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If you have gut health issues such as inflammatory bowel syndrome (IBS), leaky gut, chronic bloating, or constipation, you need to work north-to-south to identify and address problems.
Disruptions at any stage of the digestive process have a domino-like effect, preventing every following step from functioning as it should.
This is why jumping right into probiotics or other single-supplement solutions may not yield positive results. Is the problem with your microbiome? Your stomach acid? Gallbladder? Pancreas? Small intestine?
Every stop along the movement of food through the GI tract needs to be evaluated to evaluate from where problems arise.
The starting point of gut health
Just seeing, smelling, and even thinking about food jumpstarts digestion.
For example, your pancreas immediately starts releasing insulin if you think about eating something sugary and sweet. Imagining eating something bitter or high in protein causes the production of small amounts of hydrochloric acid. Your body begins to prepare for digestion before you’ve even taken your first bite.
One of the key first steps is the production of saliva, which helps break down food and signals that your brain is engaged in the digestion process.
The moment you start to chew, you activate:
- The brainstem and cranial nerves involved in the production of saliva
- The process of swallowing
- Blood flow to the gut
- The release of digestive enzymes
If you notice that you’re always the last one to finish a meal, have a chronic dry mouth, or need to drink lots of water to finish eating, you may have an issue with saliva production.
This could be caused by problems with either your saliva glands themselves or with certain brain pathways.
Some patients with autoimmune diseases such as Hashimoto’s or rheumatoid arthritis produce antibodies to their own saliva glands. Uncontrolled diabetes and hypertensive medications can also lead to less saliva production.
Problems with swallowing a gut health red flag
Another red flag that something is wrong with the early stages of digestion is difficulty swallowing.
The act of swallowing involves the glossopharyngeal and vagus nerves in the brain, which is why issues swallowing and chronic constipation can indicate problems in the upper brainstem.
The most common cause of these kinds of issues is the early onset of neurodegenerative conditions like Parkinson’s disease.
Tremors can take many years to develop as a symptom, but trouble swallowing, stiffness, and rigidity are common early signs of diseases like Parkinson’s.
Hydrochloric acid as a factor in poor gut health
If you constantly feel like you have a brick in your stomach after eating, then you might not be producing enough hydrochloric acid. Constant bloating and indigestion after eating high-protein foods is another major red flag.
This is because hydrochloric acid helps break down proteins and creates the acidity necessary to trigger the rest of the gastrointestinal tract. An acidic pH balance also sterilizes the rest of the gut so you’re less susceptible to bacterial overgrowth and pathogens.
People don’t produce enough hydrochloric acid for a variety of different reasons, but the key way to fix it is to start taking a hydrochloric acid supplement.
You can learn more about evaluating hydrochloric acid in my free guide, the Apple Cider Vinegar Challenge.
Pancreatic enzymes and gut health
The next reflex triggered by sufficient hydrochloric acid from the stomach is the release of pancreatic enzymes, which further digest foods.
If you notice bloating and distention after eating foods high in protein and starch, then your body might not be releasing adequate amounts of these enzymes.
Low stomach hydrochloric acid can prevent sufficient release of pancreatic enzymes. Hypothyroidism, brain issues, inflammation, blood sugar imbalances, and poor diet can also play a role.
Gallbladder sludge and gut health
If your gallbladder isn’t working as it should, then you’ll have difficulty processing foods high in fat.
Symptoms can include bloating, nausea, and indigestion after eating fats. Some people also experience pain under the right rib cage.
A hallmark symptom of poor gallbladder function is burping up fish oil.
Many people have what’s commonly called “gallbladder sludge,” a precursor to gallstone formation.
When this sludge develops in the gallbladder, it becomes inefficient at releasing bile into the small intestine to emulsify fats.
This is actually one of the most overlooked gut issues, especially in women. Many female patients unknowingly suffer from gallbladder conditions and they simply learn to live with them by completely cutting fatty and fried foods from their diet.
The next destination in the north-to-south journey is the small intestine.
Chronic inflammation in the gut prevents microvilli, small protrusions that line the small intestine, from properly absorbing nutrients. This increases permeability of the lining of the gastrointestinal tract, often referred to as leaky gut.
The break down of the gut lining triggers an inflammatory response that goes on to disrupt the microbiome and the large intestine. In fact, a leaky gut creates a whole host of problems in the north-to-south model and a single-supplement solution such as a probiotic isn’t going to do much to fix it.
The most common cause of a leaky gut is a pro-inflammatory diet; a diet high in sugar, carbohydrates, and without enough vegetables.
Microbiome diversity and gut health
If you’ve investigated all earlier phases of digestion and found no issues, that is when you can begin to consider the health of your microbiome.
Bacteria in the gut can heavily impact our risk of inflammation. During the Human Microbiome Project, scientists found that there isn’t a single bacteria that makes a significant difference between good health and disease.
While there are some bacteria that are more helpful or hurtful than others, the true dominant factor is the diversity of bacteria in the gut.
This is where a diverse diet with an ample variety of vegetables and low-glycemic fruits can really help. Fermented foods also have a tremendous impact on the population of bacteria in the microbiome.
Working north-to-south is the most important concept to understand when working with gut health issues. The first step is to properly identify which part of the system is malfunctioning.
The first step is saliva production. As you produce saliva, you actually engage your brainstem to activate other cranial nerves that are involved with swallowing, blood flow, enzyme production, and gastrointestinal motility.
As food enters the stomach, hydrochloric acid is released to break down proteins, neutralize the GI tract, and trigger the pancreas to release enzymes to break down starch. The gallbladder is then stimulated to release bile. Microbiome health in the large intestine further promotes good digestion and gut health.
Breakdown of any part of that process is going to cause chronic GI issues. This is why a single-supplement or probiotics might not be the answer to your gastrointestinal issues.
Learn how to identify and address your areas of gut health breakdown in my online course Gut Health: Solving the Puzzle.