Establishing Balance in the Gastrointestinal Tract
Paul A. Goldberg, M.P.H., D.C.
[In the second part of this series Dr. Goldberg explores four steps to take to re-establish balance in the gastrointestinal tract to promote good health and reverse chronic disease.]
Disruption of the gastrointestinal tract plays a critical role in the creation of a wide variety of systemic illnesses. Gastrointestinal dysfunction can be found in many patients who arrive at doctor’s offices with chronic complaints, even among those with seemingly unrelated primary complaints such as back pain, fatigue, headaches, depression, etc.
In chronic health complaints, the amount of abuse inflicted upon the gastrointestinal tract is often astounding. Years of overeating poor quality foodstuffs far beyond the patient’s digestive capacity, too little rest and sleep to allow for sufficient digestive energy production, ongoing stressors that have upset the delicate balance of the GI tract’s intrinsic nervous system, ingestion of alcohol, tobacco, coffee, drugs and other toxins which alter the body’s chemistry, all resulting in a gastrointestinal tract that is severely compromised.
How can the numerous abuses of so many years be addressed? How can the vitality of the GI tract, essential to the correction of a myriad of chronic health problems, be achieved?
SPECIFIC MEASURES
Identify and Address Specific Etiological Factors
Each patient is different in regards to the strengths and weaknesses of their systems and the abuses they have been subjected to. This infinite variety of patients often requires the counsel of a doctor with good detective skills to analyze the specific etiological factors involved with each case.i A thorough case history, physical examination and appropriate laboratory tests should be performed on each patient to identify these individual traits and then to address them thoroughly at their roots. There is no pre-packaged program that will fit the requirements of all patients, and before general measures can be taken (see below), specifics need to be identified and addressed.
GENERAL MEASURES
I. Allowing for Rest
If there is any single factor almost universally involved in GI disturbances it is overeating. A sick gastrointestinal tract is an exhausted gastrointestinal tract. Like any part of the body such as the muscles, an overworked system requires rest. Continual overeating, use of stimulants such as coffee and the ingestion of toxic drugs (prescription and non-prescription) deplete the vital energies of the body. Drugs cannot restore energy to the GI tract. All drugs have toxic effects and the body must expend energy in trying to neutralize and eliminate them from the body. This includes materials such as coffee, alcohol, tobacco and junk food. Like beating a tired horse with a whip, we might get the horse to move faster for awhile with stimulants of various types, but ultimately the poor animal breaks down unless given the opportunity to recover its energies.
Unlike the thinking of many, including numerous health care providers, food does not simply give us energy. Food constitutes raw material the GI tract acts upon to produce energy. To utilize food, digestion, absorption, assimilation, cellular excretion and elimination of wastes are called into play, all requiring the expenditure of significant amounts of energy. To continually eat when the GI tract is ill is equivalent to requiring a torn muscle to continue to exercise or to walk upon a broken leg. These are not conditions for healing.
A reduction in food is called for. It may be necessary to limit certain foods or adopt an appropriate liquid diet with careful supervision. The patient should conserve energy placed on the digestive system.ii When this is done properly the improvements are rapid and impressive, assuming that the resting period is followed by an intelligent, individualized plan of action for the patient to follow on an ongoing basis.
II. Establishing Healthy Gastrointestinal Micro Flora
The gastrointestinal tract is a delicate environment in which billions of microorganisms and the influx of ingested materials interact with lifestyle factors in working for or against establishing a healthy internal environmentiii of the gut. The intestinal microorganisms are affected by what enters the gut and in turn exert their influence on the systemic health (or disease) of the individual.
Health promoting intestinal bacteria (known collectively as probiotics) assist in the processes of digestion and absorption; synthesize nutrients including B vitamins and vitamin K; influence the production of immune factors such as secretory IgA; protect us against the presence of disease producing organisms; are involved with gastric pH;iv promote the health of the intestinal membrane and also increase our resistance to food poisoning as well as a host of other functions.
Pathogenic (disease producing) bacteria interfere with digestion and usage of nutrients, produce toxic waste materials and may cause or contribute to rheumatoid arthritisv, asthmavi ankylosing spondylitisvii cancerviii, overall immunityix dermatological problemsx, immunity against viral agentsxi, constipation and diarrheaxii, ulcerative colitisxiii, Crohn’s diseasexiv, allergic responsesxv, and many other health problems.
Gut bacteria are so numerous that the total weight of bacterial cells is estimated to be three to five pounds, all in fierce competition to establish their presence in the intestines. Approximately 400 different types of bacteria live in the small and large intestines although the majority of them are comprised of about 20 species. We ingest and expel bacteria on a daily basis as they are found in the air we breathe and the food we eat.
In the gut there is an ongoing battle among the different species of bacteria to obtain dominance. This war serves to keep the disease-producing bacteria from gaining the upper hand, but only if conditions are appropriate for the growth of the health-producing bacteria and there are sufficient good bacteria present.
Clearly, good health depends on a healthy gut and a healthy gut depends on the presence of adequate amounts of health promoting bacteria to limit the growth of disease producing (pathogenic) bacteria. Understanding the positive role of bacteria in the prevention and correction of disease processes will require a revolutionary change in standard thinking away from the misconception that all bacteria are simply disease producing agents to be avoided at all costs.
Some specific factors that disturb and limit healthy bacterial growth (and thus promote the growth of pathogens) include antibiotics, antacids, laxatives, long-term stress, simple carbohydrates, steroids and non-steroidal anti-inflammatory drugs (NSAIDS).
Improving the gut flora requires allowing adequate gut rest, and nourishing the body properly. An additional step is to bolster the amounts of health promoting bacteria through the use of appropriate probiotic supplements. These are best taken in the same form as our ancestors did for millions of years.
Since man first
appeared on the planet until very recently, human beings acquired a wide variety
of probiotic bacteria from the foods they ate that were contained in the soil.
These are now referred to as Homeostatic Soil Organisms (HSOs). HSOs are bacteria
that live in the soil and make the soil more fertile. They release an assortment
of enzymes that kill off yeasts, molds and other materials that hinder plants
from growing. Ingested by humans, as they were in the past, they are valuable
allies in combating disease producing bacteria, viruses, yeasts, molds and fungi.
In regulating the microorganisms of the gastrointestinal tract they help to
maintain a state of homeostasis in the GI tract and thereby in the body as a
whole.Our ancestors ingested significant amounts of Homeostatic Soil Organisms on a daily basis. With every root and vegetable they pulled from the soil and with every fruit they picked up from the ground in their gathering activities came millions of microorganisms. Our hunting and gathering ancestors of hundreds of thousands of years ago, as well as our farming ancestors of just a hundred years ago, were not so fastidious to wash and scrub off every speck of dirt. The carrot pulled out of the ground was simply brushed off and eaten, dirt and all. Meat and root vegetables were often buried in the ground to preserve them and then dug back up and ingested. Our pet dogs engage in the same type of behavior in burying their bones. It is notable that despite the far greater exposure and ingestion of bacteria that our pet canines engage in, that they generally have far less illness than we do, unless we keep them inside and limit their opportunity to dig around in the soil. Current agricultural practices such as germicides, radiation and fungicides meant to kill harmful bacteria and other microorganisms kill off healthful HSOs leaving our foodstuffs virtually sterile in comparison with the dietaries of our ancestors.
Most probiotic supplements on the market have to contain billions of organisms in the hope that a few might survive the stomach acids and digestive juices to reach the small and large intestines. HSOs are highly viable organisms, however, and are able to survive the stomach acid on their journey to the intestines.
Since humans have been ingesting HSOs for millions of years, the body seems to recognize them like foodstuffs and accordingly, does not attack them. Once implanted, HSOs compete with pathogens in the gut and work to displace them. They tend to be aggressive against molds, yeast, pathogenic bacteria and perhaps even some viruses.
HSOs are hardly new on the scene or a recent invention. Their usage is simply going back to a common behavior of our ancestors. A significant advantage in taking HSOs in supplemental form is that we avoid parasites and other harmful materials that can be found in the dirt in your backyard while still receiving the benefits of the HSOs themselves.
The use of HSOs fits in logically with the “Hygiene Hypothesis” discussed in part one of this article. In public health we are becoming increasingly aware that the bulk of scientific/epidemiological studies supports the idea that exposure to a wide variety of bacteria may help prevent numerous disorders including asthma, allergies, autoimmune disorders and others.xvi Supplemental HSOs can help in this regard in both the prevention of chronic disease states and in their reversal. A number of studies are already underway to investigate this. Common sense and clinical experience has already made evident to many practitioners the wisdom in providing HSOs to their patients and to themselves.xvii
A pilot study directed by the author at the Goldberg Clinic involved 16 subjects between the ages of 20 to 65, with a variety of chronic digestive and immune disorders. The subjects were placed on a protocol of HSOs for 120 days. Subjects were selected based on the types of difficulties they were having and on the highly resistant nature of their problems to both medical treatments and alternative/complementary care. All had been ill for a minimum of three years, with several having complex health problems dating back 10 years and longer.
Subjects were evaluated by changes measured via laboratory analysis and by subjective feedback from the subjects regarding changes in their conditions.
Fifteen of the 16 subjects reported clinical improvement with relief of symptoms and positive changes in their overall well-being. Eight of nine subjects had a reduction in Candida (yeast) growth verified by stool and/or blood titers. Three subjects who had suffered from long-term chronic constipation with laxative dependency were able to move their bowels daily without the use of laxatives. Four patients who had been diagnosed with “chronic fatigue syndrome” reported freedom from their symptoms at the end of the 120-day period and an additional three subjects with chronic “irritable bowel syndrome” reported between 25 to 100 percent improvement. A radiologist with chronic pulmonary fungal infection of several years duration reported a dramatic improvement in her ability to breathe along with significant improvement in her spirometer readings as evaluated by her medical pulmonologist. Particularly notable to the author were the improvements seen in three subjects with chronic asthma whom were able to reduce their inhalant medications by 50 percent or more over the 120 day study period. Details of the study will be published in a supplement to Vol. 4 of the medical journal Progress in Nutrition.
III. Establishment of Appropriate Behaviors to Prevent Re-occurrences of Health Problems
The patient should make a variety of lifestyle improvements under the doctor’s supervision. Resting their gastrointestinal tract, avoiding toxins, incorporating proper dietary measures and improving the bacterial flora by ingesting HSOs, can all be undone if there is a return to the patient’s previous habits that ultimately contributed to their illness. Many individuals still believe in “cures” in the sense that once well, they believe they can return to the prior habits that made them ill initially. Often the patient has a false sense of security once they are feeling better. They gradually start to fall back into their old, comforting, unhealthy habits once again. “Just one cup of coffee, just an occasional cigarette, just one big pepperoni pizza, overindulgence in simple carbohydrates can’t hurt on special occasions, and so what if I stay up late all this week, I will make up for it over the weekend by sleeping late on Sunday.”
At first the patient notices little difference, for the body has been able to set aside some reserves to cope with a limited amount of abuse. The abuses, however, tend to become more and more common. A week, a month, or a year later, however, the patient awakes to the unhappy fact that their prior gastrointestinal, arthritic, fatigue, dermatological or other problem(s) have returned. The glorious vitality begins to fade. Unfortunately the response of the patient may then become, “I guess the steps I took with the doctor didn’t really fix my problem,” so off they go in search of a “cure” or simply give up and sink further and further into illness.
The gastrointestinal tract, like the other body systems, can only take so much abuse for so long before pathologies are created that may not always be easily reversed. It is therefore important to stress to the patient that a return to old unhealthy ways will cause a return of their symptoms and the longer they persist in such behaviors the more difficult reversing the problems becomes. Gastrointestinal functioning, with its many positive influences on overall health and healthy enjoyment of life’s many beautiful offerings, is too precious to squander.
Summary
Gastrointestinal problems are responsible for many of the systemic chronic illnesses people suffer from in the United States. Each person is different and most will initially require an individualized program of care under the supervision of an experienced practitioner to identify their problems and assist them in their quest for good health. In addition to the identification of specific etiological factors, there are three basics applicable in almost every case: