Gut Reactions
Millions of people suffer from digestive health issues. But reaching for medication may not always be the answer.
If you think tummy troubles lack medical gravitas, consider this: the Nobel Prize for medicine in 1995 went to two scientists who discovered that a pesky bacterium (Helicobacter pylori) causes gastritis and peptic ulcers. For decades, doctors and researchers blamed stress and lifestyle habits for stomach inflammation and peptic ulcers, but the prizewinning scientists redirected attention to the actual culprit and forced the medical community to reexamine its ideas about the gastrointestinal tract and how to keep it working well.
Since that medical breakthrough, it seems as if the world too has turned its attention to the GI tract and the problems that reside therein. The most heavily marketed drug in 2005, for example, was the ever-present “little purple pill,” Nexium, a heartburn aid that AstraZeneca spent $224 million that year to advertise. And GI attention goes beyond prescriptive measures. Kraft Foods, citing 60 million to 70 million sufferers of digestive ailments, recently launched a line of cheese snacks with live cultures designed to foster digestive health.
“There seem to be quite a lot of these problems out there,” says Bret Lashner, MD, a digestive disease expert and gastroenterologist at the Cleveland Clinic Digestive Disease Center, which U.S. News & World Report ranked No. 2 in the nation in its 2007 “best hospitals” survey. “And, to some extent, we all get abnormal bowel habits; we all get occasional abdominal pain and heartburn.”
The Gamut
As Lashner points out, many syndromes fall under the gastro umbrella: gastroesophageal reflux disease, heartburn, lactose intolerance, irritable bowel syndrome, diverticulitis (an infection in bulging sacs in the colon wall), celiac disease (a digestive auto-immune disease triggered by the consumption of a protein found in wheat, oats, barley, and rye), peptic ulcers, and the more common constipation, hemorrhoids, and diarrhea. If that list seems daunting, add to it the fact that for lactose intolerance alone, there are more people in the world who suffer from the syndrome than who don’t.
Jeannie Gazzaniga-Moloo, a registered dietitian and spokeswoman for the American Dietetic Association, says most of her clients with stomach issues fit a prototypical profile. “She’s in her mid-40s, skips breakfast, is a career woman with kids, and she’s married. Lunch is haphazard at best, and then she’s rushing to pick up the kids. Dinner is completely on the fly,” Gazzaniga-Moloo says. “The last thing on her agenda is her GI health, but she gets these bouts of irritable bowel syndrome, which can be very debilitating.”
And it’s not just adults who seek relief from heartburn and digestive problems. More than 2 million infants and children used drugs for digestive or gastrointestinal complaints in 2006, an increase of 56 percent since 2002, according to researchers at Medco Health Solutions, a New Jersey-–based pharmacy benefits management company.
“We’ve made some great strides in understanding these conditions,” Lashner says, “but a lot of these problems are treated not with medication but with alterations in diet.”
The Good Guys
For starters, Lashner explains, it’s good to remember that the gut serves as a home to a vast number of microbes. “We have many, many more bacteria in our bodies than cells, and the GI tract is just loaded with bacteria,” he says. These microbes play an important role in digestion and how we process energy. The bacteria found in the stomach and intestines secrete almost 100 enzymes that break down foods into usable sugars, and another 250 or so that orchestrate the energy we extract from a particular meal.
“Our GI tract is full of good bacteria that provide health benefits, and bad bacteria that cause some problems,” Gazzaniga-Moloo adds. “It’s a continual battle between the good and the bad.” Antibiotic medications can diminish the number of all GI bacteria, and that’s why dairy products that offer live cultures, which frequently are referred to as “probiotics,” might help repopulate the bowel with more of the good bacteria.
But Lashner and Gazzaniga-Moloo agree that the best way to ensure your GI tract boasts a substantial colony of the good stuff is to eat plenty of fiber, fruits, and vegetables, which foster good bacteria growth. Although stress can also be a contributing factor to GI troubles, Gazzaniga-Moloo says her first step with her typical patient is to get the patient to eat regular meals that focus on these foods.
Current studies show that those helpful bacteria also serve as a source for current and future GI remedies. When genetically engineered, for example, they may carry the lactase gene (the enzyme that enables lactose digestion). “Isn’t that interesting, that you can populate the GI tract with this special bacteria that creates lactase so that you can digest milk and milk products?” Lashner asks. Before long, many consumers may have the chance to find out.
