Six Principles For Restoring GI Health

by Dr. Kyle Ross

Gastrointestinal (GI) health is at the core of health of the whole person. Without healthy GI function, other systems—the immune system, the skin, the musculoskeletal system, the cardiovascular system—cannot function optimally. Clinical interventions that effectively support GI function have been shown to help maintain and restore wellness and support health.  Dr. Ross' Six Principles For Restoring Gastrointestinal Health is designed to promote optimal GI function, re-establishing balance for patients with a diverse range of health concerns. 

Principle 1: Optimize Digestion

Principle 2: Provide Soothing Gastric Support

Principle 3: Restore Healthy Intestinal Mucosa

Principle 4: Support Intestinal Defense

Principle 5: Promote Detoxication and Elimination

Principle 6: Re-establish Healthy Microflora

Digestive Wellness
An optimally functioning digestive system is the cornerstone of good health. In addition to supporting the digestion and absorption of nutrients from the diet, the GI tract protects the body by participating in detoxification and immunological processes. Eating a healthy diet may not necessarily be enough. To insure optimal GI function:

  • GI secretions are produced at adequate levels (e.g., hydrochloric acid, pepsin, pancreatic bicarbonate, amylase, lipase, protease, intestinal lactase, sucrase, and maltase)

  • The gastric mucosa is protected by appropriate mucin production and microbial defenses
  • Intestinal mucosa maintains integrity for proper absorption of nutrients as well as to provide a selectively permeable barrier to permit passage of needed nutrients while barring absorption of undesirable substances
  • Stool frequency and composition is predictable and regular. Cell mediators in the colonic mucosa have proper balance and activity
  • Microorganisms in the gut lumen are in proper balance to assure healthy intestinal pH, immune activity, and microbial defenses
  • GI motility and peristalsis are regular
  • Hepatic function - assures proper metabolism of dietary lipids and detoxication of xenobiotics and endogenous toxins 

Age-Related Digestive Challenges

In addition, in healthy individuals the aging process can contribute to a decrease in basal metabolic rate (BMR) and altered gastrointestinal function. The following digestive changes have been associated with aging:

• Reduced salivary production and decreased salivary amylase

• Decreased gastric acid secretion potentially affecting nutrient absorption

• Compromised capacity of the gastric mucosa to rebound from environmental, dietary, and oxidative stresses

• Alteration of bacterial micro ora balance in the small and large intestines

• Slowed digestion and many secondary effects that can result from these changes 

Principle 1: Optimize Digestion

According to the US Department of Health and Human Services, tens of millions of visits are made to healthcare professionals seeking support for digestive comfort and function.

Supplementation with microbial enzymes can provide effective basic support for digestive function. Improved digestion can help to relieve gas, bloating, and occasional indigestion.

Microbial enzymes are vegetarian enzymes that degrade all dietary macronutrients into absorbable components. Because they are acid-stable, these enzymes are not destroyed by gastric acid and do not require enteric coatings. Active under both acid and alkaline conditions, they are effective beginning in the stomach and continuing in the intestines, across a broad range of pH conditions in the GI tract. 

Other nutritional supplements can also be used to support digestion depending on individual needs:

  • Betaine Hydrochloride (HCl) supports healthy stomach acidity, gastric function, and protein digestion.

  • Pepsin also supports protein digestion under acidic conditions in the stomach.

  • Pancreatin supplies pancreatic amylase, lipase, and protease for digestion of carbohydrates, fat, and protein under alkaline conditions in the upper small intestine.

  • Ox Bile Extract supplies bile salts to aid in the emulsification and assimilation of dietary fats.

Principle 2: Provide Soothing Gastric Support

Hydrochloric acid secretion by the parietal cells into the lumen of the stomach supports digestion and promotes microbial defense, but an acidic pH could damage epithelial tissues of the stomach were it not for protective secretions such as mucin. The stomach’s mucin barrier must be intact in order to protect stomach health and comfort, and the lower esophageal sphincter must remain tightly closed during digestion.

Occasional discomfort after consuming coffee, spicy or fried foods, and experience relief after eating food or drinking milk, may suggest a need for soothing gastric support. The following dietary supplement ingredients support upper gastric function:

  • Deglycyrrhizinated Licorice (DGL) has been shown to support a healthy gastric mucosal lining and to stimulate increased mucin production. Removal of the glycyrrhizin component preserves mucosal benefits while removing licorice’s aldosterone-like activity and potentially adverse effects on blood pressure.

  • Gamma-Oryzanol, derived from rice bran oil, has been shown to produce soothing effects on stomach tissues in the presence of stress.

  • Marshmallow Root has a long history of traditional use as a demulcent herb. Its mucilaginous properties form a soothing coat over mucous membranes of the gastric mucosa.

  • Slippery Elm is a botanical demulcent with a long history of traditional use in soothing mucous membranes.

  • Zinc-Carnosine, a unique ingredient that combines L-carnosine, a dipeptide, with elemental zinc, has been clinically shown to support mucosal integrity and gastrointestinal immune defenses. It also helps relieve occasional indigestion. 

Principle 3: Restore Healthy Intestinal Mucosa

The healthy human gut must accommodate a diverse range of non-food substances, including endotoxins and microbes. Under healthy conditions, the epithelial lining of the gastrointestinal tract provides a selectively-permeable membrane that permits the absorption of nutrients from the diet while preventing passage of potentially harmful agents. Maintaining optimal structure and function of the intestinal mucosa plays an essential role in supporting overall health and wellness.

Intestinal permeability can be assessed by laboratory tests, such as the mannitol-lactulose test or measuring sucrase enzyme activity via breath test. Identifying and temporarily eliminating foods to which the body is sensitive also supports healthy intestinal permeability. Research indicates that nutritional factors may help to support mucosal health and promote normal intestinal permeability, including certain antioxidants, such as vitamins C and E, and mucusal nutrients.

Additionally, healthy cell mediator balance in the colonic mucosa influences intestinal comfort, as well as stool frequency and composition. Laboratory tests as well as clinical assessment can help to evaluate and monitor colon health and normal function.

Nutrients for Intestinal Barrier Function

  • L-Glutamine is a conditionally essential amino acid used as fuel by enterocytes. Many well-designed clinical studies have shown that L-glutamine supports healthy gut barrier function and permeability.

  • N-Acetyl D-Glucosamine (NAG) is a precursor for production of intestinal mucin, the protective glycoconjugate (glycosylated protein) secreted by goblet cells that makes up the intestinal glycocalyx. The glycocalyx forms a protective coating on the surface of epithelial tissue, but its functions may also include contributing to normal cell-cell recognition, cell-to-cell communication, and intracellular adhesion. NAG is a component of glycosaminoglycans and glycoproteins of the intestinal mucosa.

  • Gamma-Linolenic Acid (GLA) is an omega-6 fatty acid that may support healthy intestinal mucosal integrity.

  • Gamma-Oryzanol has been shown to support gastrointestinal comfort and health of the gastric mucosa.

  • Phosphatidylcholine is a major component of cell membranes and a key constituent of the glycocalyx that protects the gastrointestinal mucosa. It may also reduce transepithelial permeability of endotoxins, although this effect has not yet been demonstrated in humans.

    Antioxidant Pathways Support for the Intestinal Mucosa

  • Quercetin has been shown to support healthy regulation of histamine release from human intestinal mast cells in vitro and to enhance intestinal barrier function in human intestinal cells in vitro.

  • Ginkgo biloba is a free radical scavenger. It has shown cytoprotective effects on cells of the gastrointestinal mucosa in vitro.

  • N-Acetyl L-Cysteine (NAC) is a precursor to glutathione.

  • Vitamins C and E help protect intestinal mucosa cells from oxidative stressors.

  • Zinc may play a role in the maintenance of healthy intestinal permeability.

Principle 4: Support Intestinal Defense

A healthy intestinal defense system is affected by the balance of intestinal microflora. An individual’s intestinal flora can be influenced by many factors such as travel, diet, or various stressors. Several nutrients and botanical extracts have been shown to support intestinal microbial defense, which may help restore optimal gastrointestinal health and comfort.

Broad Microbial Defense

  • Berberine is an alkaloid found in goldenseal, barberry, and Oregon grape. Research indicates that the supplement ingredient, berberine sulfate, can enhance intestinal health by promoting the balance of a broad spectrum of bacterial and fungal organisms.

  • Goldenseal extracts have been shown to support a healthy balance of intestinal flora, including bacteria and fungi.

  • Garlic and its key compound, allicin, have been shown to support bacterial and fungal (e.g., yeast) balance.

  • Sweet Wormwood has been shown to support healthy intestinal defense and improve microbial balance.

Healthy Yeast Balance

  • Oregano Oil has been shown to affect the growth of bacteria and yeast in vitro.

  • Thyme contains a key constituent, thymol, which has been shown to be active in controlling yeast growth in vitro.

  • Pau D’Arco Bark bark has been used traditionally to promote a healthy balance of yeast.

  • Caprylic Acid is a medium-chain fatty acid that has been shown to control yeast growth in vitro.

  • Undecylenic Acid is a monounsaturated fatty acid that, like caprylic acid, has been shown to control yeast growth in vitro.

Principle 5: Promote Detoxification and Elimination

Foreign chemicals, or xenobiotics, are ubiquitous in the environment. The human body produces endogenous toxins as a normal part of its everyday metabolism, while other toxins are produced as waste products by the bacteria that inhabit the GI tract. In a healthy gut, these toxins and waste products are detoxified by the liver and eliminated via the bowel. Efficient metabolism and excretion of xenobiotics support the health of tissues and organs throughout the body, not just in the intestinal tract. Lifestyle and environmental factors can play a significant role in determining the extent of exposure to xenobiotics. Despite the ubiquity of these chemicals in the environment from multiple sources, it is food that represents the most common source of exposure to xenobiotics. Numerous studies have found pesticide residues in a significant percentage of food samples. Use of organic and minimally processed foods can help to reduce exposure to these toxins, but one cannot completely avoid exposure to xenobiotics.

Nutritional factors play an essential role in supporting healthy detoxification and elimination. Phase I and Phase II detoxification pathways in the liver require many cofactors and conjugating agents supplied by the diet. Other nutrients, such as lipotropic factors, are able to mobilize fat from the liver, facilitating the hepatic metabolism and excretion of xenobiotics and hormones.

Agents that Support Liver Detoxification Pathways

  • Calcium-D-Glucarate supplementation supports Phase II conjugation reactions by forming glucarolactone, a powerful inhibitor of beta-glucuronidase.

  • Beta-glucuronidase is an enzyme expressed by some gut bacteria that deconjugates products of Phase II liver metabolism; deconjugated hormones and xenobiotics become available for reabsorption through the enterohepatic recirculation.

  • Glycine, Glutamine, and Taurine are amino acids that act as conjugating agents to support Phase II detoxication. Glutamine and glycine are also precursors to glutathione.

  • N-acetyl L-cysteine (NAC) supports Phase II sulfation and promotes glutathione synthesis, thus supporting cellular health and aiding the excretion of toxins.

  • Reduced Glutathione (GSH) is a conjugating agent that plays a crucial role in the detoxication of xenobiotics. GSH participates in the regeneration of antioxidants, such as vitamins C and E.

  • Vitamin E supports Phase I detoxification and protects cell membranes from damage by quenching free radicals.

  • Choline, Methionine, and Inositol are lipotropic agents (i.e., they catalyze the breakdown of fat during metabolism in the body and promote the export of fat from the liver).

  • Dandelion, Fringe Tree, Greater Celandine, Beet Root, and Black Radish Root are botanical cholagogues and choleretics. They support healthy liver and gall bladder function by stimulating healthy secretion and flow of bile from the liver to the gall bladder to the intestines.

  • Milk Thistle Extract includes the bioflavonoid silymarin, a flavonoid with hepatoprotective properties.

 Agents that Support Elimination

  • Flax Seed, a good source of dietary fiber, omega-3 fatty acids, and lignans, enhances intestinal peristalsis, thereby supporting elimination.

  • Rice Bran is a source of insoluble dietary fiber and also contains gamma-oryzanol, which has been shown to support gastrointestinal function.

  • Dried Plum is well-known for supporting healthy elimination.

  • Fenugreek, Slippery Elm, and Marshmallow Root are botanical demulcents that form a soothing film over the intestinal mucous membrane.

  • Triphala is an ancient Ayurvedic herbal blend of three herbs: amla, belleric myrobalan, and tropical almond fruits. This combination promotes healthy digestion and detoxification, and supports the immune response.

Principle 6: Re-establish Healthy Microflora

Normal bowel microflora, such as Lactobacilli and Bifidobacteria, support healthy gastrointestinal function through numerous mechanisms: they help maintain optimal pH and produce important nutrients and enzymes. Bacteria that dwell in the large intestine help break down dietary fiber to produce short-chain fatty acids, the fuel for enterocytes that make up the intestinal lining. Lactobacilli and Bifidobacteria also help to support healthy digestion, support immune health, promote healthy bacterial and yeast balance, support skin health, and promote normal intestinal permeability.

Everyday factors such as poor diet, stress, and travel can disrupt healthy intestinal microflora, contributing to digestive upset and irregularity.

Research has shown that supplementation with probiotics (beneficial microflora) and prebiotics (probiotic growth promoters, such as fructooligosaccharides), supports healthy bowel flora as well as gastrointestinal function and comfort.

  • Lactobacillus species primarily inhabit the small intestine.

  • Bifidobacteria species primarily inhabit the large intestine.

  • Fructooligosaccharides are prebiotics, factors that have been shown to promote the growth of beneficial microflora in the large intestine.

In conclusion, digestive health forms the foundation of wellness. Through the Six Principles For Restoring Gastrointestinal Health, you can improve your overall well-being and help them respond more effectively to other measures to improve specific health concerns. For some with GI health concerns, it may be necessary to address all six principles of digestive health. Others may only require support in a few areas. A seasonal program to promote detoxification and healthy elimination is another method that has been used to promote health and wellness.* 

For questions regarding digestive issues, call 262-676-9370.