Food fuels us, but our gut makes energy possible by properly processing the food we eat. How do you know if your digestive system is in good working order? By the absence of recurrent symptoms such as bleeding, bloating, constipation, diarrhea, heartburn and belly pain. Good digestion is vital to good health—what’s good for your gut is also good for you.
[cranberries]
“CRANBERRIES ARE POPULAR BECAUSE THEY CONTAIN HIGH AMOUNTS OF ANTIOXIDANTS, which slow down the effect of free radicals on healthy cells,” says CHERYL HOARD, OWNER OF CHERYL’S HERBS. Free radicals are toxic compounds produced naturally by the body and the environment, contributing to aging and associated chronic diseases, including diabetes and heart disease. “Antioxidants disarm free radicals—and fight cancer,” she says. Cranberries also are high in vitamin C, an antioxidant important for immune function, she adds.
“We carry a sugar-free cranberry extract made from fresh organic cranberries,” Hoard says. “Some people add a few drops to water or just splash it on their tongue. It’s good for the gums—according to the American Dental Association, the vitamin C in cranberries helps control gingivitis and inhibits dental plaque. They also help improve skin tone and elasticity.”
[irritable bowel syndrome]
DR. PRAKASH GYAWALI, GASTROENTEROLOGIST, WASHINGTON UNIVERSITY:
Irritable bowel syndrome is a condition in which there is pain associated with an alteration in bowel function. This alteration can manifest as diarrhea, constipation or bloating, or a combination of symptoms. IBS is diagnosed by a pattern of symptoms that cannot be explained by another condition and by the absence of a physical cause. Consequently, some patients incorrectly believe that because their doctor didn’t ‘find’ anything on a medical test, the diagnosis of IBS must be wrong and the physician should keep looking.
IBS patients have a gut that’s hypersensitive to increased or decreased bowel movements. Treatment is based on the dominant symptom and its severity.
If symptoms are simple and occasional, an antidiarrheal medicine or laxative might suffice. Patients with more severe symptoms are treated with medications that target the intestines. They might force the bowels to produce more fluid or improve sensation for better control. Patients with severe IBS are treated with therapies that alter the messaging system between the intestines and the brain. This pathway is overstimulated in IBS patients. Antidepressants and psychotropic (psychiatric) drugs are used to readjust nerve-impulse transmission.
DR. CHRISTINA ROBINS, DIRECTOR, REVITALIFE WELLNESS CENTER:
Irritable bowel syndrome is a broad, generalized label given to people who have a functional rather than an anatomic problem of the gastrointestinal (GI) tract. We can’t find a faulty mechanism and the GI tract does not sustain damage.
Because IBS is a multifactorial disorder, there’s no one-size-fits-all solution. Treatment depends on the differential diagnosis, which is based on symptoms. Possible differential diagnoses include malabsorption patterns, leaky gut, a bacterial overgrowth and food intolerance (but not food allergies) to gluten, gliadin, fructose, lactose and dairy products. After we’ve identified a differential diagnosis or two, we determine the test that’s needed to deny or confirm the suspected cause. For example, food intolerance is confirmed with blood or breath tests, whereas a complete digestive stool analysis gives multiple gut specifics.
Although there is a gut-brain connection, there also are diagnostic biases with IBS. A common one is that the patient is ‘anxious.’ While stress or depression can make your gut more sensitive, other conditions also can cause digestive discomfort.
[a peek inside: optical vs. virtual colonoscopy]
DR. JASON TAYLOR, GASTROENTEROLOGIST, SLUCARE:
Patients today have a variety of colorectal cancer-screening options. They include standard or optical colonoscopy (an examination of the entire colon and rectum), a sigmoidoscopy (an examination of the lower rectum and colon), a double barium enema, or fecal-occult blood tests. A CT colonography, otherwise known as a virtual colonoscopy, is a screening modality approved by the American Cancer Society in 2008. Today the U.S. Multi-Society Task Force on Colorectal Cancer and several medical societies also recognize it as an acceptable screening option. In fact, 22 states, including Missouri, now mandate that insurance carriers reimburse for it.
Everyone should have a screening colonoscopy when they turn 50, or sooner if they are at increased risk for colorectal cancer. Ideally, patients should have an informed discussion with their gastroenterologist about screening options. Current published data indicates that more than one-third of patients who undergo an optical colonoscopy will have polyps. A virtual colonoscopy does not allow for polyp removal, so I generally recommend the optical colonoscopy.
DR. JEFFREY KREIKEMEIER, GASTROENTEROLOGIST, GATEWAY GI SIGNATURE MEDICAL GROUP:
Virtual colonoscopies are ideal for people who’ve had incomplete colonoscopies because of a stricture, which is an abnormal narrowing, or a ‘tortuous’ colon with twists and bends that prevent the colonoscope from advancing.
A virtual colonoscopy allows us to see the part of the colon not reached by the colonoscope. Although there’s a clinical indication for a virtual colonoscopy, it’s really not meant to be a primary cancer-screening modality. Still, some people without kinks in their colon opt for the virtual exam.
Both optical and virtual colonoscopies involve bowel preparation by the patient. Patients undergoing an optical colonoscopy are sedated, whereas patients undergoing a virtual colonoscopy are not. The virtual exam involves a contrast dye given to the patient via an enema. As the dye travels throughout the rectum, a CT scanner and special software reconstruct images of the rectum and colon.
[heartburn]
DR. PAUL BUSE, GASTROENTEROLOGIST, MERCY CLINIC DIGESTIVE DISEASES:
Heartburn isn’t a disease of too much acid. It’s acid in the wrong place. Approximately 15 to 20 percent of the U.S. adult population experiences it periodically. People who have multiple episodes of heartburn weekly or daily may have a more serious condition known as gastroesophageal reflux disease (GERD).
Treatment has changed little over the years, but there are new spins on an old class of drugs called proton pump inhibitors. These drugs suppress acid production in the stomach to a high degree. Newer versions are even more potent. Another class of drugs used to treat GERD is H2 antagonists. They work well on mild reflux disease and don’t have some of the side effects associated with proton pump inhibitors, including increased risk of metabolic bone diseases such as osteopenia and osteoporosis.
My advice to patients who have uncomplicated GERD is to avoid proton pump inhibitors if you can, or use the lowest dose possible. Better yet, modify your lifestyle, pay special attention to your bone health, and make sure your calcium and vitamin D intake is adequate.
AFUA BROMLEY, OWNER/ACUPUNCTURIST, ACUPUNCTURE SAINT LOUIS & WELLNESS CENTER:
Stress and bad eating habits often trigger heartburn. Some people eat too quickly. They eat on the run or late at night, often before they retire. Refrain from eating at least two to three hours before you go to bed; by then food should have passed through the stomach. Stay away from fatty, greasy and spicy foods. If high-acid foods like tomatoes, lemons or orange juice cause heartburn, avoid them.
Some people also benefit from taking natural digestive enzymes, such as papaya. Papaya enzyme helps the body break down food. People with more severe heartburn might need a more ‘clinical strength’ digestive enzyme. Another natural technique is to drink ginger tea while eating. Ginger acts as a digestive aid. Increase your consumption of fermented foods, especially raw sauerkraut, kimchi (a Korean side dish made of vegetables) and yogurt. They all help lower the incidence of heartburn. So does kefir, a dairy product packed with a lot of good gut bacteria called probiotics. Prevention is the best heartburn medicine.
[sweeteners]
“Given the chance to choose between agave and stevia, I would choose stevia—but would really prefer no sweeteners,” says Cindy Willbrand, Naturopath, Webster Family Physicians. Although it comes from a plant, agave syrup or agave nectar, sold in most mainstream grocery stores, is processed and refined. “It’s sweeter than the sap that comes naturally from the exotic blue agave plant found in Mexico, and is similar to high-fructose corn syrup,” Willbrand says.
Stevia also comes from a plant but packs few or no calories; agave syrup has about 16 calories per teaspoon, Willbrand notes. “A 2010 study about the effects of stevia, aspartame and sucrose on food intake also found that people who used stevia didn’t overeat,” she says. “Refined sugar and some artificial sweeteners actually heighten one’s desire for more carbohydrates.” Willbrand recommends a whole-foods diet for her patients. “In general, I move them away from sugar and sweeteners. But even when people reduce their intake, they often start looking for a substitute. If they cut sugar and sweeteners out of their diet, their taste for sweets will decline.”
by Mary Konroy