DIGESTIVE

Digestive Conditions

Hippocrates, who is referred to as the “Father of Medicine” has long been quoted for saying “All disease begins in the gut”. Similarly, a common view point in naturopathic medicine has been that the digestive system is the corner stone of health and is strongly linked to the health of the immune system via the human gut microbiome or gut flora.

One of the main contributing factors to decreasing favorable gut flora is the overuse and overexposure to antibiotics. The most common digestive conditions that are commonly treated with antibiotics include diarrhea, colitis and certain types of stomach ulcers.

Naturopathic Approach

PREVENTION

Following a healthy lifestyle, including a balanced optimal diet suited to each individual is the most efficient way to maintain and prevent digestive symptoms and conditions in order to decrease the need for antibiotics.

Prevention generally includes:

1. Healthy diet with a diverse range of non-processed whole foods. [2.19]

For Example:
- Vegetables
- Fruits
- Antibiotic free animal protein sources
- Whole grains

2. Regular daily bowel movements [2.20]

3. Regular exercise and activity [2.18] [2.20]

4. Ensure proper hygiene, especially as it relates to the handling and preparation of food [2.21]

5. When traveling, eat and drink safely - stick to safe food and water habits [2.2]

Some tips include:

Eat food that is cooked and served hot, fruits and vegetables you have washed in clean water or peeled yourself, and pasteurized dairy products.
Don’t eat food served at room temperature, food from street vendors, or raw or undercooked (rare) meat or fish.
Drink bottled water that is sealed, ice made with bottled or disinfected water, and bottled or canned carbonated drinks.
Don’t drink tap or well water or drinks with ice made with tap or well water or unpasteurized milk. [2.2]

Key Points

Long-term impacts of antibiotic exposure on the human intestinal microbiota.

Diet plays a significant role in determining the health of the digestive system. Diet changes can induce significant microbial shifts within 24 h. [2.5]

A consequence of repeated antibiotic treatment is the long-term persistence of antibiotic resistance genes and changes in the human intestinal microbiata. [2.6]

Imbalance of the normal gut microbiota have been linked with gastrointestinal conditions such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), and wider systemic manifestations of disease such as obesity, type 2 diabetes, and atopy. [2.3]

Probiotics help restore the composition of the intestinal microbiota following antibiotic therapy. [2.8]

ASSESSMENT & NATUROPATHIC DIAGNOSIS

The aim of the naturopathic assessment process is to determine the cause(s) of the symptoms and conditions. Naturopathic doctors can perform examinations and order diagnostic tests to help determine the root cause of what a patient is experiencing. They invest time in visits taking an extensive history that investigates diet, exercise, habits, sleep and emotional state, in order to determine how it impacts the health of the individual.

There are many factors that can cause or worsen digestive symptoms and conditions including:

Lifestyle factors
Infections [2.22] [2.23] [2.24]
Stress and other emotional states [2.25]
Chronic constipation and/or diarrhea [2.20]
Health of the immune system [2.26] [2.24]
Poor diet [2.27] [2.28]
Certain medications (talk to your doctor) [2.29] [2.30]
Certain pathologies - hypothyroid, gallbladder/bowel surgeries etc. (talk to your doctor)

Naturopathic practitioners are able to assess both acute and chronic digestive symptoms through that naturopathic assessment and diagnosis process. The use of prescription medications, including antibiotics can often be minimized by addressing all the causal factors.

NATUROPATHIC

TREATMENTS

Naturopathic treatment is individualized and dependent on determining the cause of the symptoms.

It may include:

Modifications to diet and lifestyle are often part of the treatment regimen.
- Diet Modifications can include:
  - Increase dietary fibre intake. Adequate fiber in diet can help to insure optimal bowel movements. [2.31]
  - Increase Fruit and Vegetable intake. Fruits and vegetables contain compounds that have anti-oxidant effects and that support the anti-inflammatory pathway. [2.32]
  - Decrease Processed Sugar Consumption. Increasing consumption of refined sugar has been implicated in many gastrointestinal disorders. [2.33]
  - Optimize Water intake and Hydration
- Lifestyle factors may include:
  - Decrease of toxin burden on the body by not smoking and limiting exposure to second hand smoke.
  - Including Regular exercise into daily routine has shown to have a positive effect on Large bowl function.
    - Smoking and lack of exercise can significantly impact the large bowel (and potentially the microbiota) as they are risk factors for CRC. [2.34]
  - Identify mental-emotional drivers of stress that cause physical illness.
    - Stress can impact the normal activity of the colon via the gut-brain axis and it can alter gut microbiota and the presence of healthy bacteria including the beneficial Lactobacillus. [2.35]
  - Attaining and Maintaining a healthy BMI.
    - Obesity is often associated with excess energy intakes (eating too many calories) and sedentary lifestyles. Exercise (or rather a lack of it) may be an important influence on any shifts in microbial populations that are associated with obesity. [2.36]
Probiotics are often used to address imbalances in gut microbiome.
- There are probiotic strains that are able latch onto the epithelium of the GI tract help promote digestive health by improving the integrity of the gut and replacing undesirable species of bacteria and fungi. [2.37]
- Certain strains of probiotics have been proven to reduce the level of antibiotic resistant bacteria when administered alongside antibiotics. [2.8]
Castor oil packs can be beneficial in the treatment of constipation. [2.1]
There are specific herbs and nutraceuticals that are effective at healing the gut lining.
- Herbs that have antibacterial properties include:
  - Garlic. [2.38]
  - Berberis. [2.39]
  - Artemisia. [2.40]
- Herbs that have Anti-inflammatory properties include:
  - Turmeric. [2.41] [2.42]
  - Boswellia serrata. [2.43]
  - Ginger. [2.44]
- Herbs that have been shown to support and healing the gastrointestinal lining and support the microbiome:
  - Marshmallow root. [2.45]
  - Ginger. [2.45]
  - Slippery Elm. [2.46]
  - Licorice. [2.46]
  - Aloe Vera. [2.47]
- Nutraceuticals that are shown to support the gastrointestinal lining and support the microbiome:
  - Glutamine. [2.48]
  - Phosphatidylcholine. [2.49]
  - Probiotics. [2.50]
  - Prebiotics. [2.51] [2.52]

It is always best to work with your naturopathic practitioner or other trained health professional to determine the best treatment option.

Antimicrobial Resistance (AMR)