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Digestive Disorders: From Acid Reflux, Heartburn, and IBS, to Coeliac and Ulcerative Colitis

by Dr Sam Shohet(more info)

listed in colon health, originally published in issue 155 - February 2009

A Whole System Approach

It may well be that the signs and symptoms of heartburn or reflux appear to be confined to the stomach, Coeliac to the small intestine, ulcerative colitis to the large intestine, and those of Irritable Bowel Syndrome, IBS, to the stomach, the small intestine and the large intestine. However, the ramifications extend much deeper and farther afield than the simple confines of the digestive tract.

A whole system approach is to view the signs and symptoms of indigestion as a two-way process: On the one hand, digestive problems could arise, for example, as a result of an emotional imbalance or even perhaps a mineral/vitamin deficiency; on the other hand, digestive problems themselves could, in fact, lead to neurological or cardiovascular disease.

The Digestive System
In other words, we should be looking for what is causing the digestive problem, as well as for what the digestive problem itself is causing.
 
After all, it is only when we become fully conversant with this process that we are able to restore and maintain a good state of gut health which, in turn, should reflect the state of our general health.

A Journey

To understand this better, let us take a journey along this long tube we call the bowel, which has a total surface area equivalent to that of a tennis court and contains 2.5 kilograms of foreign cells, including parasites, bacteria, viruses and fungi which, altogether, account for more cells in our gut than the total number of cells in our entire body.

While on this journey, let us take an all-encompassing look at each section in turn, combining the understanding and philosophies of both Western and Eastern Medicine perspectives in an integrated approach.  

But before we embark, there are a number of fundamentally important systems that require some explanation in order to make an already exciting trip even more memorable.

Meridians

In Chinese Medicine there are 14 major meridians or energy channels, which interact with each other to make sure that the body maintains a balanced state at all times. After all, it is only when this state goes out of balance that we begin to feel unwell, and eventually develop illnesses we call diseases or conditions.

Peak Performance

The energy of two of those meridians that maintain balance, the Governor Vessel running up the spine and the Conception Vessel running down the midline of the front of the body, is switched on fully all the time, 24/7. This is essential to ensure there is always power in the system for as long as we are alive.

The energy in the other remaining 12 meridians, however, tends to ebb and flow throughout the day. But each individual meridian has a two-hour window when its energy reaches a peak. Therefore, in a 24-hour-day the meridians reach their peak one after the other in a specific pattern.  We call this the circadian rhythm or daily cycle, and is of special importance, especially when choosing the most effective time of day to deliver treatment in the way of supplements, herbs, drugs, or even therapy, such as acupuncture, massage, exercise, or perhaps chemotherapy, for each individual.

The Chinese Clock
MERIDIAN HOURS
Lung 03-05
Large Intestine 05-07
Stomach 07-09
Spleen 09-11
Heart 11-13
Small Intestine 13-15
Bladder 15-17
Kidney 17-19
Pencardium 19-21
Triple Warmer 21-23
Gall Bladder 23-01
Liver 01-03

Energy of Meridians

We know that Acupuncture works, and the way it works is no longer a mystery. We now know that the energy of each meridian equates to a known neurotransmitter, a chemical protein released in our brain that is carried along nerves to every cell in the body telling the cells what to do. It is our inner intelligence if you like, an intricate system where even a thought is converted into a physical result or outcome. This is the way the brain controls the body and how the cells of the body interact with one another.   

  Meridian/Neurotransmitter Translation
MERIDIAN NEUROTRANSMITTER
Lung High GABA (gamma amino butyric acid)
Large Intestine Low GABA
Stomach Low Histamine
Spleen High Histamine
Heart High Noradrenalin
Small Intestine Low Noradrenalin
Bladder Low Serotonin
Kidney High Serotonin
Pencardium High Excitatory
Triple Warmer Low Excitatory
Gall Bladder Low Acetylcholine
Liver High Acetylcholine
Governor Vessel  High Dopamine/Estrogen
Conception Vessel Low Dopamine/Estrogen

With this knowledge at hand, let us now set off on our incredible journey.

Digestion

Although, technically-speaking, the digestive tract starts with the mouth, in terms of acupuncture meridians and Chinese Medicine philosophy, the digestive tract starts with the stomach, and it is also more logical to commence our journey here.

The Stomach 

Low Histamine 07-09

Breakfast Time
The peak time for stomach function is interestingly between 7am and 9am: breakfast time. This is the time when hydrochloric acid output should be at its peak and presents the best conditions for the breakdown and digestion of proteins and fats. This should, therefore, be the best time for the traditional English breakfast and, the best time for the traditional American astronaut's breakfast of steak and chips!

Heartburn
Believe it or not, and contrary to common thinking, heartburn is a sign that there is insufficient hydrochloric acid and not an excess. Apart from digestion, hydrochloric acid is necessary to deal with pathogens or infective organisms, such as bacteria, parasites, viruses and fungi, as well as foods the body is not able to tolerate, wheat and dairy for example, which seem to give the most problems.

The stomach's inability to deal with all this at a time when stomach acids should be at high levels, results in inflammation of the lining of the stomach. Once this irritation sets in, it is made worse by even the smallest amount of acid which triggers the pain and discomfort of heartburn.

Antacids
Antacids only help for a very short period of time, but they mainly exacerbate this situation since they neutralize what little acid there is. This in turn sends a false signal to the stomach that it is not producing enough acid and tries to correct it by producing more acid, making a bad situation worse by perpetuating the inflammation. The stomach then responds to this increased insult by reducing the acid production even further, making us less able to deal with infections and the proper digestion of food.

Immune System
Let us extrapolate this further. Stomach time is also the time when the body's defences should be at their peak, considering it would be dealing with parasites and bacteria which normally come in tandem with food. It would, therefore, make sense to make sure that not only are the parietal cells from which hydrochloric acid, as well as the other digestive aids in gastric juices including intrinsic factor (essential in the absorption of vitamin B12) and complement (immune system protein) is made, remain at peak function, but also that our white blood cells have all the nutrition they need to stay alert and in full strength.

Helicobacter Pylori
With a low immune system and reduced production of hydrochloric acid, there is every chance that in some people a resistant form of what is essentially a commensal (a usually neutral organism) inhabitant of the gut, Helicobacter pylori, could become a serious infectious threat to the body requiring outside intervention.

Unfortunately, treatment with antibiotics would not only upset the delicate balance of the good bacteria, the probiotics, and the bad bacteria, it would further create resistant forms of micro-organisms with potentially dire consequences. 
    
Zinc
Hydrochloric acid is formed by the enzyme carbonic anhydrase in the stomach - carbonic anhydrase forms sodium bicarbonate in the pancreas - and is a zinc dependent enzyme, which means it works best when the level of zinc in the body is optimal.

Zinc is also an essential part of well over 100 enzymes in the body connected with processes as varied as immune function and reproduction.

Nausea
Low levels of hydrochloric acid leads to nausea, including morning sickness and nausea in pregnancy. It is therefore important to ensure an adequate intake of zinc to power carbonic anhydrase for the production of hydrochloric. Unfortunately, intensive farming techniques, and massive flooding during the last couple of decades has meant that zinc is no longer present in sufficient quantities in our food to satisfy all the systems that require zinc for normal functioning, and must, therefore, be supplemented.

The type of zinc, as well as the amount required by each person, must of course be assessed by a professional. 

Histamine
Since the stomach meridian is synonymous with low histamine (see chart above), and histamine is essential for so many important functions including sexual arousal, alertness, motor activity (muscle function) as well as immune system defence and digestion, it is perhaps most apt to ensure that it is produced in sufficient quantity to fulfil all of these functions.

Vitamin B6
Histamine is made from the amino acid histidine using an enzyme with vitamin B6 as its co-enzyme (an accessory tool to help it work). Low levels of Vitamin B6 may, therefore, lead to similar symptoms of nausea associated with low hydrochloric acid.

Vitamin B6 is also required for tissue repair, and especially the mucous membrane lining of the digestive tract. Insufficient quantities of B6 often result in a breakdown of this lining and ulcers, including mouth, gastric and duodenal ulcers, will result.

The type of vitamin B6: pyridoxine or the active form of pyridoxyl-5-phosphate, better known as P5P, as well as the amount and the best time to be taken, should always be assessed by a professional and certainly not left to guesswork. 
 

The Small Intestine

Low Noradrenalin 13-15
 
Lunch time
The peak time for the small intestine is between 1pm and 3 pm, and ideally the time that most of us should be having our lunch. This is also the time when it is best to eat carbohydrate and fat since the most active enzymes at work are those of the pancreas and bile, which are required for their digestion respectively.

Noradrenalin
Since the small intestine meridian is synonymous with low noradrenalin (see chart above), which is associated with depression, lack of 'get up and go', dementia, delusions, delirium, memory impairment, low blood pressure, short sightedness and even Asthma, it is perhaps most apt to ensure that it is produced in sufficient quantity to fulfil all of these functions.

Initially made from the protein tyrosine, the enzymes producing noradrenalin depend on folic acid in several forms, as well as vitamin B6, zinc, magnesium, copper, vitamin C and vitamin B12 for proper functioning.

Lethargy
Eating too much protein during this time will inevitably lead to inability to digest it properly, and undigested protein creates a surge in free radicals which, with low noradrenalin levels, leads to the typical lethargy experienced after a heavy lunch.

Also, should production of the enzymes of the small intestine not be sufficient to digest carbohydrate and convert it to energy-producing sugar in the bloodstream, we would experience another low in blood sugar levels and what is commonly called hypoglycaemia.    

pH
The highly acidic hydrochloric acid produced in the stomach must be neutralized by the time it reaches the small intestine, since proper absorption of nutrients within the small intestine can only take place in an alkaline or neutral medium. The same enzyme, carbonic anhydrase, which produces hydrochloric acid in the stomach, produces sodium bicarbonate in the duodenum, the first few centimetres of the small intestine. This raises the pH to about 8 from 1.5-2 in the stomach, and the same factors that were important in the proper function of carbonic anhydrase, namely the mineral zinc, play a big role here.

Gout 
Problems in the production of sodium bicarbonate mean that the medium within the small intestine and, therefore, the rest of the body, will remain acidic. This acidity may give rise to the formation of crystals of amino acids mainly within joints, such as the big toe, leading to what would be diagnosed as gout.

A simple treatment would be to alkalize the gut by taking sodium bicarbonate and, of course, not forgetting to ensure adequate quantities of zinc. This process must be properly supervised by a professional.

Liver/Gall Stones

In the case of low production of hydrochloric acid, pathogens are allowed to reach the small intestine unchallenged, and create a localized infection.

When this infection tracks up the bile duct to reach the gall bladder, the resulting inflammation can sometimes create a focal point upon which a chemical reaction takes place, and a deposit of minerals is formed in much the same way as stalactites and stalagmites in caves. These hardened deposits end up as gall stones.

Cholesterol crystals from the liver may also build up around pathogens, only this time within the liver ducts to form liver stones.

There is a simple and natural therapy available, which is drug and surgery free, for the treatment of both liver and gall stones.
  
Diabetes
Should the pathogens track up the pancreatic duct, they may create an infection within the pancreas. The resultant inflammation may precipitate an auto-immune response within the insulin producing cells, the islets of Langerhans, reducing their production and precipitating a type 1 diabetic condition.

Inflammation within the pancreas may also give rise to breakdown within the control mechanism of insulin by desensitizing it. This would result in type 2 diabetes or insulin resistance. 

Bile and Cholesterol
The liver opens into the small intestine and delivers bile, which is a combination of cholesterol and the amino acid Taurine.

Bile is essential for breaking down fat into small droplets in a process called emulsification. This enables fat to be absorbed, and for the liver to form cholesterol from which bile is subsequently made - a lovely cycle and one of so many within the body's exotic and varied biochemical magic.

Apart from bile, cholesterol is the source and cornerstone of many essential processes and systems in the body, such as the lining or insulating material of nerves and membranes of the brain, the formation of all hormones including steroids and the sex hormones and more besides. In fact, the longest living people in their 90s and 100s have been shown to have the highest levels of cholesterol in their blood!

High intake of cholesterol-containing foods, as myth has it, cannot equate to an increase in blood cholesterol. Since the liver makes cholesterol from fat in the diet, a high intake of dietary cholesterol will simply result in the liver reducing its production, not increasing it - almost all processes in the body are self limiting.

Allergy/Intolerance
The small intestine is where food intolerances and specific food allergies are first identified by the body. The ensuing reaction to these foods depends on the release of noradrenalin. A slow release results in the mild reaction we call intolerance, whereas a violent reaction we associate with the life and death emergency of a full-blown allergy.

The Large Intestine

Low GABA 05-07

Ablution Time
Although in digestion terms the large intestine is the last section of our journey, in Chinese Medicine it signals the start of the day when we need to expel all waste matter collected throughout the previous day and night.

GABA (Gamma Amino Butyric Acid)
The large intestine meridian is synonymous with low GABA (see chart above).

GABA acts as the neurological 'brake' that controls the speed at which all functions in the body are carried out.

It is initially made from Glutamate, and the enzymes producing it depend on vitamin B6, zinc and magnesium to drive them.

Low GABA is associated with symptoms of Glutamate excess, such as epilepsy, convulsions, tetany and spasticity, as well as a host of other brain disorders.

Fluid Absorption
Fluids in general, and water in particular, assist the functioning of digestive enzymes and help to lubricate the passage of food through the digestive tract. During their passage, fluids also collect water soluble waste, diluting it to safe levels should it become necessary.

While fluids are mostly absorbed in the small intestine, water is absorbed exclusively in the large intestine which is its major function.

Diarrhoea and Constipation
The large amounts of water secreted into the stomach and small intestine by the various digestive glands must be reclaimed to avoid dehydration. If the large intestine becomes irritated, it may discharge its contents before water re-absorption is complete causing diarrhoea. On the other hand, if the colon retains its contents too long, the faecal matter becomes dried out and compressed into hard masses causing constipation.

Pathogens and Probiotics
While the contents of the small intestine are normally sterile, the colon contains an enormous population of microorganisms comprising mainly bacteria, both pathogenic and beneficial, such as the probiotics.

The large intestine is also the place where parasites and fungi abound and exist in balance with the probiotics. However, the use of antibiotics in our foods, antiseptics in soap and antibacterials in surface cleaners, has resulted in creating a serious imbalance by killing the beneficial bacteria and allowing the parasites and fungi to thrive. This gives rise to many diseases and debilitating conditions, ranging from candidiasis and thrush to parasitic infestations.

Migraine Headaches and Emotional Disturbance
Dehydration is one of the most important triggers of headaches in general and migraines in particular. In fact, by the time you actually feel thirsty you are already well on the way to being dehydrated. Remember that the classical signs of dehydration are a headache, irritability as well as lethargy and tiredness.

Vitamins
The body cannot function at all without enzymes, and enzymes cannot function at all without vitamins and minerals. As vitamins are mainly absorbed in the large intestine, it is, therefore, imperative to make sure that nothing interferes with, or hinders, this process.

The major factors that prevent proper absorption and function of the gut in general, and the large intestine in particular, are toxins in the form of chemicals such as pesticides, herbicides, preservatives, colouring and flavouring. Soft drinks, toxic metals, such as dental amalgam fillings, lead, arsenic, cadmium and aluminium, and radiation, including microwaves from mobile phone masts and wireless communication systems, also contribute to this problem.

Food intolerances such as those to wheat and dairy also present an obstacle to proper absorption as do infections, especially parasites.

Conclusion   

This has by no means been a comprehensive journey through the digestive tract, since to do it justice would have required hundreds of pages of print, and would have had to cover every aspect of human physiology and biochemistry.

Our journey was a taster to highlight the interconnectedness of all organs of the body, and the importance of a comprehensive and holistic approach in assessing problems of digestion whether they arise within the gut or outside it.

With even more neurotransmitters than the main brain, it is no wonder that the gut has been known for centuries as our 'Second Brain'!

Further Information

For details of the Integral Health Hair Test which is 98% accurate and establishes the root 'cause' of a health condition contact Estelle on Tel: 01483 522133 (direct line) or Tel: 0207 467 8322.  Integral Health offer a full support service for practitioners who wish to use the hair test for their patients. Dr Shohet may be contacted via Tel: 020 7467 8322 / 01483 522133; info@integralhealth.org    www.integralhealth.org

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About Dr Sam Shohet

Dr Sam Shohet BDS MGDS RCS(Eng) LiAc MBAcC ICAK is Technical and Clinical Director of Integral Health at 10 Harley Street, London.  Dr Shohet started in oral surgery and anaesthetics, then general practice; he was one of the first dental practitioners to qualify for Membership of the Royal College of Surgeons. He worked in orthodontics in Germany at a holistic group practice; on return to the UK he studied Acupuncture, Homeopathy, Biomagnetics, Nutrition, Functional Medicine and Applied Kinesiology. For details of the Integral Health Hair Test which establishes the root 'cause' of a health condition,, or if you are a practitioner and would like to use the hair test for your patients, contact Tel: 0207 467 8322/ 01483 522133; info@integralhealth.org     www.integralhealth.org

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