Now that we have had an introduction to functional medicine, and it’s concepts, it is time to focus on one of the most important areas of functional medicine, the gut! Other than normal digestive function, our gut flora is responsible for many things. It provides protection from infection by keeping foreign substances from entering the body, regulates metabolism, and compromises more than 75% of our immune system!!! With all of those functions, it makes sense why if something goes wrong with the gut, it can cause major symptoms!!!! A dysregulated gut has been linked to many diseases, ranging from autism, depression, irritable bowel syndrome, inflammatory bowel disease, to autoimmune conditions, such as Hashimoto’s thyroiditis and type 1 diabetes.
So what causes the gut bacteria to become out of balance? Frequent antibiotic use, chronic stress, diets high in refined carbohydrates and sugars, and chronic infections are a few examples. The gut is, in essence, a gatekeeper, with its intestinal barrier. When the intestinal barrier becomes permeable (leaky) due to reasons mentioned earlier, large protein molecules of undigested food particles, such as gluten, escape into the bloodstream. Since these proteins do not belong outside of the gut, the body mounts an immune response and attacks them. This breach of the intestinal barrier by food toxins and chemicals creates an immune response, which not only affects the gut, but other organs as well (thyroid, musculoskeletal system, kidneys, brain, etc). A key point to remember is that you do not have to have any gut symptoms to have a leaky gut. It can manifest as eczema, fatigue, joint pain, headaches, and autoimmune conditions.
So what can you do to help if you think you have a dysregulated gut? The best thing to do is find a functional medicine practitioner in your area. These providers may run a variety of tests, depending on your specific case. One of these being a stool test that identifies bacterial load, potential pathogens, checks intestinal pH, along with markers of gut inflammation. Also, a breath test to check for Small Intestinal Bacterial Overgrowth (SIBO) is sometimes necessary if underlying risk factors are identified. Finally, food sensitivity to check for what foods may be inflaming you can also be helpful although an elimination diet is the only foolproof way to know what foods may be causing you problems. Below is what’s called the 4R’s of the gut, which is a helpful guide to things that can be done to help restore the gut to optimal functioning.
- Remove the inflammatory foods. The largest impact in your control is your diet. As I mentioned, food sensitivity testing can be helpful, but an elimination diet of the most commonly inflammatory foods is usually necessary to help the gut.There are different approaches, but an elimination diet usually includes at least getting rid of processed foods/grains, sugar, gluten, and dairy. Don’t worry, you don’t necessarily have to give up all these foods permanently, but you do need to avoid them strictly for at least 30 days. Focus on eating whole foods. It is very helpful to work with a provider to help you know when and how to add foods back in. If you experience nausea, fatigue, headaches, joint pain, etc. as you add foods back in, you will have a good idea of what foods are inflaming your gut. Also, any potential infections should be treated, these can be identified in testing mentioned above.
- Reinoculate the gut with a good probiotic supplement and fermented foods. I am always a fan of getting probiotics out of your food.
- Replace: Enzymes and HCL are also needed in many cases to help with digestions and intestinal pH and also just giving your gut a break while it repairs.
- Restore the gut lining with supplements, such as L-glutamine, zinc, DGL, marshmallow root, aloe vera, etc.
- And I like to add a 5th R that is very important, Relax!!! Stress doesn’t help an inflamed gut. Practice deep belly breathing and meditation, participate in massage therapy, craniosacral therapy, and acupuncture with a reputable practitioner.
There are certain cases, such as Small Intestinal Bacterial Overgrowth (aka SIBO) that should be discussed with your provider if you don’t notice symptom improvement with the 4/5 R gut program. I will be blogging on that condition next. Stay tuned!!!!!
Emily Kopek PA-C