Gastrointestinal Health

Question 1

What is hypochlorhydria?

Answer 1

Low stomach acid - fasting pH above 3 (1.5-3 = normal)

Question 2

Signs and symptoms of hypochlorhydria?

Answer 2

Gas & bloating - often 30 mins after eating
Nutrient deficiencies - Fe, Zn, Folate, B12

Also
Heartburn
Sensation of fullness after meals
Foul smelling stools

Question 3

4 Implications of hypochlorhydria?

Answer 3

Reduced mineral absorption
Protein putrefaction - creates polyamines implicated in colorectal cancer
Reduced protection from infection - H pylori / SIBO
Poor pancreatic juice and bile flow (B12 absorption)

Question 4

4 ways to naturally support hypochlorhydria?
What to consider when choosing herbs?

Answer 4

1. Chew, avoid overeating and drinking with meals
2. ACV - 1-2 tsp before meals
3. Zn & B6 foods
4. Bitter foods - greens (rocket, chicory, watercress)
   herbs - dandelion, goldenseal, gentian - cooling / stimulate the vagus nerve
   warm - fennel seed, cardamom, ginger

Consider - energetic composition - cold or warm

Question 5

What is the protocol for supplementing with betaine HCL?
What to consider?

Answer 5

• 1 capsule with a portein-cotaining meal
• If not discomfort increase dose by 1 capsule every 2 days (max 3g) until tingling warm sensation then reduce by 1 capsule

Consider
Contraindicated with some drugs and peptic ulceration
Corrosive to teeth (so don’t empty capsule)
Don’t take on an empty stomach
Smaller meals = smaller dose

Question 6

What is exocrine pancreatic insufficiency? EPI

Common symptoms of EPI

Answer 6

Deficiency of exocrine pancreatic enzymes needed for normal digestion resulting in nutrient (esp fat) malabsorption.

Bloating/ belching / flatulence 1-2 hours after eating
Steatorrhoea - excess fat in faeces
Drowsiness after meals
Food intolerances
Low Zn/ B12 and folate abosorption

Question 7

4 Causes of EPI (pancreatic insufficiency)?

Answer 7

Stress - reduce vagus nerve activity
Hypochlorhydria - reduced CCK
Damaged small intestinal wall - coeliac, IBD
Xenobiotics - pesticides, herbicides, phthalates
Infections SIBO (can be cause or effect) can create dysbiosis

Question 8

4 Naturopathic prinicals for pancreatic insufficiency?

Answer 8

1. Don’t overeat, chew adequately, avoid snacking
2. Correct stomach acid levels
3. Stimulate vagus nerve - deep breathing, gargle, hum, sing, laughter, bitters
4. Pancreatic enzyme replacement

Question 9

What are the two types of pancreatic enzyme replacement therapy (PERT)?

Answer 9

Animal-derived (pork) - standard care
Plant-based - microbe-derived - better stability, broader range

Question 10

How to supplement with digestive enzymes?

Answer 10

Take with first bite of meal and consider adding more during
15 mins meal - take at start
15-30 mins meal - start and middle
30 mins plus meal- divide into 3 - start, middle and end

Question 11

What is bil insufficiency?

Answer 11

Bile synthesis and or bile flow is compromised affecting digestion, absorption and utilisation of fatty acids

Note - bile should be quite thin

Question 12

3 Signs and symptoms and 2 stool test indications of bile insufficiency

Answer 12

1. Steatorrhoea - constipation or diarrhoea
2. Intolerance / nausea with fatty foods
3. Bloating / excess flatulence and cramping

Stool test
1. low / absent bile acids
2. high faecal fats (steatocrit)