Optimal Digestion Blueprint Part IV

<—-Part III  

   Part V —->

All of that is possible when you understand and take action on the three discoveries, I made years ago that I’m going to share with you now.

These three discoveries will help you go from chronic gut issues to a way healthier GI system, and they came about from an awareness that physicians of old use their five senses to help them arrive to a diagnosis of their patients’ afflictions.

They would smell, taste, see, hear, and touch the patient. These doctors would inquire about the nature of the stool, the smell, the frequency, color, and so on. Before technology, diabetes was diagnosed by physicians tasting the patient’s urine.

If it was sweet, they would diagnose the patient with diabetes mellitus.

The word mellitus come from Latin meaning sweet, differentiating it from diabetes incipidus. Incipidus meaning tasteless.

Or they would put some of the patient’s urine on the floor and wait and see if ants will come attracted by the sugar in the urine. These discoveries will provide you the key that will help you unlock and understand the three simple steps that will restore balance in your gut.

And in just a few minutes, I will be sharing that with you.

But I want you to appreciate that the entire optimal digestion blueprint evolved from these three key discoveries.

When I set out on a journey to find the answers, the first discovery I made was that the poop doesn’t lie.

This is called the Bristol stool scale, and it has been used by clinicians and researchers since its creation in nineteen ninety seven in Bristol in the UK. And it is the outcome of a prospective study, meaning that they observe a cohort or a group of around two thousand people, men and women, from nineteen eighty seven to nineteen eighty nine who kept track of their evacuation frequency and stool consistency.

And while a visual inspection of the stool is not enough to get the full picture, it is certainly a starting point.

The scale helped identify bowel issues based on the appearance of the stool, which was classified by seven types, from Type one being very constipated to type seven indicating diarrhea or inflammation, and normal stool somewhere around type three and four.

And the outcome of the study was to evaluate colonic transit time. In other words, how long does it take for the stool to move through the five feet or so in length of the colon or large intestine to its final destination, the toilet.

The longer the transit time would lead to constipation and conversely, the shorter the transit time would lead to loose stool or diarrhea.

Now, the chart isn’t perfect. It does not tell us why the patient’s transit time is off, leading to either constipation or diarrhea.

But it is certainly a starting point in that it helps to establish a patient doctor relationship.

In our case, a client health coach relationship, in which the patient or client becomes active in the healing process, he or she becomes more aware of the internal environment of the gut by observing what comes out of it.

 Let’s take a quick look at the function of the large intestine. The three main functions of the large intestine, absorb water and electrolytes.

This is the leftover undigested or unabsorbed nutrients from the small intestine.

Water that was not absorbed in the small intestine is now taken back into circulation in the large intestine.

The large intestine is also involved in producing and absorbing vitamins by some of the bacteria in it. Vitamins such as thiamine, riboflavin, pantothenic acid, biotin, folate, menaquinones, that’s vitamin k two.

And finally, the large intestine is involved in propelling the feces towards the rectum for elimination.

Now, let me show you about how long it should take the food to travel throughout the entire GI tract. I made this little animation to give you an idea of the transit time of each of the sessions of the GI tract.

The entire GI tract, if you were to put it in a straight line, is around thirty feet long.

If you unfold the gut on the floor, its surface area is about half the size of a badminton court.

When the food enters the stomach, it is converted into a semi liquid called chyme.

And this happens by way of the low pH, the churning of the muscles in the stomach, and the release of enzymes.

And it takes around two to five hours depending on the density of the food. Meat and other proteins will take longer to break down than a salad, for example.

It is in the small intestine that most of the digestion and absorption of nutrients from the food takes place.

When the chyme from the stomach enters the small intestine, it triggers a series of signals that activate other organs and hormones into action.

For example, the liver and gallbladder release bile, which helps to break down fats and also acts as an antibacterial.

Deficiency of bile could lead to fat malabsorption and fat soluble vitamins such as a, d, e, and k.

Hormones are also released into the small intestine that slow down gastric emptying from the stomach and trigger the pancreas into releasing insulin and glucagon and digestive enzymes.

These hormones can make the tissue more sensitive to insulin.

It’s a marvelous sequence of chemical reaction that when working properly, lead to optimal digestion.

The transit time of the small intestine is around two to six hours. And as the now mostly digested food arrives to the large intestine, any remaining water and electrolytes are absorbed, so that the food waste that arrives into the descending colon is mostly solid and well formed.

So you can see that if the motility or transit time of the waste in the colon is too quick, then not enough water has been absorbed, and the stool is either soft, mushy, or diarrhea.

On the other hand, if the transit time is too slow, most of the water has been absorbed, and the stool becomes dry and difficult to evacuate.

There isn’t enough water, in other words, to float the boat, so to speak.

The large intestine transit time can be between ten to sixty hours with the average being thirty hours.

So if we are suffering with chronic indigestion, how do we figure out where the problem lies?

Let’s take a look. Digestion really starts in the brain.

When we smell food or hear food being cooked, the salivary glands go into action, and the stomach begins to become more acidic.

This is called the cephalic phase of digestion. Cephalic meaning the head and the brain in it. And, of course, proper chewing of the food is also important.

The saying drink your salads and chew your liquids is very appropriate.

But you can chew your food till kingdom come and have and have salivary enzymes to start oral digestion, but that’s not enough.

What we need to do is to focus on four organs. Digestive problems arise when any or all of these organs are not functioning at optimal level.

If the stomach is not producing sufficient acid to break down the food or is infected with a bacteria like h pylori, or the timing of the food to empty is too long, a condition on gastroparesis, food remains in the stomach for longer than normal, which can lead to nausea, vomiting, bloating, stomach pain, acid reflux, among other symptoms.

Also, keep in mind that the stomach acid is our first barrier of protection against bacteria. If the stomach acid is not low enough, it may give it an opportunity for it to go down to the small intestine.

This should be a consideration for those who are taking PPIs, proton pump inhibitors, or over the counter antiacids, or, histamine inhibitors, prescriptions that have been prescribed by your doctor.

And we could spend hours, and volumes have been written on the stomach physiology.

But suffice it to say that it is a big player and responsible for digestive symptoms when not working properly.

The gallbladder, if it is not releasing sufficient bile or if it has been removed, the digestion of fats is impaired.

This can lead to malabsorption of fat soluble vitamins such as a, E, D, K. We talked about this earlier.

Furthermore, poor fat absorption can lead to diarrhea and fat in the stool.

And a giveaway sign of fatty stool is that it is difficult to flush it floats.

It also leaves stool stains on the toilet and it smells very foul.

The other problem with poor bile flow is that it can contribute to bacterial overgrowth in the small intestine, because bile, as we said earlier, is an antibacterial substance.

And a double whammy is when the stomach has low acid production for whatever reason and not protecting us from bacteria and the bile is insufficient to kill it once it reaches the small intestine, this will lead to what is known as SIBO or Small Intestine Bacterial Overgrowth, a topic that we will touch on later.

Now, the pancreas an interesting organ with two main functions.

It is an endocrine gland, meaning that it releases hormones such as insulin and glucagon and somatostatin, and it is also an exocrine organ in that it releases proteins as digestive enzymes and bicarbonate.

So pancreatic insufficiency can also be the culprit in digestive symptoms such as abdominal pain, gas and bloating, constipation, diarrhea, and that fatty stool we talked about, pale, oily, foul-smelling poop that floats.

You see, fat is not digested the same way other macronutrients such as carbs and proteins are.

Fat molecules are too big to be absorbed into the small intestine cells.

Bile from the gallbladder and the liver has to first break down the fat to increase its surface area, and then lipase, an enzyme from the pancreas, finish the job

The broken down fat is then packaged and sent through the lymphatic system and eventually finds its way into the blood and distributed as needed by whale triglycerides and so on.

So if the pancreas is not producing enough enzymes or not enough, bile from the gallbladder, you can now understand why fat will end up in the stool.

Now think about the intestines.

All of the products of the stomach, the gallbladder and liver and the pancreas are dumped into the intestines and are going to respond to the quality of the chyme or food from the stomach, the bile or lack of bile from the gallbladder, and the enzymes or lack of enzymes from the pancreas.

On top of that, the microbiome that resides in the intestines, the bacteria, they play a pivotal role in the further breaking down of the food.

The question is, how do you know? How do you know where the problem resides?

Of course, this is a rhetorical question since I know you can’t answer me right now. Perhaps later we can discuss this on a one to one conversation, but right now, we can’t.

 But, really, how would you know?

The answer is we know because we test. We do not guess.

You see, visual inspection of the stool such as the one on the Bristow scale with that we saw earlier can only tell us so much.

But to get into the weeds, we need to have a stool test, which will give us a good picture of the microbiota and the relationship between the various species that colonize our intestines.

We can see if we have pathogens, viruses, parasites, worms, all of which can contribute to digestive distress.

Blood labs that are commonly ordered cannot give us a full picture of what’s going on in the gut. It can give us hints like, high eosinophils or basophils. These are biomarkers in white blood cells that become, higher if there is some type of allergy or parasite, but it doesn’t really tell us much more than that.

Or some of the immunoglobulins like IgG, IgA, IgM, and so on. But in my experience of over thirty years in practice, I can tell you that that that is not enough.

This was my first discovery, and it is at the heart of the optimal digestive blueprint.

Every client I have helped has undergone the same stool testing.

 remember, Linda? Before four years of bloating, abdominal pain, chronic constipation, and foul smelling stool, nearly became dehydrated due to diarrhea and vomiting.

She had tried antibiotics, probiotics, different procedures.

And after testing her stool and testing for food sensitivities and implementing the three simple steps, well, the results reduced bloating, improved mood, more social, and enjoying food once again.