Five Overlooked Ways to Help Improve a Sluggish Gut

Are you one of those people that always seem to have slow digestion? Maybe you commonly complain of indigestion, burping, stomach pain, reflux, constipation, or just a sense that food is "stuck" in your system. If so, believe me, this is not uncommon. I talk to clients frequently who complain of many of the above. Whether it's our Western diet or something genetic, some of us just don't feel all that great after we eat.

Unfortunately the answer is not easy. I wish there was one fool-proof solution I could give to people. Instead it tends to be a lot of trial and error until we find something (well, often many things) that gets things moving. I thought I'd share a few different approaches to consider for those of you with stubborn digestion.

1. Address Leaky Gut

Yep, good ol' leaky gut. I know some of you out there still don't believe this to be a real issue, but I'd say the consensus is that there can be intestinal permeability that leads to a host of health issues, one of which is impaired gut motility. If the small intestine is not absorbing nutrients as it normally should, this can contribute to changes in how you experience digestion. While for some it results in terrible diarrhea, for others it can cause stomach pain, abdominal distension, gas, bloating... you name it. How to heal leaky gut? Ah, that's the million dollar question. Every person is unique in how they developed leaky gut so healing and treatment options will also vary. I typically recommend a clean, whole foods diet with lots of antioxidants, Zinc and l-Glutamine supplementation to support intestinal healing, daily probiotic sources (fermented foods), an abundance of healthy fats, gluten and dairy avoidance, digestive enzymes, and other dietary protocols as necessary (see #2). Talk with a naturopath or functional nutrition Dietitian like myself to assess if leaky gut might be something to address.

2. Change Up the Carbs

Often times a high fiber diet is recommended for constipation. Unfortunately, this does not always solve the problem. Some of my clients have been following high fiber diets for years with tons of fluids and it hasn't helped or in fact made things worse. In recent years more research has been done on specific types of carbs that are known to feed (ie be fermented by) various types of bacteria residing in our digestive tract. While normally these bacteria are not a problem, sometimes they migrate from the colon to the small intestine, where they should not be, and start to ferment carbohydrates there. This can produce very unpleasant side effects, one of which is slowed gastric motility. While this displaced bacteria certainly needs to be addressed, some have found improvement just by following what we call a "Low FODMAP" diet. FODMAP stands for Fermentable Oligo-, Di-, and Mono Saccharides and Polyols. You can do a quick search online to find a plethora of websites describing the diet and what types of foods to avoid. Some great links are listed below. While this is not a diet you would ideally follow forever, it can provide a start to see if your body responds. If so, definitely talk with a professional to see what other treatments might be needed to fix the problem for good. With any type of bacterial imbalance, relapse is quite common.

3. Less Snacking!

I know we are constantly told it is better to eat 5-6 small meals per day instead of 3 larges ones, but this frequent intake of food can actually slow your digestion. This was surprising to me too! We all have this process in our body called the Migrating Motor Complex, or the MMC for short. Basically, the MMC produces cleansing peristaltic waves that help push contents through the stomach and small intestine. The catch? This process only works in full in the fasting state, or to be more exact, approximately 90-120 minutes after eating. So, if you are eating every hour by nibbling on random items, you are inhibiting this process and essentially slowing down digestion. Maybe all that gas and bloating you are experiencing is due to food just not getting pushed through the small intestine as quickly as it should. What to do? Try to avoid eating between meals, or give yourself at least 3 hours before eating again. Water and coffee are OK, but avoid even small bits of food to avoid inhibiting the process. Also, definitely avoid eating late, ideally nothing after 8pm, to give your body a good fast and let the MMC do its thing overnight. There are supplements and even pharmaceuticals that can promote a fully functioning MMC as well, but discuss those options with your healthcare provider if you think your system needs a little extra help. On thing I will say, ginger is one agent that does help promote the MMC, and although high doses are necessary, it doesn't hurt to cook with some ginger or make ginger tea. I love to keep things natural whenever possible.

4. Probiotics... Or not.

Probiotics come highly recommended and are quite popular whether via pill or fermented foods. I think probiotics are fantastic and much needed in our modern environment of sterility. That being said, sometimes probiotics can make things WORSE. If this is you, don't despair. You need to chill out on the probiotics for now. You may need to start more slowly, or you may need to address #1 and #3 before your body is ready to get those critters through your digestive tract and into their proper place, the colon. In fact for many, taking probiotic capsules or eating foods like sauerkraut and kimchi make their pain, bloating and constipation worse. So go ahead, back off on the probiotics, let your system calm down again, and then assess what needs to be addressed. Probiotics are not the cure-all, especially if your system is in need of some rebalancing first.

5. Consider Food Sensitivities

Lastly, address food sensitivities if you suspect you have them (if you have #1, then you have food sensitivities). I have had several clients see an improvement in digestion and constipation by removing certain foods from their diet for a time being. While more commonly diarrhea is treated quite well by uncovering and removing food sensitivities, occasionally it helps constipation and slow digestion as well. And at any rate, if leaky gut is present then food sensitivities are likely there too, so addressing both can help with overall gut healing. Recently I've had a couple clients where doing a low FODMAP diet was helpful, but removing foods they reacted to helped finally push their digestion towards normal. How to find out which foods to remove? Elimination diets are common and can help. If going that route I usually start with removing gluten, dairy, soy, nuts and any other foods the client suspects are an issue. Another method I employ is food sensitivity testing via Mediator Release Test (MRT) done by Oxford Biomedical. This cuts to the chase and tells us right away where we need to start. In either case I've seen good results.

One last note, while this is not a cure and purely a relief aid, a little Magnesium can often be helpful for those suffering from constipation and sluggish digestion. Have you ever eaten a lot of beets or overloaded on prune juice and noticed the laxative effects? Well Magnesium works in the same fashion, by acting as an osmotic agent to draw fluids into the large bowel. Again, this doesn't address the underlying cause but can certainly provide some relief. I typically recommend Magnesium oxide (200-400mg, experiment to find your preference) mainly because it is poorly absorbed, hence it goes right to the colon and works its magic. You can use other types as well, but you may need a higher does to see any effect, especially if you are Magnesium deficient.