The 1st Step to Healing your Gut is..
Understanding How your Gut Functions
I’ve spoken to so many patients who have bounced from specialist to specialist, trying to figure out why they feel bloated or have diarrhea or constipation and aren’t getting better from conventional medicine. After they have gone to multiple doctors they often hear the common line- “Your blood work or your colonoscopy was normal, it’s all in your head”, or “Take an anti-depressant”. But they still feel like something is off.
So they keep digging on their own, using “Dr.Google” which can create more health issues than it solves! Some people become hyper focused on their health because they can’t find any answers from their doctor and all they can think about is why their stomach isn’t working right. And sometimes they find me or one of my colleagues in Naturopathic Medicine and maybe they get help, but unfortunately, most don’t. The last thing that people should be left with is a feeling of hopelessness and frustration that their bloating, diarrhea, or constipation will never go away.
Understanding your Gut
The very first thing you need to know about the healing process has everything to do with understanding the physiology of your gut health. Basically how it functions in a normal state.
Did you know that 70% of your immune system cells reside in your gut? Your gut is a barrier to the outside world and is in direct contact with the food that we eat and the bacteria that we are exposed to on a daily basis. We rely on our gut to not only keep us nourished but also to keep us healthy and free of infections.
Your gut is known as the second brain because it contains 200 million neurons. This is how many nerves there are in the entire brain of a cat. The gut has the ability to function totally on its own. This is because the gut has its own nervous system, the enteric nervous system that works totally independently from the brain.
Your Gut and Brain are Connected
What happens in the gut does not stay in the gut though, & this is why the gut-brain connection is important for our health & hormones, especially our brain hormones!
Chewing your food is step one, and this is really the only mechanical digestion that ever happens. Mechanical digestion just means that this is the only physical breakdown of food from force, the rest of digestion is chemical. This is also why chewing well is really important.
After you chew your food it passes from the mouth to the esophagus and then into the stomach. The stomach is a storage vessel to control the rate that contents can be moved to the small intestines. The stomach is also where hydrochloric acid and pepsin are released. Your stomach’s pH is about 1.5. To put this into perspective the pH of water is about 7. Our blood’s pH is about 7.4 and a battery acid has a pH of around zero. So 1.5 is very acidic. It’s more acidic than lemon juice!
Pepsin is a digestive enzyme and both the pepsin and the hydrochloric acid produced in the stomach help to break down our proteins like the chicken that we ate. The acidic environment of the stomach is also crucial for killing bacteria and breaking apart other toxins that might have gotten in through our food. It is a defense mechanism. This is why having enough stomach acid is so essential. We need the low pH of the stomach to break down our food, and to kill potential pathogens to prevent and overgrowth of bacteria.
Once food is all mixed up by the stomach and acidic enough it slowly enters the small intestines. The small intestines is called small because of its diameter, not because of its length. The small intestines is about 15 to 20 feet long. It needs to be this long, because this is where the majority of the absorption of nutrients occurs in the GI tract. Vitamins and macronutrients like carbohydrates, proteins and fats are absorbed here. In order to do this the small intestines has tiny finger-like projections called villi and on these vili there are microvilli- even smaller projects.
These little out pouches increase the surface area of the intestines so that we can absorb all of the nutrients we need. These folds make the small intestines 30x the surface area that it would be without these little finger projections. If you flattened out the small intestines it would have the same surface area as a tennis court!
Ideally these finger-like projects are nice and long and healthy so that we can absorb all of the nutrients that we need. When the food mixture enters the small intestines it is greeted by digestive enzymes that are released from the pancreas as well as bile that is released from the liver. The contents are neutralized and made less acidic from here on out.
Enzymes are Essential for Gut Health
The enzymes made by the pancreas are responsible for breaking down our chicken or protein into amino acids, they break down the sweet potato or our carbohydrates to simple sugars like glucose and they break down fats like olive oil to shorter fatty acid chains. Pancreatic enzymes are so important, they do a large majority of the digestive process. And what causes the release of these enzymes? Acidic material in the small intestines triggers our pancreas to release these enzymes, this is why having a low pH and plenty of acid in the stomach is so important. This is also why long term use of medications that block stomach acid can be really problematic for gut health.
The other thing that we use to digest our food comes from the gallbladder. The bile that is released from the liver is stored in the gallbladder until it is needed. Bile is responsible for acting like a detergent to further emulsify our fats so they can be absorbed by the body. If bile is released ineffectively then they may experience diarrhea because those fats are not getting absorbed. And when you have too much fat in your stool, well let’s just say that accidents can happen.
This is why some people who have had their gallbladder removed experience digestive issues.
If you haven’t noticed it is really important that HCL, pepsin, and pancreatic enzymes are released to help us break down our foods so we can absorb it.
But how does our body know to release these compounds?
Acetylcholine is a key neurotransmitter of the parasympathetic nervous system, or our rest and DIGEST nervous system. This means that if we are not in a relaxed state when we eat then the proper amount of digestive enzymes and HCL are not released and our food might not be broken down as efficiently leading to indigestion, reflux, diarrhea, constipation or belching. You will hear me say this over and over again but a lot of GI conditions are likely caused by a disruption in the nervous system like low parasympathetic tone causing us to be in fight or flight all of the time.
After the food passes through all 15 feet of small intestines it gets to the entrance of the large intestines or the colon. This is a much larger diameter tube that is about 5 feet long and in this tube we absorb the rest of the water to make solid stool, or poop. This seems simple but this is where we can have some issues. The rate of motility of the intestines will determine the consistency of your poop. If things are moving too quickly then not enough of the water will be absorbed and you can get loose stools.
On the flip side, if things are moving too slowly then too much water will be absorbed and you are left with those little hard rabbit pellets. The rest of the nutrients are absorbed in the colon but most of that happened in the small intestines. The colon serves another big purpose though. It is the main storage container for our gut-microbiome.
Back to our chicken, broccoli and sweet potato, these foods are now looking a lot like poop and they will finally make their way across the colon and through the rectum into the toilet. Mission accomplished!
We just covered a lot of the physiology behind the gut but as you can see, it helps us to truly understand how things can go wrong in the gut when we understand the “how” behind it all.