Suffering from digestive problems can be very frustrating. Sufferers search and search for help and never find any answers. Sometimes the problem is dismissed, and the person is told to live with it, sometimes the person is written off as a complainer, and sometimes extensive testing fails to reveal any answers.

Meanwhile, the pain, bloating, discomfort, and other symptoms continue.

Our bodies are amazing- they take what we eat, break it all apart, and use it to build the cells, organs and physical structures that make us who we are. Good digestive health is a prerequisite for the proper functioning of every other body system, yet many people are walking around with mild to severe digestive problems.

Symptoms of dysfunction in the digestive system show up in many ways. Some are obvious: constipation, loose stools, bloating, abdominal pain, and heartburn. And some you might not think to associate with the digestive system: skin complaints, lack of energy, low bone mineral density, and weak immunity.

Naturopathic doctors believe that digestive system disturbance can aggravate many other conditions. I have seen all sorts of other symptoms resolve with this approach: eczema, psoriasis, fatigue, anxiety, and autoimmune diseases. Once the offending foods are removed, the digestive system, and the immune system that surrounds it begins to recover. If the offending food is reintroduced, it usually causes a flare-up of the original condition.

There are two main ways that the digestive system can be damaged: emotional stress and infection.

The death of a loved one, the ending of a romantic relationship, an injury- we all experience major life events that cause our stress to skyrocket. For many, these major life events plant the seeds of digestive dysfunction. For others, it is chronic daily stress: relationship troubles, financial uncertainty or workplace strife.

Stress, whether it’s one big dose or a small daily dose, wreaks havoc on the digestive process. The body responds to stress in a very particular way- it’s called the stress response. When the stress response is activated, it increases blood pressure, increases breathing rate, changes brain waves, and sends blood to the muscles. It prepares the body for ‘fight-or-flight’. During the stress response, blood is directed away from the internal organs, including the digestive tract.

In contrast, the relaxation response decreases blood pressure, decreases the breathing rate, and sends blood to the internal organs. It is nicknamed ‘rest-and-digest’.

There are several ways in which stress negatively affects the digestive tract:

  • The stomach secretes less acid, causing heartburn, reflux, and reduced mineral absorption
  • The gallbladder and pancreas fail to release bile and enzymes properly, preventing proper processing of food, leaving some of it undigested
  • The intestines do not undergo their usual rhythmic contractions, affecting the speed at which food moves through the system, which can result in both diarrhea and constipation

By far, stress is the most important cause of digestive disturbances. Stress is also something that responds very well to treatment, which we will talk about after discussing the other major cause of the digestive disturbance. Furthermore, well-managed stress doesn’t need to have a negative impact on your health.

Your digestive tract is lined with billions of beneficial bacteria with many important jobs to fulfill. However, bad organisms sometimes take up residence as well: bacteria, amoebae, viruses, and, yes, gulp, worms.

Some digestive tract bugs are local. For example, E.coli O157:H7 is a mutant form of the healthy E. coli normally found in our guts. It occurs when agricultural animals are kept in improper conditions and we contract it when we eat meat from those animals that have not been cooked enough to kill the mutant E. coli.

Other bugs are contracted in more exotic locations while camping or on vacation. These bugs generally have immediate symptoms that begin within 30 minutes to 48 hours of exposure, but they can also do long term damage, causing chronic inflammation in the digestive tract that prevents it from functioning properly.

From a holistic, naturopathic perspective, assessing and treating the digestive system is a priority because it provides the energy and building blocks for all the other body systems. That is why we ask so many questions about it!

My first task is to assess what is happening with your digestive system. Often, asking questions is enough, but sometimes further testing is required.

Each patient’s treatment plan is individualized to meet their needs, however, a few common recommendations I make include:

  1. Avoid foods that your body reacts to

As a result of digestive damage caused by stress or infection, the digestive tract becomes overly reactive to certain foods. Naturopathic Doctors use a special diet to pinpoint which foods should be avoided. There is also a blood test that detects food intolerances, called an IgG Food Sensitivity Test. In some cases, I will recommend a low FODMAPs diet. Sometimes people already have a sense that certain foods bother them; other times it’s a complete surprise.

  1. Replenishing good bacteria

More and more research points to the importance of having the right bacteria in the right places. One of those places in the gut. The bacteria in our gut perform many functions, including regulating the gut-associated immune system.

There are many ways to promote the growth of good bacteria- hormonal balance, eating fiber, and supplementing with probiotics, for example. Good bacteria temper the over-reaction that damaged digestive systems are prone to.

Supplementation with probiotics is increasingly common. The more we learn, the better we are able to target the strain of probiotic organism to the requirements of the patient. For example, a type of probiotic called Saccharomyces boulardii can decrease the population of yeast in the digestive tract.

  1. Starting a stress management program

There are two ways to manage stress: to decrease the number and severity of stressors and to balance out the stress response with a healthy dose of the relaxation response. The route you take depends on your unique situation. I recommend many techniques to assist with stress management including deep-breathing, herbal remedies, acupuncture, and seeing a therapist.

One of my favourite treatments for digestive system concerns is to recommend bitters. Bitters are very bitter herbs extracted in alcohol. You take a few drops in water before each meal. The strong bitter flavor stimulates the digestive system. Bitters I recommend particularly for the symptom of bloating after eating, and for heartburn.

I also like digestive teas, known as carminatives. A strong peppermint or chamomile tea can settle your digestive system when you are feeling bloated. Taken daily, they can correct constipation.

There are specific types of digestive concerns that are quite common: irritable bowel syndrome, heartburn, and constipation.

Irritable bowel syndrome (IBS) is a label for abdominal pain and altered bowel habits that are not caused by a disease process. About 10-20 percent of adults are affected by it. Many people find it to be an irritation but some people are incapacitated by the need to always be near a washroom or the severity of their pain.

IBS includes both constipation and diarrhea, and often people experiencing both constipation and diarrhea in the course of their illness. Other symptoms include pain, bloating, nausea, and gas. The symptoms are often worse with anxiety and better at night.

Women make up the majority of IBS sufferers. Their symptoms are often worse premenstrually.

Diagnosing IBS involves inventorying symptoms and ruling out organic diseases. Symptoms that indicate a disease process are blood in the stool, malabsorption, weight loss, and fever. IBS sufferers may have mucous in the stool or may not.

There is a long list of disease processes that can cause IBS-like symptoms, some very serious and some not-so-serious. It is important that disease processes be ruled out. It would be very tedious and expensive to rule out all of the possibilities with tests, so The American Gastroenterology Association has determined that most patients require only a complete blood count, a blood test for celiac disease, a stool test for parasites, a breath test for lactase deficiency and sigmoidoscopy. Sufferers over forty years of age should have a colonoscopy.

Just about everyone gets an occasional case of heartburn, which is bad enough. Suffering from it on a daily basis is not only painful and distracting, but it also puts you at risk of developing esophageal cancer in the future (that’s cancer in the tube that connects your throat to your stomach).

The standard treatment for heartburn is to take a medicine that either neutralizes the acid in your stomach or causes your body to produce less acid.

There are two problems with this approach: high acid is rarely the problem; and, constantly reducing your stomach acid reduces your ability to absorb minerals. That’s probably why the use of acid-blocking medications is associated with a higher risk of osteoporosis.

High stomach acid is rarely the cause of heartburn. At the top of your stomach, there is a small circular muscle. The job of this muscle is to contain your stomach acid, but still, allow food to pass through. This muscle relaxes both when stomach acid is high, and when stomach acid is low!

Some people inherit high stomach acid. They are rare. Some foods can cause high stomach acid, too, like coffee. Some foods can also cause circular muscles to relax.

Most sufferers of heartburn actually have low stomach acid. There are two common causes of low stomach acid: stress/anxiety and age.

When you are stressed or anxious, your body shuts down digestion and directs that energy to your muscles. Your gut decreases its usual rhythmic contractions, you produce less saliva and your stomach decreases the amount of acid it produces

Acid production also naturally decreases as we age. It’s just a fact of life. For those over age 50, who have any sort of problem with digestion, I recommend something called bitters. Bitters come in many varieties, but they are all bitter herbs soaked in an alcohol-water solution. They taste absolutely terrible, but that intense bitter flavor kicks your digestive system into gear- you salivate, your stomach pumps out acid and the muscles of your digestive system pick up the pace.

For many people, heartburn is not caused by just one factor. Often stress and age coincide. There is also another common cause of heartburn that’s in a category of its own: H.pylori.

  1. pylori is a bacteria that lives in the stomach and can cause ulcers. This smart little bug alters the acidity of its victim’s stomach to suit its own needs. Most people who have H.pylori in their stomachs don’t notice anything, but sometimes it causes heartburn. There is a simple blood test for H. Pylori.

Most people experience constipation from time to time but what about those who suffer from it daily? It can be very uncomfortable, physically, and frustrating, emotionally.

There are three basic criteria for proper poop: it should be formed, it should be easy to pass and it should happen at least once per day. Believe it or not, there is actually a handy reference tool for classifying the consistency of stool. It’s called the Bristol Stool Chart. According to the chart, stool ranges from entirely liquid to hard lumps, like nuts. The ideal stool is “like a sausage or snake, smooth and soft”. Their words, not mine.

Constipation is rarely a sign of something seriously wrong, but rather a reminder to check in on your health habits. It responds well to high fiber intake, good hydration, and regular physical activity.

Dr. Andrea Hilborn ND is a naturopathic doctor in Kingston, Ontario.