Indigestion and Nausea

Causes. Overeating, the wrong food choices or combinations, stress, or bad bugs.

Remedies. Chew your food thoroughly and minimize sweets and sugars of all kinds. Avoid combining any sweets or grains with protein foods. (Food combining is discussed in most of my books.) Try peppermint or chamomile tea, licorice root, anise or fennel seeds, tumeric in capsules, or Aloe Vera gel or juice with a touch of lemon. Some people benefit from a supplement of hydrochloric acid or bicarbonate at mealtime (see below). Be sure to include healthy bacteria (probiotics) in capsule, powder, or liquid form.

Assessment. If your condition persists, ask your health care practitioner to test you for abnormal bacteria, yeast, or parasites.

Heartburn

Causes. Stress, overeating, irritating foods such as caffeine, alcohol, strong spices like black pepper, or infection by Helicobacter pylori bacteria (a major cause of gastritis and ulcers). The goal is to soothe and heal the upper intestinal membranes, reduce free stomach acid, and clear up any infection that might be present.

Remedies. We all have stomach acid and it is actually the way our body protects us against bad bugs. However, in cases of heartburn, the delicate tissue at the stomach's entrance is being burned by the hydrochloric acid. Eating more alkaline vegetables (especially steamed veggies) and their juices and broths can help calm the stomach. Even a bit of baking soda (1/2 - 1 tsp) directly counters stomach acid. One of the best treatments for heartburn or reflux is DGL (deglycyrrhizinated licorice); chew a tablet or two once or twice daily between meals or for heartburn. Chamomile tea can be helpful, as well as calcium or calcium/magnesium tablets or capsules, or over-the-counter antacids (such as chewable calcium-based antacids), or buffered vitamin C (calcium, magnesium, and/or potassium ascorbates).

Assessment. For persistent heartburn that doesn't respond to dietary changes and natural remedies within a week or two, see your doctor for a possible prescription, blood test for H. pylori, and a blood or stool test for parasites. If these don't reveal anything, you may need to see a gastroenterologist for a gastroscope of your stomach.

Constipation

Causes. Lack of fluids and fiber in the diet, overeating, stress, low function of the thyroid, excess alcohol or caffeine (which can cause a laxative dependency), yeast overgrowth, and other bad bugs. Constipation involves slowing of the peristaltic activity of the intestines and/or loss of tone in the abdominal muscles, resulting in sluggish bowel function.

Remedies. Chew your food well. Drink 6 to 8 glasses of water (ideally between meals), lemon water, or herbal tea. Get enough exercise. Eat more salads, vegetables, and fruits. If you suspect yeast or bad bugs, emphasize vegetables rather than fruit, due to the natural sweetness of the fruit, which can encourage yeast or bacterial overgrowth.

As supplements, you can add more fiber, such as psyllium seed husks, as well as ground flax seeds and flaxseed oil. A magnesium supplement and/or increased levels of vitamin C can help loosen the bowels. Probiotics may also help. On a temporary basis, you can use laxative herbal teas or capsules such as aloe vera, cascara sagrada, senna leaf, fennel seeds, or other herbs. However, these remedies are best started on a weekend when you can stay at home. Natural laxatives, such as cascara sagrada, can cause some cramping or an immediate need for a bowel movement at some undefined point after taking them. This can also occur with higher intake of magnesium.

Assessment. Constipation may seem routine to many, but it is a concern that can lead to major health problems. When the body doesn't clear its waste materials on a regular basis, toxins can build up in the system. This common problem can often be corrected with diet, lifestyle changes, and natural remedies. However, if constipation continues, see your physician or a natural medicine practitioner to evaluate and treat the underlying cause(s).

Diarrhea

Causes. Spoiled food, toxins, or water contaminated with unfamiliar or harmful germs (bacteria, viruses, or parasites), food allergies/sensitivities, or internalized stress. Any of these factors can that stimulate increased peristaltic activity. When food moves through the digestive tract too rapidly, there is less ability to digest and assimilate what you eat. This can also be the digestive tract's attempt to rid the body of toxins or microbes, so in some cases, diarrhea is the body's intelligence at work. Exposure to bad bugs tends to be more frequent than most of us realize, for example from food when you eat out or from drinking water containing microscopic germs, such as Cryptosporidium.

Remedies. Medicines that slow down intestinal activity are commonly used for acute and chronic diarrhea; just be sure that you are not suppressing an infection your body is trying to clear. Probiotics often help calm diarrhea because the healthy bacteria counters infections. Other natural remedies that can help clear problem microbes include grapefruit seed extract, garlic, ginger, plant tannins, and oil of oregano (in caps).

Assessment. If diarrhea persists, get checked out for parasites and pathogenic bacteria. If the problem is ongoing/chronic, consider asking for antibody testing. This approach is currently the state-of-the-art in testing for GI problems, using a simple blood test. Antibodies are tiny proteins in the blood that show if your body has "fought off" a particular germ. For example, antibody testing is widely used to indicate if someone has had the measles or had an infection with H. pylori bacteria. Your doctor can request any of a number of antibody tests that include:

• Microflora competence – checks for yeast and several different types of bacteria
• IgA testing for parasites – checks for twelve different kinds of parasites, including giardia and amoebas

Gas and Bloating

Causes. These uncomfortable symptoms can result from eating too fast, poor food combinations, allergies, intestinal yeast overgrowth (and their fermentation of food) or other bad bugs. Poorly digested food can ferment in the digestive tract, which can lead to nausea, indigestion, gas, and bloating. The toxins that are produced get absorbed into the blood and affect energy levels, moods, and brain function.

Remedies. Short term solutions include: Watch your eating habits. Chew thoroughly and relax while you eat. Avoid drinking liquids at meals unless you are on a weight-loss diet, since liquid dilutes your digestive acids and enzymes. If symptoms persist over weeks, get tested to analyze the quality of your digestion (see information on the CDSA below) or have an experienced lab look for bad bugs. Helpful natural treatments could include probiotics, grapefruit seed extract, peppermint tea, tumeric powder in capsules, and fennel or anise seeds.

Many people attempt to reduce their existing yeast or parasites with garlic, oregano oil, caprylic acid, and plant tannins. However, this may not be sufficient. I encourage you to seek more thorough treatment with your medical practitioner as I have found from years of treating these maladies may require prescription medicines to fully rid these organisms from the body. (See resources below for helpful books on this topic.)

Assessment. If this problem persists, get evaluated for yeast, parasites, and other bad bugs. Lab tests show candida and other yeast overgrowth, and clearing these food-fermenting organisms is often helpful at relieving this bloating problem.

Food Reactions

Causes. Food sensitivities can cause poor digestion or allergy-like digestive reactions. Any of the above problems such as heartburn, as well as problems like headaches, congested sinuses, achy joints, or fatigue. Pay attention to what you are eating and how you feel. If food sensitivity is a major issue, keep a food diary to track how you interact with foods. You may want to try eating only one food at a meal or even one food a day to determine what is triggering your response. The most typical causes of food reactions are the sensitive seven: cow's milk, wheat, sugar, corn, eggs, peanuts, and soy.

Remedies. Avoiding any problematic foods, obviously, is important. Since food reactions are also associated with intestinal bugs or incomplete digestion, finding the basic cause of your sensitivity may take some systematic work with your health care practitioner. Supplements that can help to reduce food reactions include vitamin C, quercitin, glutamine, bicarbonate, hydrochloric acid, charcoal capsules, and aloe vera juice (with lemon).

Assessment. There are a variety of food allergy tests, also referred to as food sensitivity testing (both food antibody assessment and cell reaction tests). A variety of labs offer these tests, but not all doctors use them. See The False Fat Diet book for a list of laboratory references. Calling one of them can help you find an appropriate practitioner in your area as well.

How to Take Digestive Supplements

Taking Hydrochloric Acid. We all need the natural hydrochloric acid produced in our stomach to help digest proteins and fats. Due to chronic stress and poor diets, many people actually don't have quite enough stomach acid, and this is even more common in the elderly.

If you feel that you are not digesting efficiently, try a product called betaine hydrochloride with pepsin (a time-released protein digestant), available at health food stores. These capsule(s) are taken after you begin eating, so the supplement mixes in with your food, which is especially helpful for digesting meals rich in protein or fats. Try one capsule for the first couple of meals; if that feels ok, you can try two and gradually increase to three or four capsules. If you have any sensation of burning or acid indigestion, stop the supplement. You can try cutting back to a more comfortable level again in a day or two. Monitor your digestion to see if it has improved. Some people who have allergies, food reactions, or even eczema benefit from taking additional hydrochloric acid. In addition, take time to eat, chew your food well, and avoid stress; these are the basics to promote good digestion.

Taking Digestive Enzymes. Lack of sufficient pancreatic enzymes is another common cause of incomplete digestion, resulting from chronic stress, overeating, poor food choices, or possibly infection. Of particular value are specially coated enzymes that survive the stomach's acid environment (called "enteric coated"). Digestive enzymes come in bottles of powdered capsules and chewable tablets. There are different qualities and combinations; some are even vegetarian formulas. I recommend taking one to two or three capsules after you eat to add enzymes to the food once it has begun to be digested. Chewing well and taking time to eat your food is the best way to get your digestive tract to work the way it should. Making the right food choices for your body is also helpful.

Taking Bicarbonate. This over-the-counter remedy is useful when the goal is to minimize excess stomach acid or to control acid/allergic type reactions. However, my observation is that most people with poor digestion need more stomach acid, rather than less. During detox programs, when your body is clearing acid wastes, bicarbonate can be useful. This can be used as regular baking soda, buffered vitamin C formulas with calcium and other alkaline minerals, or the many typical antacids available in the stores. Take as directed or use one-half to one teaspoon of baking soda after or between meals if you have any burning sensation in your belly.

Supplementing Flora

Good intestinal bacteria, termed probiotics, not only help us digest our food, they are important in our ability to resist illness. Here are a few key points about probiotics and some of the latest research.

Taking Probiotics. Use when indicated, with digestive upset (Aloe Vera juice or gel may also help), following antibiotics, or when traveling to protect against bad bugs. [Note that when you're traveling, you still want to be sure to take every precaution against bad bugs--probiotics are not an automatic protection.] Take them after antibiotics, which can alter GI flora, using probiotics in concentrated powder or liquid form. Beneficial bacteria include Lactobacillus acidophilus, Bifidobacteria, Lactobacillus bulgaricus, and Sacchromyces boulardii. I usually recommend taking your probiotics a little before or after your meals or first thing in the morning and right before bed. One or two capsules or between a quarter and half-teaspoon is typical or follow the directions on the bottle.

Yogurt

Yogurt appears to provide a source of healthy flora. We know that in societies where people (the Eastern Europeans for example) regularly eat yogurt, people have a history of living exceptionally long and healthy lives. So consider yogurt as a possible source of flora, especially fresh, homemade yogurt or a reliable brand. Check the label for the type and quantity of organisms. Certain brands may agree with you better. Some people for example find excellent results with brands that are also high in Bifidobacteria. Be sure to read labels and track your responses. Remember that food tolerances are always very individual.

Beware of food sensitivities. The first consideration with yogurt is to be sure you don't have a dairy allergy or sensitivity. Some people with dairy allergies can still tolerate yogurt every few days. People who can't handle cow's milk yogurt may want to try goat's milk yogurt, or even soy yogurt.

Research on Probiotics – Acidophilus and Other Flora

Lactobacillus Acidophilus

Lactobacillus acidophilusis the culture found in most yogurts. When ulcerative colitis was treated with eight different strains of acidophilus and Bifidobacteria, twelve of fifteen patients experienced long-term remission in a small study by the University of Bologna.

Lactobacillus DDS: One of the more studied acidophilus strains is the DDS strain, which is available nationwide in health food stores. It has been documented in the research to survive storage in dry form in the capsule on the shelf, to produce viable cultures in the gastrointestinal tract, and to boost GI immunity. (Look for products that say DDS strain, such as Megadophilus.)

Lactobacillus Plantarum

In a study of children with recurrent abdominal pain, they were given a form of Lactobacilli plantarum. Of these, 60% experienced a decrease in pain over the four-week period, in a study by the University of Nebraska.

Irritable bowel syndrome treated with L. plantarum found rates of improvement of 67% to 90%, in a study conducted in a Polish hospital. Patients who used drug therapy improved by 30% and those who took the placebo (with no medication or flora) showed no improvement.

Sacchromyces Boulardii

Sacchromyces boulardiiis another frequently recommended supplement, which is a naturally occurring yeast and a close relative of baker's yeast. It stimulates the production of secretory IgA (protective antibodies in the lining of the digestive tract). There have been a number of studies indicating that this yeast in supplement form can improve the course of GI illness.

Traveler's diarrhea was effective treated with S. boulardiiin a group of 95 German patients. Of these, 67% had failed to respond to previous anti-diarrheal or antibiotic drugs.

Colitis associated with Clostridium difficileresponded well to the use of S. boulardii, which was used in conjunction with the antibiotics vancomycin and metronidazole in a study by the University of West Virginia.

S. boulardiiwas found to prevent diarrhea in critically ill tube-fed patients in a French study.

HSO (Homeostatic Soil Organisms)

Soil-based bacteria, also known as homeostatic soil organisms, are gaining attention as viable GI flora. (See Beyond Probioticsby Ann Louise Gittleman, Keats/NTC Publishing, 1998.) HSOs are an addition to the usual probiotic agents such as lactobacillus and Bifidobacteria. Like other forms of flora, they are exceptionally helpful to some patients and moderately helpful to others. The theory is when most people lived on farms, they took in these natural substances as part of their food. (Available as Prime Defense and other products.)

Testing Your Flora

Flora levels can be measured directly with a test such as the CDSA – Comprehensive Diagnostic Stool Analysis (Great Smokies Diagnostic Lab, Asheville, NC) ordered through health care providers.

An overgrowth of yeast (candida) and bacteria can be checked through the CDSA, and presence of these organisms (and parasites) can also be discovered by antibody testing (from a blood sample) by Immunosciences Lab in Beverly Hills, CA, again available through practitioners.

In Review. Many patients comment that the choice of treatments and remedies is overwhelming. What to do? How do you know if you need more acid or less? Which vitamins? Which herbs? Everything you do requires some careful experimentation. Solutions develop out of your experience and your observation of the results. Your awareness is the key.

Try some of these simple remedies first. If they haven't worked in a few weeks, your doctor or natural medicine practitioner can also perform some simple testing to focus in on the cause of the problem. Food, fulfillment, nourishment, and replenishment are good themes for harvest time. Nourish yourselves wisely and lightly and listen to your body as it adapts to the Autumn.

Resources: A great book on digestive health is Optimal Digestion: New Strategies for Achieving Digestive Health, (to which I am a contributor) edited by Trent Nichols, MD and Nancy Faass, MSW, MPH from Avon/HarperCollins, 1999.
Guess What Came to Dinner by Ann Louise Gittleman, Avery Publishing Group, 1993.