What is the Gastrointestinal System

Whether you are experiencing bloating after everything you eat, or have a diagnosed digestive condition, there may be a natural solution to your discomfort.
Condition

Irritable Bowel Syndrome (IBS)

  • Description

    • IBS is a functional bowel disorder characterised by abdominal cramping and altered bowel motions. There are three main subtypes that are characterised by their main stool pattern:

    • IBS w/ predominant constipation (IBS-C)
    • IBS w/ predominant diarrhoea (IBS-D)
    • Mixed IBS (IBS-M).

    The pathophysiology or cause of IBS appears to be multi-factorial, differing from person to person. Most recent theories suggest dysregulation of the gut-brain axis, altered serotonin signalling, infection, gut dysbiosis and food hypersensitivity to be related.

  • Symptoms

    • The Rome III Criteria:

    Recurrent abdominal pain or discomfort for at least 3 months’ duration, with symptoms on at least 3 days a month including at least 2 of the following symptoms:

    • Relieved with defecation
    • Onset associated with a change in frequency of a stool
    • Onset associated with a change in form (appearance) of stool.

    Approximately 1/3 of IBS patients also suffer with dyspepsia (indigestion). Other symptoms may also include bloating, increased flatulence, nausea, fatigue and back pain.

  • Treatment
    • Dietary modifications: Food elimination (e.g. short-chain carbohydrates such as lactose & fructose), fibre & prebiotics, ensuring adequate protein intake.
    • Nutritional medicine: Probiotics, fibre, glutamine.
    • Herbal medicine: Anti-diarrhoeal, spasmolytic (reduce cramping/spasms), choleretic (increases bile production in liver), GIT-specific antimicrobial herbs (in the case of infection related IBS), laxatives, carminative (relax & soothe GIT, release gas), sedative & nervines (beneficial where stress & anxiety is also present).
    Condition

    IBD – Crohn’s (CD) & Ulcerative Colitis (UC)

    • Description

      • UC: Unlike in Crohn’s Disease where any part of the gastrointestinal tract can be affected, UC only affects the rectum and colon (large intestine). UC usually follows a pattern of remissions and exacerbations, where the severity can range between mild to severe. It usually requires lifetime management, so those with UC will often benefit from support services and counselling.

      Can be:

      • Proctitis: isolated to rectum.
      • Left-sided UC: found in rectum & descending colon.
      • Extensive UC: extending to the descending & transverse colon.
      • Total UC: involve the whole colon.

      10-20% of those with UC report a family member who also has UC.

      Immune dysregulation appears to be at the heart of the condition, resulting in mucosal inflammation with infiltration of macrophages and lymphocytes.

      CD: A chronic inflammatory disease of the gastric mucosa, commonly affecting the ileum and colon, but can affect any part of the digestive tract from the mouth to the anus. Similar to UC, CD usually follows a pattern of remissions and exacerbations, where the severity can range between mild to severe

    • Symptoms

      • UC: urgency, diarrhoea, rectal bleeding, rectal mucus, weight loss, anorexia, fever, abdominal pain, nausea & vomiting.

      Proctitis (disease activity in the rectum only) may present with constipation.

      CD: pain, diarrhoea, rectal bleeding, fatigue, weight loss, constipation, fever, perianal fissures, loss of appetite. Fistulas and abscess are also common. Other signs can also be seen in musculoskeletal, mucocutaneous, ocular, hepatobiliary, genitourinary and vascular manifestations.

    • Treatment

      • UC

      • Investigations: Food avoidance & challenge, lactose/mannitol testing, complete digestive stool analysis/GI effects profile.
      • Dietary: Fibre & prebiotics, antioxidants, EFAs, short-chain carbohydrate avoidance, dietary changes during flare-up (soft-cooked veggies, fish, chicken)
        Nutritional: fish oils, probiotics, iron, calcium, vitamin D, folate, glutathione, glutamine, zinc, magnesium.
      • Herbal: Anti-inflammatory, immune modulating, antioxidant, haemostatic & astringent (reduce blood & diarrhoea).
      • Lifestyle: Reduce stress, regular exercise, quite smoking.

      CD

      • Dietary: Fibre & prebiotics, EFAs, avoidance of short-chain carbohydrates, dietary changes during flare-up.
      • Nutritional: Omega 3, probiotics, iron, vitamin B12, folic acid, zinc, calcium, vitamin D, magnesium, vitamin A.
      • Herbal: Anti-inflammatory, mucoprotective (protect the mucus membranes of the intestines), immune modulating, antioxidant, haemostatic/astringent.
      • Lifestyle: Reduce stress, regular exercise, quite smoking.
      Condition

      Diverticular Disease

      • Description

        • Diverticular disease includes diverticulosis (due to herniation of the bowel wall in the large colon, leading to the formation of sacs – usually asymptomatic – responsible for 30% of rectal bleeding) and diverticulitis (occurs when the diverticular become infected due to impacted faeces, resulting in inflammation & perforation of the colonic diverticulum – occurs in 10-25% of patients with diverticulosis & most common complication).

      • Symptoms

        • Many are asymptomatic until diverticulitis develops, leading to: abdominal pain, excessive flatulence, bleeding, bowel obstruction, nausea, anorexia, abscess, fistulas and perforation.

      • Treatment
        • Dietary: Fibre, adequate hydration, food elimination.
        • Nutritional: Probiotics, anti-inflammatory (CoQ10, vitamin C, selenium, quercetin, bromelain).
        • Herbal: Bitter herbs (Stimulate digestion), antibacterial, immune stimulating, anti-inflammatory.
        Condition

        Gastro-Oesophageal Reflux Disease (GORD)

        • Description

          • AKA heartburn, it is the repeated exposure of the oesophagus to gastric contents, leading to symptoms or histological changes. It affects approximately 25% of the general population monthly. Worldwide incidence appears to be increasing due to obesity, increased longevity and increased use of certain medications that affect oesophageal function.

          Contributing factors include: obesity, age, medications, stress, hypochlorhydria, diet.

        • Symptoms

          • Sensation of burning in the oesophageal region, feeling of chest pain, chronic cough, chronic hoarseness of voice, teeth erosion, water brash and less frequently, angina-like pain, belching and queesiness.

          The condition can sometimes be asymptomatic.

          Dysphagia (heartburn) with weight loss, anaemia or bleeding must be referred for testing to exclude strictures or oesophageal adenocarcinoma.

        • Treatment
          • Dietary: Avoid trigger foods (e.g. chilli, chocolate, alcohol, fatty foods, coffee), weight loss, apple cider vinegar (gently lowers pH of stomach), protein.
          • Herbal: Anti-inflammatory, muco-protective, demulcent, mucus membrane tonic, vulnerary.
          Condition

          Peptic Ulcer Disease

          • Description

            • The ulceration of the mucous membrane of the stomach or duodenum. Bacterial infection of Helicobacter pylori (H.pylori) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are largely to blame.

          • Symptoms

            • Pain (gnawing or burning) – can occur 1-3 hours after eating or when the stomach is completely empty.

            Nausea, vomiting, anorexia, weight loss. Complications of peptic ulcers include perforation and bleeding (more common in those with ulcers from NSAID use).

          • Treatment
            • Dietary: Increase protein, increase fresh fruit & veg, restrict aggravating substances (e.g. alcohol, smoking), increase antioxidant foods & drink.
            • Nutritional: Vitamin C, EFAs, probiotics, zinc, glutamine, vitamin A.
            • Herbal: Anti-inflammatory, mucoprotective, demulcent, mucous membrane tonic, vulnerary.
            Condition

            Food Allergy & Hypersensitivity

            • Description

              • A food allergy is usually a reaction to the protein component of a food. Common food allergies include milk, eggs, nuts, soy, sesame, fish and shellfish. Food allergies often cause gastrointestinal, respiratory, dermatological and cardiovascular symptoms, sometimes accumulating in anaphylaxis.

              Food hypersensitivity symptoms are caused by exposure to a food at a dose that is tolerated by most people. Dose is important as large amounts of certain foods or food components would cause symptoms in most people e.g. 25g of fructose will cause symptoms in 50% of the population.

              Food intolerances differ in that they are more insidious, usually causing delayed symptoms. Food intolerance can be caused by an enzyme deficiency e.g. lack of lactase can contribute to lactose intolerance.

              Lactose malabsorption: affects up to 20% of Caucasians.

              Fructose intolerance: affects 30% of population.

            • Symptoms

              • Food allergy:

              • Urticaria (rash), atopic eczema, dermatitis, asthma, gastrointestinal symptoms (nausea, pain, cramping, vomiting, diarrhoea), oedema (particularly mouth, eyes)

              Intolerance:

              • Bloating, pain, diarrhoea
            • Treatment
              • Dietary: Avoidance of known triggers, increase anti-oxidant-rich foods, increase anti-inflammatory foods
              • Nutritional: Vitamin A, vitamin D, vitamin C, quercetin, glutamine
              • Herbal: Anti-inflammatory, anti-allergic, anti-histamine, immune-modulating