By
Melbourne Functional Medicine
Lorraine Cussen
Medically reviewed by:
Gut health. Everyone is talking about it - people discuss it online, during social get-togethers, in doctors’ clinics, chemists, health food shops, at the school gate, and especially in functional medicine clinics.
“My gut isn’t good” is a frequent phrase we hear from patients seeking our support. But what lies beneath this vague yet common complaint?
When a patient presents with gut issues, it takes some time to unpack what, where, which, how, and especially why. In this article, I’ll take you through a journey of the digestive tract, so you can get a better picture of where things can go awry.
The human gastrointestinal tract (GIT) is about 9 metres long (30 feet), from mouth to, well, you know where. It’s a bit like a train line or a production line, with a beginning and an end with many stations and stops along the way. If there are dysfunctions along the line, such as kinks in the tracks, blocked or poorly functioning stations that are causing delays to the passage of activity (therefore letting down the next station ahead), or causing extra load or work for the next station ahead, the journey suffers.
There are 8 important sections in the digestive tract:
The mouth
When I discuss a patient’s GIT, I usually start with the first station on the train line, the mouth. At the same time I discuss what the patient is putting in their mouth (i.e. their type of diet, the foods, the liquids), how much chewing is going on, is the patient sitting and eating or walking and eating, and drinking lots of fluids with meals, etc. All of these behaviours impact how well the food will be transported and digested further down the line.
The oesophagus
The passage of food and liquids then moves along the oesophagus. The act of swallowing begins this journey and must manage the first gate, the oesophageal sphincter. This sphincter controls the entry and exit of food and liquids, hopefully only down into but sometimes back up and out of the stomach.
The stomach
The stomach is a big station, with many actions and activities taking place during the processing of food, and many influences that change its efficacy or function. For example, stress. When you’re in ‘fight and flight’ mode, your stomach isn’t really open for business. Your body has prioritised other areas of need, such as supplying blood to the muscles to help you run away from a perceived threat, downregulating the stomach’s digestive processes.
However, if all is going to plan, the activity in the stomach will start to open its doors for business, with even just the smell of delicious food. Once food arrives in the mouth, messages, enzymes and an amount of activity triggers the stomach to fire up. The stomach will then send messages to the ‘stations’ ahead to get ready, get into action and be prepared for what’s on the way.
The liver, gallbladder and pancreas
The liver, gallbladder, pancreas and enzymes in the small intestine should kick into gear and fire up their contributions to receiving, processing, absorbing, breaking down and distributing the nutrients presented by the food and liquids we consume.
The small intestine
The small intestine (SI) is the longest stretch of track on the GIT line. It’s about 6-7 metres (22-25 feet) in length and 3 to 4 cm (about 2 inches) in diameter. Much of what we eat and consume is absorbed through this stage of digestion, and is affected by the speed of transit. Too slow (constipation) isn’t ideal, and too fast (diarrhoea and malabsorption) isn’t great either. Many of the symptoms people report such as bloating and flatulence, originate from this area of digestion.
The large intestine
The large intestine (LI) is much shorter than the small intestine, which is a bit confusing given the name. The large intestine is about 1.5 metres (5 feet) long. It’s much broader than the small intestine, and takes a much straighter path through your belly, or abdomen.
There are 6 mini stations in the large intestine: cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and an exit at the anus. Multiple activities occur in this area of the GIT, including final nutrient absorption, making of nutrients, feeding of the microbiome, formation of stool, absorption and reabsorption of water, hormones and much more.
So when presented with a symptom of “my gut isn’t good”, it’s important to explore and discover which areas of the GIT train line are or aren’t working well, identify what’s causing the dysfunction, and be specific with treatment to improve the functional and structural health of the gut.
This is a functional medicine approach to healing: honouring the philosophy that the body has an innate capacity to heal itself, providing it is supported with the right ingredients, conditions, circumstances and environments.
Read more about solutions to the gut health conditions we help with, including IBS, bloating, SIBO, acid reflux and heartburn, coeliac disease, constipation, diarrhoea, food sensitivities, allergies and intolerances, functional dyspepsia, gastritis, gastroparesis, IBD, and parasites.
