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Lisa Best, MBA, PhD Holistic Nutrition, is a Certified Clinical Nutritionist (CCN), Registered Dietitian (RD), Licensed Dietitian Nutritionist (LDN), and CEO of Healing With Nutrition in Hillsborough. She also practices with Chapel Hill Integrative Medical Associates in Chapel Hill.

Gastrointestinal Distress:
Many Symptoms, Many Sources

By Lisa Best, MBA, PhD, CCN, RD, LDN

Most people recognize the common symptoms of gastrointestinal distress: these range from tummy upset (gas, bloating, burping, GERD, vomiting) to full-out lower digestive upset (constipation/diarrhea, gut pain); to pains from diverticulosis, celiac disease, Crohn’s disease or Irritable Bowel Syndrome (IBS).

Lisa Best

When patients report these symptoms to me during nutritional consultations, we go straight to work exploring the foods that might be disturbing the patient, and looking at inflammation or imbalance in the gut requiring repair for optimal health and wellness. Since we are all individuals with unique genetic predispositions, environmental exposures and personal tastes, each of us must determine the “perfect diet” that supports our own unique dietary demands.

But what many people don’t realize is there are tons of additional symptoms—not typically associated with digestion—that can be instrumental in diagnosing gut associated problems.

For instance, when patients present with skin disorders like acne, psoriasis, rosacea, or rash, I immediately begin investigating the possibility of food sensitivities, allergies or even leaky gut.

Leaky Gut

Leaky gut occurs when the single layer of intestinal cells that separate the intestine from the blood stream (tight junctions) become damaged and allow food particles to escape into the blood stream unprocessed, where they activate immune response.

Recent studies show a high correlation between leaky gut and food allergies triggered by escaped food particles and attacked by a vigilant immune system. In the extreme, leaky gut may also be causing or contributing to the rise in auto-immune diseases as escaped food particles resemble target organs and may trigger an immune system attack within the body.

Inflammation resulting from leaky gut can manifest in many forms throughout the body. Not only are skin disruptions a common symptom, but joint pain, nasal congestion, allergic reactions and migraine headaches can also signal inflammation arising from leaky gut. When I see any of these symptoms or especially if I see all of them, I suspect leaky gut as a possible cause or contributing factor.

There are multiple theories about how the delicate gut lining becomes damaged, but consensus is that highly processed, inflammatory foods are major contributors. Exposure to pesticides, herbicides, environmental toxins, pollutants (especially heavy metals), and free radicals may also contribute to cell damage.

Although antibiotics are certainly life savers, their persistence in the food supply may contribute to gut dysbiosis or imbalance of gut bacteria that also contributes to inflammation, poor nutrient absorption and damage to tight junctions in the gut lining. When patients present with recurrent or frequent infections I often suspect disruptions in the gut biome and suggest protocols to rebuild microbiota with prebiotics, probiotics, and fermented foods.

Even signs of emotional distress like anxiety, depression, and mood swings can be clues that the gut microbiome is out of balance. Since about 70 percent of serotonin is produced in the intestines, mood fluctuations can be a sign of gut disruption.  Research relating the gut/brain connection that dubs the gastrointestinal system as the “second brain” suggests intricate interconnectivity between gut health and emotional well-being. Anti-inflammatory dietary protocols have worked wonders for patients with ADD/ADHD, Autism Spectrum Disorder, Alzheimer’s, anxiety and depression, just to name a few.

Dark circles under the eyes may be one of the most obvious physical signs of exhausted adrenal glands indicative of gastrointestinal inflammation and possibly leaky gut. This symptom is visible at all ages, but I see it frequently in small children with mood disorders and undiagnosed inflammation/food sensitivities.

Dry skin (especially on the lower legs) can indicate either dehydration or essential fatty acid deficiency. Easy bruising can indicate iron, Vitamin C or Vitamin K deficiency. Muscle cramping can indicate dehydration or electrolyte deficiency (especially magnesium). Little bumps on the back of arms can indicate Vitamin A deficiency. Low vitamin levels when diet is good could indicate digestive enzyme or hydrochloric acid deficiency. When I see these symptoms, I explore dietary intake to see if additional nutrients could be helpful.

The bottom line from the perspective of a holistic nutritionist is that the gut is the entry point into the body for both life sustaining nutrients and harmful agents. When gut function is not optimal, it is difficult for other systems in the body to obtain the resources or the defenses they need. Whenever any sign of inflammation, infection, or nutrient deficiency is present, I look to the gut to be sure it is operating at top efficiency to provide the nutrients, raw materials and immune response necessary for optimal health.