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Digestive Problems

For many Australians, the discomfort that comes from a long standing digestive disorder can have a major impact on ones lifestyle. Digestion plays a vital role in our ability to stay well and healthy, and if compromised the result can be long standing chronic malnutrition, pain and energy loss.

The main digestive complaints fall into one of two broad categories. Digestive issues can affect the upper digestive tract – heartburn, ulcers, reflux, for example, or the lower digestive tract. Lower digestive complaints can include irritable bowel syndrome, ulcerative colitis and Crohns disease, bloating and cramping, chronic constipation and coeliac disease.

Treatment for this range of conditions is fairly straightforward but can take a while to resolve completely.

Reflux and Heartburn

One of the most commonly prescribed classes of medication is medication designed to reduce stomach acidity. Reflux can be an extremely uncomfortable condition to put up with and reducing stomach acidity will often provide good temporary relief. There is a longstanding issue, however, when medication is taken repeatedly to reduce stomach acid. Stomach acid is vital for the correct breakdown of food and the subsequent absorption of nutrients to fuel the body. If stomach acid is compromised on a long term basis, poor nutrient delivery to the body can result in a malnourished state.

Another option that many people fail to look it is to strengthen the tissue that is constantly being affected by the acids of the stomach. While stomach acid can be neutralized by medication, consideration should also be given to making the mucous membranes in the upper digestive tract more able to handle the acids they are constantly coming into contact with. Once mucous membrane strength has been restored, there may be less need to keep taking long term acid neutralizing medication, which will only benefit the body by allowing a greater absorption of nutrients.

There is an anatomical feature that may also contribute to feelings of heartburn and reflux. The oesophagus – the tube that carries food to the stomach, is usually closed off at the bottom by a one way valve, or lid. The purpose of this is to allow food to pass into the stomach without any of the contents of the stomach returning back up the oesophagus. In many people who suffer from reflux, this lid no longer closes as it should, so not only does food pass down into the stomach, partially digested, acid coated food can also re-enter the oesophagus.

By improving tone to this lid, we can begin to train the body to properly close off the oesophagus once again, thus preventing that feeling of reflux and burning. This is done with the use of very specific herbal compounds that work directly on this part of the digestive tract.

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is known as a multi-faceted disorder. In people with IBS, symptoms result from what appears to be a disturbance in the interaction between the gut or intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function. This is a primary reason for why stress can play such a big role in this condition.
Irritable bowel syndrome is characterized by a group of symptoms in which abdominal pain or discomfort is associated with a change in bowel pattern, such as loose or more frequent bowel movements, diarrhea, and/or constipation. One of the classic signs of IBS is an alternating constipation with diarrhoea. IBS is also frequently associated with inflammation of the intestinal mucosa.

Inflammatory Bowel Disorders (Ulcerative Colitis, Crohns Disease)

Crohn's Disease is an inflammatory bowel disorder (IBD) that can be found in any part of the gastrointestinal tract, from the mouth to the anus, but most commonly it involves the lower end of the small intestine (ileum) and/or the large intestine (colon). Areas of inflammation can appear interspersed with healthy parts of the intestine and may involve the full thickness (all layers) of the intestine.

Sometimes different names are used to describe the part of the intestine that is involved.

Ulcerative colitis, or simply 'colitis', is also an inflammatory condition, but is confined to the inner lining of the large intestine and rectum. It is almost always present in the rectum and involves either the lower part only, or extends further along the entire length of the large intestine.

In recent years there appears to have been a dramatic rise in the number of people with Crohn's disease, whereas ulcerative colitis seems to have levelled out.

The most common age groups to be diagnosed with Crohn's disease and ulcerative colitis are those in their teens and twenties, followed by those in their forties and fifties, although people of all ages are diagnosed, including young children and the elderly.

The symptoms of IBD vary depending on the area of involvement, extent and severity of disease, and whether any complications have arisen, but abdominal pain, diarrhoea, the passing of blood and fatigue are commonly experienced.

Other signs and symptoms may include nausea and vomiting, constipation, a low-grade fever, weight loss and nutritional deficiencies.

In Crohn's disease, symptoms usually have a gradual onset over many months or years, whereas ulcerative colitis tends to develop more quickly.
Although these conditions can be very difficult to “cure” completely, there are a number of gentle yet very effective treatment options that can make life infinitely easier for sufferers.

Coeliac Disease

Coeliac disease is a digestive disorder where sufferers are unable to tolerate a protein called gluten, which is found in wheat, rye, and barley. When people with coeliac disease eat foods containing gluten, their immune system responds by damaging the small intestine. The lining of the small intestine is where nutrients are absorbed into the bloodstream, so when this becomes damaged and is unable to function, malnourishment can result.

The symptoms of coeliac can vary a lot from person to person but some of the more common symptoms include:

   Fatigue, weakness and lethargy
   Anaemia - the anaemia will either not respond to treatment or will recur after treatment (iron therapy) until the correct diagnosis is made and a gluten free diet is begun
   Flatulence and abdominal distention
   Diarrhoea - this may begin at any age and is often present for years prior to diagnosis
   Constipation - some are likely to experience constipation rather than diarrhoea although a number of  people do not experience either and some experience both
   Cramping and bloating
   Nausea and vomiting
   Weight loss - although many do not lose weight and some can even put on weight

Integrative Medical Treatments

A lot of the digestive issues that are commonly seen in pharmacy can be alleviated by removing the specific foods that are aggravating that condition.

Many people who suffer from heartburn or reflux, for example, would do well to avoid spicy foods and coffee, both of which can make this condition a lot worse.

Irritable bowel sufferers often seem to improve their conditions with the avoidance of wheat and dairy products. Wheat products in particular with their insoluble fibre can prove to be quite irritating for a bowel that may already be predisposed to inflammation. Dairy foods, especially milk, also seem to feature frequently on lists of foods that exacerbate irritable bowel syndrome. Some people have a mild lactose intolerance they aren’t even aware of which will make any IBS symptoms considerably worse. A high intake of dietary fat and coffee also trigger attacks in sufferers. High fat intakes can sneak in with some foods like salami and processed meats so these need to be watched carefully also. Finally, anything that may trigger bowel movements should be avoided. An excess of artificial sweetener (diet soft drinks, some chewing gums etc) is a primary culprit here that many people don’t anticipate.

These guidelines for avoiding wheat, dairy, coffee and fats also apply for those people suffering from inflammatory bowel disease. Refined carbohydrates and artificial sweeteners once again, are two more food types that can cause many sufferers considerable distress.

Irritable Bowel Syndrome

Many IBS sufferers have tried most of the preparations on the market. It is a syndrome rather than a condition, so the exact causes and distinguishing characteristics of IBS vary from person to person. Symptomatic treatment revolves around reducing gut specific inflammation and healing mucosal membranes.

Aloe vera is a specific mucous membrane restorative and is used to bring about healing from the mouth through to the anus and all points in between. It is very effective and is usually noticed to be working within a week. It also has potent anti-inflammatory properties (hence its use for burn treatment).

Probiotics have an anti-inflammatory effect on the digestive tract and have been marketed specifically for use in IBS. Probiotics may suppress the low-grade inflammation associated with IBS and restore normal local immune function. Probiotics are also effective at reducing colonic mucous secretions that may contribute to functional diarrhoea or IBS with diarrhoea.

Combination herbal products that have an anti-inflammatory and anti-spasmodic effect are excellent and very fast acting tools in managing the symptoms of IBS. These typically feature a combination of clowns mustard, liquorice, chamomile and mint and are extremely gentle (so much so that they are also frequently given to children as young as 6 months of age to manage colic). The product we have had great success with at Quality Pharmacy is the German formulation known as Iberogast.

Gastric Reflux

Reflux is a relatively easy condition to bring under control. While most people with this condition may be taking antacid medication, they have probably not considered doing anything to repair mucosal tissue or to strengthen the sphincter (the valve or lid) at the end of the oesophagus.

Repairing and restoring integrity to mucosal tissue is accomplished through the long term use of aloe vera – a well known herb that is renown for its healing properties. Short term healing can occur through the use of combination herbal products such as Iberogast which contains a range of anti-inflammatory and healing herbs.

Restoring tone to the oesophageal sphincter is done through the use of bitter herbal extracts. These bitters herbs stimulate a nerve response that sends a signal to the sphincter muscles to contract – this closing off the valve between the oesphagous and the stomach. Our pharmacists are trained in the use of a range of bitter herbal formulations to help you with achieve this.

Inflammatory Bowel Diseases (IBD)

As the name suggests, inflammatory bowel diseases are characterized by an inflammation of the tissues of the bowel. While selecting foods that won’t contribute to further inflammation is half the battle, we also need to address the inflammation that is already there and reduce it as much as possible.

A range of long term anti-inflammatory agents are available to achieve this reduction in inflammation. As before, perhaps the most specific digestive tract anti-inflammatory is aloe vera, and it is a supplement that many people find gives them a large degree of relief from IBD.

Some people may need stronger anti-inflammatory support than that offered by aloe vera. For these people, turmeric and frankincense herbal combinations are a better option. These herbs are particularly effective at reducing arthritic pain, but they also have significant clinical research to support their use in inflammatory bowel disorders. For long term inflammatory control, fish oil is a substance that has also been proven to be very effective at reducing the symptoms of IBD.

Your Quality Pharmacist will be able to tell you more about these specialised medications.


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