Many people struggle with digestive issues. Some of the most common symptoms include nausea, upset stomach, bloating, constipation, and reflux. The cause of these symptoms can be hard to pinpoint due to the complexity of the digestive track. Influences include stress levels, eating habits, and the natural processes that happen in the intestines. It is important to know how the digestive tract works in order to uncover where the dysfunction may be.
First phase of digestion: Chewing
The digestion of food starts with chewing. While it seems like a no-brainer, many people don’t take time to adequately chew our food. This is common in our fast-paced world where we are constantly in rushing or multitasking. When we gulp down meals we skip a crucial phase of digestion and also typically tend to overeat.
Second phase: Stomach acid
After we chew and swallow our food it hits the stomach where it is mixed with stomach acid, or hydrochloric acid (HCL). An overabundance of HCL leads to esophageal reflux, or heartburn. The most common presentation of this is a burning sensation in the chest. Some people however get atypical symptoms such as a metallic taste in the mouth, frequent throat clearing or irritation of the throat. These symptoms are referred to as “silent reflux” due to their misleading presentation. Although due to the same underlying cause as heartburn, silent reflux is often misdiagnosed as other conditions such as allergies.
Hypochlorhydria is when people have too little stomach acid. This can cause symptoms similar to that of having too much, in which case people are sometimes inappropriately placed on reflux medications. In these situations the underlying problem is actually made worse. Suppressing acid production can lead to impaired digestion and mineral deficiencies such as low calcium or magnesium.
HCL challenge
Since symptoms of hyper and hypochlorhidria are similar, it is hard to pinpoint which one is the real issue. A Heidelberg test can be done in which a capsule is swallowed and used to assess the acidity of the stomach. While this is a straightforward method, it is also invasive and unpleasant. Although not as accurate as a Heidelberg test, an HCL challenge can be done at home for similar purposes. This is where a person takes increasing amounts of HCL supplements with meals and watches for symptoms of burning. When a person experiences burning, the total acid content is too high. If a person takes 1 cap and gets burning, he or she most likely has adequate or elevated levels of HCL already. If a person needs multiple caps before symptoms arise, it indicates the initial stomach acid content is on the lower end.
Third phase: Digestive enzymes and Bile
After the food leaves the stomach it is passed to the small intestine where it is mixed with bile and pancreatic enzymes. Bile is made in the liver and stored in the gallbladder. It is released when a person consumes fat, both good and bad. The bile is needed for the absorption of fat as well as fat soluble vitamins such as vitamin A, D, E and K. If the gallbladder isn’t functioning adequately (or has been removed) people can get an array of short and long term complications. Short term issues include bowel urgency, upset stomach after eating, bloating or greasy-looking stools. Long term issues include deficiencies of fat-soluble vitamins and complications due to such deficiencies. For example vitamin K is necessary to maintain bone densities; therefore fat malabsorption can contribute to osteoporosis. The body can start to suffer from these deficiencies, especially if it’s over a prolonged period of time.
Food in the small intestine is also mixed with pancreatic enzymes which break down fats, proteins, and carbohydrates. Pancreatic insufficiency is the term for low pancreatic enzymes. With this people can experience symptoms similar to those seen with low bile. They can get full very quickly, feel like food isn’t digesting, see undigested food in the stool, or feel like food “just sits there.”
The importance of good food hygiene
Many factors play into the production of sufficient HCL, bile, and pancreatic enzymes. Good “food hygiene” is very important. Basically our body needs warning that food is coming. Typically this happens when we take time to prepare our meals; gathering, cutting, cooking, and smelling food as it’s prepared. When we eat in a rush our body isn’t ready for digestion.
Another aspect that plays a part is our nervous system. We have two parts to the nervous system, rest and digest and fight or flight. We are in a constant seesaw between the two, but cannot fully be in both states at the same time. When we are busy multi-tasking, doing things like driving, computer work, or watching TV, we are in fight or flight state, sending energy and blood flow to our muscles and brains. In doing so, energy is pulled away from the digestive system. On the contrary, the rest and digests phase occurs when we are relaxed and resting. We need less energy for being busy, and instead can have the digestive system up and running at a healthy rate.
Good food hygiene refers to having healthy eating habits including creating a restful eating environment, not multi-tasking, and taking time to prepare, chew, and enjoy our food. This alone seems so simple but can improve numerous digestive symptoms and allow us to get the full benefits from eating a healthy diet.