The primary gastrointestinal purpose is to absorb those positive elements required for nutrition, yet eliminate those that are negative, or toxic and invasive. In this process, the lining of the intestinal tract is the first barrier. The liver, the second line of processing and defense, is called upon to sort out the initial introduction of nutrients, and to remove and/or neutralize those "xenobiotics" (chemicals that should not be there) and bacteria that accompany food and pass through the intestinal barrier. Over a century ago, Dr. Ivan Pavlov, famous for his demonstration of the conditioned reflex in dogs via salivation at the sound of a bell, also demonstrated the importance of the body's defense mechanisms by tying off the portal vein, the route that nutrients and toxins take from the GI tract to the liver. Fever, kidney disease, and generalized toxicity in the animals resulted. Toxins normally neutralized by passing through the liver were unable to do so, with disastrous results.

If one or both of these tasks, getting the good things in and keeping the bad things out, are compromised, not all the building blocks, cofactors, and fuel required to keep the body's systems functioning are available, even if ingested. Leaky gut can result in large food molecules passing the barrier, sensitizing the body to the food and triggering an immunologic response involving very large molecules getting into the blood stream and "up regulating" the immune system. Cytokines released from the "Kuppfer cells," fixed lymphocytes in the liver which are a first line of defense, stimulate the immune system in general. This constant up regulation drains finite energy from the system, similar to that drained from the body when fighting infection, resulting in fatigue, diminished energy available for repair and for fighting further infections. Additionally, depletion of reserves that are for detoxification of other toxins takes place, making an individual more susceptible to toxicity from alcohol, drugs and various environmental chemicals. Identification of those food stuffs to which you are sensitive and eliminating them from your diet, frees up energy for enhanced immunity.

Another example of insight into the importance of gastrointestinal function in maintaining health occurred early in the twentieth century. Elie Metchnikoff, M.D., who succeeded Louis Pasteur as director of the Pasteur Institute, is better known for his Nobel Prize winning description of phagocytosis, the process whereby bacteria are engulfed by white cells. He theorized that unfriendly bacteria in the gut could produce illness through toxins they generated. This created a wave of enthusiasm in cleaning the gastrointestinal tract through purging, and even led to colectomies that were done for constipation. Performing such procedures during the pre-antibiotic age led to inevitable deaths, and the entire theory was abandoned as a result. The views of Dr. Metchnikoff are again realizing acceptance, although in a much more measured and scientific way. While in medical school during the early nineteen seventies, I was taught there are no reasons for laxative use other than to prepare the bowel for testing or surgery.

Bacteria are categorized in the gut under three (3) types: symbiotic, commensal, and pathogens. Those whose presence and activity benefit us, the symbiotic bacteria, help maintain the immune system, aid digestion and, in some cases, produce vitamins and substances that defend against unfriendly bacteria. Large amounts of these bacteria can even be considered another organ of the body, for health requires their presence. Commensal bacteria, producing neither good nor ill effects, such as normal Escherichia coli and streptococci, are well represented. They can, when exposed to antibiotics, develop resistance which may be transferred to the third group of bacteria, pathogens, well-known, very unfriendly bacteria that cause acute disease. Staphylococcus, shigella, salmonella, and clostridium are representative of this group for which local hospitals constantly perform tests. Other, less well known intermediate pathogens generate proteolytic (putrefactive) enzymes and toxins that produce chronic symptoms through overgrowth. Liberated toxins are able to inflict damage to the lining of the intestinal wall which may well result in the leaky gut, further compromising the earlier referenced hepatic reserve. (Many of us have experienced exposure and comment in the public restroom that "something must have crawled up and died there.") An example of this is candida, the yeast responsible for vaginitis in women, thrush, and diaper rash in infants. It remains less readily identifiable when in the gut because there is no easy test for it, and the signs and symptoms are not as recognizable as with vaginal overgrowth. Although we all have small amounts in our GI tracts normally, overgrowth of candida in the gut is the result of high carbohydrate intake and rampant overuse of antibiotics which kill off the symbiotic organisms. The resulting imbalance can produce an outcome of chronic illness through intestinal inflammation, liberation of toxins, and a subsequent leaky gut. Other organisms, such as Klebsiella and Pseudomonas, which cause acute illness when in the lungs or when immunity is compromised, may bring about persistent inflammation not recognized as acute illness, but which can, via these mechanisms, create a state of chronic unwellness. Even though parasites, such as amoeba, worms, blastocystis, and others, are believed to be the province of tropical medicine, they are present in our temperate regions as well, spawning a broad spectrum of symptoms and often-undetected chronic illnesses. Unlike Giardia that makes itself known through acute diarrheal illnesses, these parasites contribute to the development of various chronic syndromes. It is probable that fermentation of carbohydrates in the presence of yeast can lead to an "auto-brewery" syndrome, so named due to detectable levels of ethyl alcohol in the blood of some non-drinkers which can add to depressive symptoms already triggered by simple carbohydrates. The toxins from candida also have the capacity to exacerbate "brain fog," complicating the picture. The chronic up regulation of the immune system and abnormal inflammation that results may even predispose an individual to autoimmune disease.

Careful scrutiny of bowel flora is not standard procedure in most laboratories physicians employ for examination of stool specimens. Only a few labs perform a thorough assessment of bowel function by this means. Given the fact over four hundred species of organisms are present in numbers that approach 60-80 trillion, this garden is very important. Restoration of balance, controlling or eliminating the intermediate pathogens and reestablishing the symbiotic bacteria, is imperative. Reducing toxic load, healing the intestinal wall, resuming healthy defense and absorption of nutrients are prerequisites to health in the chronically unwell. Minimizing the burden on the hepatic, immune, and neurologic systems, compromised by toxins and antigens leaking through the intestinal wall, is of the essence. As part of a multi-variable intervention geared toward controlling poorly defined syndromes, presently treated only symptomatically, such action is invaluable.

Complete digestion in the upper intestinal tract is necessary to reduce nutrients presented to pathogens, to create the smaller molecules that are less antigenic, and to facilitate optimal absorption of nutrients. Enzyme replacement provides more food for vitality and less for potential pathogens below. To expedite recovery, a cover crop is applied by multiplication of friendly bacteria and healing of the intestinal wall through nutritional means, with immunologic enhancement the natural consequence.

Nutrition and bulk can be utilized to dilute and facilitate elimination. Exercise keeps everything going. There are many modalities available to accomplish the goal of a healthy gastrointestinal system that supports and defends the bodily house, or "temple" that you live in. With the work of Jeffrey Bland, PhD, of Gig Harbor, Washington, as a reference source, and sixteen years of personally practicing this component, my protocols have been tested and are ready to be applied to your case, not as a single modality, but prioritized and integrated into the total program best for you.