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The Enteric Nervous System

by June Butlin(more info)

listed in colon health, originally published in issue 42 - July 1999

Part of my responsibility as a nutritionist is to keep updated with research, to furnish me with the knowledge and understanding that I need to help my clients achieve their health goals. This month I would like to share some interesting research with you involving the digestive system, which has given me more insight into gastrointestinal problems. However, it has also left me with many unanswered questions and lots of frustration!

Studies show that over 40% of patient visit their doctors for gastrointestinal problems, with complaints ranging from irritable bowel syndrome, abdominal bloating, and diarrhoea to constipation. Often there are no answers to these problems because of a lack of diagnosed anatomical or chemical defects. Doctors tell patients that their gut problems are imaginary, emotional, or all in their heads, attributing their problems to brain malfunction. Needless to say, the quality of life for these patients will be not be ideal until their problems are understood, and a cure is found.

Part of the answer to some of these problems may be found in Dr. Michael Gershon's research. Dr. Gershon is a professor of anatomy and cell biology at Columbia-Presbyterian Medical Centre in New York, and he has proved that we have two brains, the one in the skull, and the one that is found in the human gut. The gut's brain is found in the many nerve cells contained in the tissue lining of the oesophagus, stomach, small intestine and colon, and is called the enteric nervous system. In fact there are over one million nerve cells in the small intestine, a number equalling the number of nerve cells in the spinal cord. If we add the nerve cells of the oesophagus, stomach and large intestine, there are more nerve cells in the gut than there are in the entire remainder of the peripheral nervous system. Nearly every chemical that controls the brain in the head has been identified in the gut, including hormones and neurotransmitters.

This complex circuitry provides the brain in the gut with the means to act independently. Proof of this can be seen in stroke victims whose brain stem cells, which control swallowing, have been destroyed. If this occurs, a surgeon has to create an opening in the abdominal wall, so that feeding can be accomplished by manually inserting foods directly into the stomach. Once the food is in the stomach, digestion and absorption can take place, even in individuals who are brain dead. The central nervous system is needed for swallowing and for defecation, but from the time the food is swallowed to the moment its remains are expelled from the anus, the gut is in charge.

The enteric nervous system produces those gut feelings that we have all felt from time to time. Nervous thoughts can cause butterflies in the stomach, psychotic thoughts may result in eating disorders such as anorexia nervosa and bulimia, and anxious thoughts can cause diarrhoea. Dr. Gershon goes as far as to say that "the gut may be more intellectual than the heart and may have a greater capacity for feeling". He also believes that the many gastrointestinal problems originate from imbalances within the gut's brain.

An understanding of the enteric nervous system should help to provide cures for gastrointestinal problems, but all is not known and that is where the frustrations lie.

The two areas that are well researched and that I would like to consider in terms of nutrition are stomach acid and serotonin levels in the body. High stomach acid produces problems such as heartburn, reflux oesophagitis and ulcers. Acid forming foods, anxiety, psychological stress, and a badly functioning enteric nervous system can increase acid levels. The stomach has the ability to regulate its own acidity so taking self-medication of alkaline formulas such as "milk of magnesia ", will only prompt the gut's brain to produce more acid through the chemicals gastrin histamine and acetyl choline. This sets up the perpetual cycle of suppression and elevation of acid levels. Certain medications can help to control acidity such as H2 (histamine) blockers, Zantac and Tagamet, and Omeprozole, which totally prevents stomach acid being released. These drugs have side effects and it may be wise to try natural methods first.

These would include eliminating food allergies and sensitivities, acid forming foods such as dairy, meats and grains, and following a quality wholefood diet. Also therapies to relieve stress and tension, and to enhance relaxation may help.

The second area to consider is a neurotransmitter called serotonin, which is found in small amounts in the brain, and in huge amounts in the enteric nervous system. Serotonin is calming to the digestive tract, initiates peristaltic and secretary reflexes, and sends messages from the gut to the brain. Manipulating the action of serotonin with drugs, foods or nutrients helps to relieve some of the symptoms of functional bowel diseases. Prozac, a selective serotonin reuptake inhibitor which raises serotonin levels, has gained recognition in the medical profession for the treatment of depression and bowel problems. However, long-term use or the wrong dosage may cause fluctuations between nausea, vomiting, constipation and diarrhoea, and can cause depression, anxiety, insomnia, and fluctuations in appetite. A more natural way to rebalance serotonin levels would be through nutrient intake. For example depression associated with low serotonin levels can be relieved with foods containing tryptophan, vitamins B3, B6 and iron. An excess of serotonin involving inflammation can be relieved by one or more of the following nutrients: magnesium, zinc, vitamin E and all antioxidants, eicosapentanoeic acid, tumeric, ginger and bromelain. Foods that contain significant amounts of serotonin are avocado, banana, kiwi, pineapple, plantain, plums, eggplant, tomatoes, butternut, pecans and walnuts. The herb, Hypericum also known as St John's Wort helps to rebalance serotonin levels without harmful side effects.

There is not enough research to produce all the answers for healing gut problems, but therapies aimed at the gut's brain rather than the head may work for those suffering from gastrointestinal problems of unknown causes. Without a doubt relaxation techniques and emotional stability will help all gastrointestinal problems.

References

The Second Brain Michael D. Gershon MD Harper Collins 1998 ISBN 0-684-81981-3
Total Wellness Joseph Pizzorno ND Prima Publishing 1996 ISBN 0-7615-04338
Understanding Normal and Clinical Nutrition Whitney, Cataldo and Rolfes West Wadsworth 1998 ISBN 0-534-533345

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About June Butlin

June M Butlin PhD is a trained teacher, nutritionist, kinesiologist, aromatherapist, fitness trainer and sports therapist. She is a writer, health researcher and lecturer and is committed to helping people achieve their optimum level of health and runs a private practice in Wiltshire. June can be contacted on 01225 869 284;  junebutlin@btinternet.com

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