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The Garden Within

“The successful gardener has always known you don’t need to master the science of soil in order to nourish it. You just need to know what it likes to eat- basically organic matter- and how, in general, to align your interests with the interests of the microbes and the plants.  The gardener also discovers that, when pathogens or pests appear, chemical interventions “work”, that is, solve the immediate problem, but at a cost to the long-term health of the soil ad the whole garden.”  -Michael Pollan The New York Times May 19th, 2013

While this quote may seem like it is from an article about organic gardening, it is from an article entitled “Some of My Best Friends are Bacteria” in which author Michae Pollan compares the microflora of our gastrointestinal tract with the soil microbes of a garden.

As an avid gardener and as a naturopathic doctor with a strong interest in gastrointestinal health, this comparison is one that I frequently think about while I have been tending my garden beds this summer.

In gardening we learn that if we nourish and build good soil the plants will grow well, and we will have a good harvest year after year. Plants tend to be resilient to diseases, and pests are often controlled by the beneficial insects that are attracted to a healthy diverse garden. In industrial agriculture (as well as in many backyard gardens), the focus is on getting the plants to grow as quickly, uniformly, and in as high of a volume as possible.  The soil is depleted and does not contain the diversity of soil nutrients and microbes and so high levels of synthetic fertilizers must be given to the plants.  The plants are susceptible to many diseases and pests and so they have to be treated (or genetically modified) in order to survive.  This practice needs a high level of input, produces food deplete in nutrients and is not sustainable.

Our gastrointestinal tracts can be thought of in a similar way to the soil of the garden.  The trillions of bacteria that inhabit our intestines play an integral role in promoting the health of their host (us).  If we create an optimal environment for them to grown in, provide them with the nutrients that they need to survive, and ensure that we are growing a diverse population we will be rewarded with vitamins, decreased inflammation, optimal weight management, balanced immune function, and production of calming neurotransmitters to name but a few of the benefits. 

If we create a less hospitable environment by starving them of the nutrients they need, killing them off with antibiotics from varied sources, and live our lives in such a sterile way that we don’t allow for diversity in our gut microflora, we may end up with many negative health consequences including increased inflammation, obesity, diabetes, allergies, gastrointestinal illnesses and autoimmune diseases to name but a few.

Our knowledge of the importance and influence of our gut microflora is in its relative infancy.  While there is a great deal of research being done to learn more, we do not know enough to always have certainty as to what bacteria are “good”, what bacteria are “bad”, and what the effects of differences in the diversity of the bacteria may have on our health.

We do know enough to know that it is important to nurture and foster our garden within.  While it can be changed by external influences, the microbial community is relatively stabilized by the time we are three years old.  Exposure to bacteria through vaginal birth and breast feeding seems to have the major influence on how this community develops.  While we can’t go back and change what occurred before we were three, there are steps that you can take to “help your garden grow.

  • Eat food, mostly plants, not too much”.  While this quote is from an earlier Pollan work, In Defense of Food, its wisdom holds true for creating a healthy microflora population as well.  The fibers and other polysaccharides in plant foods serve as the prime food supply for our bacteria.  The parts of the plant foods that we can’t digest, our gut microbiome can.  People consuming a diet high in plant foods and lower in animal foods seem to have a greater biodiversity of gut bacteria.
  • Limit intake of processed foods. Processed foods tend to be void of the polysaccharides and fibers that feed our gut bacteria.  Foods high in refined carbohydrates and sugars seem to feed less beneficial species of bacteria as well as encouraging the overgrowth of yeast species.  Processed foods can also contain chemical compounds that can inhibit the growth of our gut bacteria and create a less hospitable environment for them to grow in.
  • Eat more fermented foods.  Naturally fermented foods such as sauerkraut, kim chi, yogurt, kefir, and kombucha contain beneficial bacterial species that can help colonize the intestines and promote the growth of the good bacteria already present.
  • Eat foods high in prebiotics that help to feed your gut bacteria including garlic, onions, leeks, Jerusalem artichokes, dandelion greens, asparagus, bananas, legumes, oats, and avocados.
  • Don’t eat on the run or when you are under stress.  Eating quickly or when you are stressed can decrease your ability to digest your food and can lead to overgrowth of potentially problematic gut bacteria.
  • Engage in stress reducing activities such as meditation, yoga, journaling, walking or exercise.  High levels of stress hormones can decrease the population of beneficial gut bacteria.
  • Consider taking prebiotic and probiotic supplements.  Prebiotic supplements can help to feed and diversify your microbiome. Probiotic supplements can help to modify the environment in your gastrointestinal tract to help to encourage the growth of a healthy microbiome.  You can find my recommendations for prebiotic and probiotic supplements for general health at Fullscript.
  • Go slow when introducing prebiotic foods and supplements.  Consuming large amounts of prebiotics can cause an increase in intestinal gas production.  To prevent this from happening, it is best to start with a small amount and gradually increase it.

If you would like to know more about the ecology of your gastrointestinal tract, there are stool tests that can identify the bacteria, yeasts, and parasites present.  Based on the results of these tests I can make more specific recommendation on how to optimize your “garden within.” 

For more information or to schedule an appointment call (207 805-1129) or email my office.

The Road to Health is Paved with Good Intestines #3: The Esophagus

iStock_000012048107Small-300x300When last we left our journey through the digestive tract, we had prepared ourselves to eat in a relaxed state; we took a bite of food, and chewed it well to get the digestive process started.  Now its time to swallow.

We go through the act of swallowing countless times a day and think of it as a mindless act.  In actuality, swallowing is the last step in the digestive process that we have conscious control over.  Once we have swallowed that bite of food, it has begun its 30 foot journey that can last any where from 12 hours to days depending upon how well things are working.

The first part of that journey takes it through the esophagus, a muscular tube that is about 9 inches in length in adults.  The job of the esophagus is mainly to transport the food that has begun the digestive process to the stomach so that is can be broken down further.  Motion in the esophagus should be in only one direction- down to the stomach.  When digestion is working well and if you have chewed your food appropriately, you shouldn’t really notice your esophagus.

Unfortunately, many things can cause this process to go awry, and allow the acid and digestive enzymes of the stomach (sometimes along with some of the digested food) to come back up into the esophagus.  This is what happens when you experience reflux or heartburn.  While the stomach has a nice protective coating so that the acid does not irritate it, the esophagus does not have this.  So when acid comes up into the esophagus, it burns and causes discomfort.

If this happens occasionally after over eating a large meal, or laying down too soon after you eat, it is not a big deal.  However, when this occurs on a regular basis, the acid can cause damage to the esophagus and even increase the risk of ulceration and cancer in the esophagus.  This chronic reflux is called GERD or Gastro Esophageal Reflux Disease.

bitter_little_pill-taker3-300x279While this condition was hardly recognized thirty years ago, it has grown to almost epidemic proportions with 30 to 60 million people in the US suffering with it each year.  It has sparked a huge industry of medications designed to neutralize or block the production of stomach acid.  Sales of these acid blocking medications accounted for more than $13 billion dollars last year. The direct marketing commercials have become routine on television and in magazines with competition between little purple pills and berry flavored pills.  It has become so common for people to be taking one of these medications that you would think stomach acid was an evil thing.

While we shall see in the next blog that stomach acid is actually important and there can be negative consequences to not having enough of it, too much stomach acid is rarely the underlying cause of heartburn and GERD.

More commonly the problem is associated with weakness of the gate or lower esophageal sphincter (LES) at the bottom of the esophagus that is supposed to keep the acid out of the esophagus.  This gate can become weakened by overeating, being overweight, food sensitivities, smoking, coffee, not chewing your food well before swallowing, and not being in a relaxed or parasympathetic state when you are eating.

Reducing reflux can often be as easy as:

  • Following the advice in the first two blogs of this series by being in a relaxed state when you eat and taking the time to chew your food well before swallowing
  • Avoiding foods that can weaken the lower esophageal sphincter (LES) such as tomatoes, onions, citrus, citrus, peppermint, caffeine, and alcohol
  • Discovering and eliminating hidden food allergies or sensitivities to foods such as wheat, dairy products, corn, and soy.
  • Quitting smoking
  • Working on stress reduction
  • Working on achieving an optimal body weight.
  • Not laying down too soon after eating.

While you are working on making these changes, there are a couple of natural supplements that can help reduce the severity of heartburn or GERD.

LicoriceRootThe first is a form of licorice called deglycerrhizinated licorice or DGL.  Licorice has been used for centuries for its soothing effect on the entire gastrointestinal tract.  It helps to increase the mucous production of the lining of the esophagus, protecting it from the irritation of stomach acid.  While there is concern with regular intake of whole licorice as it can raise blood pressure in some people, DGL has had the blood pressure raising component taken out.  This makes it safe to take on a regular basis while you are working on the underlying causes of your heartburn or reflux.  Because we want the effects of the licorice to help the esophagus it is important to use DGL products that are powders or chewable wafers.  Chewing 1 to2 of these tablets before meals or when you first start to feel reflux coming on can help to quench the fire without suppressing your digestive function.

Bitter herbs have been consumed before and after meals for centuries to help stimulate digestive function.  While bitters have become most commonly used now as a component of cocktails, digestive bitters can be effective at reducing the occurrence of heartburn.  Taking the bitters in a small amount of room temperature water 10 minutes before meals can help to stimulate your digestive function and put an end to the burning discomfort.

The amount of bitters that you should take is going to vary from product to product, so look at the instructions on the package to determine how much to take.

While these natural remedies can be helpful, if you are experiencing frequent heartburn or reflux, it is important to figure out the underlying cause and correct it.  Working with a naturopathic doctor or Functional medicine practitioner can be helpful for determining and treating those underlying causes without impairing digestive function by inhibiting the production of stomach acid.

In the next blog we will move into the stomach, learn more about the important actions of stomach acid and curious bacteria called H. pylori.