Eating Should Not Hurt

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** Fair warning: if you don’t like to read about bodily function, this is probably a post you want to skip… unless you want to understand how your digestive system should be working. **

According to the National Institutes of Health data from 2009, at least 60 – 70 million people (19 – 23% of the population) in the U.S. have at least one digestive disorder. This includes:

  • 5% of the population who have Irritable Bowel Syndrome (IBS),
  • 7% who deal with gallstones,
  • 20% who have chronic constipation, and
  • 20% who have at least weekly symptoms of acid reflux (GERD).

(Of course, these numbers are based only on the people who were diagnosed or self-reported having the condition. The actual numbers are likely higher.)

Although many people deal with digestive issues on a regular basis, eating food is not supposed to hurt, cause pain or leave us feeling worse than before we ate. Our phenomenal bodies were designed to digest, absorb and eliminate in a virtually seamless process. Aside from a little belch here or a little flatulence there, we shouldn’t have to worry about what’s going to happen after we put food in our mouths or how our bowels are going to behave.

And we shouldn’t have to spend the estimated $100 billion in out of pocket medical expenses to deal with the symptoms caused by a poorly functioning digestive system .

If you have to think about your gastrointestinal (GI) tract, which starts with your mouth and ends with your anus, because of any kind of pain, pressure, discomfort or malfunction, then your body is trying to tell you that something is wrong. One solution is to have your doctor prescribe a medicine that will (hopefully!) relieve your symptoms. And another solution is to see if you can find the cause of the problem so you can get rid of the discomfort for good, while avoiding any unnecessary medication.

To show you that digestive symptoms are often caused by resolvable problems, here are the common digestive issues and their most common causes:

  • Acid reflux / heartburn / indigestion / GERD: there are 2 circumstances in which a person experiences the pressure and/or burning feeling associated with this condition: 1) the acidic contents of the stomach flow back into the esophagus, which is not meant to handle acid, or 2) the lining of the stomach is compromised and can’t handle the acid that is present to digest food.  The difficulty here is, if it’s situation #1, the solution is to stop the acid from getting into the esophagus, not to shut the acid down because you need acid to digest protein. If it’s the second situation, perhaps shutting down the acid temporarily is necessary while you figure out why the stomach can’t handle it (again because you need acid to digest protein, your stomach was designed to be an acidic environment). But even if you seek temporary relief by turning off acid production, you want to turn the acid on again or else you will slow down the digestive process, make it less effective, and ultimately cause nutrient deficiencies because the food hasn’t been broken down enough to get the nutrients out of the food and into your body. Although I’ve given you a longer list of causes here, the most common causes of this condition include:
    • Inadequate digestion of food, which results in the food staying in the stomach longer and increases the likelihood of acid getting into the esophagus. Inadequate digestion may be caused by:
      • Insufficient chewing
      • Eating a large (or very large) meal
      • Insufficient production of stomach acid or pancreatic digestive enzymes
      • Inadequate vagus nerve stimulation.
    • Going to bed with a full stomach. Although our GI tract is capable of moving food along, gravity helps. Plus, when you’re lying down the food sits right up next to the sphincter between the esophagus and the stomach rather than at the bottom of the stomach where the entry to the small intestine is.
    • Food sensitivity or intolerance
    • Eating foods that loosen the sphincter between the esophagus and the stomach, which makes the acid more likely to reflux. These include alcohol, citrus fruits, tomatoes, chocolate, caffeine, coffee, mint, spicy or hot peppers, and ground pepper (black, red, white and green).
    • Medications and drugs, including NSAIDs and anti-inflammatories like aspirin and ibuprofen; antidepressants; antibiotics; nitroglycerin; anxiety, hypertension or osteoporosis medications; and cocaine.
  • Bloating / belching: as a general statement, your food and its associated products should move down and not up. That’s not to say that a little burp is a problem, but that you shouldn’t have excessive belching after eating. As well, the feeling of pressure or fullness should not increase the longer the food is in your GI tract. Rather, you should feel less full over time and never bloated. Possible causes of excess bloating and belching include:
    • Insufficient production of stomach acid or pancreatic digestive enzymes that digest protein or carbohydrates. This may or may not be related to a problem with the gall bladder or bile ducts.
    • Bacteria, yeast or parasite overgrowth in the intestine. Did you know that human intestinal cells do not produce gas? Rather, it is the microorganisms living in your gut that produce gas when they consume food. If there are too many bugs living in your intestines, they create more gas than your GI tract can handle.
    • Food sensitivity or intolerance. For me, my belly swells up like an over-inflated balloon if I eat something with gluten in it!
    • Swallowing air by eating too quickly. I know it seems silly, but it does happen and slowing down your speed of eating may be all you need to stop this from happening.
  • Flatulence: Everyone has a little gas sometimes because of the good microbes that live in your intestines (see above), but it indicates a problem if the flatulence is excessive for a long period of time. (For the record, if you start taking probiotics either as a supplement or in fermented foods, your flatulence may get worse for a period of time while your new friends get comfortable in their new home. But it shouldn’t stay that way for more than a couple of weeks.) Possible causes of excessive gas include:
  • Constipation: To just get it out there, you should poop at least once per day. Bowel movements are one of the primary ways that your body eliminates waste from the body. These wastes include what was never absorbed in your intestines, dead cells from your entire digestive tract (including yours and microbes’), and fat-soluble toxins that the liver puts into the bile and secretes into the intestine (water-soluble toxins can leave the body via urine). If you aren’t getting rid of these wastes every day, they are sitting in your body! Also, the poop should come out easily (no straining). So, if the frequency is less than daily and/or the consistency is hard and pellet like, then you have some form of constipation. I’ve given you a full list of possible causes here, and these are the top five:
    • Insufficient amounts of insoluble fiber or water. Insoluble fiber speeds up transit time through the intestine and holds onto water so the feces are soft and squeeze-out-able.
    • Food sensitivity or intolerance. Often dairy is a culprit, but it can be others.
    • Overgrowth of bacteria or yeast in the small intestine, especially if eating more fiber increases the problem or if a recent history of taking opiates.
    • Inadequate digestion (so there is more bulk that needs to be eliminated) due to:
      • Insufficient bile output by the gallbladder
      • Insufficient production of stomach acid
    • Magnesium deficiency
  • Diarrhea: See above section to understand what the consistency of your poop should be like. If it’s runny or malformed (i.e., doesn’t have a shape to it), you probably have some form of diarrhea. Also, I’m not referring to diarrhea caused by food poisoning as that is acute (i.e., temporary) and has a known cause. I’m concerned about chronic diarrhea where you don’t poop properly for more than 2 weeks and you don’t know the cause. Although the full list of possible causes is long, here are the most common causes of chronic diarrhea:
    • Insufficient soluble fiber intake. Specifically, soluble fiber slows down the transit time of matter through the intestines.
    • Bacteria, yeast or parasite overgrowth in the intestine. Note that it doesn’t necessarily have to be C. difficile, even though this is the most recognized bacterial cause of diarrhea. Overgrowth of any microorganism can cause chronic diarrhea and they can be difficult to eradicate because these little buggers can practically hide against the wall of the intestine!
    • Food sensitivity. Likely offenders are wheat, gluten and dairy. In children, eggs and soy are often implicated as well.
    • Inability to sufficiently digest and absorb macronutrients, including:
      • Lactose, fructose or sucrose
      • Sugar alcohols (Keep this in mind if you’re a fan of sugar free and “diabetic friendly” snacks as they often have large quantities of sugar alcohols in them.)
      • Fat (This may be from lack of pancreatic digestive enzymes or insufficient bile output by the gallbladder, which is highly likely after gallbladder removal.)
      • Protein, especially if you have morning diarrhea or diarrhea after heavy meals
    • Prescription medications
  • Irritable Bowel Syndrome: This is often the name given when someone has constipation and/or diarrhea for an extended period of time with abdominal pain or cramps and the doctor doesn’t know why. If you have received this diagnosis and an indication of constipation or diarrhea dominance, all of the information in the above sections applies to this condition too.

It is worth noting that there are symptoms outside of the digestive system that may also indicate a problem with gut function. These include:

  • Weak or cracked finger nails
  • Brittle hair or hair that won’t grow
  • Skin irritations like acne, eczema, rosacea or skin rashes
  • Skin that bruises easily
  • Tiredness or fatigue
  • Brain fog, irritability, difficulty concentrating
  • Urinary tract infections (UTIs)
  • Sinus or nasal congestion or perennial rhinitis
  • Nutrient deficiencies, as measured by lab tests
  • Sugar or alcohol cravings

If you deal with one or more digestive issues on a regular basis, I want you to know that there likely is a solution to relieve your discomfort without prescription or over-the-counter medication. With a little investigative work, you can find and resolve the cause of the problem and get on with focusing on your life and not your digestive system.

Oh! And in case you are wondering if you have “leaky gut”, check out my video series to understand more about it.

 

Note: I am not suggesting that digestive issues should never be resolved with medication. Rather, there are alternatives for you to consider. As always, consult with your doctor before discontinuing any medication, and seek the advice of a qualified healthcare practitioner (like me!) if you are not sure how to proceed with resolving your digestive problem.

 

Image courtesy of Gratisography.

Sources:
— Allen S. Gastrointestinal Health from a Functional Medicine Perspective. Webinar held on February 11, 2015.
—Gaby AR. Nutritional Medicine. Concord, NH: Fritz Perlberg; 2011.
— The National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services. Digestive diseases statistics for the United States. In Health Statistics. Accessed on April 7, 2015.
— National Institutes of Health, U.S. Department of Health and Human Services. Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases. Bethesda, MD: National Institutes of Health; 2009. NIH Publication 08–6514.

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