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Gastrointestinal function and ecology is at the core of human health. Imbalancescan affect overall well-being. Likewise, the structure and functions of the intestinesdetermine total body toxin load and are essential to the process of detoxification.Cleansing and healing the GI tract (especially the colon) provides a base for effectivedetoxification.
"We are what we eat and assimilate, and not what we eliminate," is really sayingthat our GI tract function is vital to the process of nourishing our body and controllingtoxicity through elimination, a process which truly begins in the colon.Furthermore, we must regularly cleanse the intestinal system to effectively detoxify thebody. Specific therapies are discussed throughout this book; in this chapter, I want toprovide a basic discussion of the GI tract process and its contribution to overallhealth—a relationship often overlooked in Western medicine.
In this model (which I call Functional Integrated Medicine), the function, ecology,and permeability of the GI tract are crucial to the health of each patient. Dysbiosis isthe term used to describe imbalance of GI function (specifically, incomplete food digestionand assimilation) or its microbial populations. Preventive medicine works with thetheory that abnormal function precedes pathology, and hence the GI tract is assessedfor dysbiosis. Therefore, to prevent pathology, normal functioning,specifically of theGI tract, must be restored. If this concept of prevention is incorporated into mainstreammedicine, we can keep people healthier longer and prevent disease by evaluatingand maintaining proper internal function and environment. Fortunately, this shiftin thinking is picking up speed around the country.
The GI tract is composed of the mouth and teeth, the esophagus and stomach, thesmall intestine (duodenum, jejunum, and ileum) and large intestine (colon). Its properfunction begins with adequate chewing, which is essential for good nutrition andhealth. Other digestive organs include the salivary glands, pancreas, gall bladder, GImucous glands, and liver. Salivary enzymes begin digestion and the process is continuedby stomach hydrochloric acid and enzymes, plus the many pancreatic enzymeswhich are released into the upper small intestine. Finally, the gall bladder releases bileto promote fat digestion. Assimilation of most nutrients occurs in the small intestine;the colon absorbs water, bile salts, and a few other substances in order to prepare theremainder of the colonic contents for elimination.
Regular elimination is also crucial to overall health and control of the level of toxicityin the body—constipation is actually a greater problem than most doctors andpatients realize. Hydration, diet, level of physical activity, and stress all affect our eliminativefunction.
Health and proper functional integrity of the huge mucosal membrane surface areaof the GI tract allows the proper assimilation of nutrients. Even minor disruptions suchas inflammation or infection may cause abnormal absorption and increased barrierpermeability. With increased intestinal permeability, absorption goes out of balanceand larger-than-normal molecules get absorbed which can cause allergic reactions andother abnormal immune responses. There is a delicate balance between the assimilationof needed nutrients and the exclusion of toxic substances. Abnormal organismswithin the intestinal lumen may produce toxins which can significantly affect mentaland physical health. Also, certain pathogens within the GI tract may generate autoimmunereactions in the particularly vulnerable environment of the small bowel, wherethe majority of our immune cells are located.
Problems of dysbiosis, abnormal GI mucosal permeability, infection, and inflammationare exceedingly common and may cause both gastrointestinal complaints andother health concerns. The GI tract is stressed and otherwise adversely affected by:
refined foods and sugar
excess fatty and rich foods
overeating and failing to chew more than once or twice per mouthful of food
drinking too much with meals, thus diluting our digestive juices and reducing our ability to properly break down food
food chemicals, pesticides, and environmental toxins
the persistent use of alcohol, caffeine, and nicotine
use of prescription, over-the-counter, and recreational drugs
lack of fiber and whole foods, specifically lacking fresh fruits, vegetables, whole grains, and legumes in the diet
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The GI tract is especially sensitive to emotional turmoil. A stressful lifestyle mayadversely affect motility, digestive enzyme output, and overall function. Over 30 guthormones have been identified, many of which also act as neurotransmitters. Chemicalexposure (specifically ingested chemicals), travel and subsequent parasitic infections,or the overuse of antibiotics can cause intestinal dysfunction and disease. It may takeyears for the gut to recover from this kind of damage.
It is also important to maintain proper levels of friendly bacteria within the colonand make sure that their numbers decrease in concentration when progressing up theGI tract into the small intestine or stomach. Overgrowth of abnormal bacteria, fermentingyeasts, and parasites can disturb GI function causing inflammation along thesensitive mucous membrane of the GI tract and thereby adversely affecting the assimilationof food and nutrients.
Abnormal permeability, often called "leaky gut," creates GI imbalance which canlead to systemic disease. Over-assimilation of non-nutrient compounds and under-assimilationof required nutrients may produce deficiencies, as well as allergies andother immune system problems. Inflammation or infection in the GI tract, food allergies,and the overuse of alcohol and non-steroid anti-inflammatory drugs (NSAIDs)can all cause problems in permeability. Disorders such as irritable bowel syndrome,Crohn's disease, rheumatoid arthritis, and HIV infections are frequently associatedwith leaky gut and permeability problems. A common condition involves fermentationfrom yeast overgrowth, specifically Candida albicans and other related Candidaspecies, which can lead to a large variety of symptoms and which are often associatedwith permeability problems.
There are literally billions of microorganisms inhabiting the healthy GI tract.Friendly ones include E. Coli (the bacteria Escherichia coli), various streptococci, andLactobacillus acidophilus, as well as Lactobacillus bifidis (Bifidobacteria), which ispredominant in infants and children. However, many other undesirable organismsreside in the GI tract, particularly in the large intestine. These can include yeasts,abnormal bacteria such as Klebsiella (not always pathogenic) and Citrobacter species,a variety of pathogenic parasites that include Giardia lamblia and Blastocystis hominis,and amoebas such as histolytica, hartmani, and coil.
HEALING THE GI TRACT
An effective way to think about and heal the gastrointestinal tract has been developedand taught by Jeff Bland, Ph.D., in his nutritional education seminars. It is partof an approach to health care he calls Functional Medicine. Preventive medicine focuseson basic functions within the body, balancing or rebalancing them when they arenot right through the use of supportive nutrients and appropriate natural substances.This is similar to OrthoMolecular Medicine, a concept coined by Linus Pauling withwhom Dr. Bland worked for a number of years. Currently, Dr. Bland and his team atHealthComm in Gig Harbor, Washington, are working to find better ways to assess,heal, and support GI anatomy and physiology, as a way to remedy illness and generatehealth.
There have been a number of new tests developed in the last decade which look atdigestion and assimilation, GI mucosal surface health, and the presence or absence ofappropriate or pathogenic bacteria, yeasts, and parasites. Several licensed laboratoriesacross the country (particularly Great Smokies Diagnostic Lab in Asheville, NorthCarolina) have led the way in developing very useful, clinically significant tests, whichfollow.
Allopathic Medical Tests
1) Upper GI, or the Barium Swallow, X-Ray Study
A series of x-rays is taken (viewed with dye) from the mouth to the small intestine.It is useful for identifying anatomical and motility problems as it detects significantproblems like gastric or peptic ulcers, hiatal hernias, and tumors within (or pushinginto) the upper GI tract. Concerns with this test and the barium enema include the x-rayexposure, constipation from the relatively nontoxic dye (which only rarely causesreactions), and fluid/nutrient imbalance resulting from the enemas and oral purgativesused in preparation for these tests. Cleansing the bowels after the tests by drinkingwater and taking vitamin C will help counter some of the radiation and toxin exposure.
2) The Barium Enema
This rather unpleasant test involves the slow injection of a highly pressurized enemainto a cleaned-out colon to examine the area from rectum to small intestine. It is usedto diagnose ulcerative colitis in progressed stages, tumors (both benign and cancerous),and misshapen colons, which are often the result of many years of poor diet andconstipation.
3) Gastroscopes and Colonoscopes (also Sigmoidoscopes)
The gastroscope is a fiberoptic tube that is inserted through the mouth to view theesophagus, stomach, and pyloric area. The colonoscope is inserted through the anusand travels around the colon. Both scopes are used to search out inflammation, polyps,tumors, or ulcers. A less comprehensive test employs the "silver tube" or sigmoidoscope—arigid instrument used to assess the rectum and sigmoid colon only. The obviousadvantage of the scopes for testing is the total avoidance of any exposure toradiation. Biopsies or even complete excisions can be performed utilizing the instruments,often avoiding, or at least postponing, more invasive surgery. These procedurescan, however, be quite painful, and doctors often give multiple antipain and tranquilizingdrugs, or even general anesthesia from which it may take several days to recover.
Functional GI Tests
4) CDSA—Comprehensive Digestive Stool Analysis
This simple assessment has been a medical breakthrough. A stool is collected andmailed overnight to a lab where it is evaluated for digestion of animal proteins, vegetablematter, starch, and fatty acids. Stool pH, intestinal immune function (with theaddition of secretory Immunoglobulin A), and the presence of mucus, blood, and certainenzymes are also measured. Culturing is done to locate both normal and abnormalbacteria and yeast or fungus. If any abnormal organisms are detected, sensitivitytesting is done with both natural substances (such as garlic, grapefruit seed extract,caprylic acid) and pharmaceutical agents (such as antibiotics and antifungals) to determinewhich agents kill or inhibit the growth of the detected organism. This allows thepractitioner and patient to select the right treatment for their particular condition. Thisinformation then gives us a therapy that involves the removal of abnormal organisms,replacement of diminished enzymes or hydrochloric acid, reinoculation with appropriatehelpful microorganisms (probiotics), and repair of the GI mucosa. This constitutesthe 4R program, which is discussed later in this chapter as "the 5R program," with theaddition of rebalancing diet and lifestyle. There are no side effects or medical concernswith the CDSA or the Parasite Study other than the psychological discomfort thatsome people experience from having to handle their own feces.
5) Parasite Study
Certain laboratories specialize in identifying parasitic infections through stool exams.These exams require a loose or a special "purged" stool collection—a watery samplethat is observed under a special microscope. (The purging process may cause somediarrhea, but its mildly cleansing effect may have some benefit as well.) These parasiticinfections are quite common, even in people who do not travel outside the UnitedStates. The lab I currently use is the Institute for Parasitic Diseases (IPD) in Phoenix,Arizona; their findings correlate well with clinical symptoms. I look for parasites inanyone who presents with GI dysfunction (especially pain, gas, bloating, and nausea),allergies, fatigue, insomnia, teeth grinding at night, anxiety, or other psycho-emotionalsymptoms.
6) Intestinal Permeability
This is a simple test that measures the small intestine's ability to absorb needed nutrientsand discriminate against harmful substances. After drinking a solution comprisedof two sugars (lactulose and mannitol), a urine sample is collected and the levels ofthese two sugars are measured. Mannitol is normally absorbed at approximately 20%,while lactulose should be absorbed very little, if at all. People with increased intestinalpermeability absorb excess lactulose. This suggests that they also inappropriatelyabsorb other larger molecules due to damaged intestinal walls. Such absorption cancause secondary immunologic reactions and subsequent food allergies and intolerance.Working the 5R program will often normalize intestinal permeability. This test and theBreath Test have no side effects at all. The two mostly non-absorbable sugars mentionedabove occasionally cause temporarily loose bowels.
7) Breath Test for Small Intestine Bacterial Overgrowth
This test measures levels of hydrogen and methane gases in breath samples to assessbacterial overgrowth in the small intestine. Although this problem is more common inthe elderly, it should be considered for anyone with gas, bloating, diarrhea, or carbohydrateintolerance. Bacterial overgrowth can compromise health both in the GI tractand throughout the body and can lead to malabsorption, failure to thrive, anemia,weakened immunity, and increased risk of colon cancer (intestinal bacteria may produceadditional carcinogens). This test is suggested when the standard 5R approach isnot working effectively enough.
8) Detoxification Profile
This is a relatively new procedure that tests the detoxification functions of the liver.Our body must be able to metabolize and clear xenobiotics (environmental chemicals),endotoxins (generated from gut flora), and our own biochemicals (including hormonesand cholesterol). The Detoxification Profile measures two primary liver pathways:Phase I (oxidation and reduction, such as in caffeine metabolism) and Phase II (glycine,glutathione, and sulfate conjugation, as well as glucuronidation). Each demonstrates thepatient's ability or inability to detoxify certain types of chemicals. Test doses of caffeine,aspirin, and acetaminophen are given and then both salivary and urine samples aretaken and studied to identify the level of detoxification. The only concern with this testwould be any adverse reactions to the testing agents.
I use these tests judiciously whenever I see a patient with gastrointestinal concernsor systemic symptoms correlated with gastrointestinal dysbiosis, inflammation, or toxicity.After gathering information from these tests, I decide upon a course of therapywhich is often interdisciplinary in its approach. Detoxification practices—the focus ofthis book—are an important first step in healing, since many diseases are related tocongestion and toxicity from overintake and improper elimination.
A therapeutic regimen often includes dietary changes such as avoiding certain foodsor food groups and adding more fresh, high-fiber and low-fat fruits, vegetables, andwhole grains. I also address abusive habits and try to motivate my patients to give thistherapy a fair chance. Most modern-day abuses—Sugar, Nicotine, Alcohol, Caffeine,and Chemicals—are psychoactive substances which have mental and emotional effects.I believe that giving up at least the habitual use of these SNACCs (as I call them) isextremely important. I also promote chewing your food thoroughly along with regularand systematic undereating. If we make what we eat wholesome and nourishing, we willnot only add years to our lives, but life to our years. Choosing the right foods and dietfor ourselves, our activity level, and the climate in which we live is the key.
Other lifestyle and therapeutic activities for GI health include:
1. Learning to manage stress. Our sensitive digestive tract works better when we are calm.
2. Setting up an exercise program. Exercise improves digestive functions, stimulates lymphatic flow, and supports immune function.
3. Applying musculoskeletal therapies. This may involve osteopathic or chiropractic realignment of the spine and massage.
4. Using nutritional supplements and herbs.
5. Seeking professional advice on the use of pharmaceutical (or herbal) agents to remove infectious and harmful organisms, including abnormal bacteria, yeasts, and parasites.
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The 5R Plan
Let me now review the 5R Gastrointestinal Support Plan. This progressive therapeuticprogram normalizes the function, environment, and tissue health of the GI tractand must be tailored to the individual according to his or her particular evaluation.The five steps are:
1) Rebalance—your diet, your lifestyle, and your life. (This "R" added to Dr. Bland's4R Plan by my associate, Scott V. Anderson, M.D.) This is important as these areascontribute to health and the state of the digestive tract. Staying away from sugar,refined foods, and irritating substances such as caffeine and alcohol can make a big difference.Learning to deal with stress and developing coping and relaxation skills canhelp calm the GI tract and support better digestion and assimilation.
Changing habits is not easy. A nutritional counselor, psychologist, or hypnotherapistcan help by making us aware of the way old conditioning undermines our newpositive health habits.
2) Remove—any offending organisms, particularly pathogenic microflora and/or anyfood antigens that cause allergic and immunologic reactions.
At this therapeutic level, we evaluate and treat any organisms that do not belongin the human GI tract. These include Giardia lamblia, abnormal types or levels of yeastorganisms such as Candida albicans, and bacterial pathogens. Sensitivity testing (findingwhat therapeutic agents eliminate the specific microbe) can be done on most ofthese organisms to find the appropriate pharmaceutical or natural medications. Often,there is more than one type of pathogen, and a combination of medications may beneeded. Treatments will vary according to the practitioner's training. One useful bookis Guess What Came to Dinner by Ann Louise Gittleman; the author discusses thegreat prevalence of parasitic disease and the best ways, both natural and pharmaceutical,to treat each specific parasite.
We also encourage following an elimination diet that avoids allergenic foods andremoves irritating substances such as caffeine, alcohol, refined sugar, and flour.Following a "hypoallergenic" diet involves eliminating common food allergens suchas cow's milk, eggs, gluten grains (wheat, rye, barley, and oats), chocolate, coffee,and peanuts. Any food that is consumed regularly or over-consumed should also beeliminated. A diet of fruits, vegetables, rice and beans, fish, and poultry is usuallyan improvement for most people, producing a reduction of symptoms and an increasein energy.
3) Replace—inadequate amounts of hydrochloric acid (HCl), digestive enzymes, andpancreatic products. Fiber supplementation may also be necessary.
Nutritional substances in this category aid in food breakdown and in its subsequentabsorption into the bloodstream for travel to the metabolic factory of the liver.Proper digestion reduces the allergenic and inflammatory effects that occur from larger,more complex molecules.
The CDSA (Comprehensive Digestive Stool Analysis) helps identify digestionweaknesses and guides the practitioner and patient toward the proper replacementsupport. For instance, enzyme or hydrochloric acid insufficiency is common in peoplewho experience indigestion, gas and bloating, belching and flatulence, and the presenceof food particles in the stool. Yeast overgrowth is another problem, and shouldbe ruled out prior to treatment.
Excerpted from The Detox Diet by Elson M. Haas. Copyright © 1996 by Elson M. Haas, M.D.. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Copyright © 1995 Lissa Roche.All rights reserved.
|Before You Begin||v|
|CHAPTER ONE Gastrointestinal Health||7|
|CHAPTER TWO General Detoxification||21|
|CHAPTER THREE The Detox Diet & Other Diets for Detoxification||33|
|CHAPTER FOUR Supplements for Detoxification||41|
|CHAPTER FIVE Sugar Detoxification||48|
|CHAPTER SIX Drug Detoxification||56|
|CHAPTER SEVEN Caffeine Detoxification||66|
|CHAPTER EIGHT Alcohol Detoxification||76|
|CHAPTER NINE Nicotine Detoxification||89|
|CHAPTER TEN Fasting & Juice Cleansing||107|