Gastrointestinal

It all starts in the gut.

There is a reason why the above phrase became a commonality in the medical field.

The gastrointestinal tract is the bodies contact with the outside world. Therefore it is highly suggestible to exogenous (outside the body) and endogenous (inside the body) impacts.

For protection, 40-60% of our immune system lies in the lamina propria of our mucosal layers. This is how your immune system gets exposed to triggering proteins or the immune response can be dampened.

Our stomach acid provides protection from bacterial overgrowth and any ingested microbes.

Our digestive process provides us with the nutrients our body needs to feed the demand we require for functioning

The microbiome impacts our neurotransmitter production and mood, caloric extraction from food, nutrient extraction from food, insulin excretion and much more.

You can now understand how the gastrointestinal system can be the mediator of disease that may present solely on the skin, lungs, brain and other organ systems without direct symptoms in the gastrointestinal tract.

Gut-Brain Axis

The gastrointestinal tract has two connections with the the brain. 

1. Autonomic nervous system: parasympathetic and sympathetic arms are responsible for your “fight or flight response” and how the vagus nerve has such an immense impact on gastrointestinal health including motility and pain.

Adaptive changes are promoted through a holistic approach to patient care.

2. Hypothalamus Pituitary Adrenal (HPA) axis: interacting with the gut through cortisol, noradrenaline 

It has been published that stress resulting high cortisol is correlated to increased gut permeability (“leaky gut”) compared to stress resulting in not change in cortisol

Gut-Immune Axis

The microbiome residing in the gastrointestinal tract results in stimulation B-cell and antibody responses and the differentiation of T helper cells. 

Common Conditions Impacted By Gastrointestinal System

Gastrointestinal

  • Sinusitis
  • GERD
  • Ulcerative Colitis 
  • Crohn’s disease 
  • Diverticulitis 
  • Irritable Bowel Syndrome
  • Constipation
  • Diarrhea
  • Non-alcoholic Fatty Liver

Skin

  • Eczema
  • Psoriasis 
  • Acne
  • Rosacea

Neurological

  • Anxiety 
  • Depression
  • Concussion

Gonadal 

  • Endometriosis
  • Poly Cystic Ovarian Syndrome (PCOS)

Thyroid

  • Hypothyroid: Hashimoto

Cardiovascular risk

  • Hyperlipidemia (high cholesterol)
  • Type II diabetes
  • Weight gain

The Anatomy Of A Functional Gastrointestinal Asessment

Digestive Capacity

Assessment of digestive capacity includes sufficient salivary enzyme secretion, stomach acid, pancreatic enzyme sufficiency, bile acid secretion, micobiome diversity

Nutrient Deficiencies

Changes to nutrient levels can give a clue into pathology occurring in the gut. Often times these nutrient deficiencies can impact other organ systems. This includes iron, vitamin B12, fat soluble vitamins including Vitamin A, Vitamin D, Vitamin E, Vitamin K 

Immune System Competency

Immune response or lack of response impacts the health of the gastrointestinal system including dysbiosis (imbalance of commensal bacteria), susceptibility to infection, food sensitivities, histamine intolerance each presenting with a unique set of symptoms.

Toxin Exposure

Toxin exposure and heavy metals is often missed as it can occur due to common daily actions such as exposure to saw dust, mold exposure in a house (often gone undetected), cigarette smoking, water contamination, mechanic career, insecticides.

Neuroendocrine

The pancreas is an exocrine and endocrine organ. The hormone GLP which impacts the release of insulin from the pancreas can be influenced by intestinal health resulting a hyperinsulinemic state. 

Adrenal System & Stress

Stress has an impact on microbial diversity, secretion of digestive enzymes, immunity level, production of serotonin in the intestines and the of the vagus nerve. 

Infection & Inflammation

Inflammation directly impacts the integrity of the mucosal membrane and can allow food proteins and LPS from microbes to be exposed to the immune system. This becomes a perfect trigger for molecular mimicry and autoimmunity. The source of the inflammation is the target required for treatment.

References

Labanski A, Langhorst J, Engler H, Elsenbruch S. Stress and the brain-gut axis in functional and chronic-inflammatory gastrointestinal disease: A transdisciplinary challenge. Psychoneuroendocrinology. 2020; 111: 104501. https://doi.org/10.1016/j.psyneuen.2019.104501 

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