Gastrointestinal Tracts - The Longest Organ

Definition

The gastrointestinal (GI) tract is a continuous tube, which is about 30 feet long the average adult. It begins with the mouth and ends with the anus. Its key functions: digestion, absorption of nutrients, and the elimination of undigested materials.

GI tract comprises of mouth, esophagus, stomach, small intestines, large intestines, and anus. The pancreas, liver, and gallbladder are also part of digestive organs. The GI tract is protected with a lining called mucosa. The function of the esophagus is to transport food from the mouth to the stomach. The stomach regulates and secretes gastric juice in the form of hydrochloric acid. Esophagus is protected by lower esophageal sphincter (LES), which prevents stomach acid from entering the stomach during the food swallowing process.

Hydrochloric acid is essential for digestion and can be stimulated by three substances namely acetylcholine, gastrin, or histamine, and produced by the parietal cells in the stomach in various ways. The histamine route of hydrochloric acid production is the commonest mechanism being focused by the medical researcher today.

Some Common GI Disorders

• Gastritis
• Heartburn
• Flatulence
• Indigestion
• Constipation
• Hemorrhoid/Piles (Rectal Bleeding)
• Diverticulitis and Diverticulosis
• Gastroesophagus Reflux Disease (GERD)
• Peptic Ulcer
• Abdominal pain
• Diarrhoea
• Vomiting
• Weight los

Gastritis

Gastritis is the inflammation of gastric mucosa/stomach lining. It can be divided into acute and chronic.

In acute gastritis, there is acute inflammation of the gastric mucosa with destruction of the superficial epithelial cells. Usually, following mucosa erosion, healing occurs with mucosal regeneration and the possibility of minimal fibrosis. Drugs such as aspirin and alcohol can produce gastritis by allowing acid to diffuse into the gastric mucosa, where it causes the release of histamine, producing acute inflammation. There is no evidence that acute gastritis will eventually lead to chronic gastritis or peptic ulceration.

Chronic gastritis occurs frequently, particularly in the elderly. There is a strong relationship between gastritis and autoimmune disease such as thyroid disease, diabetes mellitus and Addison's disease. Chronic gastritis also experienced by patients following a gastrectomy due to biliary reflux.

Gastritis can be classified by the following three major groupings: (I) erosive and hemorrhagic; (ll) nonerosive; (lll) distinctive.

Erosive and hemorrhagic gastritis lesions are common in:

1. critically ill patients with stress lesions
2. in patients who take non-steroidal anti-inflammatory drugs (NSAIDs)
3. in alcholic patients who are actively drinking
4. as a result of localized gastric trauma

Nonerosive Gastritis

The most common one is caused by bacteria called H. pylori, and patients may have associated duodenal or gastric ulcers who are entirely without symptoms.

Distinctive Types of Gastritis

Uncommon. Distinctive types of gastritis can be infectious types in immunocompromised hosts, localized gastric diseases such as Menetrier's disease, Crohn's disease, and involvement in systemic disease such as sarcoidosis.

Heartburn

Heartburn is a retrosternal or epigastric burning sensation, which spreads upwards to the throat. It is a symptom of abnormal digestion. Heartburn is caused by excess acid. Heartburn may arise following the ingestion of certain foods or drugs. Symptoms typically occur 30-60 minutes after eating and may respond temporarily to antacids.

Flatulence

Flatulence is the term used to describe excessive wind. The most common one is air swallowing subconsciously during eating. Some of the swallowed air is passed into the intestines, where it was used by intestinal bacterial breakdown of food, particularly high-fibre legumes that leads to gas production.

Indigestion

Indigestion is being described as a symptom involving nausea, heartburn, acidity, pain or distention, and inability to digest food, of which occurs due to eating or drinking. Indigestion is common, almost 80% of the general population will have had indigestion at some time. However, diet is the key that causes indigestion and this can be reversed easily once the underlying eating habits are rectified. Among the causes are as follow:

1. Excessive consumption of refined carbohydrate (especially sugar)
   Refined carbohydrates can cause a rapid secretion of gastric acid.
2. Poor food combination
   This refers to complex meal that consists of too many combination of food such as raw fruit, cooked fruit, raw vegetables, cooked vegetables, soups, several types of protein, starch, coffee, alcohol and sweets, etc.
3. Excessively large meals
   Overloading stomach with excessively large amount of food can exceed the body's supply of digestive enzymes. As a result, some food that passes into the lower small intestine is only partly broken down or digested leading to fermentation and gas formation by flora bacteria.
4. Too-frequent meals
   A normal digestive process is usually disturbed if food is eaten too soon after a previous meal. It is advised to allow at least 1.5 hours after a fruit meal, 2 to 2.5 hours after a vegetable meal, 3.25 to 4 hours after combined meal with proteins, carbohydrates, and fat before a second meal is taken.
5. Insufficient chewing of foods
   A hurried meal without sufficient chewing can cause indigestion. This is because chewing stimulates salivary amylase secretions that help break food down into smaller particles for better enzymatic digestion. It also helps to stimulate secretion of digestive enzymes in the stomach, pancreas, and small intestine for further digestion.
6. Drinking with meals
   Any liquids, once taken with solid meals can lead to digestion problem as liquids dilute the action of digestive juices making the complete digestion more difficult. It is best to take liquids either at least 15 minutes before other foods are eaten, or ½ hours after food.
7. Use of strong spices or other gastric irritants
   Salt, sugar, pepper, curries, coffee, soda, and alcohol are irritants to the stomach as they cause extreme acidity in the stomach.
8. Excess acid-forming foods
   Excessive consumption of refined carbohydrates, sugar and other acid-forming foods may lead to pH abnormality in the stomach. Green vegetables are recommended, as they are the best alkaline elements for proper pH balancing.
9. Excessively hot or cold foods
   Long term consumption of this eating habit can lead to poor digestion because this process can irritate the delicate stomach linings.
10. Eating while under stress
    Stressful conditions such as anxiety, anger, or other similar emotions will cause the parasympathetic nervous system to cease its functioning for normal digestive enzyme secretion and gastric motility. It is advised to spend 10-15 minutes to relax or meditation before meals.
11. Eating when sick
    Usually it is advised to eat less when sick based on the nature that all animals fast during an illness.
12. Fried foods
    Deep frying foods are difficult to digest and it is believed to be a factor leading to high incidence of stomach cancer in civilized nations.
13. Food allergy
    Milk and wheat are the two most common offenders that cause food intolerance due to a specific digestive enzyme deficiency; e.g. lactase deficiency of milk intolerance.
14. Digestive enzymes deficiencies
    This is a result of gastric disturbances due to digestive enzyme deficiencies in the digestion of carbohydrates, proteins, or fat. These could be associated with a disorder of the pancreas, liver, or gallbladder. Common symptoms are hyperacidity with heartburn. Hydrochloric acid deficiency is common particularly in people above 50 years of age, causing bloating, poor protein digestion, and chronic malabsorption of most minerals and some vitamins. Health disorders such as asthma, allergies, rheumatoid arthritis, hypothyroidsim, osteoporosis, diabetes, chronic hepatitis, pernicious anemia, intestinal parasites, eczema, and etc are also associated with digestive enzymes deficiencies.
15. Emotional causes
    Prolonged stress, anger, or worry can upset the normal digestive cycle as they create an acidic condition of the entire body.
16. Spinal lesions
    If the lesion happens in the thoracic region, nerve and blood supplies to the stomach are altered thus interrupting normal digestion.
17. Heavy metal poisoning
    Aluminium poisoning can can indigesti

Constipation

Constipation is described as difficult passage of hard stools irrespective of stool frequency, or difficult and/or infrequent bowel movements. Constipation is an insidious health problem affecting millions of people. Bowel transit time has been slowed down. In diets composed of unrefined cereals, fruits, and plenty of raw vegetables, the transit time is usually 12 hours. On a refined diet, it may extend to 24, 48, 72 hours or even to a week.

The common symptoms of constipation involving infrequent and/or difficult bowel movements, bad breath, tiredness. It is also associated with headaches, mental depression, and mental dullness. All these are believed due to autointoxification as the body reabsorbs the fluid content in the feces and along with it many soluble toxins.

Among the causes are:

Diet
Fiber deficiency not just causing constipation but also causing hardened stools that reduces normal intestinal peristaltic actions. Long-term constipation is associated with diverticulitism (small outpocket created in the intestine due to forceful peristaltic contraction), appendicitis, and even colon cancer (prolonge constipation can alter the normal bacteria flora which subsequently alter the bile acids into a carcinogenic agent).

Excessive eating habit
Too much meat, milk, fried foods, coffee, tea, alcohol, overeating and acid-forming foods/spicy foods.

Inactivity
Lack of exercise and sedentary lifestyle, or bedridden.

Long-term laxative use
Laxatives cause a strong intestinal adverse reaction due to the irritant effect of the laxatives. Habitually and chronic use of laxative can cause the bowel reacts to unusual stimulation by becoming less active after its use. Laxatives that contain mineral oil besides causing bowels to become overstimulated and weakened, is also nutrient -robber for fat-soluble vitamins.

Liver dysfunction
Gallbladder disease

Stress
- Hectic schedules causing the "call for nature" habitually ignored or postponed. This has resulted the body to discontinue sending the message to the brain unless the bowel is overloaded.
- Eating under stressful condition paralyzes the intestine peristaltic action as all digestive enzymes fail to function normally.
- Overwork and anxiety.

Hydrochloric acid deficiency
Food allergy
Pregnancy
Anemia
Partial intestinal obstruction
Spinal
Hypothyroidism
Dehydration
Hirschsprung's disease

In conclusion, diet alone in fact stands most prominent as both cause and cure of this disorder, altering the fiber-deficient diet, would prevent and even cure constipation. However, while initiating a high-fiber diet, very often, a specific short cleansing (natural functional foods/herbal aid) is required to retonify intestinal actions. A 3 day-fruit juice is helpful too in this context. Soybean concentrate with soy protein isolate (EnerFlex®) formula has been proven very helpful in alleviating constipation too due to its dual action of cleansing and building, and cells repairing activities.

Hemorrhoids / Piles

Hemorrhoids defined as varicose veins of the hemorrhoidal plexus, which can be external or internal. Hemorrhoids are characterized by burning sensation and swellings in the anal region, itching and painful feeling and blood loss with bowel movement. Hemorrhoids are placed in the class of "diseases of civilization". Intra-abdominal pressure is the main mechanical cause of hemorrhoids, of which created by straining to pass hard fecal matter during a bowel movement. Diet plays a key role in reversing or improving hemorrhoids condition. It is always much easier to prevent hemorrhoids that their cure. This is because, once the small blood vessels have been grossly dilated, coupled with fibrotic scar tissue formation, it is difficult to remove the local damage. Post-surgery does not guarantee the recurrence of hemorrhoids. Surgery justs to get rid of the immediate symptom and does nothing/or little effort in prevention.

Among the causes are:

• Fiber deficiency and overeating
• Constipation
• Habitual laxative consumption
• Poor abdominal tone
• Lack of exercise
• Vitamin B6 deficiency
• Pregnancy
• Improper heavy lifting
• Toxicity
• Sagging abdominal region due to obesit

The dietary prevention of hemorrhoids is basically the same as for constipation. In another word, preventing constipation will help prevent hemorrhoids/piles. EnerFlex® helps to regulate this disorder effectively!

Diverticulitis and Diverticulosis

Diverticulitis develops as a result of the formation of spherical pouches protruding from the lumen of the intestine through the bowel wall, particularly found in the sigmoid colon. Transit time is usually longer and exceeding 36 hours.

Diverticulitis's symptoms include pain in lower left quadrant, nausea, vomiting, abdominal distention, colic, constipation, diarrhoea, tenderness, and fever if infected. Main cause is the excessive consumption of refined diets that are poor in fiber content. About 30-45% of American suffers the discomfort of diverticular disease. Diverticulitis occurs as and when swelling of feces blocks the neck of the diverticulum. An abscess and spasm may form resulting intestinal obstruction. Surgical procedure may be required as perforation of the abscess may occur. Prevention is always better. Invasion of bacteria may occur and they will be filled up the diverticular and large amount of B vitamins are consumed. Occult blood loss may occur leading to anemia condition among patient with diverticular disease.

A high fiber diet composed of unrefined grains, raw vegetables, and vegetables usually helps prevent diverticular disease as this type of diet favours proper intestinal action in many ways. Among the key action is that the fiber absorbs water, and making a softer stool that is passed through with less forceful peristaltic contractions. This diet usually is able to reduce the transit time to between 12-24 hours instead of 36 hours.

Among the helpful natural resources to overcome this illness are carrot juices, water with fasting, celery and lettuce juice, chlorophyll and spirulina liquid. Vitamins include vitamin A, B complex 25-50mg one or twice a day, vitamin E 200-400 IU per day and vitamin C 250-1000mg per day (up to six times a day). EnerFlex® should be able to a helping hand to improve this disorder.

Gastroesophagus Reflux Disease (GERD)

GERD occurs when the normal function of the lower esophageal sphincter (LES) is compromised, resulting stomach contents may be back up into the esophagus - a process called reflux. This occurs primarily when gastric pressure is greater than esophageal pressure, inappropriate LES relaxation and contraction. Some pharmacological agents such as theophylline (anti-asthmatic), anticholinergics (anesthesia), calcium channel blockers (anti-hypertensive), beta-adrenergic agents (anti-hypertensive), diazepam (anti-anxiety), meperidine (narcotic) and progesterone (hormone) can cause incompetence of LES.

There are a number of secondary factors promoting esophaeal injury, including: a higher volume of gastric contents, delayed gastric emptying, hydrochloric acid, impaired peristalsis, and diminished flow of saliva (as saliva neutralizes and dilutes acids-esophageal protective).

Individual may experience gastroesophagus reflux at one time or another, with or without symptoms. Prolonged gastroesophagus reflux damages the esophagus lining of which leading to the occurrence of gastroesophageal reflux disease (GERD).

If gastric juice is refluxed into the pharynx, respiratory symptoms such as laryngitis, asthma, aspiration, lung inflammation, hoarseness, and nocturnal choking may present.

Symptoms of GERD include heartburn, chest pain, regurgitation, pain with or difficulty in swallowing, chronic recurrent cough, or excess salivation. However, most often, GERD is asymptomatic and patient or doctor cannot assess the extent of the disease from symptoms.

Generally, GERD can be classified on a continuum from mild (Grade1), moderate (Grade 2 and 3) to severe (Grade 4).

• Grade 1 GERD is localized erythema of gastroesophageal junction with small areas of redness in the esophageal mucosa.
• Grade 2 is diffused erythema and mucosal friability with widespreads areas of redness and fragile esophageal mucosa.
• Grade 3 is erosive, diffuse erythema, and mucosal friability.
• Grade 4 is Frank ulceration, diffuse erythema, and mucosal friability with easily seen ulcers appear along with conditions in Grade 1,2, and 3.

Untreated GERD can lead to Barrett's esophagus, which is a pre-cancerous state. Barrett's esophagus carries a 30 to 40 folds increased risk of development of cancer. At this level, gastroenterologist is referred.

Lifestyle modication and medical treatments including the dietary treatment are keys to overcome the reflux or ameliorate the damage to the esophagus caused by primary and secondary mechanisms. Combined usage of Garlic capsules and EnerFlex® seem able to reverse the non-ulcerative GERD in 2-4 weeks time.

Peptic Ulcer

Peptic ulcer refers to ulcerative disorders of the upper part of the gastrointestinal involving principally the duodenum and the stomach. It is a chronic disease. The common forms of peptic ulcers are duodenal ulcer and gastric ulcer.

Duodenal ulcer
It is estimated that 10% of the U.S. population has duodenal ulcer. Average age onset is 33 and may be occurred from infancy to old age. The main cause results from abnormally high hydrochloric acid levels. These patients are commonly called "hypersecretors" of acid. Mucosal defense mechanism is impaired of which may be resulted from chronic debilitating illnesses, trauma, drugs such as cortisone.

The major symptom is upper abdominal pain radiating to the breastbone, back, and lower abdomen. Muscle spasm may be present. Pain usually attacks 45-60 minutes after a meal. It usually absents before breakfast; worsens as the day progresses and become most severe between midnight and 2:00 am. Proper food or antacids usually relieve the symptoms within 5 to 30 minutes.

If untreated, duodenal ulcer may lead to hemorrhage (heavy bleeding), ulcer penetration to other organ such as pancreas and liver, perforation where ulcer may penetrate the entire thickness of the duodenal wall, and narrowing and obstruction of the duodenum resulting muscle spasm, tissue swelling, or scarring. This can cause obstruction symptoms, which include a sensation of upper abdominal fullness, nausea, and vomiting after eating.

Gastric Ulcer
Similar underlying factor to duodenal ulcer. Excessive hydrochloric acid and imbalance of hydrochloric acid and pepsin is the key. The difference is the decreased tissue resistance is the leading factor to gastric ulcer. Some are due to gastrin-producing tumours that increase the production of hydrochloric acid. Others may be involving the prolonged use of drugs such as aspirin and other drugs that increase the permeability of the mucosa.

Gastric ulcer usually occurs within 6 cm of the pylorus, at or near the right-handed region of the stomach and most frequently on the posterior wall.

The major symptom is dull aching or burning upper abdominal pain . Nausea and vomiting are also common. Weight loss may occur too.

Abdominal Pain

Abdominal pain can be due to a large number of gastrointestinal conditions, and normally presents as an emergency. It can be classified as the following:

Upper abdominal pain

• Pain is usually a dull ache, but can be severe and sharp
• A common feature of peptic ulcer disease

Biliary colic

• Pain is usually due to gallstones in the common bile duct
• Pain is constant and lasts from 30 minutes to several hours
• Vomiting sometimes occurs

Right hypochondrial pain

• Pain in the right hypochondrium due to hepatic congestion
• Pain is chronic and persistent
• Pain is not due to gallbladder disease

Lower abdominal pain

• Pain is usually colonic origin and associated with bowel disease
• Persistent pain in the right iliac fossa

Proctalgia

• Severe pain deep in the rectum
• Comes on suddenly but lasts only for a short period

Tenesmus

• Pain during passage of stools per rectum

EnerFlex® 40g twice daily has been effective in reversing acute abdominal pain.

Diarrhoea

Diarrhoea implies the passing of increased amounts of loose stool exceeding 300g, and is different from the frequent passage of small amounts of stool, which is commonly seen in functional bowel disease. Watery stools of large volume are always due to organic cause. One could pass a few motions per day. Bloody diarrhoea implies colonic disease. Diarrhoea can be either chronic or acute. Acute diarrhoea very often associates with infective causes. Acute diarrhoea should not last more than 2 to 3 days. Chronic diarrhoea is likely associated with digestive enzyme deficiency.

In fact, this is due to body's attempts at internal cleansing and purging. As such, they should be encouraged and not to be suppressed. Be sure to replenish dehydration in an acute diarrhoea attack. However, infantile diarrhoea can be extremely dangerous. A physician should be consulted if diarrhoea in infants does not clear within 24 hours.

Some of the causes of diarrhoea:

• Gastric flu
• Food poisoning
• Simply injudicious eating
• Food allergy (gluten/lactose intolerance)
• Gastritis
• Colitis
• Overfeeding in baby
• Bottle feeding as it leads to gastroenteritis in babies
• Intestinal parasites
• Infection (bacterial or viral)
• Digestive enzyme deficiency- leads to food fermentation by intestine bacteria
• Heavy metal poisoning
• Excessive vitamin C intake
• Pancreas, adrenal malfunction
• Anemia
• Emotional upset, stress or fear
• Antibiotic use
• Excessive intake of zinc mineral

Diarrhoea can be treated in a natural way using the following remedies:

• Green apple
• Yogurt
• Blackberry juice and gelatin
• Soy protein (EnerFlex® 40g twice daily)
• Lactobacillus powder
• Natural bulking agent
• Bran
• Chlorophyll liquid
• Garlic capsules for infective causes
• Peppermint tea
• Carrot juice
• Raspberry juice
• Vitamin A 10,000 I.U -25,000 I.U per day
• Liquid B complex vitamin: 25-50mg per day

Vomiting

Vomiting refers to the expulsion of gastric contents through the mouth. Before vomiting, nausea occurs first and is usually associated with decreased gastric motility. Following nausea, is retching, a strong involuntary effort to vomit where the glottis remains closed and the diaphragm and the abdominal muscles contract. And, finally, sustained contraction of the abdominal muscles and relaxation of the cardia, lead to vomiting. Patient with pyloric stenosis may vomit without nausea occurrence.

Vomiting is usually associated with gastrointestinal disorders. However, chronic vomiting is not usually due to gastrointestinal disease. Chronic vomiting can be due to drugs and in women, is usually due to psychological causes.

Causes of vomiting as following:

• Any gastrointestinal disease
• Acute infections- influenza/pertussis
• Central nervous/brain disease- raised intracranial pressure, meningitis, vestibular disturbances and migraine
• Metabolic causes- uraema, diabetic ketoacidosis, and hypercalcaemia
• Drugs- digitalis toxicity, opiates, cytotoxins
• Reflex - severe pain associated with myocardial infarction
• Psychogenic - Pregnancy
• Alcohol excess

Weight Loss

This refers to loss of appetite (anorexia), which subsequently leads to weight loss. It is a frequent accompaniment of all gastrointestinal disease. It is also a psychiatric disorders. Late symptom of anorexia can be associated with carcinoma.