Digstion And Health

Question 1

3 primary functions of digestive system

Answer 1

1. Digestion
   Mechanical and chemical
2. Absorption
   Primarily small intestine
   Into blood and lymph
3. Excretion
   Waste materials

30 foot tube

Digestive tract:
Mouth, pharynx, oesophagus, stomach, small and large intestines

Accessory organs
Salivary gland, pancreas, liver, gall bladder, biliary tract

Question 2

Oral cavity

Answer 2

Linked to lifespan

Chewing breaks down food and triggers amylase to be released from salivary glands to break down starches

Breaks down long carb chains (polysaccharides) found in starchy foods

Optimal pH is 6.8

Carbs not adequately digested in the mouth can remain initialised by the body as the small intestine can only absorb simple sugars

Question 3

Saliva pH

Answer 3

Excess acidity in the body tissues will be excreted via saliva, lowering pH.
Impairs functionality of salivary amylase

Can be lowered by refined sugars, meat and dairy, processed foods, chewing gum, chronic stress, coffee

Question 4

Stomach

Answer 4

Boils enters stomach through lower oesophageal sphincter (prevents acid reflux)

Food stretches stomach:
1. Releases hormone gastrin and Stimulation of enteric nerves in stomach wall
3. Stimulates peristalsis, leading to formation of gastric juice containing HCI and digestive enzymes (lipase and pepsinogen)
4. Stomach churns boils

Stomach absorbs:
Water, alcohol, iodine, fluoride
Enters venous circulation and escorted directly to liver by portal vein to be processed

Question 5

Enzymes released by stomach wall

Answer 5

Pepsinogen and gastric lipase

Pepsinogen:
Inactive enzyme which comes active when exposed to HCI
Concerts to active pepsin to break down proteins into smaller protein chains

Gastric lipase: breaks down lipase

Question 6

Stomach acid

Answer 6

Zinc and B6 required to produce HCI

PH 2-3

Functions:
Breaking down protein and lipids
Triggers pancreatic juice and bile release into duodenum where acidic chyme enters small intestine
Eliminates micro organisms such as bacteria, virus, fungi - protecting against infection

Low stomach acid can be caused by
Chronic stress
Low B6 and zinc
AI gastritis
Medications (eg proton pump)
Chronic h.pylori
Ageing

Question 7

Helping low stomach acid

Answer 7

Fermented foods, butter foods, ACV with mother, protein
Zinc and B6 foods
Himalayan sea salt

Low HCI leads to poor digestion, resulting in protein putrificafion in the small intestine
Creates compounds called polyamines which are implicated in colorectal cancer
Undigested food allows bacteria to proliferate small intestine (SIBO)
Results in low intrinsic factor (glycoprotein secreted in stomach) compromising B12 absorption

Presents as bloating, belching and flatulence after eating with foul smelling stools

Question 8

Intrinsic factor

Answer 8

glycoprotein secreted in stomach

Question 9

CCK: cholecystokinin

Answer 9

As chyme drip fed from the pyloric sphincter into the duodenum, CCK is released

Hormone released from duodenum wall, triggering release of pancreatic juices and bile
Also induces sense of satiety

Affected by low stomach acid, as the presence of acidic chyme in duodenum is key factor in CCK secretion

Chyme has pH of 2. Usually acted upon quickly by bicarbonate, secreted by pancreas and liver. Neutralised to about pH 6.5

Question 10

Small intestine

Answer 10

6.5m long structure, key site for digestion and absorption.
90% of nutrient absorption here

3 regions
1. Duodenum: most digestion occurs here, some vits and minerals absorbed
2. Jejunum: most absorption: eg sugars, fatty acids, aa, vitamins
3. Ileum: B12 absorbed

To aid absorption, huge surface area is created
Folding of small intestine, forming finger like projections known as villi, contains blood and lymph capillaries
Further increased by cell membranes of intestinal cells folding to create microscopic projections microvilli

Nutrients into blood; fatty acids to lymph

Question 11

Brush border enzymes BBE

Answer 11

Attached to small intestinal lining and imperative for absorption

BBE break double chained carbs and proteins allowing to be absorbed

Maltase, sucrase and lactase: breaks down sugar into glucose, fructose, galactose, etc
Dipeptidase: proteins into aa

Question 12

Intestinal absorption

Answer 12

Carbs, protein and fats are only absorbed once they have been digested into their simplest forms
Emphasise importance of optimal function in areas as the mouth, stomach, pancreas, gall bladder

Proteins chemically digested into aa

Carbs and aa enter the blood capillaries in small intestine and go into liver

Fatty acids including fat soluble Vits are into lymph capillaries

Question 13

Pancreas

Answer 13

Both endocrine and exocrine function

Exocrine: produces enzymes to digest carbs, proteins and fats. Excreted to small intestine

Pancreatic enzymes are imperative for digestion and are part of pancreatic juice (1.2/1.5L) per day

Pancreatic enzymes:
Pancreatic amylase
Pancreatic lipase
Proteases

6 inches long and sits posterior abdomen l, behind stomach
Connected to duodenum by pancreatic duct
If pancreatic enzyme production is poor, foods ferment in intestines, resulting in symptoms such as bloating, flactulence and abdominal pain about 1 hour after eating

Question 14

Over eating

Answer 14

Digestive enzymes used up

Not all good can be digested

Junk food leads to cravings of nutrients

Organs such as pancreas and stomach are placed under stress

Energy directed away from healing / repair

10% of energy goes to digestion in well balanced individuals, can go up to 50% for those eating junk and dense protein

Question 15

Bernard Jensen

Answer 15

Found undigested materials are stored in mucous secreting lining of intestines, imparting absorption and delivery of nutrients
Thicker, worse absorption

Creates optimal environment for parasites and Candida

Support detoxification: intermittent fasting, dietary changes

Question 16

Gallbladder

Answer 16

Pear shaped sac under liver

Stored and released bile produced by liver

Bile contains mostly water, bile salts, cholesterol and bilirubin

Bile ducts collect bile products by hepatocytes, before pooling in the gallbladder

Bile enters small intestine via common bile duct

Poor bile flow affects fat digestion and body’s ability to eliminate toxins via the bowel

Functions:
1. Fat emulsification
2: carries detoxified products from the liver
3. Stimulated peristalsis
4. Excretes excess cholesterol

Question 17

Biliary tree

Answer 17

Bile carried from hepatic ducts into gallbladder via cystic duct

Upon stimulation (ie by CCK), gallbladder contrasts and ejects bile

Pancreatic duct meets the common bile duct and carries both bile and pancreatic juice through the sphincter of oddi into the duodenum

Adequate production and release of bile and pancreatic juice is depend on upon sufficient water consumption

Bitters also stimulate release of pancreatic juice and bile

Question 18

Liver

Answer 18

Portal vein transports all nutrients and toxins from the GIT to the liver

Filters 1.4L/ every minute

Stores carbs, fats, minerals, vitamins (not water soluble vits, except B12)

Performs detoxification and denatures hormones

Question 19

Liver detoxification

Answer 19

Hepatocytes concerts toxins into non toxic metabolised which can then be excreted from the body via the kidneys, bowels, skin or lungs

Healthy liver deals with thousands of toxins a day

If lacks essential nutrients, or exposed to lots of trans fats, heavy metals, alcohol, caffeine and pesticides, liver detox becomes impaired
Then only partially broken down toxins and dead cells and other waste being recirculated

Question 20

Phase 1 liver detox

Answer 20

Toxins arrive inside hepatocytes - most undergo phase 1
Concerts volatile toxins into smaller substances that are also water soluble

CYP450 enzymes create an active binding site on the toxin or hormone so it can be conjugated

Phase 1 is complete when toxin is oxidised.
Free radicals are being formed and must be neutralised by anti oxidants such as VIT A, C & E

To support, digestion to be optimised to ensure co factors and antioxidants are liberated from food.

Question 21

Phase 2 liver detox

Answer 21

Involves conjugation

Chemical reactions which modify reactive toxins to make them safe and excreted by binding a chemical group to them.
Blind toxins are then pumped into the blood or bile for excretion, mostly via the kidneys or bowels

Nutrients include sulphur, magnesium, B vits are required

Herbs such as dandelion, milk thistle (for hepatocytes health) and liquorice root support liver detox

Key antioxidant for neutralising free radicals in liver is glutathione which is a Tripeptide formed of cysteine l, glycine and glutamine

Eliminates waste

Question 22

Large intestine

Answer 22

Any remaining materials enter the large intestines (pH 5-7) though the ileocaecal valve, permits 1 way flow

Most nutrients should have been absorbed

Large intestine is site for final stage of digestion and absorption

Digestion assisted by MICROFLORA

Water and some vits and minerals are absorbed

Mucus is produced by goblet cells in large intestine and lubricates the lining but no digestive enzymes are released here

Question 23

Regions of large intestine

Answer 23

1. Caecum: appendix is attached
2. Colon: ascending, traverse and descending regions
3. Rectum: pushes stool into anal canal
4. Anal canal: contains involuntary and voluntary external anal sphincter

No enzymes are here so microbiome isn’t eaten

Question 24

Gut associated lymphoid tissue (GALT)

Answer 24

70% immune system based in GIT as GALT
Found in GIT walls (beneath epithelium) and glide leukocytes - macrophages and lymphocytes (in close proximity to trillions of microbes)

Leukocytes learn to identify microbes through close interactions with bacterial surface antigens located in cell membranes

GALT clusters in tonsils, walls of oesophagus, stomach and intestine

Secretory IgA is secreted into GIT mucosa providing immune defence.

IgA production is reduced during periods of stress

Question 25

MICROFLORA

Answer 25

Hosts vast community - around 100 trillion microbes. Containing over 100 bacteria species

Performs following crucial functions:
- final stages of nutrient extraction by microbial fermentation (including fermentation of remaining carbs to create the odonis waste by product methane and hydrogen, as well as fermentation of aa to create hydrogen sulphide. Excess flactulence with a strong odour can. Indicate poor digestion as a result of bacterial action on the remaining food

• synthesises vitamins (eg biotin and k2)
• supports intestinal barrier (produce short chain fatty acids from fibre they ingest, then used by enterocytes. Suppers intestinal barrier and hence protective against leaky gut)
• pathogen protection (out competes for attachment on intestinal epithelium and nutrients (eg Candida)
• GALT
• Regulates appetite / satiety (produce appetite regulating proteins)
• mood regulation (indicated by Edward Bach)

Question 26

Intestinal battier

Answer 26

GI mucosal membrane surface is largest interface between our internal body and external world, converting more than 400 square metres

Plays important role in protection (eg toxins, undigested food, etc)
When damaged, tight junctions become leaky (allows large molecules to enter circulation before being broken into simplest form)

Can be damaged by:
Poor nutrition
Heavy metals, pesticides, herbicides
Drugs
Excessive stress
Dybosis and Candida overgrowth
Alcohol and smoking
Radiation and chemotherapy
Early weaning

Dietary composition strongly influences the diversity and dominant species in the MICROFLORA

Diversity helps support immune system

Question 27

Dybosis

Answer 27

Describes imbalance in the colonies of bowel flora, leading to disruption in health

Can be associated with following:
VIT, mineral, aa insufficiency
Malabsorption of carbs and fats
IBD
Colorectal cancer
Alzheimer’s and Parkinson’s
AI, allergies, intolerances
Obesity and mood disorders

Question 28

Migrating motor complex (MMC)

Answer 28

Distinct pattern of electromechanical activity in the smooth muscle between the stomach and distal ileum during the period between meals

Thought to serve as a housekeeping role and sweep residual undigested material through the digestive tube

MMC opens the pyloric sphincter (end of stomach) and increase gastric, biliary and pancreatic secretions

Secretions aid in the cleansing activity of the MMC and assist in preventing SIBO

To support
- avoid overeating
- minimise heavier proteins
- leave longer gap between meals
- chew better (so MMC has less to clear)
- consider intermittent fasting and optimise sleep
- pro-kinetics (ginger, artichoke, etc) and drops of bitters before meals
- stimulate PNS by diaphragmatic breathing exercises

Question 29

Elimination.

Answer 29

Digestive system also acts as a key routes of waste elimination for the body

Water and fibre are key for elimination of waste via bowel

Question 30

What governs digestion

Answer 30

Enteric NS is the brain of the girl and extends from mouth to anus
Key components are 2 nerve plexuses, embedded in the wall of the digestive tract included:
- myenteric plexus (intestines)
- submucosal plexus (below mucosal layer)

Enteric NS function independently but is regulated by the ANS
- myenteric governs GIT peristalsis
- submucosal plexus controls release of digestive enzymes

Stimulated by Vegas nerve

Question 31

The gut brain axis

Answer 31

Develop from the same part of the human embryonic tissue and therefore share many nerve endings and chemical transmitters

Nearly every chemical that controls the brain is in the GIT

Serotonin plays a role in peristalsis, secretion, sensation, with over 95% of it produced in the GIT

Dysbiosis can influence serotonin manufacture in the gut through affecting the availability of tryptophan and co factors (eg antibiotics can negatively affect mood)

Question 32

Poor digestion and absorption

Answer 32

Implication of poor digestion are:
- less nutrient absorption
- fermentation of undigested food
- Increased toxaemia
- retention of undigested materials and waste in intestinal mucosal secretions

Question 33

Digestion and B12

Answer 33

Dietary b12 bound to a protein called R-protein, dependent upon presence of pepsin and stomach acid

R-B12 complex enters duodenum and is split by pancreatic protease with digest R-protein and hence release B12 (B12 can then bind to intrinsic factor - a glycoprotein complex - which is produced in the stomach by parietal cells

• b12-IF complex is absorbed in the terminal ileum into the blood

Therefore poor gastric and pancreatic function or damage to the ileum does impair b12 absorption

Question 34

Vitamin d and digestion

Answer 34

Synthesised by skin cells from provitamin D into cholecalciferol in response to UV light
Cholesterol is needed to synthesise D
- Mg co-factor concerts D in the liver and kidneys
- alcohol / drugs impairs this process

D3 action on the digestive system to increase intestinal absorption of calcium and phosphorus
D maintains calcium balance in the body, in conjunction with K2 which controls utilisation of calcium
-70-80% of infested calcium is absorbed in the more distal regions of the small intestine (ileum). Dietary D absorbed with the help of fat

D helps regulate bacterial species in the intestine

A deficiency of D3 is linked to imbalance of intestinal flora whilst also linked to increased likelihood of IBD

Question 35

Cellular health and digestion

Answer 35

Healthy functioning digestive system is crucial for delivering required nutrients to all cells in the body

Antioxidants protect cells from free radicals / oxidative damage

Good absorption and delivery of antioxidants is important to organs such as the liver. Neutralise a large number of free radicals formed through process of detoxification

A body that is poorly detoxifying and eliminating waste can increase toxic burden on cells, disrupting cellular functions

Question 36

Bone health and digestion

Answer 36

Contains key minerals (Ca, P, Mg, K)

Small intestine responsible for absorption of these minerals and aa are required to build collagen

Intestinal MICROFLORA produces K2 causing Ca deposition in bones

Calcitrol absorbs calcium from food

Mechanical stress leads to increase mineral and collagen production (weight bearing exercises)

Question 37

Muscle health and digestive system

Answer 37

Ca = muscle contraction
Mg = muscle relaxation
Fe = O2 to muscles
Na & K = nerve stimulation
Aa = muscle growth and maintenance

Poor delivery of nutrients from poor digestion, leading to muscle weakness / aging, cramping, fatigue and pain

Muscle health also crucial in supporting digestive health

Question 38

Cardiovascular health

Answer 38

Due to chemical similarities with Hb, chlorophyll - rich foods can be used as blood builders as they nourish the blood
Good digestion required for Fe absorption (stomach acid and C aids absorption in small intestine)

Heart must be nourished with abundance of minerals as well as O2
Blood pH must be better. 7.35 - 7.45

Acidic burden is balanced by alkalising minerals. If minerals fall short, taken from bones, muscles, teeth, etc

Question 39

Endocrine health

Answer 39

Hormones released from GIT epithelial cells can
- CCK: Stimulate pancreatic juice and bile blow
- Gastrin: stimulate gastric activity
- CCK: stimulate satiety
- Ghrelin: stimulate hunger
- insulin: in response to carbs

Good digestive health crucial to produce endocrine glands with the nutrients needed to produce hormones - eg thyroid needs iodine, tyrosine, selenium and zinc

Question 40

Nervous system health

Answer 40

Electrical activity relies on presence of
Na, K, Cl, and Ca ions which must be ingested and absorbed

D is very important for Ca absorption

Digestive system of responsible for absorbing substances required to manufacture neurotransmitters - eg dopamine requires tyrosine, iron, b1, 3&6

B12 crucial in NS

Poor digestive health = less minerals and B12 absorption impairing nerve activity and potentially resulting in symptoms such as tingling, numbness, loss of balance and pain

Question 41

Energetically

Answer 41

Illness or pathology can be described as a blockage or insufficiency of the viral force

Find out where force is blocked or depleted and working to restore the flow
Applied energetics to remedied

Question 42

Ayurveda & digestion

Answer 42

Agni is called digestive fire - the power to digest, transform and absorb nutrients from food

Agni is highest in morning
- constitution of person determines the amount of digestive fire and provides a guide for food intake

When Agni is weak due to energetic imbalance, or bad eating habits, food remains undifested

Undigested foods are unfit to nourish the system and are referred to as toxins (or arna) when Agni is balance, arna cannot function

Arna is reduced by:
Spices / powdered herbs
Fresh ginger root
3h between meal and bed
Eat slowly and chew well
4-6h between meals
Not eating if not hungry
Adequate exercise
Avoiding cold water and ice
Not reading, worming etc with meals or eating when stressed

Question 43

Digestion and TCM

Answer 43

Alongside spleen, stomach plays a vital role in digestion
Function of stomach = rot and ripen that also occurs in nature

Key to concept of stomach fire. Without dire, foods are improperly cooked

From TCM perspective, stomach is at the origin of all fluids and plays crucial role in immunity

Spleen (not organ) likes warm and well cooked meals, eg soup and stews
Warm and wet breakfasts
Avoid drinking liquid with meals
Avoid dampening foods
We’ll cooked whole grains, naturally sweet veg and warming herbs and spices

Meals cooked by wet cooking methods are warming, easy to digest and excellent source of hydration

For those with spleen deficiency, consider using spleen qi tonics such as ginger, cardamom, fennel and citrus peel

Naturally sweet foods support and strengthen the digestive system

Sugar cravings = spleen qi deficiency

Question 44

Tongue diagnosis

Answer 44

Shape:
-Tongue shaped = normal
-Swollen = qi/yang deficiency
-Thin = blood deficiency
-Teeth marks = weak digestion, malabsorption of nutrients in small intestine. Dehydration or hypothyroidism
-raised/upturned edges = high stress

Colour
-pale pink or pale red = normal
- red = heat / inflam/ B9 or 12 deficiency
- pale= qi/yang deficiency
- blue / purple = cold - poor circulation

Coating
Reflects state of digestive system
-thin white = normal
- brown = chronic excess heat
- greasy yellow = damp heat (eg Candida, SIBO)
- greasy white = damp cold (eg Candida, SIBO)
- no coat = yin deficiency

Cracks
- small transverse cracks at centre= damage to stomach lining / low stomach acid
- deep crack = stomach heat (eg acid reflux, ulcers) deeper crack = longer health problems

Spots / lump by area
Heat

Question 45

Nail diagnosis

Answer 45

-Spoon shaped = severe iron or zinc deficiency
-Pale = anaemia
-Brittle / easily spilt = mineral deficiency, low stomach acid
- white spots = zinc or A deficiency
- vertical lines = malabsorption of nutrients eg B, C, minerals EFAs
- horizontal lines = sign of strong illness or infection

Question 46

Facial diagnosis

Answer 46

-grey skin = constipation
- yellow skin = liver, gall bladder
- butterfly rash around nose = possible rosacea (low stomach acid) or B3 deficiency
- corrugated cardboard lines across forehead = large intestine toxicity
- vertical creases between forehead = liver dysfunction or needs more support
- dry, red forehead = possible bladder dysfunction

Acne around chin = hormonal imbalance
Rash over cheek & nose -= stomach dysfunction
Recurrent forehead acne or rashes = bladder or intestinal problems

Question 47

Eyes

Answer 47

• clear & bright = normal \ healthy
• yellow = liver / gallbladder
• bloodshot = sleeping difficulties, liver disharmony
• swollen = liver dysfunction
• dry = possible allergy, EFA def or chronic stress
• floaters in vision = blood deficiency

Iridology:
Blue or grey = sensitivity reactions (eg GI & GALT affectations), poor absorption in small intestine, IBS, etc

Mid brown or green = digestive sluggishness due to enzyme deficiency, dysbiosis and constipation

Dark brown eyes = liver and blood stagnation, poor nourishment, high cholesterol and diabetes mellitus

White in centre than rest of eye = low stomach acid
Wheel like spokes = digestive imbalance, excessive NS

Question 48

Hair

Answer 48

Dry hair = excessive heat or stress. Possible hypothyroidism

Oily hair = excessive body acidity and trans fat

Excessive hair loss = nutrient deficiency such as B vitamin (eso biotin), zinc, iron and protein

Dry, itchy scalp = lack of EFAs

Dandruff = liver problems or excessive heat

Greying = nutrient deficiencies such as B5, zinc, or copper: extreme stress

Question 49

Headaches in TCM

Answer 49

Temples = liver / gallbladder

Vertex = liver

Forehead = stomach

Conditions:
Worse for heat = heat pattern
Worse for cold = cold pattern
Worse for fatigue, improved by rest = qi deficiency