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Hompes Method Practitioner Training Level II

Lesson Three

Digestive Dysfunction

From Function to Fix

• Last time we explored how the main sections and components of the digestive function work and how they effect each other.

• In this lesson, we’ll cover dysfunction in the digestive system and the symptoms your clients and patients will complain about as a result!

Our Advantage

• Remember: by going back to basics and understanding what the gut is supposed to do, how it works and what goes wrong, we have a distinct advantage in helping people overcome their symptoms.

How Digestion Works – Top to Bottom

• Let’s take the same tour of the digestive system as last time, listing the main symptoms and disorders.

Setting the Scene - ANS

http://www.uic.edu/classes/bios/bios100/lectures/nervous.htm

Cephalic Response

• The digestive system switched on before we eat food.

• The cephalic response is a parasympathetic-driven function stimulated by thinking about food, or by the sight, smell, anticipation and taste of food. Once food is ingested, the cephalic response continues.

Cephalic Response

• Anything that stimulates the opposite side (sympathetic) can compromise the response, shutting down the secretion of digestive fluids such as stomach acid, bile and pancreatic enzymes. Many digestive symptoms start here!

Cephalic Response

• The cephalic response is compromised by:

– Mental, emotional & spiritual stress (sympathetic stimuli)

– Mechanical or structural stress – Inflammation – Poor eating habits – Eating on the go – Eating in a non-relaxed state – Eating in the standing position – Insufficient mastication (chewing)

Frequently Reported Symptoms

– Mouth ulcers – Sore throat – Heartburn / reflux – Indigestion – Belching and burping – Bloating (abdominal distention) – Flatulence – Gurgles and grumbles – Abdominal pain / cramping – Constipation – Loose stools – Diarrhoea

Red Flags

• Refer out when if & when you encounter these Sx: – Dysphagia (difficulty swallowing)

– Unexplained weight loss

– Protracted vomiting

– Vomiting fresh blood

– Vomiting “coffee grains”

– Dark / black tar-like stools

– Bright red blood in stool (when not hemorrhoids)

– Anorexia

– Very severe pain

– Very severe nausea

Bad Stuff vs. Good Stuff

Mouth – Halitosis

• Bad breath (very “painful” for people in terms of self-confidence, social settings, etc.)

– H. pylori and other bad bug infestations

– Low stomach acid (food putrefaction)

– Reflux

– Low good bug levels

– Constipation

– General “global” toxicity of the body

Mouth - Ulcers

• May be caused by many factors:

– Bad foods • Food sensitivity / allergy,

gluten, cow’s milk

– Bad bugs • Viral, fungal perhaps

– Bad toxins • Toothpaste, mouthwash,

etc.

– Nutrient deficiencies • Iron, zinc, B12

– Stress – Smoking

http://en.wikipedia.org/wiki/File:Aphthe_Unterlippe.jpg

Mouth – Angular Chelitis

• Bad bugs:

– Staphylococcus aureus, Candida, B-hemolytic Streptococci

• Nutrient deficiencies: – Iron, B2, B3, B5 B6, B7, Folic acid

• Malabsorption

• Vegan diet

• Poor immune function http://en.wikipedia.org/wiki/Angular_chelitis

Mouth – Cold Sores

• Herpes simplex virus – HSV-1 and HSV-2 (10%).

• Trigger may be stress.

• Trigger may be consumption of arginine-rich foods such as chocolate, cashews or almonds.

• Other symptoms may include headache, nausea, dizziness and painful ulcers.

http://en.wikipedia.org/wiki/Cold_sore

Mouth - Oral Thrush

• White/yellow coating on tongue and oral mucosa.

• Candida albicans

– Likely in other parts of the GI tract

• Stress

• Immune deficiency

• Overgrowth may be the result of dental amalgams.

http://en.wikipedia.org/wiki/Oral_thrush

Oesophagus – Hiatal Hernia

• Upper part of stomach protrudes into the thorax through a tear or weakness in the diaphragm.

• Sliding (C) – 95%

• Rolling (D) – 5%

http://en.wikipedia.org/wiki/Hiatal_hernia

Hiatal Hernia – Causes & Symptoms

• Pregnancy

• Obesity

• Violent coughing or vomiting

• Bending over / lifting

• Stress

• Posture

• Smoking

• Poor digestion

• Acid / heartburn

• Regurgitation of food

• Swallowing

• Difficulty breathing

• Pain in back or chest

• Ulceration in oesphagus

• Symptoms are similar to some food intolerances, H. pylori, etc.

GERD / GORD

• Where an “amount” of gastric juice gets into the oesophagus, causing irritation.

• It’s very, very common but the symptoms are similar to H. pylori, hernia, etc. and they all may be part of the picture in some people.

• Common in pregnancy and obesity.

GORD - Causes

• Hiatal Hernia

• High or low stomach acidity (putrefaction)

• Stress

• Foods – Spicy food, fatty food, alcohol, caffeine, citrus fruits,

chocolate, tomato, garlic, onions, mint, sugar, carbonated drinks

• Dysfunctional lower oesophageal sphincter – Foods listed above, calcium channel blockers, nitrates,

certain drugs and hormones

GORD - Symptoms

• Acid / heartburn

• Regurgitation of food

• Swallowing – lump in throat – food feels stuck

• Belching and burping

• Pain in back or chest

• Ulceration in oesphagus

• Symptoms are similar to some food intolerances, hernia, H. pylori, peptic ulcers.

Hypochlorhydria (Low Stomach Acid)

• Symptoms include:

– Nausea

– Belching & burping, bloating, wind/flatulence

– Feeling like stomach isn’t emptying

– Diarrhoea or constipation

– Undigested food in stool

– Foul smelling stools

– Anemia (iron, copper, B12)

– Food allergies (asthma also)

– Poor quality skin and fingernails

Hypochlorhydria - Causes

• Age – it’s thought that more than 50% aged 60 and above have insufficient production.

• Poor cephalic response

• Food intolerance (gluten/coeliac)

• H. pylori infection

• Zinc deficiency

• B6 deficiency

• Autoimmune against the parietal cells

Hypochlorhydria – May Lead to…

• Nutrient deficiencies

• Food allergies

• Autoimmune diseases

• Acne rosacea and many skin disorders

• Weak and brittle nails

• Gallbladder disease

• Chronic intestinal infections (dysbiosis)

• Asthma

• Anemia (iron and B12)

• Coeliac disease

• Heart disease (Mg deficiency, for example)

• Bone disorders

Acute and Chronic Gastritis

• Gastritis simply means inflammation of the stomach lining (anything ending in “itis” means “inflamed”. Chronic gastritis is classified as lasting longer than 4-6 weeks (some people have it for years).

Gastritis - Symptoms

• Acute gastritis is likely to cause a greater severity of symptoms:

– Indigestion

– Hiccups

– Dull pain, made worse by eating

– Nausea

– Vomiting, possibly with blood

– Reduced appetite

– Food sitting in stomach

– Fatigue, weakness and malaise (anemia)

Peptic / Stomach Ulcer

• Quite common due to modern lifestyle and the consumption of damaging food and medications.

http://www.medicinenet.com/image-collection/peptic_ulcer_picture/picture.htm

Peptic Ulcer - Causes

• H. pylori

• Alcohol

• NSAIDs (e.g. aspirin)

• Smoking

• Spicy foods

• Hyperchlorhydria

• Stress (cortisol can increase acid secretion)

Peptic Ulcer - Symptoms

• Similar symptoms to GORD and hernias, etc.

– Epigastric pain – vague

– Gnawing sensation (with food intake)

– Heartburn

– Nausea

– Belching and burping

– Lump in throat

– Weight loss

– Vomiting – may have blood or coffee-like granules (red flag)

Duodenal Ulcer - Symptoms

• Symptoms may not be the same:

– Similar symptoms in terms of belching, bloating, etc.

– Pain is often relieved by food intake

– Pain radiates into the back

– Fatty food intolerance

– May cause more pain at night

Ulcers - Complications

• The ulcer may erode blood vessels and cause bleeding, which can be serious.

– Vomiting blood or “coffee grains”

– Blood in stool

– Black tarry stool

– Sudden, severe pain

– Hard stomach to palpate

– Very sudden weight loss

– Fast-developing anemia

Small Intestine - Symptoms

• Nausea

• Inflammation and pain

• Bloating

• Gurgling and grumbling

• Flatulence

• Appetite changes

• Many symptoms can also be associated with the stomach and large intestine…

Small Intestine - Symptoms

• Responsible for nutrient absorption, so dysfunction can cause many “global” symptoms:

– Digestion

– Reproduction

– Energy

– Aches and pains

– Mood

– Sleep

– Skin

Small Intestine - Causes

• Stress

• Cephalic response

• Pancreatic insufficiency

• Gallbladder insufficiency or removal

• Food intolerances (especially gluten)

• Alcohol

• Pharmaceuticals (e.g. NSAIDs. Steroids)

• Dysbiosis (e.g. SIBO)

• Chronic infections

• Toxins

• Nutrient deficiencies

Intestinal Permeability

• As you might expect, the digestive system gets through a lot of detoxification work, over and above pooping. The intestinal mucosa is home to a large amount of Cytochrome P-450 activity, which ensures the neutralization of toxins, drugs, bugs, etc.

Intestinal Permeability

• Intestinal cells are usually held together by “tight junctions”, leaving minimal gap between cells and preventing the “leaking” of various larger particles into the blood (e.g. undigested food, toxins).

• The tight junctions can become separated when the intestinal wall is unhealthy, leading to a condition known as increased intestinal permeability, or “leaky gut”.

Increased Intestinal Permeability

• Various factors create the “leaky gut”.

• Particles leaking into circulation can overload the liver and trigger other physiological changes, leading to symptoms.

http://www.agemanagementmi.com/services/gastrointestinal-repair-leaky-gut-syndrome/

Pancreas - Symptoms

• Floating stools (steatorrhoea) due to undigested fat

• Similar / same symptoms as small intestine

– Bloating, pain, flatulence, undigested food in stool, etc.

• Reflux

• Drowsiness after meals (my Dad)

• Appetite

• Symptoms in all Seven Areas of Health

Pancreas - Causes

• Stress

• Cephalic response > low stomach acid > low secretin and CCK

• Nutrient deficiencies (e.g. amino acids)

• Poor diet / lack of variety

• Infections

• Toxins

• Radiation

• Drugs

Liver - Symptoms

• Symptoms of liver dysfunction are manifold, but some of the more common ones include: – Jaundice (yellow skin) – Right side pain (upper quadrant) – Oedema (water retention) – Fatigue, mood, neurological issues – Aches and pains – Toxicity symptoms (covered later in the programme) – Nausea – Increased frequency of urination – Similar symptoms to pancreatic insufficiency

• Bloating, floating stools, gas, appetite issues, etc.

Liver - Causes

• Increased intestinal permeability

• Higher toxic burden (all sources)

• Nutrient insufficiency

– Amino acids, minerals, B vitamins, cholesterol

Gallbladder - Symptoms

• Lack of bile and bile salts entering the duodenum.

– GI symptoms – pain, bloating, constipation, gas

– Pale brown, floating stools

– Right-sided fullness

– Nausea

– Intolerance to fatty food

– Heartburn

– Symptoms of fatty acid and fat soluble vitamin deficiency

Gallbladder - Gallstones

• More sinister gallbladder symptoms (gallstones) might include: – Nausea and/or vomiting – Severe right hand side pain, which may reflex to the

shoulder – possibly at night between 1-2am (Chinese liver meridian)

– Pain between shoulder blades – Intolerance to fatty foods – Bloating, belching, constipation, gas, etc. – Quick, sharp temper (“gall!”) – Jaundice – Cholecystitis

Gallstones - Wikipedia

“Presence of gallstones in the gallbladder may lead to acute cholecystitis, an inflammatory condition

characterized by retention of bile in the gallbladder and often secondary infection by intestinal microorganisms

, predominantly Eschereschia coli , Klebsiella, Enterobacter and Bacteroides species. Presence of

gallstones in other parts of the biliary tract can cause obstruction of the bile ducts, which can lead to serious

conditions such as ascending cholangitis or pancreatitis. Either of these two conditions can be life-threatening and are therefore considered to be medical

emergencies”

http://en.wikipedia.org/wiki/Gallstones

Gallbladder Removal

• Gallbladder removal is one of the most frequent surgeries you’ll see in clients and patients. When the gallbladder is surgically removed there’s no storage tank for bile, so its release is not timed and is a constant “drip” from the liver. This can obviously cause quite a few problems, including intolerance of fatty foods, nausea, intestinal pain, bloating, gas, loose stools, etc.

Large Intestine - Symptoms

• Major symptoms include:

– Lower abdominal pain/cramping

– Flatulence

– Constipation

– Diarrhea, loose stools

– Blood or mucus in stools

– Itchy anus

– Irritable bowel syndrome (IBS)

– Inflammatory bowel disease (IBD)

Large Intestine - Causes

• Stress

• Cephalic response

• Stomach

• Small intestine

• Pancreas

• Liver

• Gallbladder

– Food, infections, toxins, nutrient deficiencies, drugs, radiation, hormone imbalances, etc.

Diarrhea

• Diarrhea can be self-limiting (acute) or chronic. Chronic diarrhea presents a significant problem in terms of dehydration, electrolyte loss and malabsorption:

– Food intolerance (e.g. gluten, milk, soy, raw greens)

– Infection:

• bacteria, parasites, fungi, viral – some new research indicates that viruses may create chronic problems.

– Toxicity

Constipation

• Many possible causes, including the obvious ones like bad foods and bad bugs, lack of good bugs, to problems back up the digestive chain, to more subtle issues such as good nutrient deficiencies, underactive thyroid, mercury toxicity, emotional stress.

Irritable Bowel Syndrome

• “Intestinal Bull Shit” is label given to various symptom combinations.

“Irritable bowel syndrome (IBS) is a common condition of the digestive system. It can cause bouts of stomach cramps, bloating,

diarrhoea and constipation.”

http://www.nhs.uk/conditions/irritable-bowel-syndrome/pages/introduction.aspx

Irritable Bowel Syndrome

“The exact cause of IBS is unknown, but most experts agree it's related to an increased sensitivity of the

entire gut, which can occasionally be linked to a prior food-related illness. This may be caused by a change in your body's ability to move food through your digestive system, or may be due to you becoming more sensitive

to pain from your gut.”

http://www.nhs.uk/conditions/irritable-bowel-syndrome/pages/introduction.aspx

Irritable Bowel Syndrome

• The NHS acknowledges the following as possible causes or triggers:

– Stress, food poisoning, alcohol, fizzy drinks, chocolate, drinks that contain caffeine, such as tea, coffee or cola, processed snacks, such as crisps and biscuits, fatty food, fried food

– But nowhere are gluten, cow’s milk, soy, green veggies, chronic dysbiosis, etc. mentioned.

Hemorrhoids (Piles) - Symptoms

• Red blood in toilet bowl or on toilet paper

• Burning and general discomfort

• Difficult bowel movements

• Fullness of the rectum

• Lumps or swelling around the anal area

• Mucus in stools

• Incomplete evacuation

Hemorrhoids (Piles) - Causes

• They can be caused by anything that increases pressure on the blood supply to the abdominal and pelvic areas:

– Overweight, constipation and straining, tight clothing, poor posture, crossing the legs when sitting, stress, anal intercourse, laxative abuse.

– People with poor liver and gallbladder function may be more prone to developing piles.

Pruritis ani – “Itchy Butt”

• Symptoms are pretty self-explanatory!

– Antibiotics (encourages dysbiosis)

– Poo(r) hygiene

– Skin irritants – soaps, talc, loo roll, etc.

– Food intolerance

– Candida

– Pinworm (Enterobius vermicularis)

– Skin conditions

– Piles

Inflammatory Bowel Disease

• It’s not the same as irritable bowel syndrome and comprises a group of chronic diseases that are not fully understood, but are characterized by period of discomfort (flare-ups) and remission:

– Ulcerative colitis

– Crohn’s disease

– Diverticular disease

IBD – Possible Causes

• Stressful event / period of stress – Dave’s policeman client

• Acute (trigger) or chronic infection – C. diff can cause colitis, Blasto and E. histolytica also

• Antibiotic exposure

• Depletion of good bugs – They modulate immune function and are anti-inflammatory

• Food (processed, chemical-laden food) – Gluten, milk, corn, etc.

• Alcohol

• Nutrient depletion

• Genetics

Ulcerative Colitis - Symptoms

• Inflammation

• Ulcers are generally found in the rectum, sigmoid and lower left portion of the colon

• Rarely backs up into small intestine

• Bloody diarrhoea (mucus)

• Some pain in lower left quadrant may be felt

• Fatigue (water / nutrient loss / malabsorption)

• Nausea

• Symptoms in Seven Areas of Health

Crohn’s Disease - Symptoms

• It can actually manifest from mouth to anus, but predominantly in small intestine

• Can cause bowel wall to thicken, thus narrowing the lumen

• Nausea

• Abdominal pain (common, unlike colitis)

• Diarrhoea with blood and mucus

• Loss of appetite

• Nutrient deficiency – Fe, B12, folic acid

• Food intolerance

• All aspects of digestion can be compromised

• Symptoms in Seven Areas

Diverticular Disease - Terminology

• Small sacs or pockets develop in the wall of the colon:

– Diverticulosis – no symptoms (“osis” means presence of the condition)

– Diverticulitis – inflammation

Diverticulitis - Symptoms

• Symptoms can be the same or similar to many other “disorders”:

– Nausea and vomiting

– Bloating

– Abdominal pain

– Blood in stool

– Continual need to defecate

– Can lead to blockage and perforation

Summary

• Phew – a lot of info to take on board in this session. The key points I want you to take away are as follows:

– There is a tremendous amount of overlap in the symptoms, making it hard to know what’s going on without testing.

– Most symptoms and conditions we have covered are caused by “stress”, along with too much bad stuff and inadequate good stuff.

Summary

• All digestive healing plans follow the same path:

– Remove bad foods, replace good foods

– Detect bad bugs and remove where necessary

– Replace good bugs

– Repair digestive function – acid, enzymes, gut lining, support liver and gallbladder

Summary

• The exceptions are red flag symptoms and the more complex inflammatory bowel diseases, where medical input may be required.

Resources

• I’ve added three resources for you at the bottom of the video window that I think you’ll find helpful:

– Why Stomach Acid Is Good For You by Drs. Jonathan Wright and Lane Lenard.

– An extended article called An Integrated Approach to Gastrointestinal Disorders by Dr. Leo Galland, MD.

– A cool little video on how the mucosal immune system works.

Thank You!

• Thanks for consuming this information. I hope it’s been helpful and that you’ve learned (or revised) a lot! In the next lesson we’ll move into the role of bad foods and bad bugs in creating the symptoms and conditions discussed here.