Illustration by Michael Burmesch
Gut Health Part 1
In Functional Medicine, the gut, or gastrointestinal (GI) tract, is often considered the gateway to health. Most of us limit considerations of gut function to eating and nutrition, but as we explore connections with the rest of our body, there is so much more. Important aspects of gut health include barrier function, nutrition, immune balance, the microbiome, and even mental status.
Consider this. The GI tract is like a hollow tube going through our body with an opening on either end. As such, this hollow space (gut lumen) is actually “outside” our body making it the largest interface with the external environment. Flattening the numerous folds of the gut results in a surface area equal to the size of half a badminton court—-about 20x20 feet! The integrity of the gut lining is critical for providing a protective barrier while allowing nourishment—keeping the “bad” out and allowing the “good” in. This is astounding “intelligence” at work.
The immune system is an integral collaborator with our GI tract. Incredibly, it is estimated that the gut-associated immune system accounts for 70-75% of our entire immune system. It provides an additional vital layer of protection from external environmental threats. At the same time, the interplay between the gut and the immune system influences immune function. Exposures in the gut teach the immune system to tolerate things that are not threatening and to react to things that are potentially harmful. When a healthy gut is working well, the immune system “learns” for example, that a peanut should be safe and an infectious organism is not.
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Caring for our Personal Ecosystem
We can’t talk about gut health without talking about the gut microbiome, the micro-organisms in our GI tract also known as our gut flora. Consisting primarily of bacteria (but also fungi and viruses) our gut microbiome is comprised of approximately a trillion cells (similar to the number of cells making up our body) and contains 100 times more genes than the human genome. The composition of our microbiome (favorable vs. unfavorable organisms) greatly influences the health of our gut and in turn our overall health and vitality. This ecosystem is easily thrown off by such things as dietary choices, toxin exposures and medications we may need to take (think antibiotics).
One of the most fascinating connections to health and well-being is the so called “gut-brain axis.” This is a bidirectional path of communication between the gut and the brain and is very much influenced by our gut microbiome. Information between brain and gut occurs through nerves (especially the vagus nerve), hormones, metabolic channels and the immune system. These modes of communication allow the brain to influence intestinal activities and the gut to influence mood, cognition, and mental health. Ever experience nausea or sudden diarrhea when stressed? How about making a decision from your gut? This is the gut-brain axis in action.
Gut health can be compromised for many reasons and we don’t necessarily experience this as GI symptoms; problems can manifest in skin, brain, joints and more. Thus, when working with my patients, we usually start by assessing gut health often with the aid of specialized testing looking at the microbiome, digestive function, inflammatory markers and more. Many tools are available for healing and optimizing gut health. This effort alone can have a profound impact on one’s quality of life.
In upcoming articles, we will take a deeper dive into GI health and associated maladies. In the meantime, consider these first steps with diet—go plant centered with more fiber rich veggies while minimizing processed foods and refined sugars.
