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Ask the Naturopathic Doctor

You Are What You Absorb

Poor nutrient absorption can be a sign of irritable bowel syndrome. Here are some natural ways to improve digestion and ease symptoms.

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Q: I don’t think I’m absorbing nutrients from my food. I try to eat well (e.g., no alcohol, sodas, or fried foods), but I’m hypoglycemic, overweight, and have low energy and irregular bowel function. I also break out in hives sometimes. What could be wrong?

-Pamela J., Hillsboro, Ore.

A: It sounds as if you may have irritable bowel syndrome or IBS. The classic IBS symptoms of abdominal cramping, alternating bouts of diarrhea and constipation, bloating, gas, and mucus in the stool are uncomfortable and annoying.

IBS is a constellation of symptoms caused by poor digestive function, which leads to reduced nutrient absorption. The result often is low energy, overeating, and blood sugar swings.

Optimal digestion starts in the mouth. You should eat slowly, chewing your food 30 to 50 times per bite, or enough to render it “soupy” before swallowing. This alone resolves many cases of IBS. To aid digestion, sit down, eat slowly, don’t multitask while eating, and turn off the TV-even if you are eating alone. Limit the amount of fluid you drink with meals to just a few ounces of water or other liquid; drinking too much liquid during a meal dilutes digestive enzymes. Try drinking beverages up to 30 minutes before meals and then wait two hours after a meal. Some people benefit from drinking bitter teas before meals, such as heavily steeped chamomile, which stimulates the secretion of stomach acid and digestive enzymes. Drink 15 minutes before meals.

You need stomach acid for optimal food digestion, especially protein digestion. Unless you have a medical condition necessitating acid suppression, avoid acid blockers such as Tums, Nexium, Prevacid, etc. If you are taking acid blockers because of heartburn see a naturopath to help cure the problem. Stomach acid may not be the problem-you may have an H. pylori infection, a hiatal hernia, or stress ulcers, which all can be treated with naturopathic methods.

If you are not sufficiently helped by the suggestions above, start taking digestive enzymes with meals. I prefer an enzyme “multi” that contains amylase for the starch, lipase for the fat, and protease for the protein in food. A good enzyme multi may also contain lactase for dairy products and cellulase for fiber. Enzymes add potency to the natural enzymes in your saliva, stomach, pancreas, and liver that are secreted into the gastrointestinal (GI) tract during digestion.

Carminative herbs can also be helpful. A small cup of strong peppermint tea after meals, especially if you have a warm or hot metabolism, can be effective-unless you have heartburn, in which case an enteric-coated peppermint capsule is preferable (the volatile oils get past the lower esophagus without causing reflux). If you are treating a hiatal hernia or other reflux condition, strong peppermint, coffee, tomatoes, citrus, and chocolate should be avoided until the condition is resolved. If you tend to run on the cooler side, try ginger tea.

Once the food gets past the stomach and into the small intestine, with its thousands of slender, finger-like villae, nutrients can then be absorbed; however, there are numerous potential impediments to absorption. First, food needs to be alkalinized before it is absorbed into the blood. The pancreas is in charge of secreting enzymes and bicarbonate into the upper small intestine to begin the alkalinization process. If part of your GI trouble is on the left side or involves discomfort up under the ribs after eating, please see a naturopath to evaluate pancreatic function. It may be gas, which can be formed by carbohydrates fermenting or proteins putrefying. In IBS, small intestine contractions are not well coordinated. As a result, food may stay in the same part of the intestine for too long, resulting in putrefaction. Occasionally, bacteria grow in the small intestine where they should not be, causing carbohydrate fermentation. One of the very best ways to prevent gas is to thoroughly chew your food before swallowing. You could also chew on a few fennel or caraway seeds after a meal to stimulate optimal digestion, as these aromatic spices help coordinate the intestinal contraction.

To determine which foods your body accepts as nutritious and which may be difficult to digest, do an elimination diet. For details, see my Web site, The basic idea is that you eat very carefully for two to four weeks, avoiding alcohol, caffeine, corn, dairy, eggs, peanuts, red meat, shellfish, soy, tomatoes, and wheat. This will cover most people’s food sensitivities; however, I have frequently seen problems with aspirin and other NSAIDs, chocolate, citrus fruits, garlic, and gluten-containing grains (in addition to wheat).

After being on the clean diet for a few weeks, carefully reintroduce the foods listed above; eat a new food for one day, every three days. Observe any changes in your skin, mood, or bowel function. If you notice hives, rashes, or an outcropping of pimples; a mood shift to sad, irritable, or angry; or if your stomach hurts or your bowel function changes, take note. Be methodical. This is the only way to get definitive answers about which foods “work” for your body and which do not.

If you have had IBS symptoms for more than a year you will likely benefit from a high-quality probiotic (look for one that also has a prebiotic).

You may want to experiment with “priming” your stomach with an acid stimulant. For example, take 1/2 ounce of Swedish bitters to stimulate hydrochloric acid secretion just before meals. You can also try a small amount of vinegar-honey water (equal parts vinegar and warm water with 1/3 teaspoon of honey). The juice of half a lemon in a 1/4 cup of water works just as well.

Avoid eating haphazardly. Plan ahead. Make time to buy fresh produce, ideally grown nearby in organic soil. Respect your body and feed it the finest fuel available.