Proactive Steps to Strengthen GI Health
By Chris D. Meletis, ND
Often, we don’t pay attention to our intestinal health unless we develop an obvious gastrointestinal disease. Yet, the GI tract is the absolute barrier between the burdensome outside world that enters our bodies in the form of foods and contaminates (herbicides, pesticides, heavy metals and an array of other health saboteurs) and our well ordered 75 trillion cells that work in harmony to sustain our existence. Therefore, regardless of whether an individual has any overt signs of gastrointestinal dysfunction, fortifying the GI tract enhances the ability for nutrients from food and supplements to be most optimally absorbed.
Some 60 to 70 million people are affected by overt diagnosable digestive diseases,1 yet tens of millions of others suffer from subclinical GI health issues that alter their ability to absorb nutrients from their diet and supplements, ultimately undermining even the most proactive individual’s attempt to truly take care of his or her health. Annually, an astounding 234,000 people die from GI diseases including cancer.2 Yet, far more people (14 million per year) end up in the hospital from nonfatal GI conditions.3
Diagnosed GI health conditions are just that, confirmation of disease being present. This amounts to finally there is officially enough symptoms and a confirmatory diagnostic test to document either anatomical or functional dysfunction. However, it can take tens of thousands if not millions of cells to be sufficiently damaged prior to having the ability to perceive there is a problem. Proactive GI health care is of paramount importance in the endeavor to minimize the risk of becoming one of the 6 million diagnostic and therapeutic in-patient hospitalization procedures conducted annually4 or one of the approximately 45 million outpatient visits.5 This has a dramatic impact on quality of life with 1.9 million people disabled due to GI disease.6
Proactive Approach to GI Health
Without optimal health in the alimentary tract there cannot be true wellness elsewhere. For the body to heal and wellness to prevail, toxic waste absorption must be minimized.
Though the entire GI tract works in symphonic harmony, we must limit ourselves in this article to the large intestine’s anatomy and physiology. The large intestine is approximately 60 inches in length (about 5 feet) and is comprised of four segments: the ascending colon (8 inches); transverse colon (18 inches); descending colon (approximately 12 inches); and sigmoid colon (18 inches). (Fig. 1).
The large intestine absorbs about 90 percent of the water content it receives from the small intestine. If this slurry of food material and moisture remains in the colon too long, excess moisture is absorbed and toxins and waste burden are reabsorbed disproportionately, irritating the colonic lining. This is why, when individuals fail to have 2 to 3 bowel movements per day, they feel ill and tired. Furthermore, their stools are harder and drier, for the body has reabsorbed the toxic wastewater. This process of absorption and reabsorption serves as the mandate to nourish the GI tract daily—even when not experiencing GI distress.
A Life-Sustaining Function
The healthy intestinal lining is a selective barrier that normally only allows properly digested fats, proteins, and starches to enter the bloodstream. The colonic lining that comes in contact with food, bacteria, toxins and other pathogens is called the mucosa and is an epithelial (single layer of cells) lining that regenerates every 3-8 days. For proper maintenance of this nutrient-dependent barrier, sufficient substrates for healing, repair and regeneration must be present.
Nutrient absorption across this GI interface that also protects against harmful agents occurs via a few mechanisms:
Diffusion is the process by which nutrients such as potassium, magnesium, sodium, chloride and free fatty acids diffuse through intestinal cells.
Active transport allows for amino acids, fatty acids, glucose, minerals, and vitamins to cross through cells.
Tight Junction (Desmosomes) is a third way substances can pass into the circulatory system from the intestines. The tight junction spaces between cells that line the intestines are normally sealed. However, when the intestinal lining becomes irritated, the junctions loosen and allow unwanted larger molecules in the intestines to pass through into the blood. This can trigger immediate damage and immune system reactions since these large molecules are perceived as foreign. Much like the initial crack in a large dam, without immediate repair, progressive damage occurs to the intestinal lining, eventually allowing disease-causing bacteria, undigested food particles, and toxins to pass directly into the body. A cascade of events ensues as the immune system becomes involved in generating antibodies and cytokines that produce oxidative damage, localized irritation and inflammation throughout the body. This process increases inflammatory markers such as C-reactive protein (CRP), a known risk factor for cardiac damage and in this case serving as the proverbial coal miners’ canary alert that preemptive action is required.
This inflammation can result in IBS (irritable bowel syndrome), which affects 20 percent of Americans.7 Additionally, in 2004, there were 73,997 men and 71,086 women diagnosed with colorectal cancer.8
Leaky Gut Syndrome
|TABLE 1. Conditions Associated with Leaky Gut Syndrome|
|• Allergic Reactions
• Autoimmune disease
• Celiac disease
• Crohn’s disease
• Environmental illness
• Inflammatory joint disease/arthritis
• Intestinal infections
• Irritable bowel syndrome
• Pancreatic insufficiency
• Ulcerative colitis
• Chronic fatigue syndrome
• Food allergies and sensitivities
• Liver dysfunction
Disturbance of the tight junctions contribute to leaky gut syndrome (LGS). The symptoms that can arise range from subtle to severe depending on breach of the integrity of the intestinal natural defenses. Individuals with LGS can experience one or more of these symptoms: abdominal pain, anxiousness, asthma, chronic joint pain, chronic muscle pain, confusion, fuzzy or foggy thinking, gas, indigestion, mood swings, poor immunity, recurrent infections, skin rashes, diarrhea, poor memory, constipation, bloating, fatigue and feeling toxic or hung-over. Leaky gut syndrome is associated with many conditions (See Table 1).
Nutritional Support for the Colon
Specific supplements, such as those mentioned below (all found in GI Cell Support), can deliver critical building blocks for daily repair of the GI tract and also help soothe irritation that arises from innate colonic function.
Glutamine is the most abundant free amino acid in the body.9 Though it is classified as a non-essential amino acid, glutamine is absolutely essential for maintaining intestinal structure.10 Glutamine serves as metabolic fuel for enterocytes that line the colon and affect cell proliferation. The GI tract has the largest demand for glutamine in the body.11 Insufficient glutamine can present with atrophy, ulceration, and necrosis of the colon lining.
Most of the research on deglycyrrhizinated licorice (DGL) has been focused on upper GI health, including ulcer healing. Colon health is directly dependent upon the proper functioning of the entire GI tract. DGL seems to be similar to carbenoxolone, a semisynthetic derivative of glycyrrhetic acid used outside the US for treating gastric and duodenal ulcer disease.12-13 DGL utility is not limited to upper GI health, in the clinical setting it has demonstrated great utility in lessening intestinal irritation and related symptoms.
N-acetyl glucosamine is the acetylated derivative of the amino sugar glucosamine. In inflammatory bowel disease (IBD), N-acetylation of glucosamine is relatively deficient, possibly reducing the synthesis of the gastric and intestinal mucosa’s protective glycoprotein cover.14
Marshmallow leaf and root contain mucilage polysaccharides that soothe and protect mucous membranes from local irritation by creating a protective layer.15-16 The mucilage properties can also have antimicrobial, spasmolytic, and wound-healing effects.17-18
Maintaining healthy GI flora is essential. Berberine possesses antimicrobial effects including antibacterial, antifungal, antimycobacterial and antiprotozoal activity.19-20 Berberine has demonstrated activity against Staphylococcus aureus, Streptococcus pyogenes, Eschericha coli, Shigella boydii, Vibrio cholerae, Mycobacterium tuberculosis, Candida albicans, Candida tropicalis, Trichophyton mentagrophytes, Microsporum gypseum, Cryptococcus neoformans, Sporotrichum schenkii, Entamoeba histolytica, and Giardia lamblia.21-24
Berberine also helps control inflammation in the GI tract by selectively inhibiting cyclooxygenase (COX)-2 expression and blocking the proinflammatory cytokines interleukin-1 (IL1)-beta and tumor necrosis factor (TNF)-alpha as well as nuclear factor-kappaB, the transcription factor responsible for regulation of cytokine production.25
Historically called vitamin U, cabbage does not meet the official criteria to achieve vitamin status. However, cabbage constituents offer significant protection to the GI tract and thus the body in general. Individuals who consume large amounts of cabbage and other Brassica vegetables have a lower risk of developing stomach and colorectal cancer.26 In 1952, 100 peptic ulcer patients drank 4 glasses of fresh, raw cabbage juice daily. Patients indicated dramatically reduced pain, while x-rays demonstrated significantly reduced healing time. Eighty-one percent of the patients were symptom-free within one week, and over two thirds were better within four days.27 Cabbage also possesses antioxidant effects.28
The inner bark of slippery elm contains mucilage constituents that are demulcent and emollient. When used internally, slippery elm preparations trigger gentle stimulation of nerve endings in the GI tract, leading to mucous secretion that coats and protects the delicate lining of the intestines from ulcers, excess acidity, ingested irritants and toxins.15, 17-18
The clinical importance of phosphatidylcholine (PC) is illustrated by a 2007, randomized, double-blind, placebo-controlled study showing that patients with ulcerative colitis can benefit from PC supplementation. It was shown that low levels of PC in colonic mucus are a likely contributory factor involved in the development of ulcerative colitis.
The study authors concluded, “Phosphatidylcholine reduced corticosteroid dependence more than placebo in patients with chronic steroid-refractory ulcerative colitis….”29 This research correlates with the findings in clinical practice that when PC is supplemented it supports the GI function and cellular synthesis.
Gamma oryzanol contributes ferulic esters extracted from rice bran oil that possess antioxidant properties. It is highly regarded in Japan to promote a healthy gastrointestinal environment. There appears in animal models to be a modulation of pituitary secretion, inhibition of excess gastric acid secretion, and inhibition of platelet aggregation.30 There is also evidence of cholesterol-lowering properties by decreasing cholesterol absorption from the gut.31
Maintaining healthy GI function is foundational to all other health pursuits. Even those fortunate enough not to suffer from GI dysfunction should take steps to protect healthy GI function, which is critical for sustained healthy aging. Clinical practice and testing clearly demonstrate it is the rare individual who has a totally pristine GI tract. Optimal absorption of nutrients from foods and supplements consumed depend upon optimal GI health. Use of specific nutrients to protect, soothe and support the colon is the first step toward health optimization for the entire body.
1. Adams PF, Hendershot GE, Marano MA. Current estimates from the National Health Interview Survey, 1996. National Center for Health Statistics. Vital Health Stat. 1999;10(200).
2. National Center for Health Statistics. (Technical Appendix from Vital Statistics of the United States: Mortality). 2002. Hyattsville, Maryland: 2004.
3. Kozak LJ, Owings MF, Hall MJ. National Hospital Discharge Survey: 2002 annual summary with detailed diagnosis and procedure data. National Center for Health Statistics. Vital Health Stat. 2005;13(158).
4. Burt CW, Schappert SM. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1999–2000. National Center for Health Statistics. Vital Health Stat. 2004;13(157).
5. Collins, JG. Prevalence of selected chronic conditions: United States, 1990–1992. National Center for Health Statistics. Vital Health Stat. 1997; 10(194).
6. Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–1511.
7. National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/Accessed January 12, 2008.
8. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2004 Incidence and Mortality. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2007.
9. Medina MA. Glutamine and cancer. J Nutr. 2001;131:2539S-42S.
10. Sacks GS. Glutamine supplementation in catabolic patients. Ann Pharmacother. 1999;33:348-54.
11. Miller AL. Therapeutic considerations of L-glutamine: a review of the literature. Altern Med Rev. 1999;4:239-48.
12. van Marle J, Aarsen PN, Lind A, van Weeren-Kramer J. Deglycyrrhizinised liquorice (DGL) and the renewal of rat stomach epithelium. Eur J Pharmacol. 1981;72:219-25.
13. Tewari SN, Wilson AK. Deglycyrrhizinated liquorice in duodenal ulcer. Practitioner. 1973;210:820-3.
14. Burton AF, Anderson FH. Decreased incorporation of 14C-glucosamine relative to 3H-N-acetyl glucosamine in the intestinal mucosa of patients with inflammatory bowel disease. Am J Gastroenterol. 1983;78:19-22.
15. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
16. Martindale W. Martindale the Extra Pharmacopoeia. Pharmaceutical Press, 1999.
17. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
19. Amin AH, Subbaiah TV, Abbasi KM. Berberine sulfate: antimicrobial activity, bioassay, and mode of action. Can J Microbiol. 1969;15:1067-76.
20. Sun D, Courtney HS, Beachey EH. Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane. Antimicrob Agents Chemother. 1988;32:1370-4.
21. Scazzocchio F, Corneta MF, Tomassini L, Palmery M. Antibacterial activity of Hydrastis canadensis extract and its major isolated alkaloids. Planta Med. 2001;67:561-4.
22. Rehman J, Dillow JM, Carter SM, et al. Increased production of antigen-specific immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis canadensis. Immunol Lett. 1999;68:391-5.
23. Sun D, Courtney HS, Beachey EH. Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane. Antimicrob Agents Chemother. 1988;32:1370-4.
24. Kaneda Y, Torii M, Tanaka T, Aikawa M. In vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. Ann Trop Med Parasitol. 1991;85:417-25.
25. Fukuda K, Hibiya Y, Mutoh M, et al. Inhibition by berberine of cyclooxygenase-2 transcriptional activity in human colon cancer cells. J Ethnopharmacol. 1999;66:227-33.
26. van Poppel G, Verhoeven DT, Verhagen H, Goldbohm RA. Brassica vegetables and cancer prevention. Epidemiology and mechanisms. Adv Exp Med Biol. 1999;472:159-68.
27. Cheney G (1952). “Vitamin U Therapy of Peptic Ulcer”. California Medicine. 77 (4): 248-252.
28. Isbir T, Yaylim I, Aydin M, et al. The effects of Brassica oleraceae var capitata on epidermal glutathione and lipid peroxides in DMBA-initiated-TPA-promoted mice. Anticancer Res. 2000;20:219-24.
29. Stremmel W, Ehehalt R, Autschbach F, Karner M. Phosphatidylcholine for steroid-refractory chronic ulcerative colitis: a randomized trial. Ann Intern Med. 2007 Nov 6;147(9):603-10.
30. Cicero AFG, Gaddi A. Rice Bran and Gamma-Oryzanol in the treatment of hyperlipoproteinemias and other conditions. Phytotherapy Research. 15(4):277-289.
31. Seetharamaiah GS, Chandrasekhara N. Effect of oryzanol on cholesterol absorption and biliary and fecal bile acids in rats. Indian J Med Res. 1990;92:471-5.
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