Contributed by Dr. Amy Whittington, Trilogy’s Naturopathic Physician

When you mention the health of the gastrointestinal (GI) tract, a few diseases and dysfunctions immediately come to mind, such as acid reflux, irritable bowel syndrome, bloating, and general mal-digestion. However, there is a growing movement that believes many other dysfunctions may be linked to the GI tract as well. A weakened immune system, headaches, skin manifestations, autoimmune disease, and allergies are just a few health issues that may have a strong correlation to disrupted GI health. If you are suffering from symptoms that are difficult to control, regardless of the system those symptoms seem to be plaguing, you may want to start by repairing your digestive tract.

Beyond the general idea that health is holistic, there are many reasons the digestive tract is likely involved in processes outside of digestion. The GI plays a crucial role in our health by processing the nutrients and energy out of food, removing toxins, and excreting waste, and we now know that much of our immune response (our defense against any kind of invader) also occurs in our GI. We also know that our GI system houses a complex portion of our nervous system. Both of these intertwined systems are extremely complicated and not fully understood, but can cause effects that reach far beyond digestion.

It is estimated that 70% of our immune system is housed in our digestive tracts in what is known as gut-associated lymphoid tissue (GALT). GALT is an important part of mucosal-associated lymphoid tissue (MALT), which is one of our body’s initial and primary defenses. It is also thought that as much as 80% of antibodies [mainly immunoglobulin A (IgA)] reside in GALT. Aside from containing specialized immune cells, the friendly gut flora that reside within your intestines provide defense against invading pathogens. People with overt immune dysfunction in their guts (i.e. celiac sufferers) will be the first to tell you that their symptoms are not limited to digestion alone, and although it is not as clear to those with minor GI dysfunction, the same is likely true for all of us.

In addition to housing a significant portion of the immune system, we see evidence of a gut/brain connection that likely results from a huge nervous system presence within the digestive system. The small intestine alone has as many neurons (nerve cells) as your spinal cord. Although mechanisms remain unclear, many irritable bowel sufferers confirm an association between stress and GI disturbance. These nerve cells contain all of the same neurotransmitters that the brain does, including serotonin, a neurotransmitter linked to mood, sleep, and energy. It is estimated that 95% of serotonin is produced in the gut. Have you ever had “gutfeeling?” Someday, understanding this process more might give us a whole new explanation for the butterflies that we can feel during certain events and decisions.

When we take note of the high presence of immune and nervous functions in the gut, it makes sense that symptoms related to the GI reach far beyond digestion, but we are likely many years away from fully understanding the processes and implications. So what do we do with this preliminary information? For many, the answer is as simple as tending to and healing the GI as much as possible, not only to reap digestive benefits, but to improve relatively obscure symptoms that are difficult to treat.

In integrative medicine, we often refer to the process of healing the GI tract as “THE FOUR RS:” REMOVE, REPAIR, REPLACE, and RE-INOCULATE. Here is an overview of the four steps:

REMOVE: The first step in improving the digestive tract is to remove anything that might be irritating it. Bacteria and over- or under-production of acid fall into this category, but the culprits for most long-term sufferers are specific foods. Food intolerances can be discovered by testing via lab work, or by initiating an elimination/reintroduction of suspect foods. Food intolerances are not measured by skin-prick, as the antibodies noted in the reaction can be 3-4 days after ingesting the reactive food. If you are unable to have an integrative physician measure food intolerances for you, try an elimination diet for at least 7 days, avoiding any suspicious foods, along with the most common food intolerances: dairy, wheat, soy, and eggs. When you reintroduce, separate each food category by at least 4 days watching for any return of symptoms.

REPAIR: Once you have removed ongoing disruptions, it is important to repair the digestive tract. An irritated and dysfunctional GI has likely damaged the mucosal linings, imperative in housing many of our antibodies. A category of herbs known as demulcents, including slippery elm, deglycyrrhizinated licorice, and aloe become very thick in the digestive tract and can help to coat irritated mucosal lining. L-glutamine is an amino acid that is particularly useful in improving the health of enterocytes (the cells that line part of the digestive tract) and is also included in many GI repair plans.

REPLACE: For many, the removal of offending agents and repairing of tissues isn’t enough, and we must also “replace” components of digestion that aren’t working well. This is usually done with the addition of digestive enzymes, often a combination of plant-based enzymes, amylase, lipase, and bile salts where necessary. Mechanisms to increase or decrease the speed of digestion are typically also considered.

RE-INOCULATE: Damaged mucosal linings, antibiotics, and many medications often result in a decrease in the good bacteria that live in the mucosal lining. Such disruptions leave fertile grounds for not-so-helpful disease-causing bacteria or yeast to thrive. Probiotics, or good bacteria, play a role in immune system function and digestion itself; replacement can lead to vast improvements in both systems in addition to preventing the invasion of further bad bacteria.

The ramifications of a dysfunctional GI are complex and not yet fully understood, though there is little doubt based on the anatomy of the GI that the function of our guts goes well beyond digestion. A simple process to REMOVE, REPAIR, REPLACE, AND RE-INOCULATE could reap systemic benefits and for many should be a viable consideration in feeling better.

Stay healthy & be well,
– Amy Whittington, NMD