, and what to do for relief.
GI dysfunction refers to dysfunction within any role of the gastrointestinal tract. This includes dysfunction with the assimilation of food (the digestion and absorption) or dysfunction of the gut microbiome and the mucosal barrier.
Some common symptoms of GI dysfunction are:
Many conditions can lead to GI dysfunction, but the most common are:
Digestion is one of the first processes in your gut after eating. It refers to the breakdown of food that occurs both mechanically, through chewing, and chemically, through enzymes, bile, and the pH of your stomach. If you have difficulties digesting food, some common symptoms are cramping and bloating after eating, constipation, diarrhea, and changes in your stool.
Enzymes are compounds that the body produces that facilitate digestion. There is a range of different enzymes that will break down different food components. Your pancreas is responsible for producing these enzymes. Enzyme and pancreatic insufficiency (EPI) is when your pancreas cannot produce enzymes sufficiently. This results in a lack of enzymes and a reduction in digestion efficiency.
Some direct causes of EPI are:
Indirect other causes of EPI include:
These conditions can cause EPI by increasing inflammation and damaging the gut mucosa. Once the mucosa is damaged, it cannot produce a hormone called cholecystokinin (CCK), which stimulates the pancreas to release enzymes. This results in EPI.
Not only do your enzymes help to break down food, but your bile also plays a role. Your gallbladder produces bile, which helps to activate an enzyme that is responsible for breaking down fats and excreting waste products. Your body produces bile in response to fat in a meal and CCK.
Bile malabsorption (BAM) is suspected to cause 30-50% of IBS diarrhea cases. Some causes of BAM are:
A lower pH refers to a more acidic substance, while a high pH is more basic. Within your stomach, some juices are naturally acidic to help break down proteins and activate enzymes. If the pH of your stomach is not low enough, the enzymes - specifically those responsible for breaking down protein and fat - will not be able to function optimally. This will result in protein and fat not being digested properly.
There are many potential causes of a higher pH including:
Several tests can help determine whether EPI is the cause of GI dysfunction. These include testing for the enzyme elastase, which breaks down carbohydrates, protein, and fat, testing the stool for fat content, and using a breath test to measure fat digestion.
Testing for bile malabsorption is generally done through a stool sample, and the levels of bile within the sample are tested.
The stomach acidity can be tested through a stomach acid test where individuals are injected with gastrin- a hormone that stimulates the production of stomach acid. A tube is then sent through the nose or mouth, and a sample of the fluid within the stomach is tested. Another test that may indicate the changes in stomach acid is testing the blood for gastrin levels. If levels are high, it may indicate the absence of stomach acid. H. pylori is another cause of changes in stomach acid; this can be tested for through a blood test, urea breath test, or stool test.
There are nutritional strategies to assist with EPI, but these methods only provide relief while the root cause is being addressed.
Digestive enzymes, which are found naturally in foods such as papaya, avocados, and pineapples, can help provide relief and assist with digestion. However, these foods contain smaller amounts of enzymes.
Supplemental digestive enzymes can help by providing larger quantities of digestive enzymes and different enzymes, helping to ease the digestion of various foods.
Adrezyme is one example of a supplement that provides a range of different digestive enzymes, as well as the natural digestive enzyme bromelain, found in pineapples. Since this supplement assists digestion, it must be taken with every meal. If you only want to use natural digestive enzymes, some supplements offer this, such as Allerdim, which contains bromelain and quercetin, a plant-based compound.
Consuming a low-fat diet and enhancing your microbiome's health can help relieve bile malabsorption. Bacteria help to metabolize bile. Therefore, the more beneficial bacteria you have in your gut, the better the metabolism of bile.
Understanding the root cause of pH changes is important to supporting stomach pH.
If it is due to a deficiency in zinc and B vitamins, replenishing your levels of these nutrients will help support your pH. Consuming meals with protein will help release the hormone gastrin, which stimulates acid production in your stomach. Supplements that can help to support stomach pH include:
There are various aspects of absorption, including:
Passive and active absorption will be slightly different for everybody and is influenced by your genes. The surface area of your gut refers to your gut cells. These cells have small fingerlike projections known as villi, which help enhance absorption. If there is inflammation or damage within the gut, these projections can be blunted, reducing the gut's surface area and thus reducing absorption. Symptoms of reduced absorption include pain after eating, nausea, vomiting, diarrhea, constipation, and weight changes.
Your gut is constantly moving, and this helps to facilitate digestion and absorption. A reduction in motility can result in constipation, while an increase in motility can result in diarrhea.
Testing for gut motility and surface area can be more challenging. A small flexible tube is placed through the nose or rectum to test for motility within the intestines. This can measure the strength of the stomach muscles and small and large intestines.
Dietary fiber (insoluble and soluble fiber) can assist in improving the motility of the gut. Insoluble fiber is not soluble in water, so it helps to improve motility within your gut. Soluble fiber absorbs water in the gut and helps to slow down motility. This makes insoluble fiber useful in constipation and soluble fiber useful in diarrhea. Some examples of insoluble fiber are nuts, whole wheat flour, wheat bran, cauliflower, and potatoes. Soluble fiber includes oats, apples, peas, and citrus fruit.
The gut microbiome is a living population of bacteria that helps protect your gut from pathogens and toxins. It also helps to produce important compounds such as feel-good hormones and vitamins. A poor gut microbiome can cause bloating, constipation, diarrhea, weight changes, and mood fluctuations.
The health of your microbiome depends on multiple factors including:
The main causes of a dysfunctional microbiome are:
Building up the microbiome can be done by using probiotics and prebiotics.
Probiotics are microorganisms that can be ingested and help improve the beneficial bacteria population within your gut. Examples of probiotic foods include fermented foods such as sauerkraut, yogurt, and kombucha. Supplemental probiotics are also a way to enhance your microbiome. One benefit of supplements is that they can contain various bacterial strains. One example of this is the Dr. Lam's Adrebiotics supplement, which contains ten different bacterial strains that help to enhance your immune system, reduce inflammation and improve the health of the gut cells.
Prebiotics are food for probiotics, and one of its main sources is dietary fiber. Prebiotics-rich foods include fruits, vegetables, and whole grains such as oats.
The mucosal barrier is a physical barrier in your gut that consists of tightly packed cells that prevent toxins and pathogens from moving into your bloodstream. Inflammation from chronic stress, diet, and illness increases the permeability of these cells. This reduces the functioning of this barrier and can result in toxins and pathogens entering into the bloodstream, also known as a 'leaky gut.'
Other facts that can increase the permeability of your gut cells are:
Zonulin, a protein discovered in the human body, plays a significant role in maintaining the integrity of the mucosal barrier in the gastrointestinal (GI) tract. The GI Map stool test, which measures zonulin levels, is a valuable tool for assessing the health of this barrier. Zonulin regulates the tight junctions between cells in the intestinal lining, which are crucial for preventing the entry of harmful substances into the bloodstream. When the mucosal barrier is compromised, zonulin levels increase, leading to the loosening of these tight junctions. By measuring zonulin in the GI Map test, healthcare professionals can identify if the mucosal barrier has been compromised and evaluate the risk of systemic inflammation, autoimmune conditions, and gastrointestinal disorders.
Probiotics metabolize prebiotics, which produce short-chain fatty acids (SCFAs). These help to enhance mucus production, protecting your mucosal barrier and regulating your immune system (2).
Quercetin can also help regulate the microbiome's composition and help maintain the integrity of the mucosal barrier by reducing inflammation and maintaining the functioning of the mucosal barrier (3). It is available naturally in foods as well as supplements. Allerdim is one supplement that contains both quercetin and bromelain. It not only assists with enhancing the protective features of the gut but also helps with the digestion process. The bromelain enhances the absorption of quercetin. It also contains a stinging nettle that may help assist in digestive processes and reduce inflammation within the gut (4). Unlike digestive enzymes that must be taken with meals, you can take Allerdim 20 minutes before a meal.
Aloe and licorice are natural substances that support gut mucosal repair. Aloe vera is well-known for its soothing and healing properties. It contains various bioactive compounds, such as polysaccharides and glycoproteins, which have been shown to reduce inflammation and promote tissue regeneration. Licorice root, particularly the compound called glycyrrhizin, has been found to possess anti-inflammatory and antioxidant properties. It helps protect and repair the mucosal lining of the gut while supporting a healthy balance of gut bacteria. Dr. Lam's Adrenal Gut Restore combines these nutrients in an easy-to-take supplement to encourage gut mucosal repair.
Glutamine, an amino acid, is a vital nutrient for the cells lining the intestinal wall. It serves as a fuel source for these cells, aiding their growth and repair. Glutamine also helps to strengthen the tight junctions between cells, promoting a healthy mucosal barrier. When combined, aloe, licorice, and glutamine can provide a synergistic effect, supporting the healing and repair of the gut mucosa and contributing to overall gut health.
While diet is not one of the root causes of GI dysfunction, it can influence gut health. It's important to remember that medications can also damage the lining of your gut.
Foods high in sugar, artificial sweeteners, and refined carbohydrates can damage your microbiome and reduce the beneficial bacteria. This can cause an imbalance and conditions such as SIBO and an increase in the permeability of the mucosal barrier. These foods increase inflammation within the gut and can further increase the permeability of the gut.
If you are experiencing a 'leaky gut' and food sensitivities, such as gluten or dairy, it is important to avoid these foods while you build up your gut health. Your body may be able to tolerate these foods once your gut health improves; however, your healthcare provider should determine this.
Some people may need to avoid other foods, such as high-fat or FODMAP foods, depending on the nature of their GI issues.
As discussed, inflammation can compromise your mucosal barrier and cause symptoms of GI dysfunction. Certain foods can increase inflammation, but stress also plays a role. Your body handles stress through the NeuroEndoMetabolic (NEM) Stress Response Response; this system consists of six different circuits of related organ systems, each with its role. However, when stress becomes chronic, this can overwhelm your NEM system and result in imbalances within it, resulting in Adrenal Fatigue Syndrome (AFS). AFS is the non-Addison's form of adrenal dysfunction, where the body's stress response cannot keep up with life's chronic stressors.
The inflammation circuit helps to regulate inflammation within your body through your immune system, GI tract, and microbiome. When there is an imbalance within this system, inflammation increases, resulting in a 'leaky gut,' IBS, and increased food sensitivities.
AFS not only increases inflammation in the body but also makes it incredibly sensitive to foods and supplements. If you are experiencing AFS or think you may have it, chat with your healthcare provider before starting a new supplement for guidance.
Due to the many roles and systems involved in the GI tract, GI dysfunction consists of multiple symptoms and many different root causes. If you are experiencing GI dysfunction, it is important to seek guidance from your healthcare provider to help determine the cause and where in the gut the dysfunction is occurring. This will help provide relief and make eating a more enjoyable experience.
If you are currently struggling with symptoms of GI dysfunction, our range of digestive supplements may help to ease some of your discomforts. If you are seeking help identifying the root cause of your GI dysfunction, the team at Dr. Lam can help. You can call +1 (626) 571-1234.
Adrenal Gut Restore to Ease GI Dysfunction
Maric, S., et al. "Citrulline, Biomarker of Enterocyte Functional Mass and Dietary Supplement. Metabolism, Transport, and Current Evidence for Clinical Use." Nutrients, vol. 13, no. 8, Aug. 2021, p. 2794. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398474/.
Wang, H., et al. "Soluble Dietary Fiber Protects Intestinal Mucosal Barrier by Improving Intestinal Flora in a Murine Model of Sepsis." Biomedicine and Pharmacotherapy, vol. 129, Sep. 2020. https://www.sciencedirect.com/science/article/pii/S0753332220305369.
Uyanga, V., et al. "Potential Implications of Citrulline and Quercetin on Gut Functioning of Monogastric Animals and Humans: A Comprehensive Review." Nutrients, vol. 13, no. 11, Nov. 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621968/.
If the root cause of GI dysfunction is due to inflammation or a change in the gut microbiome, it can be temporary if the cause is addressed. If it’s due to genetics or a condition such as Celiac it may be permanent. However, relief is possible in most cases with the right plan.
