One of the most common complaints practitioners see in herbal medicine is some form of digestive disorder, ranging from IBS, IBD, reflux, or simply “just not feeling quite right,” to unexplained weight gain, chronic skin conditions, or auto-immune disorders. All of these conditions have something in common: Imbalance within the digestive tract. Many of these imbalances can be traced to “gut dysbiosis”, or an altered microbial state in the gut. Re-establishing homeostasis in the digestive system can bring profound relief and healing to the entire body, relieving not just digestive symptoms but disorders of the immune system, nervous system, and integumentary system as well.
Our gut is home to a large, diverse and dynamic population of micro-organisms that serve numerous purposes, including the breakdown and absorption of nutrients, immune system function, and, recent research shows, even cognitive function (Gareau, MG., 2014). We acquire our own native bacteria during birth and the first two years of life; some bacterial strains are even unique to each individual human being (Guarnar, F., 2006). Other bacteria, or transient microbiota, we acquire constantly through food, water, and probiotic cultures. These millions of little organisms in our bodies are crucial to our overall health and wellness, and an imbalance in their ecology can have a profound impact on our life experience.
Causes of Gut Dysbiosis
Several factors can contribute to a state of dysbiosis within the gut. Most people have heard of antibiotics killing off the good bacteria along with the bad; the use of antibiotics can be incredibly important in certain cases, such as Lyme disease, however the rampant and unchecked use of antibiotics in this country is wreaking havoc on our gut microbiome. Even a single dose of antibiotics creates permanent changes in our gut flora, and sometimes the healthy bacteria never fully recovers from strong rounds of antibiotics. Current research posits that changes in our dietary patterns combined with overuse of antibiotics could result in “each generation beginning life with a smaller endowment of ancient microbes than the last,” (Blaser, M., 2011, p. 476) as well as being a primary contributor to the explosion of obesity, diabetes, IBD, and allergies in our current population.
In addition to the overuse of antibiotics, several other factors can contribute to gut dysbiosis: the state of our mother’s gut flora during pregnancy and birth, our nutrition during the first few years of our life, stress, diets high in sugar and refined carbohydrates and low in fiber, poor digestive function and decreased motility, intestinal infection or inflammation, and eating a diet too high in protein, especially if that animal protein has been treated with antibiotics.
Stress in particular severely compromises the quality of digestive function. The inflammatory pathway set in place by living in a state of chronic stress and anxiety affects a wide range of physiological functions, including the digestive system.
Modern research has shown a direct connection between the central nervous system and the enteric—or gut—nervous system, that has been coined the “gut-brain axis”. When the body is living in a state of constant stress, whether that stress is mental, emotional, or physical, the sympathetic nervous system (our fight or flight mode) overrides the functions of the parasympathetic nervous system (our rest and digest mode), and consequently digestion gets de-prioritized because it is less integral to our immediate survival.
These factors work together to create a highly inflamed environment in the gut, which results in a decrease in gut flora, impairment of nutrient absorption, and the phenomenon known as Leaky Gut Syndrome (LGS).
Leaky Gut Syndrome
LGS develops as the junctions between cells of the intestinal epithelium begin to degrade. The intestine is designed to be slightly permeable to allow digested nutrients to be absorbed by the body through the selective opening and closing of cell junctions.
When the integrity of the intestinal mucosa becomes damaged due to inflammation, those cell junctions become larger and the screening process of materials passing through the intestinal wall breaks down. This allows larger proteins, pathogens, and toxins to slip through the intestinal epithelium and into circulation. When these larger molecules slip into circulation, our immune system becomes highly reactive and we begin to enter an increasingly inflammatory state of living. LGS has been suspected as a primary player in the development of several autoimmune diseases, in addition to digestive discomfort and food allergies.
Signs and symptoms of gut dysbiosis and LGS can be subtle or overt. Common signs include chronic constipation or diarrhea (often classified as irritable bowel syndrome), persistent skin disorders (acne, eczema, etc.), unexplained weight gain (after you’ve ruled out diet, lifestyle, or hormonal changes), numerous food allergies, frequent colds, brain fog, environmental and seasonal allergies, fatigue, anxiety or lack of well-being, and indigestion. Other serious conditions that have been linked to gut dysbiosis include Crohn’s Disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, Graves disease, and chronic fatigue syndrome.
Restoring Digestive Health
The good news is that with the right dietary approaches, herbs, and supplements, harmony within the gut can be restored. Because each individual is unique, and in herbal medicine we work with the person, not the condition, there is no single “right answer” that fits everyone. That being said, there are several dietary shifts, herbal supplements, and lifestyle adjustments that can help to rebuild gut flora, restore integrity to the tight cellular junctions of the digestive tract, and regulate healthy digestive secretions.
Diet
One of the first adjustments to the diet that helps heal the gut is increasing consumption of healthy dietary fiber, particularly fruits and vegetables. The Standard American Diet (SAD) is painfully high in processed foods, refined carbohydrates, and sugar, yet woefully low in soluble and insoluble fiber.
Fiber: Fiber is incredibly important to digestive health for so many reasons – not only does it add appropriate bulk to the stool, making bowel movements more comfortable and regular, fiber is essentially food for the microbia of your gut. When dietary fiber is consumed, it ferments in the colon, enabling the gut flora to produce Short Chain Fatty Acids (SCFAs). These SCFA’s provide fuel for the cells of your gut, promote healthy cell proliferation (i.e., inhibit tumor growth), promote liver health and the management of cholesterol, and promote an overall anti-inflammatory state within the gut. This means switching out processed carbs like pastas, crackers, and sweets for fiber-rich alternatives like apples, beets, dark leafy greens, and especially members of the broccoli family. Green bananas and apples are also a great source of fiber and prebiotic inulin which helps fuel your probiotics.
Fermented Foods: Fermented foods, such as sauerkraut, kimchi, and beet kvass are also very important for digestive health. Fermented foods supply your digestive system with the gut flora that are so integral to digestive and immune function. While taking a probiotic supplement is incredibly important as well, the probiotics you obtain from foods actually stay in your gut longer and have a more profound impact on restoring quantity and diversity to your gut microbiome. Having a small serving of one of these foods on a daily basis is enough to restore and maintain good digestive health; a couple tablespoons of sauer kraut on a sandwich or on top of a big bowl of turkey chili tastes delicious in addition to being so good for you!
Limit Sugar: Reducing the amount of sugary, processed foods is crucial to restoring gut health. Calorie dense, nutrient poor foods are difficult for your body to break down and digest, placing added stress on your already compromised digestive function. Sugar is also highly inflammatory, directly contributing to the degradation of the healthy mucosa of the digestive tract. Plus, sugar and processed foods slow down transit time in the gut, meaning it takes longer for these foods to be broken down and moved through the digestive system. Slower transit time means that waste products are sitting in your digestive system for longer periods of time and are actually getting reabsorbed into circulation, increasing your toxic load.
What should you be eating to restore digestive health? As a general rule, 5-8 servings of vegetables per day, 2-3 servings of fruit, and 2-3 servings of whole grains (actual whole grains like steel cut oats, quinoa, and wild rice, not “whole wheat” bread or pasta), and complex carbs such as legumes, provide your body with the fiber and anti-inflammatory flavonoids it needs to begin repair. Round that out with adequate amounts of good quality protein from free range animal sources or additional plant based protein, along with high-quality fats such as nuts, seeds, and avocado, and you are well on your way to a healthy digestive system.
Herbs and Supplements
Digestive Bitters: Bitters are a combination of herbs that are exactly what they sound like: bitter. Taking bitters before a meal stimulates the release of digestive secretions, stimulates peristalsis, enhances nutrient absorption, and tones the lining of the digestive tract. The latter is especially important for reversing LGS. Herbalist and Alchemist makes a wonderful digestive bitters formula that can be taken before meals.
Probiotics: While the best source of probiotics is dietary (kefir, kimchi, sauerkraut, etc.), getting enough of these foods on a daily basis to significantly improve your gut flora can be difficult. Supplementing with a good probiotic that has diverse strains is important for digestive health. This is especially true if you’ve just finished a round of antibiotics. Renew Life makes a Critical Care probiotic formula that has 10 strains of probiotics with over 50 billion cultures to provide a therapeutic dose for gut health; in addition, these capsules are delayed release, meaning the probiotic cultures remain intact and actually reach your intestinal tract (product available soon).
Slippery Elm: Slippery elm is a tree native to North America that was widely used amongst many Native American tribes as a gastrointestinal remedy. The Cherokee, for example, used a decoction of the bark as a treatment to soothe the stomach and bowels, as well as a remedy for dysentery (Moerman, 1998). The inner bark of slippery elm is classified as a demulcent, or soothing to mucus membranes. Another term for demulcent is mucoprotective, meaning that the mucilage of the bark forms a protective layer over the mucus membrane of the gut, helping to soothe inflammation and provide an extra layer of protective lining in the gut to minimize the permeability of the intestinal epithelium.
Triphala: Triphala is an Ayurvedic product that is a blend of three different berries from India. Triphala is considered the ultimate detoxifier and in smaller doses is one of the most effective remedies for toning the lining of the digestive tract. Banyan Botanicals makes a triphala formula that is combined with guggul, a resin from India, that also promotes detoxification and tissue tone. Removing stored toxins from the tissues is vital to restoring gut health as those toxins are continuously creating an inflammatory state in the gut.
L-Glutamine: L-glutamine is an amino acid that is of particular benefit to digestive health. L-glutamine boosts cell volume, antioxidant status, and stimulates the synthesis of new RNA and DNA so that cells can replicate at normal, healthy rates. This is important to maintaining the health of the digestive lining because daily cell turnover and digestive inflammation requires increased cellular energy in the gut. L-glutamine also encourages immune function, healthy glucose metabolism, normal cell apoptosis, and better stress tolerance at the cellular level.
Lifestyle
In addition to dietary changes and herbal supplements, changing certain lifestyle habits can contribute to increased digestive health. Getting at least 7-8 hours of sleep every night is incredibly important, as our body does most of its repair work at night. Shirking on sleep increases oxidative stress, shuts down energy allocation to the digestive system, and cuts down on the time your gut has to do its nightly maintenance work.
Practicing stress management is also necessary, as mentioned earlier. Living with constant stress de-prioritizes digestive health, so restoring gut function begins with getting your body to reallocate energy and resources to digestive system operation. Deep breathing, meditation, and yoga all help to switch your stress response from fight or flight to rest and digest, reducing inflammation and restoring homeostasis throughout the body.