Gut Fix

By Heidi Moretti

Discouraged by visit after visit with your doctor about your gut issues, you feel like there is nowhere else to turn. But you haven't lost hope and you know that there has to be something out there that is safe and worth trying to help you feel better. That's where the Gut Fix book comes in. You are meant to feel better because the body

• Language: English
• Publisher: The Healthy RD
• Release date: Jun 15, 2023
• ISBN: 9798988469834

Book preview

Preface

The Guts of the Issue

If you picked up this book thinking you are one of the unlucky few afflicted with gut health issues, let me assure you that you are not alone. In fact, worldwide, 40 percent of people suffer from at least one digestive disease. In comparison, around 66 percent of people in the US struggle with one or more digestive diseases,[1] including gastroesophageal reflux disease, gallbladder disease, inflammatory bowel diseases, and others. More money is spent on digestive remedies than heart or mental health, too, at over $136 billion per year. So why, in our so-called progressive society, are digestive issues so prevalent, and how do you find relief?

As a clinician and researcher with twenty-four years of experience, I’m passionate about gut health. This is because it is at the root of most ailments, and because of this, achieving gut health is the quickest path to feeling vitality again. Because I’m also trained in functional medicine, I have learned many techniques to help get people on the path to feeling well. In my experience, patients feel better quickly and usually permanently using this functional medicine approach. When, in fact, they previously only found temporary or no relief after trying conventional interactions with their gastrointestinal doctor.

To be clear, traditional medicine does have its place, and I urge you to visit your provider if you’re having gut issues to get a complete diagnosis. Still, it is worth knowing that there is more to treating your gut issue than conventional medicine. What’s more, if you’re having gut trouble, but your doctor can’t find the problem using a scope, scan, or other tests, you may be told there is nothing wrong with you and given little or no advice on how to feel better. And if you do receive a diagnosis of, for example, Crohn’s disease or Irritable Bowel Syndrome (IBS), you may find that the medication for your specific gut disorder only masks the issue rather than treating the root cause.

Getting to the Root Cause

As you will discover in this book, the root cause of many gut issues is a lack of essential nutrients and building blocks for the gut. For example, a lack of sufficient nutrients causes gut cells to be inflamed, function poorly, cause pain and discomfort, or all of the above. Additionally, lacking the nutritional building blocks due to stressful situations or an imbalanced diet can disrupt your body’s ability to digest foods well. This can be a root cause of distress in your gut and throughout your whole body.

Genetics may play a partial role in these gut conditions, but your genes don’t tell the whole story. Genes may load the gun, so to speak, but diet and lifestyle pull the trigger on these diseases. There is an entire field dedicated to how food and nutrients control how our genes express themselves called epigenetics.[2] Epigenetics, in simple terms, is the effect of your food and your environment on how well your genes work. In other words, what you eat has a huge impact on whether your genes cause damage to your body or not. This is good news for all of us because we can make simple diet and lifestyle changes to reduce gut symptoms even due to daunting genetic conditions. And understanding that food significantly impacts your health’s destiny is much more potent than feeling helpless due to genes.

Yet, many medical doctors ignore the basic building blocks of the gut: food, herbs, healing compounds, and nutrients. This is largely because medical doctors aren’t taught these critical healing tools in their academic training. In my experience, my patients feel better so much more quickly from a nutritional approach than any other mode of treatment for digestive issues in most cases. I’ll be sharing some of their stories in this book. And I think you’ll find that if you are willing to try some targeted nutritional support supplements and improve your diet, you will create your own personalized gut fix and discover the healing solution you’ve been searching for.

Using This Book

Knowledge is power, so we’ll journey through the digestive tract and where and how issues might develop.

So, if you’re ready, let’s dive into the ultimate gut fix, knowledge, and finding the right nutritional balance.

[1] Almario C, Ballal M, et al. Burden of gastrointestinal symptoms in the United States: results of a nationally representative survey of over 71,000 Americans. Am J Gastroenterol. 2018 Nov;113(11):1701–10.

[2] Lorenzo P, Izquierdo A, et al. Epigenetic effects of healthy foods and lifestyle habits from the Southern European Atlantic diet pattern: A narrative review. Adv Nutr. 2022 Oct 2;13(5):1725–47.

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Chapter 1

Digestion 101: The Inner Workings of the Digestive System

In this chapter, you will learn about the basics of gut structure and health through a nutritional lens and why gut ailments are so common.

Figure 1: The flow of food through the digestive tract starts in the oral cavity (mouth) and then moves down to the anus. Important organs for the digestive tract include the liver, gallbladder, and pancreas.

How Digestion Begins

The second you smell the aroma of food, your body starts anticipating eating. That mouth-watering effect primes your digestive tract for what comes next—your first bite of food. Digestive enzymes and saliva secrete into your mouth to lubricate each mouthful and start to break down each morsel as you munch and chew.

Your whole gut, including your mouth, has healthy bacteria and other microbes, known as a microbiome, that control a lot of your body’s functioning. But your mouth needs help to produce these digestive enzymes. In times gone by, foods were rich in natural enzymes and healthy bacteria, but in the modern world of packaged foods, they are often killed by heat processing and refining long before they reach your dinner plate.

Chewing your food helps to mechanically break it down into smaller pieces. But today’s commonly eaten foods are so soft that even the chewing process is altered. Foods like donuts, burgers, pizza, cereal, French fries, chips, and other processed foods require minimal chewing. The result is that the food spends less time in your mouth getting broken down. This hurries the food into your stomach, cutting the digestive process short. Combine this with the fact that many Westernized foods are basically void of many nutrients and healthy compounds, and digestion doesn’t get off to the best start. In addition, chemical fertilizers, additives, and preservatives contain highly sensitive compounds which can disrupt the gut lining.

Contrast our modern diet to our ancestors who dined out on hard-to-chew meats on the bone, fish, and organ meats that are a bit tough in texture but extremely rich in nutrients, fibrous vegetables, roots, herbs, seeds, honey, and the like. These foods mostly require a lot of chewing. These unprocessed foods are naturally rich in enzymes that promote digestive function and are rich in natural antioxidants and probiotics, as well as nutrients for the whole body and gut. Our ancestral diet slowed down the first part of the digestive process, making it easier to digest foods. Sadly, these foods today, even if available, often lack nutrients, and we will get into more of the causes of this in Chapter 2.

The traditional use of herbs combined with these simple ancestral foods had unique benefits to help the digestive processes. Containing antioxidants and healing compounds, these herbs often soothed and coated the gut’s digestive lining while destroying unwanted germs and bacteria.

Stomach and Esophageal Health

As we swallow food into the esophagus, its muscles move the food particles along the way. From the esophagus, food enters the stomach, where some major digestive processes occur primarily due to the acidity of the stomach and enzyme production. This acid helps activate enzymes, break down protein, and keep food propelling through the digestive tract.

Did You Know . . . Genetics Is Not Necessarily to Blame

Esophageal cancer cases are rising due to increased gastric or acid reflux, ironically related to a poor diet. There is also an increase in inflammatory conditions related to food intolerances, i.e., eosinophilic esophagitis. This condition was rare, but now at least two in a hundred people undergoing endoscopy for any reason have it.¹ Our genes haven’t changed much. What has changed is our food supply. Eosinophilic esophagitis is thought to be predominantly a food-related allergic condition rooted in gut imbalances. We will get into more of why there are more problems with acid reflux and esophageal issues throughout the text.

A majorly essential but underappreciated part of the stomach and digestive tract is the mucus lining, which helps create around 10 liters of mucus per day. That’s 40 cups of mucus per day! It is a gel-like substance that helps carry away unwanted and harmful compounds while protecting the stomach and intestinal cells from damage. In your gut, you have a mucus layer attached to the intestine and another unattached layer with more liquid. Mucus production is affected by what you eat, and many herbs can help your body increase its protective mucus production.

Figure 2: The gut lining produces 40 cups of protective mucus daily in a healthy gut. This crucial lining protects the body from harmful germs and toxins and helps prevent inflammatory reactions.

When there is a disruption in the integrity of the mucus lining, the gut is susceptible to bacteria, inflammation, and more. Some scientists believe that damage to this lining is one of the major causes of severe digestive diseases like ulcerative colitis and that strengthening mucus production through diet and nutrition may be highly beneficial.², ³ In Chapter 4, I have included an extensive section on how to help treat stomach issues with a natural approach when possible.

Did You Know . . . Acid Reflux Has Little to Do with Acidity

Acid reflux isn’t necessarily related to acid at all. Still, it remains a significant problem in the United States, with up to 25 percent of people struggling with gastroesophageal reflux disease (GERD). Even more disturbing is that the rates of GERD continue to worsen among young people. Between 50 to 80 percent of the population suffer from symptoms like fullness, heartburn, nausea, anorexia, regurgitation, bloating, and burping.⁴ The collective term for these symptoms is functional dyspepsia.

The Small Intestine and Biliary Tree

The most complicated and orchestrated digestive events occur in the small intestine because most of your food’s nutrients are absorbed into your body here. Your gallbladder and pancreas, also known as the biliary tree, perform their roles at this point. Here, a bolus of acid-neutralizing compounds and many enzymes are released from the pancreas to further break down your food for absorption. Your gallbladder releases a large volume of bile to help you digest and absorb fats and fat-soluble vitamins.

The lining of the small intestine continuously produces most of your digestive enzymes. Within that lining, as you may recall from earlier, is mucus that adheres to the intestinal wall and protects it from germs and damaging chemicals. Ideally, any toxins get passed along into the large intestine and out of the body. But today’s diets undoubtedly cause disruption in this mucus lining and the enzymes you need to break down food, causing inflammation and more. This makes us susceptible to many of the common gut ailments we have today.

One of the most challenging aspects of the small intestine, however, is that it isn’t reachable with scopes, so identifying and treating conditions is next to impossible. However, there are increasing ways to rule out issues such as small intestinal bacterial overgrowth (SIBO), which continues to be a more common issue than once thought.

It is also hard to identify issues with the biliary tree until it is too late. Processed foods and poor eating patterns contribute to our ever-increasing gallbladder problems. Additionally, there can be sludge and inflammation from poor diets in the biliary tree, reducing the pancreas’s release of enzymes. This further worsens inflammation and damage in the small intestine due to poorly absorbed food compounds.

As a result of all this inflammation and poorly absorbed food along with highly reactive foods, an increased intestinal permeability can occur. This is often called leaky gut. Leaky gut causes unwanted and poorly digested compounds to enter the bloodstream. These compounds directly affect the body’s immune response, sending out threat signals throughout the body. The body thinks it is being attacked by foreign invaders, and the immune system goes into overdrive to fight response. Due to your body’s fight-or-flight response, inflammation occurs at a magnified level throughout the body and even the brain.

As you can see, problems starting in the mouth related to food quality can create a snowball effect of problems further down the digestive tract.

Did You Know . . . Signs of a Leaky Gut

Symptoms of a leaky gut can appear anywhere in the body, including the skin, hair, joints, heart, muscles, and more. For many people, including me, the most obvious sign of a leaky gut is skin inflammation, including cystic acne, eczema, psoriasis, and more. Eliminating food sensitivities often gives the gut a chance to heal. One of the first pleasant signs of gut healing is a reduction in unsightly skin issues and digestive complaints.

The Large Intestine and Its Microbiome

The body absorbs fluids and electrolyte minerals from your diet in the large intestine. Probiotic bacteria live in the large intestine; they ferment fiber and feed on the probiotics from your diet. This is also where some of the primary fuel for the gut is made, called short-chain fatty acids. This fuel is made from the fermentation process of undigested whole foods. These bacteria also do some fascinating work in helping you digest and absorb vitamins and minerals. Many healthy gut bacteria have enzymes that further break down foods for improved digestion of nutrients.

Not surprisingly, your gut bacteria, also known as the microbiome, vary vastly, and some experts believe that your gut probiotics are as unique to you as your fingerprint.⁵ Sadly, a typical Western diet can disrupt the balance of the microbiome, causing lots of intestinal distress. Sugars (i.e., refined carbohydrates such as pastries, white bread and pasta, and candy) can severely disrupt the microbiome balance, for example. But you can do plenty to support your gut health and bring it into balance, and we’ll be exploring those remedies in later chapters.

Did You Know . . . A Disrupted Microbiome Can Lead to Ill-Health

Long-term or extensive microbiome disruption is linked to increased mood disorders such as depression and anxiety. It is even linked to heart disease, Alzheimer’s, autoimmune diseases, cancer, liver disease, skin disorders, and more.⁶ All told, the microbiome is responsible for a considerable amount of your overall health, so finding a balance in your gut is critical to your health.

¹ Dellon E, Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018 Jan;154(2):319–32.e3.

² Johansson M, Sjövall H, et al. The gastrointestinal mucus system in health and disease. Nat Rev Gastroenterol Hepatol. 2013 Jun;10(6):352–61.

³ Paone P, Cani P. Mucus barrier, mucins and gut microbiota: The expected slimy partners? Gut. 2020;69: 2232–43.

⁴ Sperber A, Bangdiwala S, et al. Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome foundation global study. Gastroenterology. 2021 Jan;160(1):99–114.e3.

⁵ Cryan J, O’Mahony S. The microbiome-gut-brain axis: from bowel to behavior. Neurogastroenterol Motil. 2011 Mar;23(3):187–92.

⁶ Vijay A, Valdes A. Role of the gut microbiome in chronic diseases: A narrative review. Eur J Clin Nutr. 2022 Apr;76(4):489–501.

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Chapter 2

Why Diet Just Isn’t Enough

You’ve probably heard it many times, supplements are a waste of time or stop taking supplements from either news sources or ill-informed doctors. Not surprisingly, most doctors today are deficient in diet knowledge due to receiving little to no training in nutrition in medical school. According to the Association of American Medical Colleges, only 20 percent of medical schools provide any nutrition training, and most doctors average less than twenty hours of total nutrition training in their whole career.⁷ This is even true of gastrointestinal doctors, which is somewhat mind-boggling given the exclusive role of the gut in absorbing food and nutrients. In contrast, dietitians receive around twenty hours of nutrition education each week of undergrad training and more in graduate school. For nutritionists like me, nutrition training is over 4,200 hours before graduating with a master’s degree. And personally, I haven’t stopped learning about nutrients since then.

Granted, there are exceptions, as some doctors have a profound desire to heal, so they self-teach nutrition. And some dietitians also care very little about the healing process and are highly influenced by the power of Big Food and Big Pharma. Generally, however, nutrition advice in the world is often lacking critical thinking and leads many people astray, especially when it comes to supplements. As a nutrition practitioner for over twenty years, I have conducted and published clinical research on vitamins, so I can say with authority that negative headlines about supplements are not doing anyone any good. And the comments and headlines telling you to avoid supplements are flat-out misguided for most people. They are also way too generic to suit you as a unique individual.

Since you are reading this book, you likely realize that anti-supplement media hype is untrue and probably had some success feeling better when taking various dietary supplements. You should be proud of yourself for taking positive steps toward improving your health.

Why Supplement?

The only supplements that likely cause any significant level of harm are usually bodybuilding natural steroids or stimulants, as these pose health risks. But there are countless reasons why certain dietary supplements can help you. They range from spices and herbs to whole food compounds and antioxidants, as well as vitamins and minerals. Not only are they vastly different from each other, but some can literally be life-changing when chosen well.

Regarding gut health, there are some truly healing supplements on the market, and by reading this book, you’ll discover when and how to use them best. There are some valid reasons and scenarios when you might want to avoid certain supplements, but they are fewer than you might realize. While the benefits of taking dietary supplements usually far exceed the reasons not to, it is all about making informed decisions. However, you should always review any new supplements with a healthcare provider well-versed in nutrition to ensure they are a good choice for you.

There are six main reasons to include dietary supplements if you struggle with gut issues or are just trying to be healthier. First, modern food production methods mean our food is becoming less and less nutritious—even if you eat whole foods. Second, ancestral ways of eating (the diet our bodies are designed to eat) have been abandoned. Next, the chemicals in food alter gut health, whether listed on the label or not. It is also tough to resist and avoid processed foods, alcohol, and sugar because they are everywhere, and these foods deplete nutrients and antioxidants. Around half of Americans are also on prescription medications that deplete nutrients. Last, gut cells can repair quickly if you give them what you need. We will explore all of these reasons in more depth next.

Foods Today Are Lacking

Let’s face it: a carrot in today’s grocery store is not the same carrot that was grown by your great-grandparents. Today, the soil is inundated with chemical fertilizers that encourage growth but leave food lacking in its naturally abundant nutrient and antioxidant qualities. This is because chemical fertilizers are simply nitrogen, phosphorus, and potassium. But there is much more to growing food that affects the nutrient content of foods.

In traditional farming methods, the only fertilizers were natural compost made from manure and decomposing plants. These complex soil compounds make humus, which is rich in probiotics, trace minerals, and nutrients. Humus makes each piece of food grown on them more able to absorb nutrients from the soil and, frankly, taste much better.

Sadly, the longer crops are grown with synthetic fertilizers, the less nutritious they become, and your body suffers. This means you are likely low in the essential vitamins and minerals required for proper gut function.

While some farmers and ranchers are returning to regenerative agriculture practices, there is a long way to go to get our soil rich again. But regenerative farming increases the vitamins, minerals, and antioxidants of your food, so you should always try to choose foods grown regenerative if you can. But until there is an agricultural revolution, you will thrive better with more nutrients and antioxidants from supplementation, and this has been borne out countless times in my practice and in my own life.

Ancestral Foods Have Gone by the Wayside

Remember the low-fat craze? It is now sneakily being replaced by the latest trends and scare tactics to lure us into buying similarly gimmicky packaged foods. Before dietary guidelines, people ate whole foods, natural foods, period. Current diet crazes and dogmatic eating practices cause us to be too restrictive with our diets. For example, people are replacing whole foods like homemade bone broth chicken soup with boneless, skinless chicken breasts and fat-free chicken bouillon instead, which is stripped of many of its nutrients. The introduction of fake meats is also questionable as they are highly processed. Sadly, we rarely return from the processed propaganda put before us as a society.

We were meant to eat more holistically than that. For example, chicken liver and organ meats are the most nutritious parts of the chicken and shouldn’t be tossed out. They provide vital nutrients. Vegetarians used to eat more holistically as well. Unlike our ancestors, our food often travels long distances and loses a lot of its nutrients by the time it gets to our plates. In other words, we need to return to holistic eating by using real food. But supplements are often required because our foods are so far removed from whole.

Chemicals in Foods Alter Your Gut

Whether you know it or not, your food contains many chemicals, even if the packaging claims it is all-natural. An excellent example of this is whole wheat products. Farmers, under pressure to provide high yields, use desiccation. This means right before harvesting the crop, they spray glyphosate (Roundup®) on wheat or other grains to quickly and uniformly ripen them. This chemical cannot be rinsed or cooked off, so we end up eating it. I find that even health food stores struggle to keep foods free of products with chemicals. In addition, there