Digestive problems are estimated to affect greater than 70 million adults in the United States each year. Two symptoms, abdominal pain alone accounts for 16 million visits to health care practitioners each year. Reflux symptoms account for another 9 million visits.
While there are several serious digestive pathologies such as tumors, the majority of digestive symptoms come from functional disorders where there is not visible disease, but things do not “function” properly resulting in symptoms. One such functional disorder is IBS (irritable bowel syndrome) which is the most common reason for visits to gastroenterologists and accounts for 12% of all primary care visits.
Figuring Out and Treating Digestive Problems
We use a combination of tools in evaluating and treating digestive problems. The solution may be solving a food sensitivity, helping digestive activity with supportive supplements, eliminating less preferred bacteria and yeast, restoring helpful bacterial balance and reparative support for gut barrier (lining) repair.
Evaluation is done with a complete history and testing of the causative components. That may include specialized stool testing, Biomeridian evaluation of digestive function and related factors such as food reactions. In some cases other specialized tests may be indicated such as food reaction antibody panels. Some digestive problems are related to one issue, while others are caused by interaction of several. Each patient must get an individualized evaluation and specific targeted treatment for the best result.
Irritable Bowel Syndrome (IBS)
IBS is a functional disorder of the intestines. A broad group of factors can be involved in the cause of the “irritation”. These may include food sensitivities, overgrowth of less preferred bacteria or yeast, improper balance of the beneficial bacterial population, weak digestion and others. These issues can be related to antibiotic use, diet, stress induced digestive inhibition and drugs that inhibit digestion.
The key to resolving IBS is to investigate and properly treat each part of the unique collection of the above factors that exist in each individual. Perhaps more than any other functional digestive problem IBS requires very patient specific treatment. There is no “one size fits all” treatment for IBS.
Food sensitivities are a common and increasing cause of digestive symptoms. While they typically cause symptoms out of the digestive system, digestive symptoms are the most common feature affecting 60-80%. There is additional discussion regarding food sensitivities which you may want to refer to.
Autoimmune Digestive Disease
Inflammatory bowel diseases are autoimmune diseases or “immune against self”. They include Crohn’s disease, Ulcerative colitis and Celiac disease. These patients have pronounced lower digestive tract symptoms, and biopsy of the intestines confirms the disease.
Autoimmune diseases are associated with a genetic predisposition to attack self-tissue when inappropriate immune activation occurs. Two key pieces of information suggest that while a genetic predisposition is present, activation of the disease requires an environmental trigger. The first piece is the result of studies which examine groups of individuals with the genetic variation; only a small fraction of them ever actually develop the disease. The second piece supporting the information is the fact that most cases of autoimmune disease begin at ages 30 to 50 years in spite of the existence of the genetic trait since birth.
Once an autoimmune digestive disease is present, 60-70% of affected individuals develop significant improvement or remission after removing the environmental trigger such as a food sensitivity.
Reflux and indigestion
Indigestion is typically a symptom of burning or irritation in the upper digestive tract. Reflux, which means movement of irritating gas or digestive fluid up into the lower esophagus, can be a cause of indigestion. Reflux/indigestion can be either hyperacidic (too much acidity), or dyskinetic which means “poor digestive movement”.
Hyperacidity is rare even though it is assumed to be common simply because medications targeted at lowering stomach acidity provide some symptom relief. In full digestion the stomach obtains an acidic pH of 1.5-3.5. The normal esophageal pH is 7 (neutral), and its lining does not tolerate pH below 5.
Often when inadequate stomach digestion is occurring food will sit too long allowing bacteria to ferment it excessively producing gas. The gas pressure may cause some to back up into the esophagus and be irritated at a pH of 5, thus dyskinetic or poor movement reflux. The answer in that case is often to increase stomach and small intestinal digestion increasing upper digestive tract movement.
While use of acid inhibiting medications may bring relief, they inhibit the absorption of several nutrients and have been associated with increased risk of osteoporosis, anemia and other B12 associated disorders.
Food sensitivities are another common cause of indigestion/reflux. Treatment centers around identifying and resolving these food reactions.
Constipation and diarrhea are common features of IBS. Some individuals have a consistent pattern of just one or the other, while many go through alternating periods of both symptoms. The investigation and treatment is often of that for IBS. Other causes such as gastroparesis (insufficient nerve signal to the digestive tract) must also be ruled out. In this case treatment centered on procedures that balance autonomic nerve function that regulates digestive activity produces the best outcome.
Effective treatment may involve digestive support supplements, dietary changes and other therapies targeted at the cause of IBS. Treatment must be specific to the group of triggers for each individual patient.
Like fatigue, there are several causes of digestive symptoms. Solving the problem for each individual involves accurately identifying all of the involved factors and targeting specific corrective treatment. Typical testing looks for pathologies (tumors, etc). The majority of digestive symptoms are “functional” however, and the answer is found in testing function and using treatment to restore it.