5. DIGESTION Flashcards
This module covers: • Digestion and its influences on health and other body functions. • The different areas and organs of the digestive system, including their anatomy and functions. • How food is digested and how the different macronutrients are acted on by digestive juices. • The gut-brain connection and the microflora. • How digestion can be impaired and supported. • Digestion and energetics. • Naturopathic signs of poor digestive health.
Explain the three functions of the digestive system
1. Digestion
* Mechanical digestion (i.e., chewing, peristalsis).
* Chemical digestion (gastric juices, pancreatic enzymes, bile and enterocyte enzymes).
2. Absorption
* Primarily in the small intestine.
* Absorption into the blood and lymph.
3. Excretion
Waste materials (including toxins acted on by the liver) are excreted via the intestines as faeces.
Elimination also occurs via the urine, skin and lungs.
What is ‘digestion’?
The process of breaking down food by mechanical and chemical action.
Give two examples of mechanical and chemical digestion
Mechanical: Chewing/peristalsis
Chemical: gastric juices/enzymes
Where does absorption mainly occur?
Small intestine
Name four organs of elimination
- Intestines
- Bladder
- Skin
- Lungs
Name four accessory organs of the digestive system
- salivary glands
- pancreas
- liver
- gall bladder
- biliary tract
Which enzyme is released by the salivary glands?
Salivary amylase
What is the optimal pH for salivary amylase and what does it break down?
It has a pH of 6.8 and breaks down polysaccharides found in starchy foods, into smaller sugar units.
Suggest two things that help digestion in the mouth
- Chewing up to 20 times
- Avoid drinking during meals
Give 4 examples of factors that can impair the functionality of salivary amylase
- Heavy metals
- refined sugars
- dairy
- chewing gum
What happens when food enters the stomach?
The hormone gastrin is released and the enteric nerves are stimulated
Name four organs that form part of the digestive tract
- mounth
- pharynx
- oesophagus
- stomach
- small and large intestine
What does gastric juice contain?
HCI and digestive enzymes (lipase and pepsinogen)
Name the two enzymes released from the stomach wall and explain their functions
Pepsin breaks down protein and Gastric lipase breaks down lipids
Name four substances absorbed in the stomach which go directly to the liver via the portal vein.
- Water
- alcohol
- iodine
- fluoride
What’s the pH of HCI?
2-3
Which minerals are required for the production of HCI? Name two food sources for each.
- Zinc (oysters / pumpkin seeds/fish, meat, eggs)
- Vitamin B6 (Walnuts / sunflower seeds/green vegies/avocado, fish)
What are the actions performed by stomach acid
- Breaks down proteins and lipids into chyme
- Chyme further triggers peptide cholecystokinin (CCK), pancreatic juice and bile release into duodenum
- eliminates micro-organisms such as bacteria, viruses and fungi, protecting against infection.
Name four possible causes of low stomach acid
- Chronic stress
- chronic H. pylori
- autoimmune gastritis
- low Vit B6 and Zinc
- Ageing
How does low stomach acid typically present?
- Bloating, belching and flatulence
- abdominal pain and fullness
Detail three ways in which low stomach acid can impair digestion
- Poor protein digestion, leading to putrefaction and polyamines, implicated in colorectal cancer
- Undigested food allows bacteria to proliferate in the small intestine, causing SIBO
- Reduced gastric activity results in less intrinsic factor, compromising Vit B12 absorption.
Name 5 ways of increasing stomach acid
- Apple cider vinegar in a little water before meals.
- Bitter herbs and foods taken 15-20 minutes before meals stimulate stomach acid release. (Herbs: Gentian, Barberry bark, Andrographis, Dandelion, Goldenseal. Foods: rocket, chicory, artichoke and watercress).
- Zinc (meat, Fish, eggs, Rice, Pumpkin seeds) and Vit B6 (Organ meat, Poultry, Tuna, Salmon, Chickpeas)-rich foods.
- Avoid over-eating and ensure meals are relaxed (eat mindfully). Avoid processed foods.
- A diet rich in fruit & vegetables.
- Eat fermented vegetables (e.g. sauerkraut).
- Himalayan and sea salt provide the chloride for HCl.
What is CCK and what triggers its release?
CCK (Cholecystokinin) is a hormone released from the duodenal wall, triggering the release of pancreatic juice and bile.
Its release is triggered by the initial presence of the acidic chyme in the duodenum, meaning that low stomach acid can ultimately significantly impair digestion.
What is the pH of chyme and how is it neutralised?
Chyme has a pH of about 2. It is usually acted upon quickly by bicarbonate, which is secreted by the pancreas and liver. This neutralises chyme and creates a pH of about 6.5 in the duodenum.
90% of nutrient absorption takes place in the small intestine. Name the three regions of the small intestine and what characteristically happens in each.
- Duodenum (30cm) – most digestion occurs here, aided by the influx of pancreatic juices and bile. Some vitamins and minerals are absorbed, too.
- Jejunum (2.5m) – most absorption occurs here, i.e. sugars, fatty acids, amino acids, vitamins.
- Ileum (3.5m) – vitamin B12 is absorbed.
Which structures in the small intestine creates a vast surface area to aid digestion?
Villi and microvilli
‘Brush border enzymes’ are attached to the small intestinal lining and break double-chained carbohydrates and proteins, allowing them to be absorbed. Name four and state their specific functions.
- Maltase, Sucrase & Lactase: Breaks down sugars into glucose, fructose, galactose, etc.
- Dipeptidase: Breaks down proteins into amino acids.
Complete:
————- and —– —- enter the blood capillaries of the small intestine to be sent to the liver.
Carbohydrates
amino acids
Complete:
—– —– including fat-soluble vitamins are digested in the small intestine and enter lymphatic ———–.
Fatty acids
capillaries
What is the key exocrine function of the pancreas?
The key exocrine function of the pancreas is to produce enzymes that digest carbohydrates, proteins and fats. These enzymes are secreted into the small intestine.
How much pancreatic enzymes are produced daily?
1.2-1.5L
Name three pancreatic enzymes and what they digest.
- Pancreatic Amylase: carbohydrate-digesting.
- Pancreatic Lipase: fat-digesting.
- Proteases (trypsin, chymotrypsin): protein-digesting.
What can result from poor pancreatic enzyme production?
Foods ferment in the intestines, resulting in symptoms such as bloating, flatulence and abdominal pain about 1 hour after eating. The lack of digestion can also lead to weight loss.
What are the consequences of over-eating?
- When eating often and too much, digestive enzymes are used up.
- Not all food can then be digested, resulting in malnutrition and bodily dysfunctions.
- Organs such as the pancreas and stomach are placed under stress.
- Energy is directed away from healing & repair, increasing the risk of disease.
Name three ways that can help to support the digestive system
– Do not eat more than 3 meals a day.
– Avoid over-eating and snacking between meals.
– Don’t drink with meals.
Explain Bernard Jensen’s findings
- Bernard Jensen found that undigested materials are stored in the mucus-secreting lining of the intestines, impairing the absorption and delivery of nutrients to body tissues.
- This would create an optimal environment for parasites and candida to flourish, as well as under-nourishing body tissues and organs.
What did Jensen suggest to support the digestive system?
- Detoxification
- intermittent fasting
- vegetable broths
What is the function of the gallbladder?
Storage and release of bile which is produced by the liver.
What are the main components of bile?
Bile consists mostly of water, as
well as bile salts , cholesterol and bilirubin.
Describe the function of bile in relation to:
1. Fat Emulsification
2. Detoxified liver products
3. Peristalsis
4. Cholesterol
- Bile breaks lipids into smaller molecules, increasing the surface area for digestion by pancreatic lipase.
- The liver excretes detoxified harmful materials into bile to be excreted.
- Bile stimulates intestinal peristalsis.
- Bile contains excess cholesterol that the body wishes to excrete.
What is carried by the pancreatic duct?
Pancreatic enzymes and bile
What is the result of poor bile flow?
Poor bile flow negatively affects fat digestion and the body’s ability to eliminate toxins via the bowel.
What can be used to stimulate the release of pancreatic juice and bile?
Bitters
What is the production and release of bile and pancreatic juice dependent on?
Sufficient water consumption
How many liters of blood does the liver filter per minute?
1.4L
What substances are stored by the liver?
Vit A, D, E, K ,
iron and B12
Carbs and fats
Name two functions of the liver other than storage.
Detoxification and deactivation of hormones
What can impair liver detoxification?
Lack of nutrients,
trans fats,
heavy metals,
alcohol, caffeine
and pesticides
Outline Phase I Liver Detoxification
- VOLATILE TOXINS are converted into smaller substances that are water soluble.
- CYP450 enzymes create an active BINDING site on the toxin / hormone so that it can be Conjugated (in phase II).
- On completion of phase I, toxins are OXIDISED and free radicals are formed. These must be neutralised by anti-oxidants (Vit A, C and E) to protect against oxidative damage.
Outline Phase II Liver Detoxification
- Reactive toxins are made safe and excretable by conjugation with a chemical group.
- The bound toxins are then pumped into the blood or bile for excretion mostly via the kidneys or bowels.
- The key antioxidant for neutralising free radicals
in the liver is glutathione, which is a tripeptide
formed from cysteine, glycine and glutamine.
*Nutrients including sulphur (e.g., garlic and onions), magnesium, B vitamins are required for phase II. Whilst herbs such as dandelion, milk thistle and liquorice root support liver detoxification.
Which nutrients are required for Phase ll liver detoxification?
Sulphur, magnesium and B vitamins
Which herbs support liver detoxification?
Dandelion, milk thistle and liquorice root
Which tripeptide is the key antioxidant for neutralising free radicals in the liver? Which three amino acids is it formed from?
- Glutathione
- Formed from cysteine, glycine and glutamine
Where does the final stages of digestion and absorption occur?
Large intestine
Describe the four regions of the large intestine
- Caecum – attached to appendix (twisted tube about 8cm long, almost entirely formed of immune tissue in its wall (macrophages, lymphocytes) which acts as a key reservoir for beneficial gut bacteria.
- Colon – ascending, transverse, descending regions.
- Rectum – pushes stool into anal canal.
- Anal canal – contains an involuntary internal anal sphincter and voluntary external anal sphincter.
Where is GALT found and what does it contain?
Gut associated Lymphoid Tissue is found in GIT wall and houses leukocytes (macrophages and lymphocytes).
What is the function of the leukocytes in the GALT?
Identification of microbes through close interaction with bacterial surface antigens
Providing immune defence, what is secreted into the GIT mucosa and is reduced during periods of stress?
Secretory IgA
What are the functions of the microflora?
- Final stages of nutrient extraction through microbial fermentation (creating methane & hydrogen)
- Fermentation of amino acids (creates hydrogen sulphide)
- Synthesis of vitamins such as Biotin and K2.
- Supports intestinal barrier: Bacteria produce short-chain fatty acids from fibre they ingest, that is then used by enterocytes. Protective against leaky gut.
- Pathogen protection: Out-competes for attachment to the intestinal epithelium and nutrients (e.g. against candida).
- GALT: Crucial for effective functioning of the immune system.
- Appetite-regulating proteins are produced by bacteria .
- Mood Regulation: The microflora can synthesise neurotransmitters
Name five things that can damage the intestinal barrier, possibly causing ‘leaky gut’?
- Poor nutrition: hydrogenated & trans-fats, refined sugars, processed foods / junk foods.
- Heavy metals (e.g. mercury, lead, aluminium), pesticides, herbicides and cleaning toxins, etc.
- Drugs: Corticosteroids, NSAIDs, antibiotics, vaccinations.
- Excessive stress.
- Dysbiosis and candida overgrowth.
- Alcohol and smoking.
- Radiation and chemotherapy.
- Early weaning (<6 months).
As well as poor nutrition, name two things that could negatively alter the colonies of bacteria in the large intestine, causing them to become pathogenic?
- Chronic stress
- Diabetes
- Medications (e.g. antibiotics, antacids)
- Lack of digestive secretions (e.g. stomach acid, bile)
How could ‘leaky gut’ be implicated in an inflammatory condition?
Bacterial toxins can cross the intestinal wall if the barrier has been impaired. This can create a systemic inflammatory response.
Describe the term ‘dysbiosis’
‘Dysbiosis’ is an imbalance in the colonies of the bowel flora, leading to a disruption in health.
What can indicate poor digestion as a result of bacterial action?
Excess flatulence with strong odour
Which vitamins are synthesised by the microflora?
Biotin and vitamin K2
Explain how the microflora supports the intestinal barrier
The enterocytes uses short-chain fatty acids produced by bacteria, which helps maintain the tight juctions.
What happens when the GI mucosal membrane surface is damaged?
Tight junctions become “leaky”, allowing undigested proteins to enter circulation.
What happens when cell membranes of gut bacteria abnormally enter the blood?
Excessive immune response, potentially leading to allergies and autoimmunity
Name four possible causes of “leaky gut”
- Poor nutrition
- heavy metals
- drugs
- excessive stress
- dysbiosis and candida overgrowth
- alcohol
- smoking
- radiation / chemotherapy
- early weaning
What effects could be associated with dysbiosis?
- Vitamin, mineral, amino acid insufficiencies.
- Malabsorption of carbohydrates and fats.
- Inflammatory Bowel Diseases (e.g. Crohn’s)
- Colorectal cancer.
- Alzheimer’s and Parkinson’s.
- Autoimmunity
*Allergies and intolerances. - Obesity and mood disorders.
Name the effects of eating junk food
- Gut dysbiosis –> inflammation, reduced immune function, “leaky gut”.
- “Spikes” in blood glucose –> excess insulin production, increased risk of T2D, Obesity, PCOS, Acne.
- Increased blood pressure & cardiovascular disease (atherosclerosis).
- Deficiencies in vital vitamins and minerals.
- Addictive eating behaviour, mood swings.
Who developed the ‘Germ Theory of Disease’ and what does it propose?
Louis Pasteur (1822 – 1895) developed the ‘Germ Theory of Disease’, which holds microbes such as bacteria responsible for disease. He said “germs cause disease” and proposed that disease occurs from outside of the body.
What is the ‘Terrain Theory’ and who developed it?
Antoine Béchamp (1816 – 1908) developed the Terrain Theory, which holds that it is not the microbes, but the internal environment that is responsible for disease.
He said that “germs were ‘opportunistic’ in nature & lived with us symbiotically”.
To prevent illness, he advocated not to ‘kill’ germs but to promote health (i.e. through diet, exercise etc.)
What is the Migration Motor Complex and its role?
A distinct pattern of electromechanical activity in the smooth muscle between the stomach and distal ileum during the periods between meals.
It sweeps residual undigested material through the digestive tube.
How does the MMC operate and how can it be supported?
Opening the pyloric sphincter and increasing gastric, biliary and pancreatic secretions. The secretions aid in the cleansing and also preventing SIBO.
Avoid over-eating/ leaving longer gaps between meals/ chew better / intermittent fasting/ pro-kinectics before meals / diaphragmatic breathing exercises.
What is key for the elimination of waste from the body?
Water and fibre
What is known as the “brain of the gut”?
Describe it.
The enteric nervous system.
It consists of two nerve plexuses - myenteric and submucosal plexus.
What regulates the enteric nervous system?
The autonomic nervous system
What does the myenteric plexus govern?
GIT peristalsis
What does the submucosal plexus control?
Release of digestive secretions such as gastric juice and digestive enzymes?
How does the parasympathetic system influence the enteric nervous system?
Increases muscular activity as well as glandular secretions
How does the sympathetic nervous system influence the enteric nervous system?
Decreases muscular activity and decreases glandular secretions
What does the Vagus Nerve connect and where it is located?
When is Vagus Nerve activity suppressed?
Connects brain and gut and extended from the head to digestive organs.
During chronic stress
Which plexuses does the vagus nerve stimulate?
Myenteric and submucosal plexus.
What connection do the brain and gut have?
Nearly every chemical that controls the brain has been identified in the GIT.
What neurotransmitter plays a role in peristalsis, secretion and sensation?
Serotonin
What percentage of serotonin is produced in the GIT?
95%
What key factors compromise digestion?
- Not chewing properly
- Eating junk food
- Excessive protein & soya
- Drinking whilst eating
- Overeating and snacking
- Drinking coffee
- Chronic stress
- Nutritional deficiency
What is mindful eating?
Whilst eating notice your thoughts, feelings and sensations
What are the implications of poor digestion and absorption?
Less nutrient absorption, fermentation of undigested food, increased toxaemia, and the retention of undigested materials
What molecule is dietary vitamin B12 bound to? On the presence of which substances is this dependent?
R-Protein , it is dependent on the presence of pepsin and stomach acid.
What are pancreatic proteases?
Protein digesting enzymes
Where is vitamin B12 - intrinsic factor complex absorbed?
The terminal ileum
What is produced in the liver from dietary fats and is needed to synthesise vitamin D?
Cholesterol
What element is a co-factor for the conversion of vitamin D in the liver and kidneys?
Magnesium
Outline the functions of Vitamin D3 in the digestive tract
- Vitamin D3 acts on the digestive sytem to increase the intestinal absorbtion of calcium and phosphrus.
- Vitamin D maintains calcium balance in the body, in conjunction with Vitamin K2, which controls utilisation of calcium (depositing it in bones).
- Vitamin D helps regulate bacterial species in the intestines.
What is needed for the absorbtion of vitamin D?
Healthy fats
Name four anti-oxidants absorbed from foods that protect cells against free radicals / oxidative damage.
- Beta-carotene
- Vitamin C
- Vitamin E
- Quercitin
Which organ neutralises a large number of free radicals through detoxification?
The liver
Where are the amino acids and minerals absorbed which are required for collagen synthesis?
The small intestine
How could dysbiosis lead to osteoporosis?
The small intestine is responsible for the absorption of key minerals and amino acids required to build the collagen matrix of bone. The intestinal microflora also produce vitamin K2, which causes calcium deposition in bones. Dysbiosis disturbs this balance, resulting in osteoporosis.
Which nutrients are required to support muscle health?
- Calcium - for muscle contraction.
- Magnesium - for muscle relaxation.
- Iron -to help deliver oxygen to the muscle.
- Sodium & potassium - for nerve stimulation of muscles.
- Amino Acids - for muscle growth and maintenance.
How does poor digestive health negatively impact muscles and vice versa?
- Poor digestive health results in poor delivery of essential nutrients, leading to muscle weakness, aching, cramping, fatigue and pain.
- Muscle health is also crucial in supporting digestive health: Diaphragmatic movements provide a visceral massage on the abdominal digestive organs and stimulate the release of serotonin, promoting digestion and hence nutrient absorption.
To which molecule in red blood cells is almost all oxygen bound?
haemoglobin
Which foods are known as ‘blood builders’ and why?
Due to chemical similarities with haemoglobin, Chlorophyll-rich foods (green leafy vegetables, chlorella, spirulina, etc.) can be used as ‘blood-builders’ as they nourish the blood.
How is digestive health linked with cardiovascular and mitochondrial health?
- Good digestive health is crucial to support the effective absorption of iron. Stomach acid is particularly important for this process, whilst the presence of vitamin C also aids absorption in the small intestine into the blood.
- Oxygen transport (using the key mineral ‘iron’), is crucial for cells to produce energy aerobically.
Which vitamin aids the absorption of iron ?
Vitamin C
What is the strict range of pH that must be maintained in the blood and what can challenge this?
- The blood must maintain a strict range of pH between 7.35 and 7.45 to keep the body alive.
- This is challenged by excess acidity, toxins, poor nutrition (refined sugars), chronic stress and limited movement / exercise.
Which hormones are released from the GIT epithelial cells and what do they stimulate?
- CCK - stimulates pancreatice juice and bile flow & sense of satiety (fullness)
- Gastrin - stimulates gastric activity
- Ghrelin - stimulates hunger from the stomach.
What hormone is released in response to the ingestion of carbohydrates?
Insulin
Which nutrients, reliant on good digestive health for absorption, are needed to produce thyroid hormones?
iodine, tyrosine, selenium and zinc
Which nutrients must we be able to digest and absorb to enable nervous system electrical activity?
Sodium (Na+), Potassium (K+), Chloride (Cl-) and Calcium (Ca2+) ions.
Which vitamin is important for Ca2+ absorption?
Calcitriol (vitamin D)
How does the digestive system impact on the neurotransmitter ‘dopamine’?
The digestive system is responsible for absorbing substances required to manufacture neurotransmitters. Dopamine requires: Tyrosine, Fe, B1, B3 and B6
Tyrosine : (chicken, turkey, fish, peanuts, almonds, avocados, bananas, pumpkin seeds, and sesame seeds
Iron: (Red Meat, liver, Edamame Beans, Spinach, Pumpkin seeds, Lentils)
B1: (Pork, Fish, Beans, lentils, Green peas, cauliflower, oranges, potatoes, asparagus, and kale )
B3: (Red meat: beef, beef liver, pork, Poultry, Fish.
Brown rice, Nuts, seeds, Legumes, Bananas Avocado and Mushroom)
B6: (Beef liver, Tuna, Salmon, Poultry, Chickpeas, Raw Bananas, Avocados)
Why is the absorption of Vitamin B12 crucial for the nervous system?
- Vitamin B12 myelinates neurons – increasing their speed of conduction.
- Poor digestive health results in less mineral and B12 absorption, impairing nerve activity which potentially results in symptoms such as in tingling, numbness, loss of balance and pain.
What are three areas of consideration when aiming to create a healthy ‘terrain’ where cancer cannot take hold
- Dietary and lifestyle factors affect the environment that we bathe our genes in.
- Good nutrition, as well as a healthy digestive system and lifestyle nourishes the body on a cellular level.
- Well functioning detoxification and elimination pathways are important to support this healthy terrain, by preventing the accumulation of toxins in body tissues.
Complete:
‘Genes load the ____ and the environment pulls the ____’
gun
trigger
What kind of terrain do cancer cells thrive in?
- An acidic environment: Red meats, processed foods, dairy, refined sugars, table salt and smoked foods create acidity in body tissues.
-
An anaerobic environment: “Lacking oxygen”. Consider stress, poor breathing mechanics
(upper rib breathing), poor nutrition, lack of exercise. - A glucose-rich terrain: Refined sugars fuel cancer cells. Malignant cells are dependent on glucose for their own metabolism.
TRUE OR FALSE:
90-95% of cancers are attributed to genetics.
False
90-95% of cancers are attributed to the environment and lifestyle.
List five environment and lifestyle risk factors for cancer.
- Chronic inflammation (i.e. a disease / lifestyle-induced).
- Radiation (e.g. medical, microwaves, phones).
- Compromised detoxification and elimination pathways (e.g. liver dysfunction).
- Chronic stress and obesity.
- Smoking and alcohol.
- Medications e.g. antibiotics, immunosuppressants.
- Heavy metals (e.g. aluminium, mercury, lead).
- Cosmetics (e.g. parabens).
List five dietary risk factors for cancer.
- Low fruit/vegetable intake (a low antioxidant diet).
- Red meats - mostly non-grass-fed/non-organic, with a higher risk if charcoal cooked/smoked & at high temperatures).
- Burnt starchy food - produces ‘acrylamides’.
- Low fibre - high in phytochemicals, fibre clears toxins & hormones such as oestrogen through the bowel.
- N-nitroso compounds - e.g. cured meats.
- Refined sugars - feed and promote growth of cancer cells (and increase acidity). Especially concentrated fructose, e.g.
pasteurised fruit juices, High Fructose Corn Syrup (HFCS), etc. - Dairy (especially cow’s) - pro-inflammatory & contain IGFs
(insulin-like growth factors) that promote tumour growth. - Table salt, pesticides, artificial sweeteners.
What happens when there is blockage of insuffiency in the vital force?
Illness and pathology.
In Western energetics the digestive system is described as?
Fire, hot - this governs the digestive enzymes and bile flow.
Give 5 foods and herbs that are energetically hot, and what is their function?
Ginger, garlic, rosemary, thyme, and cayenne warm up a cold condition, such as weak digestion
What is inflammation associated with?
Excess heat
Constipation is considered which type of energy? What could help?
Dry. It would benefit from moist mucilaginous herbs, like marshmallow and aloe vera
Diarrhoea is considered which type of energy? What could help?
Moist. It would benefit from drying foods such as whole grains, nuts, seeds and pulses
What is known as ‘Agni’ in Ayurveda?
Digesitve fire, which is the power to digest, transform and absorb nutrients from food
When Agni is weak due to energetic imbalance what does this cause and increase in?
Ama = toxins which are caused by excess hot or cold, bad eating habits which can cause food to remain undigested.
How can you reduce Ama?
- Increase consumption of spices and herbs, such as coriander, fennel, cumin, cardamom, and fenugreek. Fresh ginger root tea,
- Leaving 3 hours between last meal and bed. Eating slowly , chewing well, leaving gaps of 4-6 hours between meals, not eating if not hungry,
- Adequate exercise
- Avoiding ice cold drinks
- Not working/reading whilst eating.
What does TCM stand for?
Traditional Chinese Medicine
According to TCM, what is the function of the spleen?
It is an organ that encompasses all aspects of the digestion and absorption of food.
Symptoms of diarrhoea, bloating after eating, food intolerances, and indigestion are all signs of?
Spleen Qi deficiency.
What is the function of the stomach?
To ‘rot and ripen’. The stomach completes the process of rotting meats and ripening fruits, vegetables and grains.
Note: Chyme is created in the process that will then go into the duodenum thus trigger CCK for further digestion.
What is ‘stomach fire’ within TCM closely linked to?
Stomach acid (in the Western notion).
What is the TCM point of view of the stomach?
It plays a crucial role in immunity as it provides fluids to the mucous membranes and for sweat.
What foods will a spleen friendly diet include?
Warm wet breakfasts, such as porridge and congees which hydrate. Avoid drinking liquid with meals or energetically cold meals. Avoid dampening foods such as gluten, diary and refined sugar.
What indicates spleen Qi deficiency?
Sugar cravings
What western medical conditions would relate to the ‘damp and heat’ associated with spleen Qi deficiency?
Overgrowth of candida, weight gain, diabetes mellitus, hypertension and cardiovascular disease.
What times of the day are linked to which organ?
5am -7am: Large intestine.
7am - 9am: Stomach
11am-1pm: Heart.
3pm -5pm: Bladder
5pm-7pm: Kidneys
What does the pulse represent in relation to determining constitution?
Rapid = heat
Slow = cold
Weak = Qi deficiency Wiry = Qi stagnation
Name the 4 distinct areas of the tongue and the organs they are related to.
- Root/ Back = kindeys, bladder, intestines and reproductive organs
- Centre = central abdomen, stomach and spleen,
- Sides = gall bladder, liver
- Tip and front = chest, heart and lungs
Outline tongue diagnosis by shape and colour
Tongue shaped, pale red or pink = Normal.
Swollen tongue, pale in colour = Qi / yang deficiency
Thin togue, red in colour = blood deficiency, B9 /B12 deficiency
Teeth marks on edge = weak digestion
Raised upturned edge = high stress, liver issues
Blue / purple = cold / poor circulation.
What do the following tongue coatings mean:
a) Thin white
b) Brown
c) Greasy yellow
d) Greasy white
e) No coating
a) Thin white coating = normal
b) Brown = chronic excess heat
c) Greasy yellow = damp heat
d) Greasy white = damp cold
e) No coating = Yin deficiency
In tongue analysis, what presentation would indicate the following?
1. Spleen Qi deficiency
2. Candida, SIBO or IBS
3. Stomach ulcers or IBD
- A pale swollen tongue with teeth marks
- Grey thick coating at centre, and root OR yellow thick coating in the centre and root.
- Brown centre and root.
What do cracks and red spots on the tongue indicate?
Damage to stomach lining, heat and inflammation.
Using nail anaylsis, link the following observations to the deficiencies:
1. Spoon shaped nails.
2. Pale nails
3. Brittle easily split nails
4. White spots in nails
5. Vertical lines/ridges
6. Horizontal lines / ridges
- Severe iron or zinc deficiency
- Anaemia
- Mineral deficency / low stomach acid
- Zinc and or Vitamin A deficiency
- Malabsorbtion of nutrietns such as B, C, minerals and EFA’s
- Sign of strong ilness or infection
Using facial diagnosis, link the following observations to the body dysfunctions:
1. Grey skin
2. Yellow skin/ jaundice
3. Butterfly rash around nose
4. Corrugated cardboard lines across the forehead
5. Vertical creases between eyebrows
6. Dry red forehead
- Constipation
- Liver, or gall bladder / or biliary disease
- Possibly rosacea linked to H pylori ( stomach) vitamin B3 deficiency
- Large intestine toxicity has been present
- Liver dysfunction
- Possible bladder dysfunction.
In facial mapping -
1. What does acne round the chin area indicate?
2. Rash over the cheeks and nose?
3. Recurrent forehead acne or rashes can indicate?
- Hormonal imbalance
- Stomach dysfunction
- Bladder or intestinal problem, suggest possible detoxification needed.
Eye analysis:
The following observations would indicate what imbalance?
1. Clear and bright
2. Yellow/jaundiced
3. Red / blood shot
4. Swollen
5. Dry
6. Floaters in vision
- Normal/healthy
- Liver, gall bladder or bilary disease
- Issues with sleep = liver disharmony
- Liver dysfynction
- Possibly allergies, ESFA deficiency or chronic stress
- Blood deficiency , possible link to liver.
Hair - the follwoing observations would indicate what issue?
1. Dry hair
2. Oily hair
3. Excessive hair loss
4. Dry itchy scalp
5. Dandruff
6. Greying
- Excess heat or stress, possibly hypothryoidism
- Excess body acidity and trans fats
- Nutrient deficiencies such as B vitamins like biotin, zinc, iron, and protein
- Lack of EFAs
- Liver problems , excess heat
- Nutrient deficiencies such as B5, zinc or copper. As a result of extreme stress
What are the teeth numbers and their associated organs?
Upper Jaw -
Right 1 & Left 16 heart and small intestine
R2&3, L15 &16 stomach, thyroid, and pancreas
R4&5, L12 & 13 Lung and colon
R6 & L11 Liver and gallbladder
R7 & 8, L9 & 10 Kidney, bladder , prostate and uterus
Lower Jaw -
Right 32 & Left 17, heart and small intestine.
R31 & 30, L18 &19 Stomach, thyroid and pancreas.
R29 & 28, L20 & 21 Lung + colon
R 27 & L22 Liver and gallbladder
R26 & 25, 24, 23 Kidney, prostate, bladder and uterus.
What do headaches in the daytime or evening relate to?
Day time = Qi / Yang deficiency.
Evening = Blood / Yin deficiency
What does the location of headaches at the Temples, Vertex and Forehead indicate?
Temples = liver, gall bladder
Vertex = liver
Forehead = stomach
What is fatigue an indication of?
Qi deficiency
