Doctor Digestion

Got Heartburn Or GERD? Try Gentian - An Herb For Digestion
By Scott Isaacs, ND, D.C.

Millions of people deal not only with the scourge of heartburn, acid reflux, and GERD (gastroesophageal reflux disease), but also with chronic consumption of acid blockers and proton-pump inhibitors and the many potential diseases that could also be caused by them. However, there is an herb that, when used regularly, can help decrease the incidence and severity of these conditions and even decrease the need for acid blockers.

Gentian (with the taxonomic name Gentiana lutea) is one of the best herbs to support digestion. It enhances the body’s natural actions, and doesn’t work against them. In the act of digestion, the body normally secretes saliva in the mouth to begin digestion of carbohydrates (and to a lesser extent, proteins). Hydrochloric acid is then secreted in the stomach to further break down proteins. The body also secretes various digestive enzymes from the gall bladder (and by extension, the liver) and the pancreas to further assist in digestion of fats, carbohydrates, and proteins. And finally, the stomach and intestines engage in peristalsis, or rhythmic movement, to ensure that every last bit of food comes in contact with digestive juices and has the best opportunity to be assimilated into the body. Gentian increases the body’s secretion of digestive juices, and to some extent, also increases peristalsis. Having said this, it does not increase the risk of diarrhea unless you overdose. There is also a theory that when taken after meals, gentian actually (harmlessly) decreases peristalsis.

Gentian is a very bitter herb, but that’s what makes it so beneficial for digestion. Imagine eating something bitter. What’s your first response? To spit it out, right? That’s your body instinctively trying to protect itself from something potentially poisonous. But if you end up swallowing this bitter and potentially harmful substance, the body wants to destroy it as much as possible. This is where secretion of the body’s digestive juices and increased peristalsis comes into play. Gentian is not poisonous - at least, in doses of 5-30 drops of the tincture at a time. (As with everything, including water, the dose determines whether a substance is helpful or harmful.)

The best way to take gentian is different from how most other herbal preparations are taken. Usually, people pop capsules, drink tea, or squirt a dropperful or two of a tincture in the mouth, then wash it down with water. But with gentian, the most beneficial action is seen when you taste it. So the dose, again, is 5-30 drops of a tincture, in about 4-8 ounces of water. Sip the water slowly about 10 minutes before eating to stimulate digestion. You may also use the same dose after eating if you feel that typical “brick in your stomach” feeling that doesn’t go away easily. It also can help in cases of mild nausea after a meal. Of course, if you just can’t handle the taste of gentian, you can take capsules that do a reasonable job of stimulating digestion as well.

Disclaimer: Gentian is not always the best herb to reach for in severe cases of GERD. Sometimes, there is so much inflammation in the esophagus that stimulating more acid in the stomach could be harmful. Here, herbs and nutrition to soothe the esophagus and decrease inflammation may be necessary before using gentian. Food sensitivities may also play a part in GERD, so if you are dealing with GERD that doesn’t seem to respond to different therapies, this may be an avenue to explore. Finally, although not necessarily harmful, the acid-producing properties of gentian temporarily counteract the antacid properties of acid blockers and proton-pump inhibitors, potentially making them less effective. In any case, GERD is a potentially serious issue that should be managed by a health care professional well-versed in supporting the body’s natural healing processes, or co-managed with a gastroenterologist in severe cases.

Gentian (Gentiana lutea)

Part used: root
Dose: 5-30 drops of tincture in water, sipped 10 minutes before a meal
Indications: weak digestion, low appetite, heartburn, acid reflux, mild cases of GERD, mild nausea after meals, general debility.
Contraindications: advanced cases of GERD, Barrett’s esophagus, esophageal or stomach cancer.
Combines well with: ginger root (to increase appetite); skullcap root (to enhance overall digestion and relaxation during meals).

Do you have health issues that aren’t being adequately addressed by traditional medicine? Naturopathic care may be the answer you’re looking for. Visit http://www.DrScottIsaacs.com for more information about naturopathic medicine, and begin your journey toward optimal health!

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Understanding Equine Digestion
By Tammy Patterson

Since its first domestication (about 5000bc), the horse has been used for many purposes; initially for meat, then for transport and for use in battle, leading us to its modern use, for pleasure. The horse is suited to a high fiber diet due to the continual microbial fermentation within its caecum and colon. It is its domestication that leads the horse to use and therefore need more energy than can be provided by their usual high fiber natural diet of grass. It is these requirements that have lead to the inclusion of grains and supplements to the horse’s diet. In many ways, this being possible has lead to a lot of benefits, but it also has the potential to result in many problems.

Feeding horses is a combination of science and art. By using information relating to the scientific processes of digestion, metabolism and nutritional requirements, the owner can put this factual knowledge into practice for each individual horse.

The first part of the horse’s digestive system is relatively simple; it is the later part that requires us to carefully consider how we feed our horses. Horses do not ruminate like cattle and therefore need to take in small amounts of food, chew and swallow; this is where the term ‘trickle feeders’ stems from. The nature of the feed that the horse eats will greatly influence the chewing rate and speed of ingestion. The average 500kg horse will chew at a rate of 40 minutes per kilogram of hay.

The same 500kg horse would eat oats at a rate of 10 minutes for each kilogram! This can have knock on effects. The less time eating, the more chance behavioural problems can occur out of boredom. The ability to eat food so quickly also prevents the horse from chewing and breaking down the particle size of food before swallowing, significantly reducing the nutritional value that is gained from the feed ingested. Saliva is produced in response to chewing, rather than in anticipation of food. The more food is chewed the more saliva the horse produces. It has been suggested that 12 liters of saliva is produced a day on a hay and concentrate diet. On a diet of dry hay up to 100 litres can be produced. This helps to lubricate the bolus and prevent choke.

The horse’s stomach volume is between 9-15 litres. It is relatively inelastic and ingested food is retained for 20 minutes although there is always some food retained for several hours following a meal. The larger the meal the quicker the horse’s stomach empties. This also means that food empties into the small intestine more quickly. The dryer the bolus that passes though the horses digestive system, the slower the digestion and mixing of the feed with the gastric juices, reducing the effective fermenting that needs to take place.

Most digestion occurs in the small and large intestines, rather than the stomach. Naturally the horse will graze for 16-20 hours a day and they have evolved without a gall bladder. Bile is secreted continuously as food passes through the gastrointestinal tract. It is this that helps alkalise the digesta and is required to emulsify and digest lipids. A horse’s dietary energy is provided to the horse by 4 sources:

• Starch
• Cellulose (found in a primarily fiberous diet)
• Fats (usually less than 3% of total feed intake and any supplementary oils should be introduced gradually)
• Proteins (not a preferred energy source due to their inefficiency for this purpose)

Adult horses secrete over 100 litres of fluid per day into this pre-caecal part of the gastrointestinal tract (GIT). Large pelleted or grain filled meals fed infrequently can result in a low blood volume due to to meal stimulated secretions in the upper GIT. These changes can be avoided when chaff is included in the feed to slow the horse down as it eats or by frequently feeding smaller meals. It is also important to remember this when wanting to exercise after feeding. Greedy or fast eating horses will already be in a state of relative dehydration. There are other factors that need to be considered in relation to exercising after feeding:

• Glucose reaches its peak between 1-3 hours after feeding. The brain can only use glucose as a fuel and if the horse is exercising at this time would result in a larger drop in glucose levels. The horse would have to rely even more on stored glycogen potentially resulting in a quicker onset of fatigue.
• Having a full GIT after eating would restrict the amount of space available for lung expansion.
• Blood flow is diverted to the gut to enable digestion effectively. This would reduce the blood flow to muscles used when in work, again quickly bringing on fatigue.

Food travels quickly through this upper section of the GIT and most of it will reach the Caecum / Colon within 45 minutes. This does vary depending on the feed fed and the way in which it is fed. Fiberous food moves the slowest though the horses GIT. It is in the Caecum and colon that the majority of the nutritional value of the feed is utilised and the time it spends in here determines the effectiveness of the processes. Digestion and absorption of carbohydrates relies on microbial action and absorption in this section of the GIT, there is very little enzyme activity here. The fact that the microbial fermentation occurs after the ‘monogastric’ first part of the horses GIT is very important to the way we feed our horses.

It is this microbrial breakdown that can rid the large intestine of undigested proteins and urea, resulting in urea as a byproduct, the majority of which is reutilised by the bacteria, actually stimulating important bacterial growth. Any microbial protein synthesised here can not be used by the horse. Horses requiring higher protein levels need to have dietary protein supplements which can be broken down before the large intestine. Most of the water soluble vitamins are synthesised in the large intestine, so no additional feeding of these are needed. It is in the large intestine that water is stored and absorbed.

The upper part of the digestive tract has a small capacity and the horse has digestive and metabolic limitations to high grain, highly soluble carbohydrate diets. Due to the requirements we place on our horses to exercise for prolonged, frequent or intensive periods of exercise, it it vital that we remember that they have not evolved to cope with large quantities of grain feed. Whilst giving the horse the energy to perform as we require, the horses stomach can easily be overwhelmed and its digestive capability can be reduced.

This can lead to rapid fermentation of the grain carbohydrate in the hindgut, causing a decrease in the pH. This in turn will cause a negative chain reaction including a change in the microflora within the GIT, changing the action of these, possibly allowing the release of endotoxins that can cause damage to the large intestine. It is good to remember that a horse on a roughage based diet would not result in decreases in the GIT pH and therefore none of the potential problems associated. This is one of the reasons that supplementary oils and fats have become popular as a non-starch energy source.

Good nutrition can not improve the core ability of a horse but poor nutrition can place limitations on its performance.

Tammy is a passionate equine rider who wishes to promote the correct ways to be treating horses. Tammy works part time for Anything Equine who specialise in Riding Chaps as well as long riding boots, riding hats and riding jackets in the UK.

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Yaz Gallbladder Removal - Digestion Side Effects
By David David Whitney

Bile is an important part of digesting fats, and following Yaz gallbladder removal surgery, normal digestion can be affected causing problems such as bloating and diarrhea. Bile is still produced by the liver, but rather than being stored and then released when needed during a meal, bile is continuously released in into the intestine. Problems can occur when eating a meal that is high in fat content since there may not be enough bile in the intestine to adequately handle the normal absorption process. In some situations your doctor may prescribe medications to control the availability of bile salts or a drug like Questran (cholestyramine) which is used to lower high levels of cholesterol in the blood.

It is not uncommon to have temporary digestive problems after gallbladder removal (cholecystectomy). The main reason is usually a difficulty in the digestive system handling fats in the diet. Fat and certain fat-soluble vitamins require bile in order to be absorbed. When the gallbladder is present, it stores bile that the liver makes. While eating the gallbladder contracts and releases a flood of bile into the intestine that is used for fat absorption. After cholecystectomy, bile is still produced by the liver, but is released in a continuous, slow trickle into the intestine. Thus, when eating a meal that is high in fat content, there may not be an adequate amount of bile in the intestine to properly handle the normal absorption process.

The change in intestinal bile concentration during high-fat intake may cause diarrhea or bloating, because excess fat in the intestine will draw more water into the intestine, and because bacteria digest the fat and produce gas. Some studies suggest that diarrhea after cholecystectomy may also be caused by excess bile in the intestine between meals, because bile is released into the intestine continuously.

It is estimated that as many as 20 percent of patients develop chronic diarrhea after having their gallbladder removed. This life-changing condition can last for many years. A significant proportion of people following surgery develop a condition called postcholecystectomy syndrome (PCS). PCS is caused by changes in bile flow due to the loss of the reservoir function of the gallbladder. Two different types of problems may occur. The first problem is continuously increased bile flow into the upper GI tract, which may contribute to esophagitis and gastritis. The second consequence is related to the lower GI tract, where diarrhea and lower abdominal pain may result. Symptoms of PCS include gastrointestinal distress and persistent pain in the upper right abdomen. Many women who have suffered from side effects after gallbladder removal surgery continue to have digestive problems including PCS.

John Davidson is author of this article on Yaz gallbladder disease. Find more information about Yasmin gallbladder disease here.

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Amazing Cure Eliminates Digestion Pain in Under a Day
By Jessica Katz

While thinking of digestion pain, the kind that generally comes to mind is the kind that trails up the lower back and into the hip. While this is the most common, stomach back pain or digestive pain is also fairly common and can create huge problems over time. When dealing with stomach back pain, the middle of the spine is affected, this is composed of a dozen vertebrae that span along the center of the back, attaching to the rib cage.

A majority of the time, stomach back pain is the result of a strained muscle, but sometimes is the effect of a herniated or slipped disc. Diagnosis can be easily determined with use of an x-ray. You can then talk with your doctor to work out a treatment plan.

Signs of Stomach Digestion Pain Problems:

It is not always required to go to the doctor when dealing with stomach pain alone as it is usually the result of eating something you shouldn’t have. When dealing with other pain you should always get it checked out because it could be the start of something bad.

When they occur together you should get it checked out immediately as stomach back pain is a leading cause of disability. Any pain in your back should be checked out immediately to avoid further problems.

Treatment for Stomach and Back Pain:

When dealing with both pains, doctors recommend spending only a couple days in bed. Lying on your back with your legs elevated is the best position for treatment for this type of pain. After you are feeling better, you should start an exercise course to help you stomach and back muscle to become stronger. This will help make sure digestive pain doesn’t reoccur.

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