If you have read anything related to diet and inflammation the past few years you have likely come across some information related to the digestive system or “gut” and how influential it is not only in processing the food we eat but in nearly every aspect of our lives. There are also lots of natural ways to improve your gut health which will help you to enhance your overall health.
If, perhaps, you have not come across this then, don't worry I am about to catch you up!
Recent research has redefined the role of our digestive system and revamped how we think about our food choices. Processes in the gut including food particle digestion, nutrient absorption, and waste excretion have far-reaching effects on the body rather than just providing us with energy and a nice poop.
The secret world of the intestines is a marvelous being in and of itself consisting of hills and valleys, bacterial colonies, stealthy viruses and pathogens, highly sophisticated transport systems, and vigilant gatekeepers. Intrigued? Let’s step inside…
After food passes through the stomach and duodenum, the digestive “muck” spends from 1-10 hrs between the small and large intestines. Sometimes longer if you have constipation issues! It is here that the final stages of digestion and absorption take place. In a healthy environment, nutrients get extracted and absorbed and toxins or waste gets removed. A major player in this system is the gut microbiome.
Gut Microbiome
The gut microbiome in part consists of bacteria, yeast, parasites (yep!), and viruses. A balance amongst these organisms is essential to maintain overall health and vitality in such processes such as maintenance of energy levels, brain function, immune response, and general digestive health. This is achieved partially through two-way communication directly with the brain. Recent research has linked a dysfunctional gut microbiome with neurological diseases such as Alzheimer's and Parkinson’s(1). It is also involved in the development of chronic pain states including headaches, inflammatory conditions such as arthritis and neuropathic pain(2). It's a pretty big deal!
Digestive Hormones and their Roles
The digestive system is also the housing and production area for over 50 hormones. Hormones are vitally important chemical messengers that communicate with the brain in an attempt to maintain homeostasis (balance) in the body (3). Some significant ones related to this blog post include:
Dopamine: is known as the “feel-good” neurotransmitter and is involved in emotional response, learning, memory, sleep, focus, pleasure, and satisfaction
Serotonin: another feel-good hormone that helps regulate mood and assists in the production of melatonin, which is important for sleep.
GABA (Gamma-aminobutyric Acid if you want to sound fancy): the chief inhibitor or down regulator of the nervous system. Plays a large role in stress response, cognitive function, sleep, and behavior responses such as fear and anxiety
Cortisol: although not produced in the gut, it is indirectly influenced by digestive processes.
Estrobalome: is not a hormone, but a branch of the microbiome specifically involved in the metabolism of estrogen (hello my perimenopause ladies!) We function best when estrogen is used and then moves along (excreted).
Have you fully digested all that information so far? 😉
So, what happens when there is a gut dysfunction or imbalance?
Gut Dysfunction and how does it affect you?
To put it in simple terms when there is an imbalance, the intestinal lining becomes more permeable. In a normal state, there are close junctions that tightly regulate what comes in and goes out across this intestinal “barrier”, think gatekeeper. Well, when the gatekeeper slacks off on the job, the gate swings open, and things (toxins, waste) that were supposed to move on out through our poop end up leaking into the abdominal cavity (aka “leaky gut”) creating an inflammatory response that then develops into a cascade of responses.
Common symptoms of a “leaky gut” include:
Joint and/or Muscle pain
Fatigue
Decreased exercise tolerance, shortness of breath
Painful gas, bloating, distention
Cognitive challenges and brain fog
Food intolerances
Sound familiar to anyone??
I know the next question...what creates this chaos and what can be done about it?
Your gut microbiome is about 60% “permanent” based on what was passed down to you genetically (thanks mom, dad, grandparents, great-grandparents..). Another 20% is affected by the environment you live in, travel to, what you are exposed to, and your diet. A final 10-20% is more fluctuant and based on daily food, fluid intake.
A few things that are microbiome disrupters include:
Frequent use of antibiotics, laxatives, and proton pump inhibitors such as Zantac
Chronic use of opioids. (Even short term use due to high incidence of constipation)
High BMI (body mass index)
Chronic constipation
Diets high in processed foods (those foods where you can't pronounce the ingredients on the label or you just avoid reading it at all because you don't really want to know… )
Natural Ways to Improve Gut Health
Regaining homeostasis and a happy gut can take a long time and a few twists and turns. It can help to talk with a clinician who has experience in this area. I offer guidance as part of My peri Plans here
4 things you can try on your own include:
1. Eating a varied diet with adequate fiber
that includes whole foods and high fiber fruits and vegetables such as broccoli, cauliflower, legumes, oats, and barley (I know booorrring… but you can get creative..yes, you can!) Honestly, this is the best place to start and it is where I begin with my clients.
2. Add Prebiotic foods to your diet
These types of foods help stimulate the bacteria to properly digest and process necessary nutrients and include onions, garlic, bananas, asparagus, oats, and barley (yep, again!). These foods can cause gas, bloating in some people so proceed slowly.
3. Avoid foods that contain antibiotics (some meats) or which cause constipation, diarrhea or stomach irritability
4. Probiotics
This is a hot topic. Probiotics are live microorganisms that, simply put, promote the growth of good bacteria and inhibit the action of the “bad” bacteria. You can nerd out on the lengthier, sciencier explanation here. There are a gazillion supplements and billions of strains out there and since we all have unique bacterial environments it may take some time (and money) to land on the right combination. Research on probiotics is strong in some areas and not so strong in others so I caution against randomly choosing to go on a probiotic without first discussing it with a trusted health care provider. A later post will discuss how to choose a legit probiotic so stay tuned! Side effects can include gas, bloating, and diarrhea.
How does Physical Therapy help you improve your gut health?
As a physical therapist, I always address nutrition and counsel my clients on healthy, anti-inflammatory food choices. It can be a major piece of the healing puzzle and it is, unfortunately, not often addressed in traditional settings. In my experience, it gives the client some control over their symptoms and can often decrease their need for NSAIDs, opioids, or other pain medications(2).
The previous list that I have said earlier about natural ways to enhance gut health represents just a start to managing gut and inflammation issues.
Other areas that need to be addressed are stress management, lifestyle changes, and other wellness strategies. At My Peri Plan, we work out a tailored plan that meets your individual needs and in a way that is digestible (yep, I did it again!) and sustainable without being overwhelming. You can get more information at elainemele.com
Research utilized:
1. Wang Y, Kasper LH, The role of microbiome in central nervous system disorders Brain Behav Immun 2014; 38:1-12
2. Ran Guo, Li-Hua Chen, Chungen Xing and Tong Liu Pain Regulation by gut microbiota: molecular mechanisms and therapeutic potential BJA 123 (5): 637-654 (2019) doi: 10.1016/j.bja.2019.07.026
3. Strandwitz P. Neurotransmitter modulation by the gut microbiota. Brain Res. 2018 Aug 15;1693(Pt B):128-133. doi: 10.1016/j.brainres.2018.03.015. PMID: 29903615; PMCID: PMC6005194.
4. Hemarajata P, Versalovic J. Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013;6(1):39-51. doi:10.1177/1756283X12459294
