30 Sep The Importance of Optimal Gut Health
The gut is considered in traditional Naturopathic philosophy, as the seat of all health. It’s not surprising then, that managing the gastrointestinal tract (GIT) is a key step in managing almost all other body systems. The gut is a complex system and any dysfunction in the gut can have a profound influence over other body systems. As a result of this complexity, managing digestive disorders isn’t always simple and there are often many contributing factors that lead to, and are a consequence of, GIT dysfunction.
To truly restore gut health, a treatment plan will ideally address each and every one of these six functional layers, which form an interrelated web. As such, imbalances in any one layer can lead to imbalances in the others.
Diet
Food is consumed to not only provide the body with the energy and nutrients it requires; it also has a strong influence on digestive health. For example, a diet high in refined carbohydrates may result in a dysbiotic GIT.
Many people make food choices that are detrimental, whether it is due to low nutrient content, high calories, excessive processing or food intolerances and allergies; a patient’s diet should be reviewed and improved as part of any treatment protocol. Particularly in those patients whose primary condition is digestive, food intolerances should be determined using the Metagenics’ Allergy and Reactivity Reduction Program. A custom elimination diet or low FODMAP diet may be useful. Visit the Metagenics website to learn more about this program for your patients.
Enzymes
Most food that is consumed contains nutrient complexes that are too large for the body’s cells to utilise. In a healthy system, digestive organs secrete acids and enzymes that break down these nutrients to make them small enough for the cells to use. When digestive secretions are reduced, nutrient absorption is also compromised, betaine hydrochloride and pepsin may need to be prescribed.
Bacteria
What comes first – the chicken or the egg? When it comes to gut function, is it inflammation at the barrier that’s deteriorating the microbial environment; or are dysbiotic bacteria and pathogens driving the loss of mucosal integrity? Both may be at play, highlighting the necessity of also addressing the bacteria level. Probiotics are the ideal way to develop a healthy microbiome and restore digestive balance.
This balance can be restored via the use of antimicrobials, good quality probiotics and diet, and lifestyle corrections.
Barrier
There are three main lines of defence in preventing bacteria from penetrating the gut barrier. Firstly, secretory immunoglobulin A (secretory IgA); secretory IgA in the GIT binds to bacteria, and therefore keeps those bacteria in the digestive tract where they can do less damage.
The second line of defence is the mucus. This is a physical barrier between the gut lumen and the epithelium which prevents bacterial adherence to the epithelial cells. Nutrients, such as glutamine and EpiCor®, increase levels of secretory IgA and improve mucosal health.
The third line of defence against bacteria in the GIT is epithelial cells. These cells have selective permeability designed to exclude detrimental particles and absorb beneficial items, such as nutrients from food.
In a sub-optimal digestive tract, and when inflammation occurs, the tight junctions between these epithelial cells can become opened which can lead to intestinal hyperpermeability (leaky gut), allowing foreign particles to penetrate the gut barrier. Many nutrients can support the health of these junctions, including glutamine and zinc. Aloe vera and BosPure® Boswellia improves the integrity of the gut epithelial lining due to the healing, anti-inflammatory action.
Immune
With 70% of the immune system being in the gut, the digestive and immune systems are very closely related. Immune balance is influenced by the gut microbiome and, in turn, gut microbiome is influenced by immune balance. Immune function ought to be considered in treating gut health, as immune driven inflammation in the gut can lead to gut barrier dysfunction. There are two main approaches in treating this ‘see-saw’. The immune system can be treated with a patient specific immune protocol, and the gut microbiome can be brought back in line with the use of good quality probiotics.
Evidence based strain-specific probiotic strains, at the correct researched dose, exert specific actions to either regulate or stimulate the immune system. Lactobacillus rhamnosus (LGG®) and Lactobacillus paracasei (LP-33®) modulate immune reactions by interacting with dendritic cells within the gut associated lymphoid tissue (GALT), stimulates the production of regulatory T cells and increases the production of anti-inflammatory cytokines.
Enteric Nervous System
The commonly held belief that the gut is the body’s ‘second brain’ may have been originally referring to the enteric nervous system (ENS) and its role in digestive health. The ENS regulates the behaviour of the GIT, including motility and gastrointestinal secretions. Managing a patient’s stress and nervous system can have an impact on gastrointestinal symptoms. This is particularly apparent in patients with medically diagnosed irritable bowel syndrome (IBS), for example.
Taking a Holistic Approach
With digestion as the seat of health, treatment that focuses on restoring barrier and bacteria function will result in resolution of the majority of your patients’ digestive complaints and many systemic issues.
However, it is essential to take a holistic approach, addressing the specific factors affecting each individual, including poor diet, weakened digestion (enzymes) and imbalances in the immune and enteric nervous systems. Just as the gut is central within our body, and its health is central to our continued wellness, these treatment recommendations may well become central to your practice.
FIONA STOCK | THE CHILDREN’S NATUROPATH | MELBOURNE NATUROPATH
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