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Optimising Digestive Health: A Guide to Optimal Gut Wellness

IMCD NewsPharmaceuticals
Published:27 August 2024 - 10:00 AM

Explore the significance of the digestive system and its impact on overall health and gain insights into the prevalence of digestive dysfunction affecting over 40% of the global population.

The digestive system is one of the most important systems within the body, playing several key roles in health. A dysfunctioning digestive system gives rise to a wide variety of symptoms, many of which impact day-to-day life. Between 30% and 50% of people may experience common symptoms such as gas, bloating, abdominal cramps, constipation, diarrhoea, nausea, and fatigue.(1) 

Sleep patterns, energy levels, and the ability to exercise can all be affected and there can be a resultant impact on mood and motivation. The link between digestive dysfunction and emotional wellness is becoming more recognised and over half of those affected by digestive issues acknowledge this.(1)

There is a wider impact to poor digestive health and other symptoms that can be experienced include rashes, headaches, brain-fog, and musculoskeletal pain. A dysfunctioning digestive system over the long-term has now been associated with many chronic health conditions.(2)

The gastrointestinal tract

The gastrointestinal tract consists of many parts, and several supporting organs ensure adequate function is achieved. The digestive tract is responsible for the breakdown, absorption, transportation, and utilisation of food and nutrients and ensures a wide variety of nutrients, in the right form, are supplied for the body to use for essential functions. The process of digestion is reliant upon mechanical actions, acids, nerves, enzymes, and hormones, which all work together. Disruption to any of these may have an impact on other aspects of functioning.

Immune interaction

The gastrointestinal tract holds far more responsibility than just digestion and around 70% of the immune system resides in the gut,(3,4) including gut-associated lymphoid tissue (GALT).(5) The intestinal lining is comprised of many cells tightly squeezed together, forming a natural barrier preventing the entry of ‘foreign substances’ such as viruses, bacteria, toxins, and other potential allergens. Added to this is a mucosal layer that also aids in forming a complex defence against the external world. Despite being a natural barrier, there is also a degree of flexibility required to allow for the absorption of essential nutrients and fluids. 

Disruption to the strength or flexibility of the barrier results in an immune response and increased intestinal permeability, also called ‘leaky gut’, and has been linked to conditions such as irritable bowel syndrome, inflammatory bowel diseases, coeliac disease, food allergies, obesity and metabolic diseases (6). These conditions commonly lead to many symptoms such as fatigue, pain, digestive disturbances, low mood, and anxiety, which may significantly impact day-to-day living and quality of life.

Nervous system interaction

Embedded in the gastrointestinal lining is the enteric nervous system, which governs mechanical contractions and movements within the gut as well as essential secretions. The enteric nervous system can function independently but also communicates with the ‘central brain’ through the gut-brain axis.(7)

The role of the gut-brain axis is not only to monitor and influence gut functions but to provide a link between emotional and cognitive areas of the brain with intestinal functions. Communication is bi-directional, with messages being sent from the gut to the brain and vice versa. This relationship can give clarity on why emotions can be linked to digestive symptoms, and also why digestive dysfunction can cause psychological symptoms such as low mood. Vagal nerve interaction is involved in gut-brain crosstalk, and the gut microbiota also play a key role.(7) 

Microbiota interaction 

The complexities of the gastrointestinal tract continue as housed within the intestines are over 40 trillion bacteria.(8) These contribute, along with fungi, viruses, and their genes, to the gut microbiome. This complex eco-system has many functions, including supporting gastrointestinal motility and function, nutrient metabolism and synthesis, immunomodulation and inflammation, communication through the gut-brain axis, as well as supporting the structural integrity of the gut lining.(9)

An imbalance in the types or numbers of gut microbiota, also known as dysbiosis, can lead to a variety of symptoms and is associated with many aspects of poor health, including many of those also associated with poor intestinal barrier integrity.(2,10)  

Optimising digestive functioning
Approaching digestive dysfunction can be daunting due to the complexities of the system and the many functions associated with the gastrointestinal tract. It can be hard to know where to begin with so many diverse symptoms such as altered bowel movements, discomfort, fatigue, and low mood. Several steps may be needed to restore and optimise digestive health.

Remove and replace 

Remove anything that may be impacting the gut environment - this can include certain foods,(11) chemicals, parasites, yeasts or pathogenic bacteria. 

Replace digestive secretions that may be reduced, such as hydrochloric acid or digestive enzymes. This ensures food is fully broken down and nutrients can be absorbed correctly, reducing larger than normal particles from crossing the intestinal barrier and causing an immune response.

Repopulate 

Repopulate the gut microbiota with a wide variety of probiotics - live microorganisms. Reinoculation is known to give much benefit, not only to digestive functioning and gastrointestinal health, but also to wider aspects of health including mental health,12 inflammatory and autoimmune disorders, and cardiovascular health.(13)

It is vital to provide food for the microbiota, and the presence of prebiotics is essential, not only to provide fuel but also for encouraging an optimal environment for microorganisms to flourish. Fermentation of prebiotics by bacteria results in the production of metabolites – such as short chain fatty acids (SCFAs), which support the health of the gut lining and play a role in other areas of health.(14)

Prebiotics include various oligosaccharides, two of the most common being galacto-oligosaccharides (GOS) and the fructo-oligosaccharides (FOS). Other non-digestible oligosaccharides include human milk oligosaccharides (HMOs), important for promoting the development of an immature infant microbiome, and more recently shown to have a positive impact on the adult microbiome and irritable bowel syndrome - improving stool consistency, reducing symptoms, and supporting quality of life.(15-19)

Non digestible polysaccharides also have prebiotic effects and pectins and mucilages in many plants contribute to enhancement of microbiome colonisation and balance. Plants such as prickly pear (Opuntia ficus Indica L.) have been used traditionally for digestive health due to prebiotic actions as well as mucoadhesive abilities which help to protect the gut mucosa. In addition to this, Opuntia is also known to have anti-inflammatory and antioxidant properties.(20-23)

Synbiotics are a blend of prebiotics and probiotics that work synergistically to repopulate the gut microbiome.
It is key to mention postbiotics as well, these are distinct from probiotics and are inanimate microorganisms, rather than live, that are present with components such as the cell wall, other cell components, and metabolites, which may include short chain fatty acids (SCFAs). Postbiotics are known to influence intestinal integrity, support gut immune defences, inhibit undesirable bacteria, and restore colonisation and balance of gut microbiota species.(24-28)  

Repair and rebalance

Repairing intestinal damage is essential and an adequate intake of healing and anti-inflammatory nutrients ensures intestinal integrity and repair.29 Herbal support brings a multitude of benefits for repair through several mechanisms including providing a protective mucilage film - relieving irritation, supporting digestive enzyme secretion, encouraging intestinal motility as well as providing anti-inflammatory and antioxidant actions.(30-39)

Rebalancing lifestyle factors that may be detrimental to digestive health such as lifestyle factors including stress, sleep disturbances, and a lack of physical exercise(24-26) also give significant benefits.

Digestive dysfunction involves many factors and gives rise to many physical and psychological symptoms. Taking a holistic approach to restoring digestive balance and optimising functioning involves looking at many aspects, and central to this is supporting the microbiome – a key factor in the promotion and balance of many aspects of health.



References
  1. FMCG (2024) https://fmcggurus.com/reports/fmcg-gurus-digestive-health-in-focus-claims-purchasing-habits-global-report-2024/
  2. Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J. D., Serino, M., ... & Wells, J. M. (2014). Intestinal permeability–a new target for disease prevention and therapy. BMC gastroenterology, 14, 1-25. https://link.springer.com/article/10.1186/s12876-014-0189-7
  3. Vighi, G., Marcucci, F., Sensi, L., Di Cara, G., & Frati, F. (2008). Allergy and the gastrointestinal system. Clinical & Experimental Immunology, 153(Supplement_1), 3-6. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2249.2008.03713.x
  4. Furness, J. B., Kunze, W. A., & Clerc, N. (1999). II. The intestine as a sensory organ: neural, endocrine, and immune responses. American Journal of Physiology-Gastrointestinal and Liver Physiology. https://journals.physiology.org/doi/full/10.1152/ajpgi.1999.277.5.G922?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
  5. Mörbe, U. M., Jørgensen, P. B., Fenton, T. M., von Burg, N., Riis, L. B., Spencer, J., & Agace, W. W. (2021). Human gut-associated lymphoid tissues (GALT); diversity, structure, and function. Mucosal immunology, 14(4), 793-802. https://www.nature.com/articles/s41385-021-00389-4
  6. Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J. D., Serino, M., ... & Wells, J. M. (2014). Intestinal permeability–a new target for disease prevention and therapy. BMC gastroenterology, 14, 1-25.https://link.springer.com/article/10.1186/s12876-014-0189-7
  7. Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of gastroenterology: quarterly publication of the Hellenic Society of Gastroenterology, 28(2), 203. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/
  8. Sender, R., Fuchs, S., & Milo, R. (2016). Are we really vastly outnumbered? Revisiting the ratio of bacterial to host cells in humans. Cell, 164(3), 337-340. https://www.sciencedirect.com/science/article/pii/S0092867416000532 
  9. Jandhyala, S. M., Talukdar, R., Subramanyam, C., Vuyyuru, H., Sasikala, M., & Reddy, D. N. (2015). Role of the normal gut microbiota. World journal of gastroenterology: WJG, 21(29), 8787. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528021/
  10. Cho, I., & Blaser, M. J. (2012). The human microbiome: at the interface of health and disease. Nature Reviews Genetics, 13(4), 260. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418802/
  11. De Punder, K., & Pruimboom, L. (2013). The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients, 5(3), 771-787. https://www.mdpi.com/2072-6643/5/3/771/htm
  12. Sharma, H., & Bajwa, J. (2022). Approach of probiotics in mental health as a psychobiotics. Archives of Microbiology, 204(1), 30. https://www.researchgate.net/profile/Sharma-17/publication/357171964_Approach_of_probiotics_in_mental_health_as_a_psychobiotics/links/61c05fd9fd2cbd7200b26d73/Approach-of-probiotics-in-mental-health-as-a-psychobiotics.pdf
  13. Tegegne, B. A., & Kebede, B. (2022). Probiotics, their prophylactic and therapeutic applications in human health development: A review of the literature. Heliyon, 8(6). https://www.sciencedirect.com/science/article/pii/S2405844022010131
  14. Ashaolu, T. J., Ashaolu, J. O., & Adeyeye, S. A. O. (2021). Fermentation of prebiotics by human colonic microbiota in vitro and short‐chain fatty acids production: a critical review. Journal of Applied Microbiology, 130(3), 677-687.https://enviromicro-journals.onlinelibrary.wiley.com/doi/full/10.1111/jam.14843
  15. Kunz, C. (2012). Historical aspects of human milk oligosaccharides. Advances in Nutrition, 3(3), 430S-439S. https://www.sciencedirect.com/science/article/pii/S2161831322010171
  16. Bode, L., & Jantscher-Krenn, E. (2012). Structure-function relationships of human milk oligosaccharides. Advances in Nutrition, 3(3), 383S-391S. https://www.sciencedirect.com/science/article/pii/S2161831322010110
  17. Dinleyici, M., Barbieur, J., Dinleyici, E. C., & Vandenplas, Y. (2023). Functional effects of human milk oligosaccharides (HMOs). Gut Microbes, 15(1), 2186115. https://www.tandfonline.com/doi/full/10.1080/19490976.2023.2186115 
  18. Elison, E., Vigsnaes, L. K., Krogsgaard, L. R., Rasmussen, J., Sørensen, N., McConnell, B., ... & Bytzer, P. (2016). Oral supplementation of healthy adults with 2′-O-fucosyllactose and lacto-N-neotetraose is well tolerated and shifts the intestinal microbiota. British Journal of Nutrition, 116(8), 1356-1368. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/oral-supplementation-of-healthy-adults-with-2ofucosyllactose-and-lactonneotetraose-is-well-tolerated-and-shifts-the-intestinal-microbiota/FF17B6683EB09EE97F5FD5CB78E1218C
  19. Palsson, O. S., Peery, A., Seitzberg, D., Amundsen, I. D., McConnell, B., & Simrén, M. (2020). Human milk oligosaccharides support normal bowel function and improve symptoms of irritable bowel syndrome: a multicenter, open-label trial. Clinical and translational gastroenterology, 11(12), e00276. https://journals.lww.com/ctg/fulltext/2020/12000/human_milk_oligosaccharides_support_normal_bowel.15.aspx
  20. Rubio, J. M. C. (2021). Oligo-and polysaccharides isolated from the mucilage of Opuntia ficus-indica and Opuntia joconostle cladodes: characterization and potential use as a pharmaceutical prebiotic ingredient. PDF available online https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=Rubio%2C+J.+M.+C.+%282021%29.+Oligo-and+polysaccharides+isolated+from+the+mucilage+of+Opuntia+ficus-indica+and+Opuntia+joconostle+cladodes%3A+characterization+and+potential+use+as+a+pharmaceutical+prebiotic+ingredient.&btnG=
  21. Guevara-Arauza, J. C., de Jesús Ornelas-Paz, J., Pimentel-González, D. J., Rosales Mendoza, S., Soria Guerra, R. E., & Paz Maldonado, L. M. T. (2012). Prebiotic effect of mucilage and pectic-derived oligosaccharides from nopal (Opuntia ficus-indica). Food Science and Biotechnology, 21(4), 997-1003.https://link.springer.com/article/10.1007/s10068-012-0130-1
  22. Gómez‐Maqueo, A., García‐Cayuela, T., Fernández‐López, R., Welti‐Chanes, J., & Cano, M. P. (2019). Inhibitory potential of prickly pears and their isolated bioactives against digestive enzymes linked to type 2 diabetes and inflammatory response. Journal of the Science of Food and Agriculture, 99(14), 6380-6391. https://onlinelibrary.wiley.com/doi/abs/10.1002/jsfa.9917
  23. Giraldo-Silva, L., Ferreira, B., Rosa, E., & Dias, A. C. (2023). Opuntia ficus-indica Fruit: A Systematic Review of Its Phytochemicals and Pharmacological Activities. Plants, 12(3), 543. https://www.mdpi.com/2223-7747/12/3/543
  24. Lievin-Le Moal, V., Amsellem, R., Servin, A. L., & Coconnier, M. H. (2002). Lactobacillus acidophilus (strain LB) from the resident adult human gastrointestinal microflora exerts activity against brush border damage promoted by a diarrhoeagenic Escherichia coli in human enterocyte-like cells. Gut, 50(6), 803-811. https://gut.bmj.com/content/50/6/803.short
  25. Coconnier, M. H., Bernet, M. F., Kernéis, S., Chauvière, G., Fourniat, J., & Servin, A. L. (1993). Inhibition of adhesion of enteroinvasive pathogens to human intestinal Caco-2 cells by Lactobacillus acidophilus strain LB decreases bacterial invasion. FEMS microbiology letters, 110(3), 299-305. https://academic.oup.com/femsle/article/110/3/299/488820?login=false
  26. Montalto, M., Maggiano, N., Ricci, R., Curigliano, V., Santoro, L., Di Nicuolo, F., ... & Gasbarrini, G. (2004). Lactobacillus acidophilus protects tight junctions from aspirin damage in HT-29 cells. Digestion, 69(4), 225-228. https://karger.com/dig/article-abstract/69/4/225/104413/Lactobacillus-acidophilus-Protects-Tight-Junctions?redirectedFrom=fulltext
  27. Coconnier, M. H., Liévin, V., Bernet-Camard, M. F., Hudault, S., & Servin, A. L. (1997). Antibacterial effect of the adhering human Lactobacillus acidophilus strain LB. Antimicrobial agents and chemotherapy, 41(5), 1046-1052. https://journals.asm.org/doi/abs/10.1128/aac.41.5.1046
  28. Warda, A. K., Clooney, A. G., Ryan, F., de Almeida Bettio, P. H., Di Benedetto, G., Ross, R. P., & Hill, C. (2021). A postbiotic consisting of heat-treated lactobacilli has a bifidogenic effect in pure culture and in human fermented fecal communities. Applied and environmental microbiology, 87(8), e02459-20. https://journals.asm.org/doi/full/10.1128/aem.02459-20
  29. Rao, R., & Samak, G. (2012). Role of glutamine in protection of intestinal epithelial tight junctions. Journal of epithelial biology & pharmacology, 5(Suppl 1-M7), 47. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/
  30. Cheema, H. S., & Singh, M. P. (2021). The use of medicinal plants in digestive system related disorders—a systematic review. J. Ayurvedic Herb. Med, 7(3), 182-187. https://www.researchgate.net/profile/M-Singh-15/publication/354272150_The_Use_of_Medicinal_Plants_in_Digestive_System_Related_Disorders_A_Systematic_Review/links/612f6e6c0360302a006fde39/The-Use-of-Medicinal-Plants-in-Digestive-System-Related-Disorders-A-Systematic-Review.pdf?uid=7fe8e7ade0
  31. Blumenthal, M., et al. Ginger – Clinical Overview - The ABC Clinical Guide to Herbs. American Botanical Council, Austin, Texas, USA. First Edition 2003. ISBN: 3-13-132391-4 https://www.cabdirect.org/cabdirect/abstract/20033106791
  32. Bodagh, MN., et al. Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food Sci Nutr. 2019;7:96–108. https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.807
  33. Yarnell, E. Synergy in Herbal Medicine. Journal of Restorative Medicine, Volume 4, Number 1, 1 December 2015, pp. 60-73(14) https://restorativemedicine.org/journal/synergy-in-herbal-medicines-part-1/
  34. Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:244-248. https://www.cabdirect.org/cabdirect/abstract/20003018530
  35. Zaghlool, S. S., Shehata, B. A., Abo-Seif, A. A., & Abd El-Latif, H. A. (2015). Protective effects of ginger and marshmallow extracts on indomethacin-induced peptic ulcer in rats.Journal of natural science, biology, and medicine, 6(2), 421–428. https://doi.org/10.4103/0976-9668.160026
  36. Chen JK, Chen TT. Chinese Medical Herbology and Pharmacology. Crampton L, editor. City of Industry (CA): Art of Medicine Press Inc; 2004.
  37. Kwon, H. K., Hwang, J. S., Lee, C. G., So, J. S., Sahoo, A., Im, C. R., Jeon, W. K., Ko, B. S., Lee, S. H., Park, Z. Y., & Im, S. H. (2011). Cinnamon extract suppresses experimental colitis through modulation of antigen-presenting cells. World journal of gastroenterology, 17(8), 976–986. https://doi.org/10.3748/wjg.v17.i8.976
  38. Costantini, L., Molinari, R., Farinon, B., & Merendino, N. (2017). Impact of omega-3 fatty acids on the gut microbiota. International journal of molecular sciences, 18(12), 2645. https://www.mdpi.com/1422-0067/18/12/2645/htm 
  39. Suzuki, T. (2013). Regulation of intestinal epithelial permeability by tight junctions. Cellular and molecular life sciences, 70(4), 631-659. http://thehealthsciencesacademy.org/wp-content/uploads/2015/02/Regulation-of-intestinal-epithelial-permeability-by-tight-junctions_Takuya-Suzuki_Cellular-and-Molecular-Life-Sciences.pdf

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