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Posted on June 13, 2018 by in Natural Practitioner Magazine, NP 2018, NP 2018 06 07, NP Features
It seems that more Americans are complaining about gastrointestinal issues. Here’s how to help.
Watching TV commercials for a period of time shows you what’s trending in consumer behavior, as well as desires and needs.
During the past several years, no matter the channel or the time of day or night, there is something being sold cleverly or discreetly that promises to take care of digestive issues that are debilitating, discomforting or embarrassing. Touted products include prescriptions, OTCs (over-the-counter), supplements and yogurts. We are a nation of GI (gastrointestinal) woes.
For example, statistics presented at the 2015 annual meeting of the American College of Gastroenterology showed that approximately 63 million Americans experience chronic constipation. The information site, www.aboutibs.org, notes that as of 2016, irritable bowel syndrome (IBS) affects up to 45 million Americans, and the sufferers are predominantly women (two out of three). And nearly 20 percent of Americans have gastroesophageal reflux disease (GERD), whose primary symptom is the highly uncomfortable burning underneath the breastbone to the throat.
Another survey (statista.com) published in February 2017, showed that 31 percent of respondents said they deal with bloating at least once a month, while 31 percent admitted to suffering from flatulence at least once a month. In this survey, the top complaints respondents said they dealt with at least once monthly were heartburn (43 percent) and constipation (43 percent), and these were followed by diarrhea at 39 percent. Clearly, the digestive tract in millions of Americans is a long, bumpy road from ingress (the mouth) to egress (the colon).
Many patients are unable to, at first, pinpoint or recognize what may be awry with their digestive system when they feel discomfort. According to Jacob Teitelbaum, MD, best-selling author, it’s important to help them to learn how to distinguish between upper digestive complaints and intestinal issues. Upper digestive complaints include acid reflux and indigestion symptoms, which stem from enzyme depletion and excessive stomach acid. Through time, a processed-food-heavy diet can cause or exacerbate these issues. “In large part, these issues are occurring because food manufacturers learned that destroying the enzymes present in food, which ripens a food, prolongs their shelf life, and these cause the symptoms,” he pointed out. “Instead of adding digestive enzymes, most doctors give acid blockers. This eliminates the symptoms of acid reflux, but further worsens digestion.”
Further, he warned, these acid blockers have been shown to be deadly, while also increasing the risk of osteoporosis and Alzheimer’s. When the patient stops taking them, this can cause rebound acid hypersecretion. Dr. Teitelbaum advised that instead of cold turkey, patients need to be weaned off of them.
In fact, cited Jason P. Edwards, CEO, Rebel Herbs, Indiana, Americans are consuming acid blocking or antacid medications “at an alarming rate.” Antacid sales in 2017 in the U.S. exceeded $1 billion dollars in just branded products, not to mention generic.
Meanwhile, intestinal symptoms patients may complain about, he said, are largely gas, bloating, diarrhea and/or constipation. If this is chronic, it may be due to a condition called small intestinal bacterial overgrowth (SIBO), and one hallmark is that the flatus has a sulfur odor. “SIBO is best treated with an excellent herbal mix called Ultra MFP Forte (Douglas Labs), two twice a day for one month,” he suggested. Another possible cause is candida overgrowth; if this is the case, said Dr. Teitelbaum, Diflucan at 200 mg a day with nystatin for six weeks is an effective solution.
Digestive complaints seem to be on the rise, as noted, and many common traits are lifestyle and diet related. There are many causes, as one factor, say fried foods, will give one person diarrhea, and not affect another. Some people can eat beans without a problem, while others experience highly uncomfortable bloating with flatulence.
Hannah Braye, technical advisor, Bio-Kult (Protexin) in Florida, observed that good gut health is on the decline, with a growing number of people complaining of IBS-type symptoms such as diarrhea, constipation, bloating and cramps. Also, more people are complaining of intolerances and the incidence of irritable bowel diseases such as celiac disease, ulcerative colitis and Crohn’s disease is also increasing.
Stress, medications, poor diet are the triple threat that either singularly, or in combination, cause any type of GI disturbance or dysfunction.
When it comes to diet, anything can trigger bathroom runs in anyone. For example, pointed out Edwards, “Many popular foods in the U.S. contain unprocessed soy which is very difficult for the body to digest; ancient cultures would ferment or cook soy to prepare it for consumption. Additionally, synthetic flavors and colors may be in small quantities but we have no idea how the human digestive tract will deal with them long term.”
Brendan Gaughran, president, Florida-based Liver Medic points to GMOs (genetically modified organisms) as a prime trigger in modern GI issues. “There is a grand experiment that started back in the late 1990s in the U.S. that correlates almost perfectly to our intestinal epidemic. Now, GMO technology has captured most U.S. crops and has forced farmers to use more extreme forms and higher amounts of herbicides and insecticides due to the resistant GMO plants.” Glyphosate, he stated, has been shown to decrease healthy bacteria, compromise the gut lining and inhibit important enzymatic reactions in the liver. It has contributed to leaky gut, which has been officially recognized recently by conventional medicine.
Consuming processed and packaged foods, along with high stress and related fast-paced, frazzled lifestyle often results in an imbalance in the colonic micro ecosystem, resulting in production of low levels of inflammation and lower immunity, according to Terrence O. Tormey, CEO, Kibow Biotech, Pennsylvania. “The altered gut microflora leads to higher energy harvest, leading to fat storage in the adipose tissue,” he explained. “Recent studies have pointed to the imbalanced gut microbiome as being causative in numerous diseases, from general gut and digestive health to areas like autism, anxiety and the gut-brain axis.”
Not all healthy microbiomes look alike—as “each of us has a completely different mix of these microbes—like our gut fingerprint,” Braye pointed out. “Research is indicating that it is the wide diversity of these strains that appears to be more beneficial than the presence of individual strains. It is this lack of bacterial diversity that is now commonly being seen in many gut-related conditions.”
According to Ross Pelton, RPh, PhD, CCN, scientific director, Texas-based Essential Formulas, some of the potent, numerous contributors to gut dysbiosis are: pervasive use of pesticides and herbicides on produce crops and GMOs in crops, frequent use of antibiotics compounded by consumption of antibiotics in commercial livestock, food processing, fiber-deficient diets, gluten intolerance, use of microbiome-disrupting drugs, short duration or lack of breast feeding and C-section births.
Further, he added, two primary causes of intestinal inflammation and development of intestinal disorders are gluten and pathogenic bacteria. “Therefore, two of the most important recommendations for people with intestinal disorders are to adopt a gluten-free diet and attempt to recreate and maintain a healthy microbiome by taking a high-quality probiotic. People also need to be taught the importance of consuming a high-fiber diet as non-digestible fibers in multi-colored vegetables, fruits and leafy greens are the preferred prebiotics.
Natural Solutions for Gut Calming
When working with patients who are complaining about GI disturbances, diet is first that comes to mind, as does what medications he or she is taking. Lifestyle is also a rather lengthy discourse, as people can be enduring chronic high stress and not realize it. If sleep tends to be frequently insufficient, low-grade anxiety exists and even if the person often “eats on the run,” all these factors contribute to the higher levels of stress that impacts healthy digestion and the quality of the microbiome.
When presented with symptoms of what you suspect may be acid reflux and indigestion, Dr. Teitelbaum recommends the following:
• Plant-based digestive enzymes, such as Complete Gest, with meals
• Add some vinegar-based salad dressings to the meal to supply more acid.
• Advanced DGL one (twice daily) to help regenerate the mucous lining
• After six weeks on the above, switch the person to Tagamet 200 to 400 mg twice daily, and taper from there.
• For nighttime acid reflux, if present, tell your patient to raise the head of the bed, and take melatonin 5 mg at bedtime (which has been shown to decrease reflux) with ½ teaspoon of baking soda in 4 ounces of water to neutralize any stomach acid. “This will allow the esophagus to heal, which is critical for resolving long-term acid reflux symptoms,” he explained.
There are also numerous products to recommend by manufacturers. It’s not too surprising that probiotic formulas are dominating this wellness sector.
Oregon-based Yerba Prima’s Prebiotic Colon Care is beneficial for people dealing with the discomfort of GI issues, according to organic chemist Craig Hays, quality assurance manager. Prebiotic Colon Care promotes overall colon health with fiber, calcium, magnesium, selenium and FOS probiotic growth complex. “These nutrients provide dietary support for normal, healthy functioning of the colon including: regular elimination of toxins and waste material, promoting the growth of friendly bacteria, such as acidophilus and bifidus, and support for proper digestion,” he described.
New Hampshire-based MegaFood has two key probiotics that can be widely recommended. Its signature product, MegaFlora is formulated to support intestinal health, immunity and bowel regularity. Its proprietary blend of 14 strains of probiotics provide 20 billion active bacteria that help restore and maintain the balance of healthy intestinal probiotics.
MegaFlora for Over 50 promotes colon health, regularity and relief from gas and bloating, according to Erin Stokes, ND and medical director at MegaFood. Aging slows down digestive efficacy, she said, so supplementing with a probiotic is a good idea to maintain optimal digestive function. MegaFlora for Over 50 provides additional amounts of Bifidobacterium lactis (HN019) and Lactobacillus plantarum (LP115) in addition to the company’s signature blend of 14 strains of probiotics and 50 billion active bacteria. The supplement also contains FoodState turmeric root helps maintain an already healthy inflammatory response of the colon, and the company’s FoodState prebiotic blend to encourage the growth of healthy gut bacteria.
New from SOFAR Americas is Innovia Nectar probiotics micro-shots, which uses the LP-DG strain (Lactobacillus paracasei CNCMN 1-1572), which supports gut health by replenishing and rebalancing intestinal microflora. Your patient just presses down on the cap, shakes and gulps it down. The patented cap contains eight billion live and stable probiotics and the liquid contains herbal extracts, vitamins and other nutraceuticals for a wholesome digestive-support blend.
New is Liquid Fiber, combining LP-DG with fructooligosaccharides and vitamin C to restore microflora balance and increase good bacteria for optimal digestive efficacy.
Essential Formulas sells Dr. Ohhira’s Probiotics, which are different than all other commercial probiotic products, said Dr. Pelton, because they are made through a multi-year fermentation process. This production process begins with 12 strains of probiotic bacteria and then dozens of different kinds of organically grown foods are added to the fermentation vats. The bacteria are then allowed to digest and ferment their prebiotic food supply for three years before the resulting paste is encapsulated. During the three years of fermentation, the bacteria are producing a wide range of compounds called postbiotic metabolites.
“It is not your probiotic bacteria, but the postbiotic metabolites that they create, which are the critical health-regulating substances in your GI tract,” Dr. Pelton explained. “Dr. Ohhira’s Probiotics don’t just deliver probiotic bacteria. Dr. Ohhira’s Probiotics are a complete microbiome. Each dose of Dr. Ohhira’s Probiotics delivers probiotic bacteria, prebiotic foods and most importantly, a multitude of postbiotic metabolites. In fact, recent research has reported that Dr. Ohhira’s Probiotics contain over 400 different postbiotic metabolites.”
EndoMune products are formulated by Dr. Lawrence Hoberman who is board-certified in gastroenterology and internal medicine, according to Dawn Goforth, director of operations, Medical Care Innovations, Inc. (DBA EndoMune), Texas.
EndoMune Advanced Probiotic for adults (age 8 and older) contains 20 billion CFU and 10 potent bacteria strains. Its delayed-release formulation is designed to resist stomach acid and ensure delivery to the intestinal tract. A one-per-day capsule can be swallowed, added to smoothies or opened and sprinkled on food.
EndoMune Metabolic Rescue, which is new, combines 1 billion CFUs of Bifidobacterium lactis with 600 milligrams of the prebiotic Xylooligosaccharides (XOS), which Goforth described as “a powerful fiber shown to optimize good bacteria in the colon and stimulate the release of hormones that affect our satiety center, slow gastric emptying and improve insulin sensitivity. This unique mix works as a synbiotic that produces short-chain fatty acids and promotes a feeling of fullness and natural, effective weight loss.”
Similarly, there are other hybrid products that support healthy digestion as well as weight control and even cholesterol balance. For example, “based on the scientific data regarding the importance of healthy gut flora to reduce various pathological and immune and gut health, we developed Kibow Fortis, a novel proprietary formulation of a multi-functional prebiotic fiber of highly concentrated soluble and insoluble fibers,” said Tormey. This multifunctional blend, he elaborated, features (1,3/1,6) beta glucans, which have been well studied for their immune boosting properties, as well as oat (1,3/1,4) beta glucan, known for its cholesterol reducing properties. In addition, it contains prebiotics inulin, arabinogalactan and xylooligosaccharide, which are known to for supporting immune and digestive health as well as weight and lipid management, satiety and maintenance of intestinal flora,” he suggested.
“Many people remember their parents giving them ginger ale when they were young to settle an upset stomach, and this is a proven remedy,” Edwards asserted.
According to Edwards, Rebel Herbs’ Formula #76 Digestade is a broad formula that stimulates the digestive processes to improve the entire operation of digestion. The company’s dual extracted ginger powder delivers a full spectrum extract in a convenient easy to use powder that you can put in water (cold or hot) or smoothies or even sparkling water. Ginger extract is well known to improve digest-ion and reduce nausea. Synergistic ingredients in Digestade include fennel seed, Embelia ribes, Plumbato zeylanica, Aegle marmelos (bael fruit) and Holarrhena antidysenterica.
Avie Gastrointestinal Balance from Louisiana-based Avie Nutraceuticals is a proprietary formulation of water-soluble ultramicronized turmeric curcumin and DGL licorice. According to Dr. Carola Leuschner, The formulation eases digestive discomfort and relief from occasional heartburn and indigestion. Avie Gastrointestinal Balance contains natural turmeric at a dose of 5 percent per capsule—25 mg turmeric and 200 mg deglycyrrhizinated licorice per 500 mg capsule. For best results, Dr. Leuschner recommended that patients take one capsule of Avie’s Ultramicronized Turmeric Curcumin in the morning and one in the evening, both with a full glass of water.
“Studies performed by scientists at Avie have shown that Avie’s Ultramicronized Turmeric Curcumin has 352 times greater antioxidant activity, 1,400 times greater radical scavenging capacity and 126 times greater inhibition of the inflammatory enzyme COX-2 than the competition products that contain BCM-95 or C3-complex curcumin,” stated Dr. Leuschner. “Most importantly, it is fully water-soluble, unlike competitor products that are insoluble in water and require addition of pepper to promote absorption and efficacy.”
The supplements mentioned here are certainly viable in the road back to digestive balance, and healthy digestion is about balance. Enzymes, probiotics and prebiotics (microbiome), when produced in vivo or ingested, often work collaboratively to restore optimal function—from the in door through to the out door. When combined with diet monitoring, and stress management techniques, your patients can beat the GI woes.
Healthy Take Aways:
• Approximately 63 million Americans experience chronic constipation.
• As of 2016, irritable bowel syndrome affects up to 45 million Americans, and the sufferers are predominantly women.
• The top complaints respondents said they dealt with at least once monthly were heartburn (43 percent) and constipation (43 percent), and these were followed by diarrhea at 39 percent.
• Antacid sales in 2017 in the U.S. exceeded $1 billion dollars in just branded products, not to mention generic.
• Two primary causes of intestinal inflammation and development of intestinal disorders are gluten and pathogenic bacteria.
For More Information:
Avie Nutraceuticals, www.avienaturals.com
Essential Formulas, www.essential formulas.com
Kibow Biotech, www.kibowbiotech.com
Mega Food, www.megafood.com
Rebel Herbs, www.rebelherbs.com
SOFAR Americas, www.innoviaprobiotics.com
Yerba Prima, www.yerba.com