The gastrointestinal system has the critical task of supplying essential nutrients to fuel all the activities of the body. The way it functions affects our quality of life. Malfunctions anywhere in the system produce profound effects.
The system has two major components: the alimentary canal or GI tract and accessory organs. The alimentary canal is a hollow muscular tube that begins in the mouth, continues to the pharynx, esophagus, stomach, small and large intestines and ends at the anus. Accessory parts are glands such as salivary glands, and the liver, biliary duct system or gallbladder and bile ducts, and pancreas organs. The complete system has two major functions: digestion or breaking down food and fluids into simple nutrients that can be absorbed into the bloodstream and trans- ported throughout the body; and the second is elimination of waste products.
Disorders in the system can manifest in vague, non-specific complaints, such as gas, bloating, distention or specific concerns such as vomiting or nausea, diarrhea or constipation, or loss of appetite. A person may have only one concern or may have several complaints. Among the most commonly seen disorders is inflammatory bowel diseases.
Chronic inflammatory disorders of the intestines - ulcerative colitis in the large intestine and Crohn’s disease of the small intestine - hold an estimated 2 million Americans in its grip. Symptoms come and go with intermittent attacks, even going into a long quiet spell. However, if there are continuous symptoms, these cases suffer serious complications. The inflammation can cause sores, ulcers, or erosion of the mucosa, but it can extend into the deeper layers of the intestinal wall causing permanent scarring, narrowing or even obstructing the channel. Typically, the patient has a normal-appearing GI tract. With careful examination of the colon, functional irritability or an abnormality in colonic smooth muscle function marked by excessive peristalsis and spasms can be noted.
To understand what happens in IBD we have to look at how smooth muscle controls bowel function. Normally, segmented muscle contractions mix intestinal contents while peristalsis moves the contents through the tract. Motor activity is most propulsive in the stomach area and the sigmoid portion of the intestine. Activity in the rest of the intestine is slower to allow for nutrient and water absorption. In IBD the autonomic nervous system which innervates the intestines does not allow the contractions and relaxations which propel stools smoothly through to the rectum. The result is constipation or diarrhea or both.
If there is constipation, spasmodic intestinal contractions set up a partial obstruction trapping gas and stools. This causes distention, bloating, gas, and pain. On the other hand, some patients have dramatically increased intestinal motility. Stimulation such as eating triggers the small intestines to push out its contents in a rush, dumping watery stools and irritating the mucosa. This is the diarrhea side of the problem. If further spasms trap liquid stools, the intestinal mucosa absorbs water from the stools, leaving them dry and hard. They are difficult to pass and the result is alternating diarrhea and constipation.
One complication is toxic megacolon, involving the deeper layers of the colon. The colon enlarges, becomes paralyzed, and may rupture needing surgery. Another complication is fistulas which develop between loops of the small and large intestines, interfering with nutrient absorption and forming pockets of infection or abcesses. Either disorder can lead to intestinal blockage due to scar tissue and both can lead to cancer.
A healthy colon is needed for the absorption of vital nutrients and is a major organ for the natural elimination of waste and toxins. The colon is a key component of the gastrointestinal system, the largest system of the body. The length of the tract is around 28 feet with a surface area of nearly 6000 square feet. Good functioning of the colon depends on high fiber diet especially grains, legumes, vegetables and fruit; a balance of bacteria and microflora to help manufacture vital nutrients and maintain proper pH balance and keep harmful bacteria in check; healthy mucosa that allows passage of nutrients into the blood stream; and regular elimination, preventing toxic residues and by-products remaining in the body.
When the colon is under the burden of an over accumulation of waste material such as impacted feces, fungi, bacteria, viruses, parasites and dead cell matter, the result is “bowel toxemia”. The condition leads to inflammation which disrupts absorption and a build up of putrefactive gases. Toxic matter and undigested food are absorbed into the bloodstream the undigested food molecules act as antigens (foreign substances) which provoke an immune response. The immune reaction leads to destruction of healthy tissue and studies suggest this may contribute or even cause autoimmune problems. Bacteria and their by products can also be absorbed into the bloodstream. Toxins that enter the bloodstream from the colon burden the liver, lungs, and kidneys. Bowel toxemia can alter the DNA of cells. Tampering with cellular blueprints leads to abnormal cell reproduction.
Treatment of irritable bowel disease, inflammatory bowel disease, and colitis is best done in a multi-faceted approach. First any medications that are associated with gastrointestinal reactions should be discontinued if possible. Among these are Alka- Seltzer, Accutane, Bayer Aspirin Tablets, Ecotrin, Feldene, Piroxicam. These OTC medications can add to the problem.
Second, what we eat has powerful effects on our bodies: food can be a most valuable tools for improving the problem or can maintain inflammation. We are beginning to realize that some types of food are pro-inflammatory or able to increase inflammation and other types of food are anti-inflammatory. If you know whether a food causes or reduces inflammation then you can make choices about which foods to eat more of and which to avoid. Too many people eat a diet that puts them in a constant pro-inflammatory state. Anti-inflammatory eating means eliminating some foods and increasing consumption of others.
A diet of lots of fruits and vegetables - five a day is the usual recommendation. Research has definitely proved that eating lots of fruits and vegetables reduces the risk of colitis and Crohn’s . These foods plays a role in slowing down aging and its accompanying problems, and in general boosts the quality of life. You may look at the guideline and think you could never meet it. But if you ate even an additional1 ½ servings of fruit or vegetables every day for six months, you would increase the amounts of anti-oxidants and anti-inflammatories in your blood and your blood pressure would drop. This extra increase can easily be one salad a day, a handful of raisins or an apple a day or a tall glass of orange juice or a large grapefruit. The reason fruits and vegetables are so effective is in the nutrients they provide. These nutrients are compounds of phytochemicals (phyto = plant). Plants have thousands of phytochemicals; up to now only a few have been studied for their contribution to health but many more are yet to be discovered.
How powerful are phytochemicals? Research has discovered they are anti- oxidant, anti-inflammatory, anti-allergic, antiviral and anti-cancer. They just don’t keep us alive, they protect us as well! A Finnish study looked at blood levels of lycopene, a phytochemical found in high quantities of tomato products and watermelon, and discovered that middle aged men with the lowest levels of lycopene were more than three times as likely to have a heart attack or stroke compared with men with higher lycopene levels. Feeding senile rats with extracts of blueberry or spinach, both high in phytochemicals not only prevented many age- related learning memory deficits but actually reversed documented deficits.
Phytochemicals are available in their original packaging - the actual fruit and vegetable (nuts, gains, and seeds are further sources). It is generally agreed that the benefits of eating lots of fruits and vegetables come from a full collection of phytochemicals and their effects depend on the interactions of several phytochemicals working together. By eating a variety they all contribute to health. A variety protects you against many possible diseases. If you eat only popular fruits and vegetables you would be missing out on an as-yet-to-be discovered health surprise. Eat by colors: eat a variety of different colors - a virtual rainbow - throughout the day, for each color concentrates an amount of phytochemicals.
Which foods provide the greatest amounts? From what is known right now, some of the top inflammation fighting foods are the cruciferous vegetables, the leafy and dark green vegetables, citrus fruits, berries, and dark orange colored fruit. And don’t forget the legumes or grains: unprocessed, they have very high levels of phytochemicals. The darker the color - brown rice versus white rice for instance - has been associated with lower risks of digestive cancers, breast cancers, and prostate cancers. A twelve-year study of 43,000 men pointed out that those who rarely ate whole grain foods were about 60% more likely to develop type 2 diabetes than men who ate about three servings of whole grain foods daily.
In the active stage of an inflammatory bowel problem, eating only a liquid diet gives the patient the opportunity to start the healing process and to determine the cause or triggers of the inflammation. A liquid diet should consist of juices from cabbage, leafy green vegetables for their chlorophyll healing properties and even seaweed. Fiber has to be eliminated because it is too harsh. A four-day plan of vegetable juice or broth is recommended and then followed by a slow introduction of other vegetables back into the diet. If the patient pays close attention to how he feels after introducing a vegetable into the mix for two or three days, he can definitely see how each food effects him. If he has reactions to a food then it can be removed from his diet indefinitely. In a month, the diet can include steamed vegetables and simple salads. After another month he can be back on whole foods, ideally of a mostly vegetarian diet.
A restrictive diet takes time but it can give the patient lots of information. Supplements are needed to counteract the decreased food intake. Quercetin, a plant flavonoid, is helpful in reducing the inflammatory response. Peppermint and chamomile are great for gas and colic. If one chooses peppermint, the enteric-coated kind has to be used; pure peppermint oil can cause heart-burn and reflux. To soothe the lining of the digestive system, marshmallow and slippery elm are good choices. Comfrey and meadowsweet lessen any local bleeding and bitters combination helps healing in the latter stages.
There are excellent herbal medicine formulas for IBD: Atratylodes from Seven Forest Herbs has a mix of ingredients that will address several facets of the problems. Another formula Imperata , from the same company, stops internal bleeding. Robert’s Formula is an old and true cure. It consists of a mixture of marshmallow root, wild indigo, echinacea, Geranium, goldenseal, poke root, comfrey, and slippery elm, each herb selected for its unique effect on one aspect of the problem ( soften tissues, cure an infection, stop bleeding, healing ulceration, soothe the lining). Several herbs for inflammation could also be used: tumeric, rosemary, green tea extract, ginger, quercetin, boswellia. Some products include a grouping of several anti-inflammatory herbs.
Other herbs and supplements are effective as well. In Germany, Chamomile is a licensed OTC drug for internal use against gastrointestinal spasms and inflammatory diseases of the GI tract. Ginger is known for its ability to act on soothing and allaying nausea. Because of its bitter effects, goldenseal helps many digestive problems such as loss of appetite and production and secretion of digestive juices. Licorice is used as a treatment for peptic ulcers and gastritis and relieves abdominal colic. Thistle compounds including milk thistle, artichoke, dandelion and other plants of the family are great liver cleansers. Witch hazel will stop diarrhea and aid in the treatment of hemorrhoids. Senna is a laxative with no known side effects.
Food combinations can help or aggravate. The general rule is that proteins be eaten alone or with green leafy vegetables. Fruits are eaten alone; vegetables with grains and legumes. The rationale is the difference in digestion time for the various food groups. Digestion is optimal if foods having roughly the same digestion time are eaten together. Digestive stimulants prior to meals may also be helpful, this could be a little green tea or ginger tea sipped about ten minutes ahead of eating. (Ginger tea is easy to make and so elegant in taste. Simply cut several rounds off a ginger root and steep them in hot water. Keep the ginger root in the freezer and it will last a long time. ) The combination of herbs called “ Bitters” is a great appetite stimulant and digestive aid. Half a lemon squeezed into half a cup of water and taken ten to fifteen minutes before eating will stimulate gastric juices. Digestive enzymes can do the same thing and cut down on acid production and acid reflux.
Common trigger foods are milk and milk by-products such as casein, other dairy products such as cheese, yogurt, and butter, eggs, corn and corn by-products such as corn syrups, wheat, nuts and peanuts, tomatoes, onions, chocolate, apples, bananas and citrus fruits, and some meats. Common safe foods include brown rice and rice products such as crackers, pasta, most vegetables, most fruit, and lots of water. Trigger foods can be added back into the diet as symptoms disappear.
Another answer to gastrointestinal problems is to add more essential fatty acids particularly omega-3 to your diet. When you want to get inflammation in balance, you have to consider fats. There are three main kinds of fats: saturated fats found in animal products, mono-unsaturated fats as found in olive oil, and poly-unsaturated fats, the essential fatty acids omega-6 found in vegetable oil and omega-3 found in fish oil and some plant oils (borage, black current, evening primrose and flaxseed). Increasing the omega-3 fatty acids and reducing the omega-6 fatty acids which are in vegetable oils would protect you from inflammation-related disease. An Italian study looked at over 11,000 people who had suffered a heart attack; half of these received 1,000 mgs of fish oil daily in supplement form and the other half received a placebo. Patients who took fish oil realized short and long-term benefits: at the end of three months they were more likely to be alive than patients who didn’t take fish oil with a 41% reduction in sudden death. At the end of 3 ½ years, the group taking the fish oil had 45% fewer fatalities.
Omega-9 comes from olive oil and if you fry food, you can substitute it for vegetable oils. The cold- pressed, extra-virgin varieties are preferable. Ideally, you can try to cut down the amount of frying you do in the home and stop eating fried foods outside the home.
The American diet now has an unequal balance between omega-3 and omega-6 favoring omega-6. We evolved on a diet that contained small but roughly equal amounts of both fatty acids. This changed with the introduction of feed grains to domestic livestock which happen to be rich in omega-6 and low in omega-3 fatty acids. At about the same time the vegetable oil industry began to hydrogenate oil which also reduced the oil’s omega-3 content. These factors contributed greatly to a new diet of EFA ratio of 20-25 omega-6 to 1 omega-3. Boosting intake of omega-3 EFA’s can be done through diet: fish is a good source, as are beans such as kidney, navy, and soy, and flaxseed..
Vegetarian diets are great at fighting inflammation. The anti-inflammatory action of such a diet may be as good as medication. In a study following patients with severe rheumatoid arthritis, in the four weeks after a switch to low-fat vegan diet, the patients reported less pain and they had lower levels of inflammatory markers such as C-reactive protein. If you want to change do it slowly, perhaps starting with lowering portion size and eliminating one type of meat. If you eat meat every day, start by introducing a vegetarian day once a week; gradually you can increase your vegetarian days. If you eat meat two or three times a day, try to cut meat out of one meal, then two.
Calorie restriction has impressive anti-aging effects due to its anti-inflammatory action. As we age body chemicals that are associated with inflammation such as prostaglandins increase. In a lower calorie diet the production of pro-inflammatory chemicals is greatly reduced. Calorie restriction lowers the levels of damage done by free radicals. Free radicals are a direct result of environmental stress on the body. Oxidative stress is the single greatest cause of aging and age-related diseases. The body fights oxidative stress with anti-oxidants, but the body’s manufacture of anti-oxidants falls sharply with age. It’s never too late to start calorie restriction. In studies of middle-aged mice, calorie restriction increased their life span by 15% and reduced the incidence of cancer. Scientists have also figured out that degeneration of nerves in the brain seem to be caused in part by oxidative stress and oxidative stress is countered by calorie restriction. Scientists can now prevent Alzheimer’s and Parkinson’s disease in mice by cutting back on the calories the animals are fed. To start lowering calories gradually cut down your food intake by 25% or eating only three-quarters of what you usually eat. Eliminate sugary snacks which tend to be high in calories and unhealthy fats. Cut out fried foods which are full of calories. Definitely don’t have second or third helpings.
You can go one step further and try short-term fasting. A little fasting can be good for the body: brain cells become more active, the body’s ability to process sugar is improved, and while normal cells are nor harmed by fasting, abnormal cells are weakened. A short term fast of two to four days (two for older adults, four for young adults) has many benefits including giving the system a much needed rest particularly the liver. A great deal of energy is used to break down food into its nutritional components; when the intake of calories is restricted the body fuels itself through alternate means. During two days of a fast, the liver converts stored sugars into glucose that the body can use. When these stores are depleted, fast is used as a source of energy. The body continues its natural process of excreting stored toxins but the total body toxicity is reduced. With the elimination of food and its allergens, the immune system’s workload is also greatly reduced and the digestive tract starts to recover from the constant inflammation. The burning of fat releases fat-stored chemicals such as pesticides, drugs, etc. into the bloodstream. Because less energy is directed at food digestion, there are greater reserves of energy for use by eliminatory systems. The enhanced eliminatory capabilities can deal with the toxins. Some diseases can even by benefited by fasting: heart disease, hypertension, arthritis, allergies, inflammatory disease, and headaches. Chronic conditions often require several periods of fasting, i.e. three separate short fasts.
There are types of fasts. A weekend fast of two days is convenient and doesn’t disrupt one’s work schedule. The fast can be a water fast or a juice fast (very popular in European spas). Acceptable juice combinations include carrots and green vegetables diluted with water 50:50. Fruits juices contain large amount of sugars and are not generally advised for fasts. Herbal teas can be taken such as chamomile, or rosehips. Slowed-down activity - a walk instead of hours at the gym-, rest in general such as napping or reading, sunbathing or relaxing in the open air are all highly recommended. Coming off a fast is simple: initial meals should be small at frequent intervals, and no highly refined or spiced foods (these can cause abdominal pain). A water fast is broken with vegetable juices sipped throughout the day for a couple of days then small meals of vegetables. Vegetables can be raw or lightly steamed in either method.
Certain conditions contraindicate fasting: diabetes, eating disorders, epilepsy, kidney disease, pregnancy, lactation, severe asthma, terminal illness, tuberculosis, ulcerative colitis. A person’s nutritional status and degree of toxicity prior to a fast should determine the type of fast and its length. If you have never fasted before, a very short fast is the answer. Going through one does make body changes and experiences ( a coated tongue, unpleasant taste in the mouth, a headache, and so on). You’ll know what to expect the next time.
Vitamin therapy is another way to reduce inflammation. Vitamin E can reduce the inflammatory marker C-reactive protein and the inflammatory interleukin-6. In the B family, folic acid aids in the removal of artery-damaging h homocysteine from the blood but it needs to work closely with vitamin B6 and B12, a B complex is the solution. Nutritional supplements should be taken with meals to promote increased absorption. Fat-soluble vitamins such as A and Beta-carotene, D, E and essential fatty acids should be taken with a meal that contains fats. If you are taking high doses, spread them out during the day. Basically what phytochemicals and nutrients do is regulate inflammatory response mechanisms maintaining a balance of enzymes such as COX-1 and COX-2 (the enzyme cyclooxygenase). The enzyme COX produces a class of chemicals called prostaglandins which are in the chain of events leading to inflammation. Blocking COX means that prostaglandins aren’t produced and inflammation is sidestepped. Any or all of the inflammation fighters can be paired with non-steroidal anti-inflammatories (NSAIDS).
Psychological stress can cause temporary increases in pro-inflammatory chemicals. Scientists believe that the inflammatory changes brought about by stress can begin the process of inflammatory bowel disease or accelerate the process in someone already suffering from the disease. Chronic stress has been shown to cause flare-ups. A bit of exercise, meditating, using stress management techniques, getting a massage or an acupuncture treatment and other healthy behavior is very important to balance out the damage.
For supplies and further information consult Marie Cargill.