The Holistic Gut Prescription

Create Your Own Personal Path to Optimal Digestive Wellness

Lauren Deville

• Publisher: Morgan James Publishing
• Year: 2018
• Print ISBN:
  9780062362179
• eBook ISBN:
  9781683506683
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

"The most thorough guide to intestinal wellness I've seen to date . . . to reverse leaky gut, chronic infections, candida and chronic inflammation" (Alan Christianson, NMD, New York Times–bestselling author of The Metabolism Reset Diet).
 
The Holistic Gut Prescription is designed to be a simple guide to healing the gut, based on the following premise: If people give the body what it needs to heal itself and remove the obstacles to its cure, then within reason, healing will follow.
 
"Nature Cure" is not easy to employ, but it is usually easy to understand. There are only so many building blocks, and there are only so many possible obstacles to cure. The physician's job is not to "make someone well," but rather to facilitate the process of healing. In this guide, Dr. Lauren helps readers recognize which obstacles to a healthy gut they face, how to remove them, and how to supply the specific building blocks they lack so they can create their own personal path to optimal digestive wellness.
 
"Dr. Lauren Deville drives this one HOME! This is one of the most comprehensive books on one of the most important subjects in our modern day, 'gut health' . . . Dr. Deville does an amazing job at helping you understand what the barriers to good gut health, therefore overall health, are and most importantly, what you can do about it to live your best life. This book covers everything you need to know to truly be empowered and help yourself heal. 5 stars from me! Bravo, excellent and timely work!" —Dr. Holly Lucille, ND, RN
 

Part 1

OBSTACLES TO A HEALTHY GUT

All of the various components of digestion have to work together in order for assimilation of nutrients to happen. Before we get into the obstacles, let’s take a brief look at how things are supposed to work.

Digestion In A Nutshell (A.K.A. Bowel Transit)

When you chew your food, the enzymes in your saliva begin to break down the simple carbohydrates you consume, turning them into glucose. You swallow, and the food travels from your throat (A.K.A. pharynx) to your esophagus.

The function of your esophagus is to connect your throat to your stomach, but it’s also a muscle, pushing your food downward in rhythmic waves called peristalsis.

The esophagus opens into the stomach via a small muscle called the esophageal sphincter. The sphincter is coordinated with the peristaltic waves, opening in response to the waves, and closing in response to the low pH of the stomach acid below it.

Your stomach processes the food bolus you’ve just swallowed, and produces hydrochloric acid which breaks down your food into bits for the next stages of the digestive process. Hydrochloric acid is especially necessary for breaking down protein; if there is too little, the later stages of digestion won’t be able to assimilate nutrients that are still trapped in their organic material, leading to malabsorption. Also, if those bits of food can’t go through later stages of digestion, the bacteria in your intestines will break it down for you, leading to gas and bloating.

Your stomach is also the place where you secrete Intrinsic Factor, a protein necessary for the later absorption of Vitamin B12.

Your stomach dumps food into your small intestine, where peristalsis continues. Your gut can only absorb simple molecules, so the first part of your small intestine, called the duodenum, receives digestive enzymes from the pancreas to further break down protein, carbs, and fat. Think of enzymes like pairs of scissors that cut bigger molecules into smaller pieces. There’s a different pair of scissors, or different enzymes, for different types of food.

The duodenum also receives bile from your gall bladder (or directly from your liver if your gall bladder has been removed) to emulsify fat and allow its absorption. Bile works on fat the way soap works on dirt. Most toxins from solvents are fat-soluble, so if these have entered your digestive tract, the bile will sweep these up too.

Nutrients absorbed by the small intestine travel to the liver for processing. This is where your body packages triglycerides into cholesterol, and the main site of storage for certain nutrients like Vitamin A and iron. Any chemicals your intestines absorb that your liver doesn’t recognize end up going through the liver’s phases of detoxification at this stage as well, so that they don’t circulate throughout your bloodstream. The liver is also the site of bile production; the gallbladder just stores it and secretes it into the intestines.

Beneficial bacteria, or probiotics, gobble up whatever’s still not simple enough for your body to absorb, and they leave behind lactic acid as a byproduct. This process is called fermentation. A little chemistry digression here: fermentation happens in the absence of oxygen, and it’s the conversion of carbohydrates (sugar) to alcohol or lactic acid, and carbon dioxide (CO₂). Lactic acid and/or alcohol act as a natural preservative, because bad bacteria cannot survive in an acidic environment—they keep the “bad” bacteria and yeast in check. They also break down antinutrients (called phytobiotics) that block the body’s ability to absorb vitamins and minerals.

Actual absorption of nutrients occurs mostly in the second and third part of the small intestine, called the jejunum and the ileum. The ileum is also the site of absorption of Intrinsic Factor, which is bound to Vitamin B12.

After extracting all the good stuff, the ileum, the last part of the small intestine, then dumps whatever’s left over into the colon. The colon consists of the cecum (the connection between the ileum and the rest of the colon), and then the ascending, transverse, and descending colon, which are what they sound like. The descending colon turns into the sigmoid colon, so named because it’s shaped like an S, and it empties into the rectum. Peristalsis continues throughout the colon, pushing waste downward for elimination. The colon also reabsorbs water from the stool, so that it is neither too watery nor too dry.

The rectum is about eight inches long, and acts as a storage reservoir for stool. When it becomes full, the brain tells you that it’s time to have a bowel movement (or to release gas, left over from the fermentation process above). The rectum is connected to the anal sphincter, part of the muscles of the pelvic floor. These are voluntary muscles that relax when we get to a toilet.

Ideally this whole process takes about 24 hours. For the rest of Part One, we’ll look at reasons why things don’t always happen this way.

Keep in mind as you read that the above “nutshell” is simplified. The body is composed of organs that are highly interrelated. For example, the gut also houses about 70% of your immune system; it’s also where almost 90% of your serotonin (the feel-good neurotransmitter which, if low, can lead to depression and anxiety). So many aspects of your well-being depend upon healthy gut function!

All right, let’s jump in.

Toxic Buildup from Food = An Inflamed Gut

Lots of things can lead to gut inflammation. In this chapter, I’ll be discussing toxic exposures from genetically modified food, food allergies, and food additives, which can lead to (or perpetuate) gut inflammation.

It can be easy to read this chapter and feel overwhelmed—we cover a lot of information. Again, not all of it may be important for you. We’ll recap this at the end of the chapter again, but as you read, please keep in mind that healthy eating is not all that complicated. Most of what I write in this chapter can be encompassed with a few simple rules:

1. Read the ingredient list. The shorter the ingredient list, the better. If there is no ingredient list because the product is a whole unprocessed food, that is best of all!

2. If you don’t recognize the ingredient, don’t eat it if you can help it.

3. Choose foods that will spoil, and eat them before they do. The less processed, the better. You can usually accomplish this by shopping the perimeter of the grocery store: that’s where all the real foods are. The processed junk is usually in the center aisles, in bags, boxes, or cans.

4. Avoid sugary, processed beverages. Especially avoid sugary, processed beverages laden with carcinogenic chemicals and food dyes.

If you do just these things, you will likely feel much better. These rules may or may not be enough to get you back to where you want to be, though. For many of you, it will also be necessary to identify and remove food allergens. Before we get into food allergies, let’s talk about what allergies are in general.

Allergies

Your immune system is designed to protect your body against harmful substances, such as bacteria, viruses, and foreign substances (allergens). In that sense, allergic responses are not inherently bad. But in a person with allergies, the immune response is exaggerated, and you react to substances that are not generally harmful.

The word “allergies” is kind of a catch-all term, since it can refer to allergic conjunctivitis, atopic dermatitis (eczema), contact dermatitis, hay fever (seasonal allergies), or food or drug allergies, which tend to manifest symptoms all over the body.

Common allergens include medications, dust, food (these reactions can be to the protein, starch, additive, or pesticide on the food), insect bites, mold, pet dander, pollen, hot or cold temperatures, sunlight, or other environmental triggers.

There are actually five kinds of antibodies in your body, but for the purposes of allergy testing, we usually only test two: IgE and IgG. IgE are considered “immediate sensitivity” antibodies, which means your body mounts an immune response to that substance immediately. IgG are “delayed sensitivity” antibodies, which means it may take your body up to 72 hours to mount an immune response.

Skin prick tests are the most common method of allergy testing. This measures IgE (“immediate sensitivity” antibodies). Blood tests can measure either IgE, or IgG. Food allergies are best measured with IgG antibody blood tests, because 80-95% food reactions are of the IgG variety. Blood tests for IgE antibodies are more valuable for environmental allergens such as molds, pet dander, pollens, grasses, dust and the like. These IgE tests are usually covered by insurance, but sometimes you have to fight for it. I will occasionally check IgA as well—these immunoglobulins are only present in the gut, and indicate a gut-only sensitivity, rather than a systemic sensitivity, though most gut inflammation heals by just addressing IgG immunoglobulins.

Allergies of any kind almost always involve the gut. This is because 80% of your immune system resides in your gut. Ideally, your gut should produce a lot of IgA (a lot, but not too much), because it’s your first line of defense against any foreign substance. The flora and the lining of your gut need to be healthy in order to produce adequate IgA so that the rest of your body never has to deal with those substances. I test total IgA in stool cultures frequently, in order to identify the integrity of the body’s defense system.

Food Allergies

Food allergies are the first thing I think of when I see recurrent sinusitis or upper respiratory infections, asthma, ear infections, eczema, GERD (reflux), heartburn, or psoriasis. In addition to those, though, food allergies can also cause chronic gut issues (gas, bloating, IBS), fluid retention, autoimmunity, behavioral changes (lots of ADD/ADHD kids do much better when allergens are removed), and I’ve even seen cases where food sensitivities are responsible for hypertension and weight gain.

Nobody is really sure why food allergies are so prevalent, but there are a few theories that make sense to me.

Food allergies could stem from a lack of beneficial flora (probiotics) in our diets. Probiotics are important because they feed on the waste left over after we digest our food, and produce lactic acid, which helps protect our guts against pathogens. We used to get plenty of them by eating raw and fermented foods… but these days, our food is so processed and overheated that there are precious few good flora left over. That sets us up for overgrowth by the bad flora.

Medicines that wipe out gut flora are also suspected of causing allergies. These include antibiotics, certainly, but they also include proton pump inhibitors (such as omeprazole), nSAIDs (like ibuprofen), steroids (like prednisone), birth control, and many others. (More on this in Chapter 4.)

It has also been suggested that genetically modified foods may cause food allergies. If true, this could be because the glyphosate toxin produced by these foods kill off our gut flora, or because the novel components themselves are stimulating our immune systems. It has not been scientifically established that genetically modified foods cause food allergies, but the evidence is strong enough that I avoid them and counsel my patients to do the same. (More on this shortly.)

Really, though, anything causing inflammation in the gut is capable of causing food allergies. This can be a bout of gastroenteritis, trauma, untreated malabsorption syndromes, environmental toxicity, and even chronic stress. If there’s inflammation in the lining of the small intestines for any reason, it sets you up to develop sensitivities to foods you could otherwise consume with no problem.

If you think you might have food allergies, you have two choices: 1) see a naturopathic doctor or Functional Medicine doctor who will run an IgG food allergy test for you. 2) Follow an elimination diet. (For more information on how to do this, see Appendix A.)

Leaky Gut Syndrome

Leaky gut syndrome, or Intestinal Hyperpermeability, can be measured with a biomarker called zonulin, which is necessary for a tight intestinal barrier. Higher levels in the stool correlate with increased gut permeability, as do the presence of antibodies against it in the blood.¹

The cells that line your small intestine ought to be tight enough that nothing can get between them without the aid of digestive enzymes. In a leaky gut (or increased intestinal permeability), the junctions between the cells are loose enough that food particles can come in contact with the bloodstream before they’ve been properly digested. Your blood expects digested nutrients and assumes therefore that the food particles are foreign invaders, and it creates antibodies against them.

Leaky gut also can be the gateway to autoimmune conditions, since allergies and autoimmunity are so closely linked. Allergies are when your immune system thinks a friend is an enemy; autoimmunity is when your immune system thinks you are the enemy. The one can set you up for the other.

Zonulin and another protein called occludin are the major building blocks of the intestinal tight junctions. Higher levels in the stool, or antibodies in the blood, ...

Table of contents

• Cover
• Title
• Copyright
• Table of Contents
• Introduction
• Part 1: Obstacles to a Healthy Gut
• Part 2: Building Blocks for a Healthy Gut
• Conclusion
• Appendix A: Allergy Elimination Diet