If you have a stomachache, nausea or some other digestive problem, you know that it stems from your gastrointestinal (GI) tract.

But very few people think of the GI system when they have a health problem such as arthritis, depression, diabetes, asthma or recurring infections.

Surprising: Tens of millions of Americans are believed to have digestive problems that may not even be recognizable but can cause or complicate many other medical conditions.

Latest development: There's now significant evidence showing just how crucial the digestive system is in maintaining your overall health. How could hidden GI problems be responsible for such a wide range of seemingly unrelated ills?

Here's how: If you can't digest and absorb food properly, your cells can't get the nourishment they need to function properly and you can fall prey to a wide variety of ailments.

Good news: A holistically trained clinician can advise you on natural remedies (available at health-food stores unless otherwise noted) and lifestyle changes that often can correct hidden digestive problems... *

*Consult your doctor before trying these remedies especially if you have a chronic medical condition or take any medication.

Low Levels of Stomach Acid

Stomach acid, which contains powerful, naturally occurring hydrochloric acid (HC1), can decrease due to age, stress and/or food sensitivities.

Adequate stomach acid is a must for killing bacteria, fungi and parasites and for the digestion of protein and minerals. Low levels can weaken immunity and, in tum, lead to problems that can cause or complicate many ailments, including diabetes, gallbladder disease, osteoporosis, rosacea, thyroid problems and autoimmune disorders.

If you suspect that you have low stomach acid: You can be tested by a physician-or simply try the following natural remedies (adding one at a time each week until symptoms improve)...

Use apple cider vinegar. After meals, take one teaspoon in eight teaspoons of water.

• Try bitters. This traditional digestive remedy usually contains gentian and other herbs. Bitters, which also are used in mixed drinks, are believed to work by increasing saliva, HC1, pepsin, bile and digestive enzymes. Use as directed on the label in capsule or liquid form.

• Eat umeboshi plums. These salted, pickled plums relieve indigestion. Eat them whole as an appetizer or dessert or use umeboshi vinegar to replace vinegar in salad dressings.

• Take betaine HC1 with pepsin with meals that contain protein.

Typical dosage: 350 mg. You must be supervised by a health-care professional when using this supplement-it can damage the stomach if used inappropriately.

If you still have symptoms, ask your doctor about adding digestive enzymes such as bromelain and/or papain.

Too Much Bacteria

When HC1 levels are low, it makes us vulnerable to small intestinal bacterial over growth (SIBO). This condition occurs when microbes are introduced into our bodies via our food and cause a low-grade infection or when bacteria from the large intestine migrate into the small intestine, where they don't belong. Left untreated, this bacterial overgrowth can lead to symptoms, such as bloating, gas and changes in bowel movements, characteristic of irritable bowel syndrome (IBS). In fact, some research shows that 78% of people with IBS may actually have SIBO.

SIBO is also a frequent (and usually overlooked) cause of many other health problems, including Crohn's disease, scleroderma (an autoimmune disease of the connective tissue) and fibromyalgia.

SIBO can have a variety of causes, including low stomach acid, overuse of heartburn drugs called proton pump inhibitors (PPIs) and low levels of pancreatic enzymes. Adults over age 65, who often produce less stomach acid, are at greatest risk for SIBO.

Important scientific finding: A study recently conducted by researchers at Washington University School of Medicine found that, for unknown reasons, people with restless legs syndrome are six times more likely to have SIBO than healthy people .

To diagnose: The best test for SIBO is a hydrogen breath test-you drink a sugary fluid and breath samples are then collected. If hydrogen is overproduced, you may have SIBO. The test, often covered by insurance, is offered by gastroenterologists and labs that specialize in digestive tests. A home test is available at www.breatbtests.com.

How to treat: The probiotic VSL 3, available at www.vsl3.com, can be tried. However, antibiotics are usually needed. Rifaxamin (Xifaxan) is the antibiotic of choice because it works locally in the small intestine.

Leaky Gut Syndrome

The acids and churning action of the stomach blend food into a soupy liquid (chyme) that flows into the small intestine. There, the intestinal lining performs two crucial functions absorbing nutrients and blocking unwanted substances from entering the bloodstream.

But many factors, such as chronic stress, poor diet, too much alcohol, lack of sleep, and use of antibiotics, prednisone and certain other medications, can inflame and weaken the lining of the small intestine. This allows organisms, such as bacteria, fungi and parasites, and toxic chemicals we encounter in our day-to-day activities, to enter the blood. The problem, called increased intestinal permeability, or leaky gut syndrome, is bad news for the rest of your body.

What happens: The immune system reacts to the organisms and substances as "foreign," triggering inflammation that contributes to or causes a wide range of problems, such as allergies, skin problems, muscle and joint pain, poor memory and concentration, and chronic fatigue syndrome.

To diagn0se: A stool test that indicates the presence of parasites, yeast infections or bacterial infection is a sign of leaky gut. So are clinical signs, such as food intolerances and allergies. However, the best test for leaky gut checks for urinary levels of the water-soluble sugars lactulose and mannitol-large amounts indicate a leaky gut.

How to treat: If you and your doctor believe that you have leaky gut, consider taking as many of the following steps as possible...

• Chew your food slowly and completely to enhance digestion.

• Emphasize foods and beverages that can help heal the small intestine, including foods in the cabbage family, such as kale, vegetable broths, fresh vegetable juices (such as cabbage juice), aloe vera juice and slippery elm tea.

• Take glutamine. This amino acid is the main fuel for the small intestine-and a glutamine supplement is one of the best ways to repair a leaky gut. Start with 1 g to 3 g daily, and gradually increase the dosage by a gram or two per week to up to 14 g daily. Becoming constipated is a sign that you're using too much.

• Try the probiotic L. plantarum. A supplement of this gut-friendly bacteria, such as Transformation Enzyme's Plantadophilus, can help heal the small intestine.

• Add quercetin. This antioxidant helps repair a leaky gut. In my practice, I've found that the products Perque Pain Guard and Perque Repair Guard work better than other quercetin products.

Typical dosage: l,000 mg daily.

• Use digestive enzymes with meals to help ensure your food is completely digested.

Good brands: Enzymedica, Thome and Now.

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