One of the beautiful things about modern science is that it’s starting to prove certain age-old wisdoms. There’s a Bone Broth Bar in Cape Town. Kombucha is ‘on tap’ at the food markets. Hippocrates said that ‘All disease starts in the gut,’ and we are beginning to realize how apt this eons-old statement might be.
A huge portion of presenting complaints to a GP practice is to do with digestive issues – heartburn/reflux or other features of ‘gastritis,’ IBS – irritable bowel syndrome - is such a common diagnosis with, but, as with all ‘diagnoses by exclusion,’ patients want to understand more about WHY their bowel is so irritated and what they can do about it besides taking Iberogast drops or a PPI.
An Integrative / Functional medicine consultation will always enquire about digestive health, nutritional status, potential links between a person’s gut health, and their main complaint. Autoimmunity is closely linked to the state of a person’s gut. We are discovering how depression and anxiety can also be linked to gut health, as well as low immunity with recurrent infections – eg bronchitis, sinusitis, ear infections, non-healing wounds – the recurrent natures of these infections can be understood if one understands the barrier function of the mucosal lining of the gut.
The medical term for ‘leaky gut’ is ‘increased gut wall permeability.’
The gut lining is by nature a permeable membrane (it has to be so that you can absorb nutrients from your food) but that membrane can become too permeable (hence the term ‘leaky’) and lead to chronic immune system activation, which in turn can lead to autoimmunity and chronic disease.
70% of the immune system lies in the gut – a very effective way of supporting your immune system would be to support the health of your gut. And this does NOT simply entail taking a probiotic, sometimes quite the opposite.
Most Integrative /Functional doctors use the ‘4R approach’ to supporting gut health. In brief, REMOVE / REPLACE / REINOCULATE / REPAIR. The details of which will be covered in a separate article, and a Gut Repair Regime should be done under the guidance of a registered Integrative / Functional doctor as it’s not a one size fits all approach – it should be tailored to supporting your gut’s specific requirements.
Someone with gastritis from high stomach acid levels needs to be managed very differently from someone with hypochlorhydria (low stomach acid) – the presenting symptoms can often be very similar.
Someone with features of SIBO – small intestine bacterial overgrowth – will do more damage if they reintroduce probiotics and probiotic-rich foods (fermented foods like sauerkraut/kefir/kombucha) too soon.
There has been a massive surge in autoimmune disease in the last few decades
We are hearing more and more about people being diagnosed with Hashimoto’s, Lupus, Crohn’s, Rheumatoid arthritis – diseases that used to be rather rare, and also that used to occur in older age groups, are now becoming common amongst our younger generations.
As mentioned above, there is a clear link between gut health and autoimmunity.
It is estimated that 90 percent of the body's serotonin is made in the digestive tract.
Gut Health is a crucial element to holistically managing low mood and anxiety.
The work of Dr. Zach Bush, who is an Integrative Endocrinologist in the USA, on the microbiome and how it affects almost every aspect of our body’s health is hugely enlightening and worth a read.
Protect your health, protect your gut!
For further reading, visit the following references
- 1. Indigenous Bacteria from the Gut Microbiota Regulate Host Serotonin Biosynthesis Yano, Jessica M. and Yu, Kristie and Donaldson, Gregory P. and Shastri, Gauri G. and Ann, Phoebe and Ma, Liangand Nagler, Cathryn R. and Ismagilov, Rustem F. and Mazmanian, Sarkis K. and Hsiao, Elaine Y. (2015)
- 2. Diet, Microbiota and Autoimmune Diseases Silvio M Vieira,1 Odelya E Pagovich,1,2 and Martin A Kriegel1,3 Indian J Med Res. 2013 Nov
- 3. Bugs & us: The role of the gut in autoimmunity David Luckey,1 Andres Gomez,2 Joseph Murray,3 Bryan White,2,4 and Veena Taneja1,5 2017 Mar 15;
- 4. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy Uday C Ghoshal 1, Ratnakar Shukla 1, Ujjala Ghoshal 1 Integr Med Res. 2014 Sep
- 5. Current knowledge on alleviating Helicobacter pylori infections through the use of some commonly known natural products: bench to bedside Malliga Raman Murali,a Sangeetha Vasudevaraj Naveen,a Chang Gue Son,b and Hanumantha Rao Balaji Raghavendrana,* J Immunol Res. 2019
Illustration: Handre vd Merwe and Jacques Van Zyl