Soothing chronic digestive discomfort requires a search for underlying factors.
by Lisa James
The first time it happened, Ingrid Cepeda thought it was food poisioning. The diarrhea, nausea and vomiting, and stomach pain, plus fatigue, fogginess and headache, lasted five days.
Then it happened twice more within six months. “All the test results showed no issues whatsoever,” says Cepeda, 53, a bookkeeper from McAllen, Texas. And soon after that, “every single day I had one, two or multiple symptoms in varying degrees. The fatigue intensified day by day and the headaches were unbearable.”
Intestinal distress is often seen as a minor annoyance, and sometimes it is.
Appearances can be deceiving, though. According to the National Institutes of Health, digestive diseases account for nearly 105 million office visits and 13.5 million hospitalizations a year.
“The gut is somewhat ignored compared to organs such as the brain and heart,” says Victor Sierpina, MD, professor at the University of Texas Medical Branch School of Medicine in Galveston and author of The Healthy Gut Workbook (New Harbinger). But that lack of respect can be costly; problems that start in the gut can have body-wide consequences.
Poor diet, especially a lack of fiber, not drinking enough water and not getting adequate exercise can all lead to intestinal distress. Some people react badly to certain foods, which can lead to symptoms such as pain, diarrhea, fatigue and weight loss.
Disordered emotions can also lead to disordered digestion because the intestines are controlled by the enteric nervous system. “The mind in your gut has a mind of its own,” says Raphael Kellman, MD, who practices holistic medicine in New York City and is the author (with Carol Colman) of Gut Reactions (Broadway Books).
Whatever the cause, digestive disorders can lead to inflammation “that starts in the gut but can affect structures such as blood vessel linings and joints,” says Sierpina. “It also clearly contributes to disorders such as diabetes, heart disease, Alzheimer’s and other illnesses. Some of these problems are so far downsteam that people don’t realize the root problem is inflammation in the gut.”
For many people, regaining digestive health begins with an elimination diet, in which common trigger foods such as wheat and other gluten-bearing grains, eggs, shellfish, corn and peanuts are removed from the diet and then added back to see if symptoms return. “Going through the elimination diet gives you a sense of what you react to: what makes you feel better, what makes you feel worse,” Sierpina says.
The elimination diet Sierpina put Cepeda on worked, but it took time. “I stuck to this diet for five months. Finally I realized that the only meat I was eating—chicken—was making me sick. After eliminating chicken I truly felt a difference,” she says.
The helpful probiotic bacteria normally present within the intestinal “can provide detoxification, protect against bacterial or viral infections and help with the absorption of food,” says Sierpina. In fact, researchers are looking at probiotics as an aid in cases of inflammatory bowel disease, liver injury and other conditions (Nutrients 6/11).
Supplemental probiotics need to contain enough live organisms to be effective; a quality product should also provide prebiotics, substances that feed the microbes.
In addition to probiotics, Sierpina finds other supplements helpful. “Fish oil is a good anti-inflammatory for the gut,” he says. “I’ve been very keen on vitamin D; that seems to be a mediator of many important reactions in the body” (he recommends having levels checked by a practitioner). Sierpina also recommends ground flax seed for constipation, ginger for nausea and enterically coated peppermint oil for irritable bowel syndrome.
L-glutamine “can improve the function of the protective gut mucosa [lining],” says Kellman. “Without enough L-glutamine the gut cells cannot reproduce rapidly enough and the intestines will atrophy.” This amino acid works best in combination with a probiotic/ prebiotic blend and calcium, which helps buffer acidity, and the antioxidant nutrients selenium and vitamins C and E. (Some people find a short cleanse to be helpful; suitable fiber types are discussed in this month's Supplement Savvy.)
Digestive enzymes, such as amylase, bromelain, lactase, lipase, papain and others, help the body digest fats, proteins and carbohydrates. “The body’s production of digestive enzymes can be disrupted by illness, hormonal shifts, stress and even aging,” says Kellman. One study found that digestive enzyme supplementation “may provide benefit in disorders in which compromised digestion may be involved” (Alternative Medicine Review 12/08).
Easing digestive woes isn’t always easy, but the results are worth it. “Taking away most foods has been the hardest thing I’ve gone through, and that includes giving birth!” says Cepeda. “But if I cheat, I feel sick—it’s as simple as that.”