Category: Digestive Health

Regular HealthBeat News readers know that we believe a healthy G.I. (digestive) system is vital to the healthy functioning of all parts of the body. In our recent HealthBeat article “Pearls From Recent Medical Conferences” we mentioned that even conventional medicine has come to realize that supporting digestive function and the ability to digest and assimilate nutrients is essential to good health. Unfortunately there is some confusion around the buzzwords that are being tossed around with regard to digestive enzymes, prebiotics, and probiotics. Just what is each of these things, and what do they do?

Digestive Enzymes
The initial breakdown of the dietary macronutrients carbohydrate, fat, and proteins is accomplished by digestive enzymes that are produced by the the pancreas and the small intestine. The main enzymes responsible for breaking down these macronutrients are pepsin, pancreatic amylase, lipase, and protease. The production of these enzymes frequently slows with aging, and insufficient production or secretion of them can lead to reduced G.I. function and digestive complaints like bloating, gas, and irregularity.

Prebiotics
Prebiotics are dietary fibers from carbohydrates that are resistant to hydrochloric acid and digestive enzymes and so avoid being broken down until they reach the colon where they are acted upon by colonic microbes – those good gut bacteria that we have discussed before. Prebiotics are found in complex carbohydrates such as inulin, fructooligosaccharides (FOS), galactooligosaccharides (GOS), and resistant starches.

When these prebiotic dietary fibers arrive in the colon they serve as food for beneficial colonic microbes such as bifidobacterium. Through a process of fermentation they produce the short-chain fatty acids (SCFAs) acetate, butyrate, and propionate. Butyrate is the main energy source for the cells that line the colon. Acetate is primarily utilized by skeletal and cardiac muscles, and propionate is metabolized by the liver and is important in cholesterol synthesis. SCFAs promote the growth of bifidobacterium strains in the intestinal tract and by helping these beneficial microbes proliferate they inhibit the growth of other less beneficial (or even harmful) microbes.Including prebiotics in the diet has also been shown to increase fecal bulking, improve stool consistency, and promote the bowel mobility called peristalsis. Absorption of minerals like calcium, selenium, and magnesium is also improved with prebiotic use due to SCFAs’ ability to breakdown phytic acid complexes and release these minerals in their free form.

Besides promoting G.I. health, prebiotics have been shown to support satiety (the feeling of fullness after eating), insulin secretion, and cellular responsiveness. G-protein coupled receptors for short-chain fatty acids have been found on enterocytes, leukoycytes, and enteroendocrine cells, giving SCFAs the ability to stimulate GLP-1 secretion. Poor fiber intake is common among all age groups, with fiber intake barely averaging half of the Dietary Reference Intake(DRI). (But be careful: Even though most people may need to increase their fiber intake, an abrupt addition of large amounts of fiber-rich prebiotic foods can cause abdominal discomfort – like exercise, start slow and work up!) So, prebiotics serve as food for probiotics and they get their name from this function. Prebiotics are of interest to both researchers and clinicians because carefully choosing a prebiotic may lead to the proliferation of certain probiotics – and that is what we call a “positive wellness outcome”!

Probiotics
The microbiotic “garden” that resides in the human gastrointestinal tract contribute to a great many of metabolic, nutritional, physiological, and immunological functions. Although different gut bacteria have different jobs, their health benefits are mainly derived from their antimicrobial effects, immune modulation activity within the gut-associated lymphoid tissue (GALT), and their contribution to intestinal barrier integrity through increased IgA production and expression of adhesion proteins in the tight junctions. Gut microbes have also been studied for their role in glycemic function and supporting lipids within normal limits.

The proportion of beneficial microbes in the gut can be influenced by the addition of probiotics — that is, live gut bacteria taken in oral supplement form. The most widely used and studied probiotics are Lactobacillus and Bifidobacterium. In spite of their extensive clinical application, it is necessary to be aware of certain cautions when using probiotics since probiotic benefits are genus and species specific and their therapeutic use should be tailored for each individual person.

There are specific factors that suggest the need for digestive support with probiotics and it is important to remember that each person is unique in their needs, and that needs may change for each person over time. A skilled Naturopathic doctor will use assessments that can include testing of breath, stool, blood, and urine but usually the first assessment tool to determine the use of enzymes, prebiotics, and probiotics, is a detailed interview and health questionnaire.

With proper use, enzymes, prebiotics, and probiotics can optimize digestive function, ensure the assimilation of vital nutrients, promote healthy immune function, and lay a strong foundation for better overall health.

Resources and references:

Useful supplements:

35 Billion Probiotic: https://www.drmyattswellnessclub.com/supremadophilus.htm

Prebiotics (fiber): https://www.drmyattswellnessclub.com/MaxiFiber.htm

Digestive enzymes: https://www.drmyattswellnessclub.com/similase.htm , https://www.drmyattswellnessclub.com/betainehcl.htm

HealthBeatNews article:

Pearls From Recent Medical Conferences http://healthbeatnews.com/pearls-from-recent-medical-conferences/

Scholarly references:

Ianiro G, Pecere S, Giorgio V, Gasbarrini A, Cammarota G. . Digestive Enzyme Supplementation in Gastrointestinal Diseases.  Current Drug Metabolism. 2016. 17:187-93.

Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R,  et al. Prebiotic effects: metabolic and health benefits.  Br J Nutr. August 2010. 104. 2:S1-63.

Scholz-Ahrens KE, Ade P, Marten B, et al.. Prebiotics, Probiotics and Synbiotics Affect Mineral Absorption, Bone Mineral Content and Bone Structure.  J Nutr.. March 2007. 137. 3 Suppl. 2:838S-46S.

Walker AW, Duncan SH, McWilliam Leitch EC, Child MW, Flint HJ. pH and Peptide Supply Can Radically Alter Bacterial Populations and Short-Chain Fatty Acid Ratios within Microbial Communities from the Human Colon. Applied and Environmental Biology. July 2005. p. 3692-700.

Niittynen L, Kajander K, Korpela R Galacto-oligosaccharides and bowel function. Scand J Food Nutr. June 2007. 51(2):62-6.

Jones JM. Dietary Fiber Future Directions: Integrating New Definitions and Findings to Inform Nutrition Research and Communication. Adv Nutr. Jan 1 2013. 4(1):8-15.

Saulnier DM, Ringel Y, Heyman MB, Foster JA, Bercik P, et al. The intestinal microbiome, probiotics and prebiotics in neurogastroenterology. Gut Microbes. January/February 2013. 4:1, 17-27.

Yoo J, Kim S. Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders. Nutrients. 2016. 8:173.

Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015 May 15;60 Suppl 2:S129-34.

How to End the Pain and Save Your Gallbladder

Nearly half a million gallbladder surgeries — removal, or cholecystectomy to be precise — are performed each year in the US. Many of the people who give up their gallbladders to such surgery appear to be fine, and the pain of their gallbladder attacks are over. Oddly enough, for many others, gallbladder "attacks" continue even in the absence of a gallbladder – in fact, one authoritative source indicates that Post Cholecystectomy Syndrome (PCS) affects at least 10 to 15% of people who have had their gallbladders removed!

Are the people who have given up their gallbladders really "fine"? And why do others continue to have pain in spite of removal of their gallbladder?

Conventional medical doctors make no attempt to help people "save" their gallbladders when stomach or other symptoms is believed due to gallbladder attacks. In fact, many gallbladders are removed even when scans do not show anything wrong with the gallbladder. Because there is no attempt to preserve this organ in conventional medicine, and because many people feel better after surgical removal of their GB, people mistakenly believe that the gallbladder isn’t important and that living without it makes no difference. Unfortunately, this viewpoint is incorrect and can be downright unhealthy.

Contrary to common belief, the gallbladder isn’t just a "vestigial organ" with little or no importance. One of the primary jobs of the gallbladder is to control the flow of bile which in turn is needed to absorb fats, oils and fat-soluble nutrients. Once the gallbladder is removed, these functions cannot happen normally, at least not without additional "outside help" from supplementation.

Although steps can be taken to prevent nutrient deficiencies if you have already had your gallbladder removed, let’s talk about another important question. How can you get rid of gallbladder "attacks" and keep your gallbladder in the first place? After all, "prevention" is always easier than cure.

The Real Cause of Gallbladder Pain

Gallbladder pain is usually blamed on gallstones, although stones are rarely the cause of intermittent GB discomfort.

Stones of a particular size that get stuck in the bile duct are indeed incredibly painful. If they are not passed quickly, gangrene of the duct and gallbladder can set in with life-threatening complications. This is the only true "surgical emergency" of gallbladder stones.

However, most stones are too large to obstruct the gall duct. Other people have "sand," which is fine particulate that is too small to obstruct the gall duct. So where does the pain come from?

The real cause — and cure — of gallbladder pain was discovered back in 1968 by a physician named James C. Breneman. Dr. Breneman was chairman of the Food Allergy Committee of the American College of Allergists, or ACA (now called the American College of Allergy and Immunology, or ACAI). Dr. Breneman discovered that attacks of gallbladder pain are caused by food allergies.

In 1968, he put 69 people who suffered from recurrent gallbladder attacks on an elimination diet to determine their food allergies. Six of the subjects already had their gallbladders removed but were still having gallbladder "attacks," a phenomenon known as "post-cholecystectomy syndrome." Dr. Breneman found that all 69 people — 100 percent! — were totally symptom-free of gallbladder pain when they avoided their individual food sensitivities, and all 69 had a recurrence of their symptoms when they ate the foods they reintroduced the foods they were allergic to back into their diets.

The most common allergenic foods were found to be eggs (92.8%), pork (63.8%), onions (52.2%), chicken and turkey (34.8%), milk (24.6%), coffee (21.7% ), and oranges (18.8%). Corn, beans, nuts, apples, tomatoes, peas, cabbage, spices, peanuts, fish, and rye accounted for between 1 to 14.5% of gallbladder attacks. 14 of the 69 study participants (over 20 percent) also had gallbladder attacks caused by medications.

How Allergies Cause Gallbladder Attacks

The body’s reaction to allergic substances is to cause swelling (remember how your nose swells if you have seasonal allergies?). When food and medication allergies cause swelling of the gallbladder ducts, bile flow is obstructed. The symptoms of allergy-caused obstruction are the same as a stone being stuck in the duct. (Hence the blame being laid on a "stone" when in fact, swelling of the tissue caused by a food or medicine reaction is the real culprit).

The Cure for Gallbladder Pain

The real treatment for most GB pain isn’t to remove this important organ, but to perform an elimination / challenge diet or food allergy testing and find the offending foods and medications.

The Dangers of Gallbladder Removal

The gallbladder stores and then releases bile in response to fats contained in a meal. Bile is necessary to assist the digestion of fats and fat-soluble vitamins.

When the gallbladder is removed, vitamins A, E, D, K, and essential fatty acids are not absorbed properly. Unfortunately, the symptoms of declining fat-soluble vitamins and essential fats come on slowly and most often, unnoticeably. Health problems can be many and varied, associated with a deficiency of any or all of these fat-soluble vitamins.

Who would guess that removal of the gallbladder, especially without replacement of bile salts (which is NEVER suggested in conventional medicine), could contribute to the premature development of so many and varied health problems, all related to fat soluble nutrient assimilation?

Other Nutrients for Gallbladder Health

Low stomach acid can cause or contribute to the development of gallstones. Correcting a stomach acid deficiency is of primary importance when addressing gallbladder health.

Here is more information about the many symptoms and diseases associated with low stomach acid.

And here is a simple self-test kit to help you determine if you need supplemental betaine hydrochloride:

Magnesium deficiency is extremely common among people who suffer from gallbladder pain and stones (even when the stones are not the actual cause of the pain). And if magnesium deficiency relates to the development of stones, the news gets even worse for those who don’t supplement: 60% of post-GB removal patients suffer from magnesium deficiency and 40% from calcium/magnesium deficiency.

A high-quality daily multiple vitamin/mineral supplement such as Maxi Multi contains a full daily recommended dose of magnesium and calcium. For those taking "one-per day" multiples or no extra supplementation at all, additional magnesium supplementation is highly recommended.

References

1. Jensen, Steen W.  "Postcholecystectomy Syndrome" Jan 16, 2008 http://emedicine.medscape.com/article/192761-overview
2. “Fast Stats: Inpatient Surgery, 2002,” U.S. Centers for Disease Control (www.cdc.gov), accessed 8/25/04
3. Breneman JC “Allergy Elimination as the Most Effective Gallbladder Diet.” Annals of Allergy 1968; 26; 83-89
4. Breneman, James C. Basics of Food Allergy. Springfield (IL): CC Thomas (pub), 1978.
5. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Long-term effect of magnesium consumption on the risk of symptomatic gallstone disease among men. Am J Gastroenterol. 2008 Feb;103(2):375-82. Epub 2007 Dec 12.
6. Szántay J, Varga D, Porr PJ. Post-cholecystectomy syndrome and magnesium deficit.Acta Physiol Hung. 1992;80(1-4):391-8.