GUT HEALTH & IBS

GUT HEALTH & IBS

 

Your digestive system comprises of the gastrointestinal (GI) tract, made up of organs including the mouth, oesophagus, stomach, small intestine, rectum and anus, as well as accessory organs such as the liver, pancreas and gallbladder, which support digestive processes. As the food you eat travels through your GI tract, these organs work synergistically to digest it into smaller components so that vital nutrients and water can be absorbed, and waste products eliminated from the body.

This process begins in the mouth when food is chewed and mixed with enzymes present in saliva. As food moves into the stomach after swallowing, additional digestive enzymes and acids are produced by the stomach to further promote food breakdown. Specifically:

  •  Proteins break down into amino acids
  •  Carbohydrates are reduced to simple sugars such as glucose
  • Fats are broken down into fatty acids

Within two to four hours after eating a meal, the stomach contents move further down the GI tract into the small intestine, where they combine with additional enzymes and acids produced by the liver, gallbladder and pancreas, which facilitate nutrient absorption. From here, food waste is also pushed into the large intestine before it is eliminated with a bowel motion. The nutrients and water absorbed during this process are distributed throughout your body, providing energy and supporting growth and repair of your body’s cells. As your body relies on a consistent stream of nutrients to support its function, you can appreciate the importance of maintaining a healthy digestive system for optimal health.
The road to health is paved with good intestines”.

Pillars of a healthy gut

The gut is a complex system, influenced by many factors that either enhance GI health or compromise digestive function. Disruptions to any of these components creates imbalances that can compromise gut function and lead to disease development. Therefore, improving the function of these components may be the kickstart you need to strengthen your digestive health. No guts, no glory!

  •  Diet: ‘You are what you eat.’ Our dietary habits have a profound effect on gut function, as well as our overall health. Our Western diet is proinflammatory, with its over-consumption of processed foods, sugars and trans fats, increasing gut symptoms and conditions such as obesity, type 2 diabetes, inflammatory disorders and cardiovascular disease. A Mediterranean-style diet, with less bread and pasta, is linked to fewer gut presentations and reduced disease prevalence.
  • Enzymes: Digestive enzymes are produced in the mouth by saliva glands, as well as in the stomach, pancreas and throughout the GI tract. As food travels through your gut, it combines with digestive enzymes, which speed up food breakdown. This is necessary for absorption of vital nutrients.
  •  Bacteria: Trillions of microorganisms, collectively known as the gut microbiome, live within your gastrointestinal environment. Gut microbes play important roles in supporting many aspects of human health including digestive, immune, metabolic, hormonal and nervous system processes.
  •  Barrier: The gut barrier is the internal lining of the GI tract, composed of a mucus layer and specialised cells (gut epithelial cells). This lining facilitates the absorption of nutrients from your food, while also providing a physical barrier that separates the gut environment and its microbes from the rest of your body.
  • Immune: The digestive and immune systems are very closely related, with most of your immunity located in your gut. Immune cells and the gut microbiome work together to coordinate immune responses, including defence against infections.
  •  Enteric: The gut has its own nervous system, known as the enteric nervous system (ENS), which regulates your digestive activity including the movement of food through the GI tract and production of enzymes and acids required for food breakdown and absorption. The ENS also interacts with the body’s central nervous system (CNS), which processes stress, making the ENS sensitive to changes in your stress levels. 

Balancing your bugs

Your gut plays host to trillions of microorganisms – 38 trillion to be precise! Collectively, they make up the gut microbiome and include a variety of bacteria, viruses, protozoa and fungi, that mostly reside in the large intestine. Together, these gut bugs form a community, working together to maintain a healthy gut environment. Your gut microbiome is at its healthiest when you have abundant levels of beneficial gut microbes (known as commensal flora) and a large variety of different types of microorganisms (termed microbial diversity). Balanced levels of gut microbes benefit your body in many ways including the provision of health promoting nutrients such as vitamins B1, B2, B5, B12, vitamins K, folate and biotin, as well as enhancing digestive processes, preventing harmful microorganisms from causing disease and supporting overall immune function.  In addition to influencing your digestion and immunity, a balanced gut microbiome encourages optimal metabolic and nervous system function. 

 

Ways to improve the gut microbiome

  • Consuming a wide variety of fibre-rich foods and fermented foods, which nourish your gut flora.
  •  Reducing your intake of foods that disrupt gut microbial balance including refined processed foods, sugar and alcohol.
  •  Managing your stress levels. Uncontrolled stress has been shown to deplete levels of health promoting gut microbes.
  •  Getting more sleep. Studies have shown a link between sleep deprivation and detrimental changes to gut microbiome composition.
  •  Moving your body. Regular exercise has been found to increase the number of beneficial gut microbes and enhance their diversity.

Factors that promote dysbiosis include:

  • Western-style diet
  • Physical inactivity
  • High stress
  • Poor quality sleep
  • Certain pharmaceuticals including antibiotics, reflux medication, antidepressants, oral contraceptives and laxatives.

Did you know?

The vagus nerve provides a direct telephone line between your gut and brain, allowing them to communicate regularly. The vagus nerve receives information from your gut microbes and communicates this from the gut to the CNS (i.e. the brain) – known as the gut-brain axis. This communication is a two-way street, with the CNS also using the vagus nerve to relay information from the brain down to the gut. Collectively, this long-distance phone call helps orchestrate your body’s digestive, immune, hormonal and nervous system processes. The gut-brain connection explains why a nervous brain can also lead to a nervous stomach, otherwise known as ‘butterflies in your stomach’, as well as stress-driven digestive conditions such as IBS. Likewise, your gut can impact the function of your brain’s cognitive and emotional centres, influencing your mood and body’s ability to adapt to stressful situations. Therefore, maintaining the health of your gut microbiome has benefits that extend well beyond your digestive tract.

Common factors that contribute to poor gut health

  • Dietary crimes: Processed foods, saturated fats and trans fats, and meat products require higher levels of digestive enzymes to enable their breakdown and absorption. If your gut struggles to produce adequate amounts of enzymes, symptoms such as flatulence, abdominal cramping and pain, bloating and altered bowel habits are more likely to occur. High intake of animal fat, sugar and alcohol, which deplete levels of health promoting gut microbes, also contribute to gut bacteria imbalances. A diet low in fibre and prebiotic foods can disrupt the transit of food through your digestive tract, altering how frequently you pass a bowel motion, as well as hindering the growth of certain beneficial bacteria that keep your gut healthy.
  •  Guzzling food too quickly: Eating too quickly and not chewing your food thoroughly limits the digestive processes that begin in the mouth when food is chewed and mixed with enzymes present in saliva. This places an additional burden on the digestive processes that occur as food funnels further down the GI tract.
  •  Reduced enzymes: Decreased production of digestive enzymes reduce your gut’s ability to breakdown and absorb nutrients from the food you eat, leading to digestive symptoms including flatulence, abdominal cramping and pain, bloating and altered bowel habits. As we age we tend to produce less enzymes and are at greater risk of digestive conditions such as coeliac disease, pancreatitis, pancreatic cancer, cystic fibrosis and diabetes.
  •  Pathogenic pests: Gut infections can develop after consuming contaminated water or food, or through contact with a person who is already infected. Harmful pathogens including bacteria, viruses, parasites and fungi disrupt gut health by interacting with multiple gut barrier layers, beneficial gut bacteria and the immune barrier. While many infections are self-limiting and pass quickly, the injury to the affected gut layers may cause ongoing digestive discomfort such as chronic bloating or changes to bowel habits. If left untreated, in some people it may progress to chronic digestive disorders such as IBS.
  •  Uncontrolled inflammation: Severe and persistent gut inflammation can overwhelm the functional layers of the GI tract, resulting in digestive dysfunction. For instance, conditions such as IBS, IBD, gut infections and infestations, gluten sensitivity, autoimmune diseases and metabolic diseases are known to instigate gut inflammation.
  •  Stress: Communication between the ENS and the CNS is known as the gut-brain axis. This communication highway links the emotional and cognitive regions of the brain to your gut function. With this in mind you can see how instances of severe and persistent stress or CNS disorders such as anxiety and depression can disrupt this relationship and influence activities of gut function. For example, negative emotions and stress disrupt gut motility (causing constipation or diarrhoea), alter gut bacteria levels, increase gut sensitivity and pain, and amplify inflammation, leading to poor digestive health.
  •  Medication use: Antibiotics kill off both harmful and beneficial gut bacteria, creating imbalances, particularly if taken regularly or for prolonged periods. In fact, studies indicate that antibiotics alter gut bacteria levels for up to four years after use. Additional medications that further affect bacterial composition include proton pump inhibitors (prescribed for reflux), selective serotonin reuptake inhibitors (used to manage anxiety and depression), oral contraceptives (birth control) and laxatives (used to stimulate bowel movements).
  •  Irregular habits: The circadian rhythm (the body’s internal clock) regulates GI function including digestion, absorption and motility. While regular dietary habits promote robust gut function, irregular diet and lifestyle patterns, especially late-night activities and eating, imbalance circadian rhythm and promote GI dysfunction, gut symptoms and gut disorders. 

Got gut troubles?

Given how hard working your gut is, constantly digesting food and absorbing and distributing nutrients, it’s normal to experience an occasional performance hiccup and digestive symptom. However, recurrent or severe symptoms may indicate something more serious, such as a digestive disorder. Here are some common ones below.

IRRITABLE BOWEL SYNDROME (IBS)

This is a chronic gut disorder featuring abdominal pain and altered bowel habits that occur without any visible signs to the digestive tract. It can be treated with changes to the diet, nutritional support, stress management and improved sleep.

Symptoms

The most common symptoms include abdominal pain, cramping, excessive wind and bloating when passing stools or following meals. Altered bowel habits (diarrhoea, constipation or both), abdominal bloating and flatulence may also occur. Also, changes in the appearance of stools and frequency of passing stools are often reported. In Western countries IBS affects women twice as often as men. There seems to be a familial component as many IBS patients report having another family member with IBS symptoms.

Causes

IBS has been linked to dietary triggers, such as lactose and fructose, gut inflammation, an imbalance in the number of ‘good’ and ‘bad’ bacteria and stress. IBS symptoms are commonly first experienced by people in their 40’s, but can be diagnosed at a younger age often as a result of having had several courses of antibiotics, after a severe viral infection and even after a bad bout of gastroenteritis. Our highly processed Western diet is also highly problematic for our gut and can be the cause of many gut symptoms over the years.

GASTRO-OESOPHAGEAL REFLUX DISORDER (GORD)

GORD is a motility disorder caused by the reflux (backward flow) of contents within the stomach including food, digestive secretions and stomach gas into the oesophagus

Symptoms

Heartburn and pain in your chest are most common, however symptoms beyond the gut may include laryngitis (inflammation of your voice box), cough, asthma and dental erosions due to acid.

Causes

Weakness or damage to the muscle that connects the oesophagus to the stomach (known as the lower oesophageal sphincter), allowing the stomach contents to splash upwards. This can be a side effect of certain medications including blood pressure medication, sleeping pills and sedatives, antibiotics, antidepressants, or due to smoking, pregnancy or being overweight. Foods also known to weaken the oesophageal sphincter include onions, chocolate and peppermint, and drinks such as alcohol and coffee, as well as overeating in general.

INFLAMMATORY BOWEL DISEASE (IBD)

IBD is a chronic, recurring condition caused by an abdominal immune response that triggers inflammation to the gut lining and damage to the cells of the infected area. Ulcerative colitis (see below) and Crohn’s disease (see Auto Immunity), are two forms of IBD.

Symptoms

Diarrhoea, abdominal pain and cramping, blood in stools, reduced appetite, unintentional weight loss and fatigue.

Causes

IBD develops in people with an underlying genetic susceptibility. A variety of triggers including gut infections, medications and emotional stress initiate an immune response, causing inflammation and damage to the cells of the gut lining.

ULCERATIVE COLITIS

This is an inflammatory condition in the colon, the main part of your large intestine, and also the rectum. Inflammation in the colon can be caused by an infection such as occurs with food poisoning, or trauma to the region. This can impact the stools, making them more urgent, painful or loose, and blood may be seen in the stool.

Symptoms

Common symptoms experienced are: abdominal pain, bloated stomach, urgent diarrhoea, loss of appetite, weight loss, nausea and vomiting, fever, fatigue, dehydration, anaemia or malabsorption of nutrients. Dietary changes and support with the right nutritional formula, can improve the gut function dramatically.

GASTRITIS

This condition describes inflammation of the mucous lining of the stomach. Our stomach lining acts as a protective barrier and when it is inflamed, it is under attack. Our immune system detects the threat, resulting in an inflammatory response in the tissues to help fight the infection and promote healing. The inflammation may also be caused by a reaction to something you have eaten, exposure to toxins or even digestive enzymes that are out of balance, making it hard to digest your food.  Common symptoms experienced are: indigestion, stomach ulcers, loss of appetite, pain, bloating, nausea and vomiting.  This condition can be treated with an anti-inflammatory diet and nutritional support to help heal and balance the gut.

 

DIVERTICULITIS

This is an inflammatory condition of the large bowel, where small bulging pouches can develop along the inside of the colon. These pouches can become inflamed or infected, resulting in the symptoms. Diverticulitis can be an acute problem that flares up occasionally, causing discomfort and pain. It can be treated with an anti-inflammatory diet and nutritional support to help heal and balance the gut.

Symptoms

Common symptoms are: severe abdominal pain, distended stomach, fever, nausea and vomiting, constipation, diarrhoea and less often, rectal bleeding.

Causes

Low intake of dietary fibre leading to constipation can put extra strain on the walls of the gut, causing weak points to form and subsequently, bulging pouches.

DYSBIOSIS

Imbalanced gut bacteria levels caused by loss of beneficial bacterial species, creating a gut environment where ‘bad’ bacteria can flourish. Sub-categories of dysbiosis include Candidiasis, featuring overgrowth of the Candida albicans yeast, and small intestinal bacterial overgrowth (SIBO).

Symptoms

Common symptoms include bloating, diarrhoea, constipation and gut pain.

Causes

A diet low in fibre and prebiotic foods, as well as a high intake of animal fat, sugar and alcohol. Antibiotic use which kills off both beneficial and harmful bacteria, in addition to reflux medication, antidepressants, oral contraceptives and laxatives. Dysbiosis may also occur when chronic inflammation damages intestinal cells, such as in IBS or IBD.

PEPTIC ULCERS

This is a condition where the mucous lining of the stomach or the duodenum has been damaged, causing ulcerations or erosions to the lining.

Symptoms

Gnawing or burning pain in the stomach or chest, which can radiate to the back or other parts of the abdomen. Pain is more likely to occur at night and can improve with eating (especially ice-cream or milk). Additional symptoms include nausea and vomiting, and dark stools in extreme cases, which indicate bleeding in the gut.

Causes

Helicobacter pylori infection (a type of bacteria) is the most common cause of damage to the gut lining. Additional triggers include medications, (particularly
anti-inflammatories), GORD, smoking and alcohol intake.

FOODS THAT MAKE YOUR GUT SING

Beneficial, diverse and health promoting gut microbes require a fibre-rich diet to thrive. There’s nothing your gut bugs love more than consuming a wide variety of prebiotic foods and microbiome accessible carbohydrates (MAC’s), which provides them with the energy required to grow and flourish. Prebiotics present in fruits, vegetables and wholegrains are a type of fibre that your digestive system cannot breakdown. Types of prebiotics include fructo- oligosaccharides (FOS), inulin and galacto-oligosaccharides (GOS). Additional foods that can be utilised by your gut microbiome include MAC’s also known as resistant starches, such as rolled oats, lentils and beans. Through a process known as fermentation, your gut microbes breakdown these food components and convert them into nutrients that can be used for nourishment and growth. For instance, compounds known as short chain fatty
acids (SCFA’s) are produced from microbial fermentation of prebiotic and MAC foods, which supply your microbiome with a healthy environment to flourish, as well as providing additional digestive, immune and metabolic health benefits. The Mediterranean Diet provides protection against several diseases associated with digestive dysfunction, inflammation, poor immunity and psychological distress – giving you the best chance at supporting optimal health and wellbeing. This diet includes high intake of vegetables and  fruit, lean protein, quality essential fatty acids (good fats including omega-3’s) and some wholegrains.

Techniques to help you eat more mindfully

  • Before eating ask: Am I hungry? Am I thirsty?
  •  While chewing, pay attention to the colours, smells, flavours and textures of food.
  •  Chew slowly – this allows the body time to catch up, reducing the likelihood of overeating.
  •  Put utensils down between mouthfuls.
  •  Avoid multitasking. Remove distractions such as TV, phones, computers and books while eating. If a meal is consumed at work, take meal breaks away from the desk.
  •  Take note of when food cravings occur and what emotions or stimuli trigger these cravings. It can be helpful to keep a journal.
  •  Observe the feeling of hunger and satiety throughout the day