Digestive Disorders

Far too many people bear with the symptoms of digestive disorders daily. Many seek help from their conventional doctor or gastrointestinal (GI) specialist, but the treatments are very often for symptom relief not treatment of the root causes. The vast majority only get symptomatic relief with regular use of prescription drugs or over the counter and/or home remedies. People typically consult me 2-10 years after having exhausted the conventional medicine options. Naturally, many of them are skeptical because by the time people find me they often have been to 5 or more practitioners and/or have been dealing with the problems for years. Unfortunately, by the time they see me, they typically have bad cases of digestive disorders, such as chronic Irritable Bowel Syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), Small Intestinal Fungal Overgrowth (SIFO), or chronic autoimmune thyroiditis.

I treat various types of digestive disorders. Below is a list of the most common and/or the most problematic among them.

Acid reflux is very likely the most common among digestive disorders. In fact, it has been reported as the most common GI complaint by U.S. hospitals. Acid reflux is commonly known as heartburn. It is also known as pyrosis or acid indigestion. The term “indigestion” is commonly used to refer to acid reflux, however, this is not technically accurate. Indigestion is a non-specific term that could mean various digestive problems.

A great majority of people use an antacid, a natural remedy or a diet modification as remedy. Using a remedy is acceptable if it’s happening infrequently. Infrequent acid reflux may occur depending on mild food intolerances or sensitivities. However, this is not something to be ignored or routinely remedied if frequently recurring.

Acid reflux can progress to Gastroesophageal Reflux Disease (GERD), a more problematic chronic disorder that can result in damage to the esophageal lining. Damage from chronic GERD can lead to Barrett’s Esophagus, a condition where there are precancerous changes in lower esophageal cells.

Conventional stomach hydrochloric acid suppression treatments for acid reflux and GERD primarily decrease symptoms, while the ongoing result of suppression of stomach hydrochloric acid leads to many health problems. Because acid reflux and GERD are often the result of low stomach acid being produced, often times taking supplemental hydrochloric acid can be greatly therapeutic.

Irritable Bowel Syndrome with Constipation (IBS-C) is a digestive disorder that is most commonly initiated by a bout of food poisoning. The common toxin produced in all cases of food poisoning is Cytolethal Distending Toxin B (CDT-B), according to researchers headed by Dr. Mark Pimentel’s research laboratory at Cedars Sanai Medical Center.

The types of bacterial overgrowth particularly common in IBS-C and SIBO are methane producing bacteria, while the types of overgrowth of bacteria common in IBS-D are hydrogen producing bacteria. On the other hand, the types of bacterial overgrowth common in IBS-M are both methane and hydrogen producing bacteria. Methane predominant SIBO typically is harder to resolve and takes longer to resolve than hydrogen predominant SIBO.

One of the quickest and most effective treatments for decreasing the symptoms of severe SIBO, is doing a 2 to 3 week elemental diet.

The Rome Foundation is an independent not-for-profit internationally recognized organization that provides support for activities designed to create scientific data and research-based educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders (FGIDs). FGIDs symptoms are called that because they’re characterized by symptoms of abdominal pain, cramps, constipation. diarrhea for which a cause may not be determined.

The latest research compilation by the Rome Foundation is Rome IV.  IBS-C, IBS-D, and IBS-M are classified as FGIDs.

Inflammatory Bowel Disease (IBD) is not classified as a functional gastrointestinal disorder like IBS, because there are more causes known for IBD. The primary cause of IBD is inflammation within the GI tract.

The two major types of IBD are Crohn’s Disease and Ulcerative Colitis (UC). There is an autoimmune component of Crohn’s and UC, and as such they are classified by the National Institutes of Health (NIH) and the American Autoimmune Related Diseases Association (AARDA) as autoimmune diseases. Crohn’s Disease is also called terminal ileitis because it’s characterized by inflammation in the terminal ileum (the end part of the small intestine). Ulcerative Colitis is designated as such because it is characterized by inflammation in the colon (the large intestine) with ulcerations.

IBD symptoms can be the same as IBS, with additional symptoms of eye inflammation, extreme fatigue, weight loss, intestinal scarring, malnutrition and rectal bleeding.

Functional Medicine diagnostics for IBD may include the conventional tests of colonoscopy. However, DNA-based Polymerase Chain Reaction stool tests can be very useful for diagnosis of IBD without the discomfort and inconvenience of colonoscopy.

Conventional treatment of IBD is typically anti-inflammatory drugs, such as non-steroidal anti-inflammatory drugs (NSAID’s) and corticosteroids. Immunosuppressive drugs are also used to treat of IBD conventionally. On the other hand, natural treatments also focus on decreasing inflammation but with dietary modifications, anti-inflammatory herbs and nutraceuticals, and therapeutic lifestyle modifications.

Due to the potential symptom severity of IBD, patients often go towards conventional treatment methods, but are not aware of the efficacy of using more natural Functional Medicine approaches.

Small intestinal Bacterial Overgrowth (SIBO) is a condition resulting from excessive amounts of a variety of bacteria in the lower parts of the small intestine. Like IBS-C, SIBO is among digestive disorders that is often initiated from a bout of food poisoning, that have typically occurred within the last few weeks to 24 months.  The characteristic symptoms of SIBO are abdominal gas and bloating, with either constipation or diarrhea, or mixed constipation and diarrhea. Gas and bloating are often aggravated by certain foods, but many people with SIBO feel worse after eating anything.

The key to treating SIBO is “starving” the excess bacteria. Conventional medicine use antibiotics to selectively target bacterial strains that cause SIBO. In my experience, I have seen antimicrobial herbal treatment to be just as effective.

Increased intestinal permeability, also known as “leaky gut”, occurs when the small intestine single-cell thick lining tight-junctions loose integrity. They become “leaky”.  There is a measurable protein called zonulin that increases the more leaky the intestinal lining becomes. Laboratory tests that measure zonulin levels in the blood or the stool gives diagnostic indication of how “leaky” the gut lining is. The higher the level of zonulin the more leaky the gut.

This is a problem because there are blood vessels right under this one-cell thick lining. Since blood vessels go all over the body, harmful microbes and other potential pathogens can gain entry into the bloodstream from a leaky gut, and cause damage of tissues and organs apart from the gut. Immune cells in the bloodstream can then detect harmful microbes or improperly digested food components. These microbes or poorly digested food components are called “antigens”.  The more antigens that get into the bloodstream, the more antibodies are produced attaching to these antigens. The antigen-antibody complexes travel throughout the bloodstream. Antigen-antibody complexes in the bloodstream can “appear” similar to some tissue cells, such as connective tissue.

When there’s a tissue similar enough to the antigen, antibodies may be produced against that tissue also. This process is called “molecular mimicry”. Molecular mimicry is the mechanism by which autoimmune disease develops. Therefore, increased intestinal permeability is the process involved in the initiation of autoimmune disorders! The recognition of this fact came to awareness by the scientific community after a seminal research review paper was published in 2005 in Nature Clinical Practice: Gastroenterology and Hepatology by Dr. Alessio Fasano.