Bonus for Humans:
 

Digestive System Problems

      

Since so many of us, caretakers of animals, have digestive troubles of our own, this is offered for your edification and aid...  
  
 

The elegant design of the digestive system consists of not just the digestive tract through which whatever we ingest moves but also a series of events that take place (or should take place) along it. When we experience digestive trouble, something (more likely some things) will be found to be wrong with the functioning of the system – so understanding how the system is "set up" should be the basis for diagnosing and deciding on a remedy.

Unfortunately, most of what’s wrong with us is related to our dietary habits – not just what we ingest but when and how. This is compounded by various drugs we take to quiet the symptoms of digestive or other distress. The great news is that we can control our habits. Some possible bad news is that we might not want to! Further good news, though, is that there are ways other than drugs to counteract some of our dietary foibles.

And we had better look at the facts – because most M.D.s are drug- and surgery-oriented and simply don’t concern themselves with the basic physiology (as opposed to anatomy) of the digestive system.

  

An Overview...

"Indigestion" can cover a wider array of troubles than we’re likely to think of. Symptoms of indigestion "can include abdominal pain, allergic symptoms, belching, a bloated feeling, a burning sensation after eating, chronic bowel irritation, chronic fatigue, constipation, diarrhea, gas, insomnia, joint and muscle pain, nausea, rumbling noises, skin disorders, sugar cravings, and vomiting." (1)

As we’ll see, digestive enzymes and that much-maligned stomach acid play a heroic role in keeping our bodies truly "well-fed"… especially since our own habits are often contradictory to our digestive welfare and health in general.

"Digestive enzymes break down food particles for storage in the liver or muscles. This stored energy is later converted by other [metabolic] enzymes for use by the body when necessary." (2) If food nutrients aren’t assimilated via digestion, what results is a lack of vital energy. …And since "enzymes also utilize the nutrients ingested by the body to construct new muscle tissue, nerve cells, bone, skin, and glandular tissue" (3), problems in these areas seemingly unrelated to digestion can develop over time. "Extreme fatigue may be caused by an inability to digest proteins and fats, which cause the blood cells to clump together and not circulate like they should. When the blood is clumped it can not carry as much oxygen and can result in fatigue and slow and muddled thinking. The white blood cells [an important component of the immune system] have a difficult time moving around and getting where they need to be when they’re caught in the sluggish, clumped blood as well." (4)

"The importance of … stomach acid cannot be overemphasized, since if it is present in ample amounts, food is digested easily, acid-fast bacteria are destroyed, the stomach empties in normal time, and the bowels function regularly. … Hydrochloric acid is also essential for the systemic assimilation of calcium and other minerals [as well as vitamins]… Insufficient stomach acid results in symptoms of indigestion due to delay in the emptying time of the stomach, indigestion of protein, and non-destruction of acid-forming bacteria. Thus, foods putrefy in the stomach, causing gas, bloating, and discomfort … and lactic acid, a forerunner to cancer, is formed. … Both the bile duct and pancreatic ducts are hampered, causing the liver to become engorged with bile [which should be being released for use in digesting acid foods and assimilating fat-soluble vitamins]. The malfunctioning pancreas becomes hard and tender, unable to supply important digestive juices to the small intestine, hindering the latter’s digestion and assimilation of food." (5)

  
  

The Physiology:
 

It all starts in the mouth…

Of course, first there’s the food and drink we take in, and its nutritional value and relative digestibility (more on that later). Once it’s in, the teeth chew our food – which begins a process of a pulverizing breakdown that continues on down the digestive tract. Salivary glands – triggered by stimulation of the tongue’s taste buds – produce the initial digestive juices (in which is ptyalin, a type of amylase, or starch-digesting enzyme – that begins a process of chemical breakdown that continues on).

Right away we find some possible habits to correct (bypassing, for the moment, the issue of what we decide to take in). If we don’t chew our food well, we rely that much more on the rest of the (perhaps already debilitated) digestive tract to do this job. Nor do we mix the food with the salivary juices well for the next step in its decomposition. And the less time we spend chewing and tasting, the less saliva (and starch-digesting enzyme) is produced to aid in the entire digestive process.

"Also, with more chewing, a person eats more slowly, is better satisfied, and is less likely to overeat" (6) – and (even if you aren’t concerned about weight) overeating uses up more of our digestive energy.

And about drink specifically… The more extra liquid you drink with a meal (that is, other than the liquid of a nutritive soup or smoothie), the more diluted your all-important food enzymes are.

Liquid, too, can either be "chewed" or just swallowed down. …And the more you chew, as noted before, the better you’ll digest.

Then, on a merely mechanical level, gulping (of food or drink), rather than taking in smaller mouthfuls, leads to not only less complete digestion but less effective swallowing of food on down the esophagus – because it’s the swallows themselves that stimulate the peristaltic action that moves food into the stomach.
 

On to the esophagus…

After the mouth, of course, the food/drink moves through the esophagus into the stomach. The barrier between the two is a muscular sphincter, or valve, in the diaphragm, the layer of muscle separating the abdominal and chest cavities. This ring of muscle opens and closes in response to food and drink "coming down the pipe".

Normally there’s little to go wrong here… except the possibly major issue of heartburn and/or a hiatal hernia, where stomach contents (and the stomach itself, in the case of a hernia) back up into the esophagus. In other words, there would be something causing the musculature of the sphincter to work improperly.

Heartburn (also known as "acid reflux disease" or "reflux esophagitis", lately officially called "gastroesophogeal reflux disease", or GERD) is simply the burning sensation of stomach contents (notably the irritating hydrochloric acid!) entering the esophagus, because the sphincter isn't functioning properly. (But heartburn may occur without herniation, just by the inopportune opening of the esophageal sphincter.) Taking an antacid for this (most doctors’ recommendation) sets you up for other digestive troubles (read on).

"Eating jagged foods like crackers or corn chips can cause little lacerations to develop in the esophagus and [lower esophageal sphincter]. Then later consuming acidic foods, like spicy over-cooked tomato sauce, can exacerbate the [heartburn] problem. This scenario is typical of why many people" suffer when acid reflux occurs. (7)

Hiatal hernias can be constant or, more usually, intermittent. If constant, there’s likely to be pain from more than just heartburn – and sometimes such chest pain is assumed to be from heart problems.

"The easiest way to tell if you or someone you know has a hiatal hernia is to place your fingers on the solar plexus, just below the breastbone. Then take a deep breath. You should feel the solar plexus expand and move outward. If there is no movement at the solar plexus and you have to lift your chest and shoulders to take a deep breath, then you probably have a hiatal hernia. You should be able to take a deep abdominal breath without lifting your shoulders." (8)

"The slightest upward displacement of the stomach through the diaphragm disorders the vagus nerve. Immediately, the stomach no longer is able to produce the proper amount of hydrochloric acid. The entire digestive process is then adversely affected. The final result is often that the entire body will become too acid [see more about systemic hyperacidity later]. From an imbalanced vagus nerve, any other organ can begin to malfunction depending on genetic weakness and various other factors. … So many seemingly unconnected illnesses can often be immediately improved by pulling the stomach out of the diaphragm." (9)

One of the possible causes of a hiatal hernia is straining during bowel movements… which would be due to constipation (which would be due to any combination of:  dehydration, lack of dietary fiber, drug side-effects, stress, or just plain "holding it"). Other logical causes could be prolonged, violent vomiting or coughing (either of which might also be attributable to digestive problems); obesity, pregnancy, or large uterine fibroids or other tumors (all of which would cause the stomach to press up against the esophagus); the strain of delivery from pregnancy; or sudden physical exertion such as heavy lifting (the type that could cause other kinds of hernias). …Not to mention bad posture (especially while sitting) that aggravates by pushing the stomach upward.

And, the more you eat at one meal, the more you distend your stomach – so that if your esophageal sphincter is already weakened, a hernia can be activated just by "eating big". Unfortunately, "eating when the stomach is up may immediately cause the sufferer to get hungrier (and not satiated) as s/he eats! (Stomach hyperacidity and ulcers – themselves linked to the HHS – can also cause this hungrier-while-eating condition. Stomach pH should be measured.) Over-eating – one of the worst things for this condition – often results." (10)

"Low stomach acid allows food to remain too long in the stomach and can cause or aggravate a weak esophageal sphincter." (11) Plus, as mentioned above, when it’s herniated, "the cramped position of the stomach can also stress the vagus nerve, which stimulates the release of hydrochloric acid. This can cause both over and under secretion of hydrochloric acid and stomach enzymes. It may also affect the sphincter or valve at the bottom of the stomach so that digestive secretions ‘leak’ out of the stomach and are lost before they have completed their job." (12)

This poor digestion leads to gas… which can distend your stomach. Likewise, drinking carbonated beverages is a bad idea – you hardly want any extra gas to push your stomach out of bounds!

Hard-to-digest "fatty food tends to slow down the transit of food through the stomach, thus resulting in greater amount[s] of stomach acids to be left-over, causing more frequent heartburns." (13)

The sphincter, being a muscle, might also be affected adversely by chemical factors – i.e., by a nutritional imbalance or a drug that weakens muscle functioning. As we all know, imbibing alcohol relaxes muscles – so it’s no surprise that one of the proscriptions for a GERD diet is against drinking alcohol. Smoking, too, worsens the condition – "the nicotine in tobacco relaxes the esophageal sphincter." (14)

Anything that causes your large diaphragm musculature to spasm could open your esophageal sphincter at an inappropriate time. This would indicate a need for keeping in decent condition generally, so that your chest muscles – and others! – would remain supple and strong, via exercise and good blood flow and nourishment.

"According to one applied kinesiologist text, a hiatal hernia comes from repressed anger. … When you get angry, you suck your breath upward. If you fail to release this anger, your stomach stays up. [In the experience of this author,] … most of the people with severe hiatal hernias have a great deal of emotional stress and hold a lot of it inside." (15)

Yes, a hiatal hernia can be "treated" (the sphincter tightened up) by surgery… but there is no guarantee that it won’t develop again (and any surgical cutting creates weaker tissue at that spot).
  

Now we’re at the stomach…

We’ve all felt the muscular action of the stomach (and are aware of its stretching and shrinking, depending on how much is in it). One of its jobs is to continue the grinding of food into smaller particles via its musculature. Its gastric glands also secrete the crucial hydrochloric acid (HCl) and two important digestive enzymes that work with it, pepsin and rennin, which break down proteins and milk respectively. …So the contraction of the stomach walls also serves to mix the gastric juices into the food.

Here we have a site of all sorts of possible problems! First, the more liquid we ingest around the time of a meal, the more stress we place on the digestive tract in general. "Only a limited amount of absorption [of liquid] occurs in the stomach – that of some water, alcohol, and certain drugs." (16) …And the liquid dilutes whatever enzymes and HCl we take in and produce internally.

Not only this, but thoroughly chewed food is required for HCl to work properly. (17)

And what if you cause yourself digestive misery and take a commercial antacid in hopes of calming it down? Many people think that any digestive distress warrants an antacid – even when they don’t actually have "heartburn"… or enough HCl to begin with. Gas and bloating aren’t caused by HCl (only, indirectly, by the lack of it, as food goes undigested).

Heartburn most often occurs when a person with a weakened digestive system (and perhaps too much food taken in) lies down (especially on the right side) or bends over soon after a meal. (And if it makes its way into the lungs, "it can cause asthma-like symptoms." (18)) The common medical claim is that heartburn is a result of too much HCl – so you take an "antacid" (anti-acid – which neutralizes HCl, "inviting the stomach to produce even more acid." (19)). In reality, it’s usually too little stomach acid that causes digestive problems! – and taking an antacid only compounds the trouble by leaving food sitting undigested in the stomach. …Which leads to nausea. (And if your doctor prescribes a drug that empties your stomach willynilly, that leads to trouble further down the digestive tract.) The problem isn’t that your stomach produces acid, it’s that the sphincter is malfunctioning – and probably that your stomach isn’t digesting food well, due to a shortage of HCl and enzymes.

Heartburn, by the way, can also be a side effect of many drugs, including aspirin and ibuprofen. (20) (And read the fine print in those prescription drug leaflets!) "Heartburn drugs can decrease absorption of other drugs, too. These include some antibiotics, antifungals, and the heart medication digoxin (Lanoxin)." (21)

Osteoporosis can be associated with taking proton pump inhibitors to suppress HCl (e.g., Aciphex, Nexium, Prevacid, Prilosec, Protonix). A 2006 "analysis of 116 yeqars of medical records from 13,556 patients with hip fractures and 135,386 patients without fractures (all over age 50)"… concluded that those "who took PPIs at average doses for more than a year had a 44% increased risk of breaking a hip. Those who took higher-than-average doses more than doubled their risk of hip fracture." Only one year! And if that weren’t enough to concern you… "Ironically, PPIs are often prescribed when GERD develops as a side effect of the osteoporosis drug alendronate (Fosamax). …The drug causes reflux, so patients are then given PPIs, which make bones even weaker! Other GERD drugs that impede acid production include histamine-2 receptor antagonists" (H2 blockers:  e.g., Tagamet HB, Pepcid AC, Zantac 75, and prescription analogs) and antacids (e.g., Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, Tums). (22)

Another diagnosis for digestive upset might be "gastritis" (i.e., an irritated or inflamed stomach). Various health sources say that inflammation could come from any or all of:  infections, stress, food allergies, autoimmune disorders, severe anemia, or side effects from drugs (notably NSAIDs, some asthma drugs, alcohol, and cocaine). Anything that erodes the protective mucous lining of the stomach (such as smoking does, by the way) would leave it open to bacterial/viral or HCl damage… Which is different from "you’re producing too much HCl, so just take an antacid to damp it down" – not enough HCl, and you’ll be open to infectious agents meant to be killed off by it!

"…Chronic use of aluminum-containing antacids [common] causes bone loss" (23) and constipation, interfering with the absorption of nutrients in general. (24) "Longterm use of antacids may lead to damage to the stomach lining." (25)

Long term use of antacids has also been shown to increase risk of getting pneumonia. (26) Perhaps this is because they prevent hydrochloric acid from fulfilling one of its important roles, that of destroying harmful bacteria. (This is why use of antacids also make a person more liable to food poisoning.) (27) "When acid is low, Helicobacter pylori – a bacterium that causes stomach ulcers and increases the risk of stomach cancer – can flourish. So can fungi and bacteria that target the intestines, leading to bloating, diarrhea, constipation, gas, and itchy rectum." (28)

Not only do antacids interfere with the working of many drugs, the use of other drugs in any case leaves a residue of toxic byproducts that build up in your body, slowing your ability to metabolize everything else as you age. (And this is aside from the problem of more immediate drug side effects, particularly if you’re taking a "stew" of several. Adverse drug reactions are one of the leading causes of death in hospitals [after heart disease, cancer, and stroke]. (29)

And as if the physical intake issues weren’t enough, "psychological factors, such as anxiety, stress, worry, or disappointment can disturb the nervous mechanism that controls the contractions of stomach and intestinal muscles." (30) Certainly we can understand why eating when you’re upset is problematic! In fact, "it has been observed that irritability, depression are not rare among GERD patients. GERD patients generally consider their Health Related Quality Of Life (HRQOL) as very low, indicating immense psychological suffering." (31)

If you don’t have enough HCl and enzymes to digest your food thoroughly, you could be subject to the problems of "gastric dumping syndrome" (or "rapid gastric emptying syndrome" – though it may not be rapid!), where "food is emptied too quickly from the stomach, filling the small intestine with undigested food that is not adequately prepared to permit efficient absorption of nutrients in the small intestine. … The symptoms of dumping syndrome include nausea, abdominal cramps, diarrhea, dizzy spells, weakness, and cold sweats, either with or after eating. The symptoms are often divided into ‘early’ symptoms which begin during or right after a meal. These include nausea, vomiting, bloating, cramping, diarrhea, dizziness, and fatigue. Late dumping symptoms occur 1-3 hours after eating and include hypoglycemia, weakness, sweating, and dizziness." (By the way, "dumping syndrome is easily triggered by any rich emulsions such as a liquid nutritional supplement or a milk shake.") (32)

Are you sure you want to take antacids and/or drugs to force your poor stomach to empty?
  

Moving on to the small intestine, which the stomach empties into…

Most nutrient absorption takes place in the small intestine, after further churning and enzymatic action (from enzymes both ingested and produced by intestinal glands). Most liquid absorption takes place in the rest of the colon. (33)

"As food is broken down, friendly bacteria are generated in the small intestine." (34) As most of us know, this bacterial flora helps to keep our digestion stable. "All gut flora have specific DNA codes that define their mechanism of action. Individual species inhabit certain sections of the GI tract and target certain sugars, proteins, or fats for digestion." Some also manufacture vitamins; increase the bioavailability of minerals; stimulate the immune system; produce natural antibiotics and antifungals; metabolize hormones, antioxidants, and flavonoids; and reinforce the beneficial mucous barrier of the intestines, "helping to prevent pathogens, toxins, and allergens from entering the rest of the body. In this way, their presence ‘teaches’ the immune system which allergens and toxins are tolerable and which need to be disposed of. … Friendly flora also keep unfriendly bacteria in check by depriving them of nutrients and secreting acids (acetic, lactic, and formic) that create a hostile environment for pathogens." (35)

"Hiatal hernia just about always accompanies a swollen ileocecal valve. The ileocecal valve is the valve between the small and large intestines which permits material to enter the colon from the large intestine, but prevents material in the colon from moving back into the small intestine. When this valve becomes swollen and irritated it cannot close properly. This allows material from the colon to leak back into the small intestine. This is analogous your sewer backing up into your kitchen. This creates gas and indigestion, which puts pressure on the stomach and presses it tighter against the diaphragm." (36) 
 
  

The pancreas (which many people associate only with insulin production) also gets into the act…

"The pancreatic juices which empty into the small intestine … contain three essential digestion enzymes:  (1) trypsin, which breaks down protein into amino acids; (2) amylase, which acts on carbohydrates, changing compound sugars to simple sugar; and (3) lipase, which reduces fats to fatty acids." (37)

Another field for trauma, the small intestine…

The beneficial intestinal "bacteria are destroyed by many of the preservatives found in modern-day foods" (and antibiotics, which also inhibit digestion in other ways). Many "friendlies" are, in fact, "changed to unfriendly bacteria … which break the food down into toxins which the body cannot handle, thereby forming gases and causing flatulence, … indigestion, ulcers, diverticulitis, and other diseases…" (38) So, "a shortage of the ‘friendly’ bacteria is often the cause" of indigestion. (39)

Then we have "leaky gut syndrome", the result of food not being broken down properly (by chewing, churning, enzyme action, and HCl). "This condition occurs when particles of undigested food normally eliminated in the feces pass through tiny rips in the intestinal lining and get absorbed into the system, causing severe digestive distress" (40) (and a host of other symptoms, from anxiety to bed-wetting to rheumatoid arthritis). (41)

Remembering the importance of the pancreas’ contributions to digestion, "if the pancreas is damaged, infected, or worn out, or if there is a blockage so the pancreatic juice cannot reach the intestinal tract, serious digestive and malabsorptive problems may ensue. … Malfunctioning of organs such as the liver and gall bladder, which are closely allied with the pancreas, may precipitate pancreatic problems. Duodenal ulcers, systemic infections, hydrochloric acid deficiency, lack of chromium in the diet – all may adversely affect the pancreas." (42) 
  
  

And as for the large intestine…

Once food reaches the large intestine, it is supposed to be fully digested, the nutrients derived from it – and here more liquid is removed from the "compost" and concentrated feces are formed.

Ah, the colon – the seat of so many obvious problems… Constipation, diarrhea, flatulence, pain from diverticulitis, etc., etc… As well as the less obvious ones that poor digestion overall can lead to (like cancer). Suffice it to say, it’s worth it to keep your intestines in good shape!

At the very least, do make certain your diet contains the fiber needed to naturally cleanse the colon.

   

As to Diet...

Aside from a need for fiber, there are a number of dietary considerations for those suffering from digestive troubles…

"Proteins should be eaten first; the hydrochloric acid can then work on them immediately upon ingestion. Fruits cause an alkaline substance to be excreted which inhibits protein digestion." (43) (Interesting – and perhaps this alkalinizing effect is at least one reason why many people swear by the old folk remedy of eating a piece of fresh apple every night to control symptoms of acid reflux?)

Here we get into a need for understanding the difference between stomach acid, acid foods, and systemic acidity versus alkalinity…

Acidity vs. alkalinity:

"High acidity has been associated with gout and other painful [inflammatory] conditions. Calcium, magnesium, potassium, and sodium are minerals that push the body's pH to the more basic, or alkaline. So foods high in these minerals are recommended, such as dark, leafy greens, nuts, fruits, and vegetables like celery." (44) "Joint pain and gout can be a result of undigested proteins, fats, and minerals which form uric acid crystals that ‘get caught’ in the joints." (45)

"Unlike [the] stomach, [the] esophagus does not have cellular protection against … [stomach] acids. But nature has provided additional protection to [the] esophagus by providing human beings with an alkaline (opposite of acid) saliva and an acid-neutralizing bi-carbonate secretion flowing in to [the] esophagus. These neutralizers make any spillover of acid from [the] stomach to [the] esophagus harmless. …Acidic foods [such as tomatoes] neutralize the alkaline saliva and the bi-carbonate secretions in the esophagus. This makes [the] esophagus more vulnerable to any stomach acid washback." (46) (But it doesn’t create the problem!)

"A diet that lacks essential vitamins and nutrients and is high in acid-forming foods will show up in acidic urine. This is a good indicator that your body is struggling to maintain an optimal digestive environment… Considering whether a food is acidic or alkaline in the diet can require some mind-bending because it’s easy to think of acids as things that dissolve and corrode. That comes from our common use of the word. But think of the corrosive nature of raw lye (very alkaline), and it’s easy to see that we have to think of the words differently when it comes to pH in the diet. … Some foods that we think of as "acidic" are, in fact, alkaline in the diet. This is because what is being measured is whether the food is acid-forming or alkaline-forming, not where the food itself falls on the pH scale. So, things like lemons and tangerines are alkalizing, even though we think of citrus as sharp and sour, and it does contain several acids. … What’s important is not the pH of the food as it goes into our bodies, but the resultant pH as our digestive systems burn the food, and what sorts of residue the burned-through nutrients leave behind." (47)

"Neutral" (but not necessarily "normal") pH is 7.0, on a scale that measures acidity as below that and alkalinity as above it. "Part of the confusion over body pH arises from the relatively neutral pH balance of our blood, saliva, and urine — what we can easily test for. … In terms of body pH balance, there is no one ‘correct’ reading for the entire body … because different parts of our bodies serve different purposes. Each of those purposes and the related processes requires a different acid/alkaline environment for optimum function. … For instance, healthy human skin has a proper pH of 5.5 (slightly acidic). Saliva, on the other hand, has a pH of around 6.5-7.4 (teetering on either side of neutral). Similarly, when the body is in good working order, human blood reveals a pH of about 7.3-7.4 (slightly alkaline). Other parts of a healthy, well-functioning body will show still different pH readings. …

"Amylase, responsible for breaking down starch, works in a fairly neutral environment, so when the pH falls below 6.5 it is no longer active. As food makes its way from your mouth to your stomach, the pH along the passageway begins to fall. Your stomach pH can range from 1.5 to 7.0, depending on the stage of digestion it’s in. Pepsin, the enzyme responsible for protein breakdown, needs an acidic environment and therefore gets released into the stomach when pH is low [i.e., acidity is high]." (48)

"A pH above 4 starts to inhibit the digestive enzymes, thereby inhibiting the breakdown of food. When food is not broken down properly it causes low grade chronic inflammation, thereby further worsening the nutritional problem of absorption of nutrients. … The decrease of acid and digestive enzymes in the gastrointestinal tract decreases the body's ability to absorb vital nutrients from the food we eat. The body pulls the nutrients it needs from the skeletal system to support other organs. This process leads to nutrient deficient conditions such as osteoporosis, herniated or bulging discs, etc." (49)

"The stomach pH continues to fall, and at about 2.0, fat collects into globules and the ‘bolus’ of food makes its way to the small intestine. Your small intestine is where most of the nutrients in your food get absorbed, and where the pH increases from 2.0 to 6.5 as the food passes from the stomach to the small and large intestines. … Protein — particularly in the form of red meats — requires huge amounts of alkaline minerals for complete digestive processing. When the system goes looking for this alkalinity needed to offset the acids, it looks first to the foods in the digestive system. This is where the good greens and essential vitamins and minerals come in. If it fails to find alkaline nourishment there, one of the first places it goes searching is to the calcium (as well as magnesium, phosphorus and potassium) stored in our bones." (50)

The importance of bile:

Bile (of which cholesterol is a necessary component) is secreted by the liver, stored and concentrated in the gall bladder, and from there secreted as needed into the small intestine…

"The role of bile in digestion is to emulsify fats. Emulsification breaks fat into small droplets and increases the surface area available for digestion. This increased surface area exposes the fat molecules so digestive enzymes can get at them. Bile does not breakdown fat or lipid molecules. It is the lipase enzyme, produced in the pancreas, that breaks down fat into glycerol and fatty acids." (51)

"Impairments to the flow of bile can arise from damage to the hepatocytes (e.g., with liver diseases); obstructions in the ducts or gallbladder; and dietary habits [see next paragraph] that might adversely affect emptying of the gallbladder. Among the adverse consequences from any such disruption of bile flow are digestive disorders due to fats being inadequately solubilized and absorbed (symptoms can include nausea, gas, and loose stool), formation and growth of gallstones (with abdominal pain and possible need for surgery), and liver damage (due to stasis of flow in the ducts)." (52)

"Trouble starts when the diet is too high in refined sugar and starches and fats and too low in protein. When too little bile is formed by the liver and when the gall bladder is too ‘lazy’ (due to nutritional deficiencies) to empty its content, the fat can not be readily absorbed. When not absorbed, the fat then unites with calcium and iron from food (stopping these minerals from entering the blood where they can do some good), and forms a hard soap, then hard packed fecal matter and causes constipation. This persistent stealing of essential iron and calcium can bring on iron-deficiency anemia, osteoporosis (honeycombed bones) or osteomalacia (weak and caving-in bones). Without enough bile, fats, which quickly melt at body temperature, cover the carbohydrates and proteins that is also being digested, making it hard to continue the digestion process. Then bacteria attack this partially digested mess, bringing on gas and discomfort, contributing to a smelly bowel movement and an equally foul breath. Much of the undigested food is usually lost in the stools. Poor elimination associated with gall bladder problems invariably indicates a major loss of vital minerals. Because the lack of bile acids prevents the absorption of vitamin A, D, E, & K, and whatever fat has been broken down, deficiencies are produced. People with insufficient bile flow are usually so deficient in vitamin A that they have difficulty in driving a car at night, sewing, or doing other close work." (53)

Though digestion of fats can be a problem, a fat-free diet can wreak havoc as well:  "Without fats, too little bile is formed, and the gall bladder holds its reserve bile. This faulty emptying may be a factor contributing to the formation of gallstones. If a fat-free diet is continued long, the gall bladder eventually shrivels, or atrophies." (54) (This is one of so many illustrations of the wisdom of the adage "moderation in all things"!)

Fiber of all kinds (from fruit, vegetables, grains, and meats) stimulates the gallbladder to release bile as well – another reason to ensure that your diet contains ample amounts of it.

And, once again we come around to a lack of hydrochloric acid… "If the stomach is too alkaline, it cannot properly break down food into a state for proper digestion, thus lowering our nutritional absorption, which causes energy levels to drop. In addition, if an alkaline state continues, often bile from the gall bladder is regurgitated into the stomach to activate acid production. Bile is a base, a corrosive to stomach tissue, and could cause an ulcer. Thus you can see the importance of optimal HCl balance." (55) Bile is needed, fulfilling an important function… but bile without hydrochloric acid can create problems (actually, it is the lack of HCl that creates the problems!).

Intake that affects the esophageal sphincter:

"Certain foods cause the esophageal sphincter to relax for an hour or more while they are being digested. Avoid these foods, especially coffee, chocolate, fatty foods, whole milk, peppermint and spearmint." (56) "Fatty foods [also] … slow stomach emptying… Smoking increases acid reflux and dries your saliva. Saliva helps protect your esophagus from stomach acid." (57)

"Tobacco prevents the oesophageal sphincter from working properly, reduces the rate at which the stomach empties and increases stomach acid production." (58)

  

The Solutions...

We see from the above that there might be many solutions to digestive unease. It’s likely that you have anywhere from a couple of habits to many that contribute to it. No doubt some are easier than others to see yourself changing. Let’s look at the possibilities, again starting "at the top"…

How we eat:

We can certainly help ourselves by eating more slowly, chewing more, drinking less with meals (and "chewing" any meal-time liquids), and refraining from going to bed soon after eating. And probably not taking antacids!

Even chewing gum can help to stimulate those initial digestive constituents in your mouth. "Gum chewing can increase saliva quantity by 130%." And here’s a surprise bonus:  "Saliva is rich in esophageal protective factors including epidermal growth factor, mucin, proteins, and prostaglandin E2." (59)

Excessive eating (a particularly Western, and widespread, habit) can be stimulated because "incomplete digestion causes a condition of undernourishment and hunger. When incompletely digested food reaches the colon, the colon reacts by slowing down, causing chronic congestion of food in the colon"… leading to distension of the belly as well as constipation. (60) Excessive eating sets up a vicious cycle, too, as too much food intake overwhelms what digestive resources we do have. Ensuring that we have enough hydrochloric acid and digestive enzymes to properly digest our food (see below) can be as important as…

What we eat:

In terms of what you ingest, you can probably tell that the Great American Diet leads almost inevitably to digestive distress. Hitting the highlights:

  • It lacks fresh food (from which supplemental enzymes are obtained);
  • It abounds in sugars and processed carbohydrates (from which little nutrition is derived, and which acts like glue in the intestines),
  • And in fats, especially processed fats (which, after being difficult to digest, clog the arteries… which leads to that much less energy being distributed to the digestive tract to help it do its many jobs);
  • (61))
  • Then there are the sodas, caffeine, and alcohol…
  • And it contains lots of milk products… which produce an excess of mucus… which leads to inadequate protein digestion. (62)

Ay-yi-yi! And these are all the very things to consume if you want to "acidify" your system. (63) A diet consisting of acid-forming, hard-to-digest foods "constantly taps energy just to digest food, leaving little for functional operation or for re-building." (Interestingly, "high-stress foods will increase the pulse rate 16 or more beats over the pre-meal rate", non-toxic foods no more than 10 beats per minute.) (64) And we eat it fast!

Yes, you can do a lot of digestive (and other) good for yourself by simply eating way more live foods, lightly-cooked (steamed or baked at low heat to preserve some enzymes) veggies, and a modicum of whole grains, with way less meat and very infrequent fast foods and bready desserts. ("Enzymes are extremely sensitive to heat, … so to obtain enzymes from the diet, one must eat raw foods." (65)) Naturally, going cold into a completely different diet is extremely difficult (and that would probably cause some digestive upset in itself) – but you can ease into dietary changes gradually without too much disturbance to your routines.

Here’s a tip of especial interest to those already dealing with acid reflux:  "Since the pressure of abdominal gas can push the stomach upward, it would be advisable to avoid gas forming foods like beans. It would also be wise to watch food combinations carefully and to avoid overeating." (66) The basics of food combining are (67):

  • Don’t combine fruits with either vegetables or starches (i.e., eat fruits alone). Melons, in fact, shouldn’t even be eaten with other fruits, because "they require special enzymatic action which other foods inhibit."
  • Don’t combine high-acid and low-acid foods – that is, "in which the acid-alkaline balance is opposite in the extreme." This would mean that "poor combinations would be protein and acid fruits, leafy vegetables and acid fruits, leafy greens and sub-acid fruits, … protein and starch, oil and starch, fruits and starch…" So the simpler your meals, the better, as far as digestion goes!

(More "fodder" for a substantially raw food diet:  Any heating destroys vitamins, enzymes, and amino acids. Boiling also leaches minerals; and frying also hardens the oils and adds to your free-radical overload. It’s said that a 75%-raw food diet is optimal… (68) But obviously any greater amount of raw over heat-damaged food you can achieve will be of that much more benefit!)

Supplementing with more digestive enzymes:

If you’re in digestive distress now, though, you’ll probably want to take supplementary digestive enzymes. The fact is, it would take pounds and pounds of raw food to match just one capsule of a digestive enzyme supplement – so anyone should find benefit from the extras.

There are three categories of digestive enzymes:  Amylase (in saliva and in pancreatic and intestinal juices) enzymes break down carbohydrates. (Lactase, for instance – which digests lactose, a sugar from milk – is a form of amylase, since sugar is a carbohydrate.) Protease (in the stomach, pancreatic, and intestinal juices) breaks down proteins. Lipase (in the stomach and in pancreatic juices) breaks down fats (lipids). Be sure to look for a supplement that covers the gamut of enzyme types.

There are a number of other enzymes that might be included in a multi-enzyme capsule as well – or which may be found singly or with only a few other enzymes that target specific physical problems. Cellulase, for instance, digests cellulose-type fiber. Different types of amylase other than lactase digest other specific forms of sugar. Serrapeptase and nattokinase digest fibrin, which collects in arteries and joints, and which composes uterine fibroid tumors. Papain and bromelain (from papaya and pineapple, respectively) are popular protease enzymes used for both digestion and inflammation.

"Digestive enzymes taken with meals assist in digestion and help correct the problems caused by incomplete breakdown of foods. When digestive enzymes are taken between meals, they have an anti-inflammatory, anti-clotting effect. Plant [or fungus] enzymes are preferred because they function in a broader pH range than animal-derived enzymes." (69) (As an example, "Fat in food exposed only to pancreatic lipase … in the intestines is not as well digested as fat that is first worked on in the stomach by food lipase." (70)) …So you might want to choose an enzyme formula whose label states that it works in both acid and alkaline environments.

Then, enzymes "require adequate amounts of other substances, known as coenzymes, to be fully active. Among the most important coenzymes are the B-complex vitamins, vitamin C, vitamin E, and zinc." (71) If you’re in dire digestive straits, you might do well to supplement with these nutrients too.

It’s also useful to be aware that lentils, peanuts, and soybeans contain an enzyme inhibitor (72), so these might be good to avoid while you’re correcting a severe digestive problem.

When you need extra hydrochloric acid:

Then there’s the hydrochloric acid issue… Most people (especially after age fifty) need more of it.

To check whether your heartburn is from too much or too little HCl, take one tablespoon of apple cider vinegar or fresh lemon juice in a little water. If it makes your heartburn go away, you need more HCl, not less. Other digestive deficiencies may also be aided by these liquids. "Vinegar has a low pH, which means that it is highly acidic, similar to your stomach acid. If you add a tablespoon of apple cider vinegar to your meal and your symptoms of indigestion decrease, it is likely that you have low stomach acid." (73))

If you need more, look for a supplement made from beets:  "betaine hydrochloride" or "betaine HCl". ("Supplemental HCl is not sold in powder or liquid form because contact with teeth can damage tooth enamel." (74) So don’t chew these tablets to give the digestive process a kick-off!) If you’re anxious about heartburn, you may want to begin to manage the other aspects of your digestion to alleviate acute symptoms before adding in HCl.

Another way to gradually build up HCl in your body is to take apple cider vinegar with raw honey (and, over the long haul, eat lots of raw vegetables). Raw cider vinegar is enzyme-laden as well. Some people like to sip water with a small dollop of cider vinegar stirred into it (or add it to fruit juice). Apple cider vinegar can also occasionally be used in baths and enemas. (75)

Another easy-access stimulator of HCl production is vitamin B1 (which is usually lacking in the typical American diet). Interestingly, a diet lacking in B1 has been shown to quickly make people forgetful, irritable, and depressed; and, later, constipated, noise-sensitive, anemic, prone to headaches and insomnia, and with diminished heart and lung capacity - ! (76) (This sounds like so many people we know, doesn’t it? Hmm…)

Other HCl-boosters, commonly available, are said to be: taking a full-spectrum B vitamin supplement, taking digestive bitters daily, eating bitter salad greens, drinking German chamomile tea just before or after a meal, and sipping lemon juice in water throughout the day.

Protein, which (with fat) takes a great deal of energy to digest, is broken down by HCl in the stomach. So here’s a tip on when to eat your fruity/salady meal components:  "Proteins should be eaten first; the hydrochloric acid can then work on them immediately upon ingestion. Fruits cause an alkaline substance to be excreted which inhibits protein digestion." (77)

Adding more bile:

And if you suspect that you have too little bile available? (which is certainly going to be the case if you’ve had your gallbladder removed!; and which may be evident in an oily slickness to the feces)… You can take an ox bile supplement (it might be a component of an enzyme supplement) to take its place. Or you might wish to consider an herbal alternative:  "Artichoke leaf helps to improve bile production and decrease stone formation. Take 250 to 500 mg of standardized extract two or three times daily." (78)

The liquid we ingest:

What you drink, too, is important, as we’ve seen… and we all need plenty of good, clean water (except during meals!). Water is critical for all functions of the body. "The body is composed of about 70 percent water, and water is required for many of its essential functions. Water is utilized as a solvent and also provides the means to transport nutrients, hormones, and other vital supplies. It's used to produce hydroelectric energy, especially in the brain. It's essential for maintaining cell structure. Water is also necessary to enable proteins and enzymes to function more efficiently. Chronic dehydration can lead to a loss or decease in all these functions and may ultimately result in disease or can worsen an existing condition." (79) "Water maintains proper muscle tone by giving muscles their ability to contract by preventing dehydration." (80) …And digestion relies on muscular peristalsis in the esophagus, the stomach, and the colon (not to mention in the tongue!).

All those other drinks we like? – you certainly cannot replace water with them. Most of them are actually diuretics (stimulating urination), which leads to dehydration, not hydration. Drink water, not any old liquid! (81)

If we look specifically at just the digestive tract, the significance of water is seen to be enough to get us drinking…

  • Obviously, it’s needed for the manufacture of saliva, and of any other moist components of the body such as protective mucus.
  • "Dehydration causes constipation. When water is in short supply in the body, the colon will act to restrict unnecessary water loss through the stools. …
  • Colitis pain is a sign of water shortage in the large intestine. …
  • Dyspeptic pain, which can range from simple heartburn to gastro-esophageal reflux disorder (GERD), may be one of the early signs of dehydration. …
  • [The acid-mixed content of the stomach] must be neutralized before it damages the intestinal lining. The pancreas is responsible for secreting the bicarbonate ions, which neutralize the acid. A large amount of water is required to produce this bicarbonate solution. If sufficient water is not available, the digestive process may be delayed and food may remain in the stomach longer than necessary." (82)
  • Also, "the pyloric valve does not receive the signals to open and release the stomach’s acidic contents into the intestines. This is a self-protective response since the walls of the intestines lack the protective layer against acid that is present in the stomach. The pyloric valve constricts more tightly and the lower esophageal sphincter relaxes. This results in the "anti-peristalsis" that reverses the contractions and sends stomach contents upward into the esophagus." (83)

It’s a good idea to get in the habit of drinking pure water about half an hour prior to a meal, and a couple of hours afterward (assuming your stomach is emptying properly – or when it has emptied).

If you do truly have too much hydrochloric acid, you might get some relief by boiling your water. It’s thought that the gaseous chlorine from chlorinated water causes over-production of HCl – and water filters of all types remove only solids, not gases. (84)

Then, "…the recent innovation of making water alkaline with a water ionizer [is] one of the best methods of alkalinizing the body. … These water ionizers also make the water become wetter and a potent anti-oxidant – greater than fresh wheat grass juice – and you can't become allergic to the water." (85)

Probiotics, digestive aids, and soothers:

While you’re getting your dietary intake into better alignment with your body’s needs, there are some other things you can ingest that will soothe and fortify your digestive system…

You can take probiotics (the beneficial bacteria of the intestine, like acidophilus) to help colonize the colon. If you don’t wish to take an encapsulated probiotic supplement, look for yoghurt with "live cultures" and eat a small amount once or twice a day.

Ginger and peppermint are great standby digestive aids. (Ginger is especially good for nausea. You can easily travel with candied ginger to pop into your mouth in a restaurant – or with a small dropper bottle of peppermint extract, adding a few drops to a swig of water at the end of a meal.) Even for a baby with GERD, an extremely diluted herbal tea can help quieten colic. Try "a very dilute tea of ginger, peppermint, and crushed dill seeds (make one cup of tea, then add another cup of water) – a teaspoon during or after eating aids digestion and helps prevent some of the muscle spasms that send the acids back upwards." (86)

For immediate soothing of esophagus, stomach, and/or intestinal tract, use one of the wonderful demulcents:  soaked flax or psyllium seeds, or powdered slippery elm bark, mixed in water (add a little fruit juice if you want to disguise their mild flavors). Each gives the added benefit of being excellent fiber for the colon. Then there's aloe vera, which is anti-inflammatory to soothe the whole digestive tract lining. "Three times daily, 20 minutes before meals, swallow 600mg in capsule form…or four tablespoons of extract…or two teaspoons in powder form, mixed in water." (87)

Manipulating the digestive tract into working better:

Then there are some "mechanical" aids that may do wonders for the state of your digestion…

For immediate need if you experience acid indigestion, "lie on your back and draw knees up to chest to relieve abdomen pressure." (88) (And lying on your left side is supposed to be better than on your right.) Many people get great benefit from simply creating an "incline board" to sleep on, by raising the legs at the head of the bed up 4-6" on blocks... relying on gravity to help keep the stomach, and acid, down.

Something you can do for yourself is to work acupressure ("reflexology") points related to digestion. For food assimilation, rub the soft sides of your thumbs. For nausea, press your thumb into the arm area two inches above the crease in your wrist (i.e., into a "slot" between the muscles). (89) Any chart on acupuncture/acupressure points – in the ear, foot, tongue, hand, as well as elsewhere on the body – will give you some other ideas if you look for spots associated with the stomach and intestines, pancreas and gallbladder (and the liver, which is responsible for detoxifying the results of poor digestion).

"Naturopathic and osteopathic physicians are trained in soft tissue manipulation. Hiatal hernias often respond to manipulative therapy." (90) Chiropractic, too, may well help greatly. One doctor has said, "In my practice, all patients presenting a hiatal hernia also present a C3 subluxation, with a stomach disorder perhaps being the only symptom." (91) Acupuncture is also used to tonify and restore the gastrointestinal tract over time. (92)

Some chiropractors, applied kinesiologists, or massage therapists know how to manipulate the stomach so as to bring a constant hiatal hernia back down. First, though, you could try this self-help technique:  "Drink a pint of warm water first thing in the morning, then stand on your toes and drop suddenly to your heels several times. The warm water helps to relax the stomach and diaphragm and puts some weight in the stomach. By dropping down suddenly, the weight of the water helps to pull the stomach down. In a mild case, this might be enough to bring the hernia down. In a more severe case it may loosen the stomach and make it easier for someone else to bring it down. It will also help you to keep the stomach down once mechanical corrections have been made." (93)
  


      

CITATIONS:
  

Those found within the text:

1 –   Prescription for Nutritional Healing ("PNH") – Phyllis A. Balch, C.N.C. (2000)
2 –   PNH
3 –   PNH
4 –   http://www.vbsc.com/home.htm
5 –   Own Your Own Body ("OYOB") – Stan D. Malstrom, N.D., M.T. (1977)
6 –   OYOB
7 –   http://www.refluxgoneforever.com/documents/TheAcidRefluxBlue1.pdf
8 –   http://www.joyfullivingservices.com/hiatalhernia.html
9 –   http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201216/
10 – http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201216/
11 – http://www.drmyattswellnessclub.com/hiatalhernia.htm
12 – http://www.joyfullivingservices.com/hiatalhernia.html
13 – http://www.sachhealth.com/Acidity_GERD2.html
14 – http://www.drmyattswellnessclub.com/hiatalhernia.htm
15 – http://www.joyfullivingservices.com/hiatalhernia.html
16 – OYOB
17 – OYOB
18 – PNH
19 – Healthy Healing ("HH") – Linda Rector Page, N.D., Ph.D. (1997)
20 – PNH
21 – "Bottom Line Natural Healing", June 2007; Dr. Mark Stengler, "Harmful Heartburn Drugs" ("BLNH")
22 – BLNH
23 – HH
24 – PNH
25 – PNH
26 – Dr. Bruce West
27 – http://heartspring.net/acid_reflux_symptoms.html
28 – BLNH
29 – JAMA. 1998 Apr 15;279(15):1200-5; Lazarou J, Pomeranz BH, Corey PN, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies." – summary)
30 – PNH
31 – http://www.sachhealth.com/Acidity_GERD2.html
32 – http://www.aboutgimotility.org/dumping.htm
33 – OYOB
34 – OYOB
35 – http://www.womentowomen.com/digestionandgihealth/probiotics.asp
36 – http://www.joyfullivingservices.com/hiatalhernia.html
37 – OYOB
38 – OYOB
39 – PNH
40 – PNH
41 – http://altmedicine.about.com/od/healthconditionsdisease/a/TestLeakyGut.htm
42 – OYOB
43 – OYOB
44 – http://www.docevaonline.com/askdoc.html#gerd
45 – http://www.american-longevity.com/enzyme.html
46 – http://www.sachhealth.com/Acidity_GERD.html
47 – http://www.womentowomen.com/digestionandgihealth/phbalance.asp
48 – http://www.womentowomen.com/digestionandgihealth/phbalance.asp
49 – http://www.bcnaturalmedicine.com/newsletter/bcnm-newsletter-5.html#three
50 – http://www.womentowomen.com/digestionandgihealth/phbalance.asp
51 – http://www.coolschool.ca/lor/BI12/unit8/U08L06.htm
52 – http://www.itmonline.org/arts/chlorogenic.htm
53 – http://www.mcvitamins.com/gallbladder.htm
54 – http://www.regardingme.com/bodies-ability-efficiently-utilize-oxygen-factors-
continued-good-health-a-18.html?sPath=56&iPath=5
55 – http://www.road-to-health.com/am/publish/article_40.shtml
56 – http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10058.html
57 – http://www.dreddyclinic.com/findinformation/dd/hiatalhernia/hiatalhernia_4.htm
58 – http://www.drraomd.com/diseaseindex/h_hiatus_hernia.htm
59 – http://www.diagnose-me.com/cond/C374158.html
60 – http://www.road-to-health.com/am/publish/article_40.shtml
61 – PNH
62 – HH
63 – HH
64 – OYOB
65 – PNH
66 – http://www.joyfullivingservices.com/hiatalhernia.html
67 – OYOB
68 – OYOB
69 – http://www.drmyattswellnessclub.com/hiatalhernia.htm
70 – PNH
71 – PNH
72 – PNH
73 – http://www.highlandpdx.com/blog/?p=115
74 – PNH
75 – OYOB
76 – http://www.road-to-health.com/am/publish/article_40.shtml
77 – OYOB
77 – http://www.wellfx.com/InfoBase/cond_Gallbladder_.html
78 – http://www.kitchenmedicinebook.com/016800.html
79 – http://www.bodybuilding.com/fun/kosloff2.htm
80 – http://www.kitchenmedicinebook.com/016800.html
81 – http://www.kitchenmedicinebook.com/016800.html
82 – http://faculty.olin.edu/~jcrisman/Service/KWTWebNews/Nutrition/water.htm
83 – http://www.reflux-relief.com/
84 – http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201216/
85 – http://en.allexperts.com/q/Herbs-Health-3224/natural-medicine-acid-reflux.htm
86 – BLNH
87 – HH
88 – HH
89 – http://www.drmyattswellnessclub.com/hiatalhernia.htm
90 – http://www.chiroweb.com/archives/16/06/03.html
91 – http://www.bcnaturalmedicine.com/newsletter/bcnm-newsletter-5.html#three
92 – http://www.joyfullivingservices.com/hiatalhernia.html
  

Two long and well-researched articles that might be of fascination to those with inclination to delve into important physiological mysteries:

"A missing link to chronic illness, allergies and longevity? Vagus Nerve Imbalance/Hiatal Hernia Syndrome", by physics professor Steve Rochlist – http://www.findarticles.com/p/articles/mi_m0ISW/is_241-242/ai_107201216/  (The author and the author of his main source aver that a huge percentage of the population has VNI/HHS - and that the "repair" is very straightforward.)

"Food Intolerance in Pets and Their People", by John B. Symes, DVM ("Dogtor J") – http://dogtorj.com/main-course/food-intolerance-in-pets-and-their-people/  (The author presents - in this and in a longer work, "The Answer" - far-reaching arguments about the widespread problems with "glue foods" [wheat, soy, milk] and other major dietary allergens that can lead to a host of ailments.  NOTE:  For animals - as well as for us - diets that simply avoid these foods can have major positive effect on health, often quickly.)

    


     

  
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