Gastrointestinal (GI) Disorders!

Symptoms

Gas, bloating, abdominal pain, vomiting, diarrhea, and abdominal cramping: these are not things that one would normally think of when building muscle.

For millions of people who suffer from food allergies or gastrointestinal (GI) disorders, you may experience these symptoms on a daily basis.

These symptoms not only make life very unpleasant, but their causes may mean that the nutrients you intake may not be absorbed properly and if you aren't absorbing nutrients properly, then you are getting the maximum muscular development "bang" for your nutrient "buck."

This article will discuss several common GI disorders and food allergies and will also detail eating strategies to maximize nutrient absorption.

Understanding Gastrointestinal Disorders

Brief Overview Of Digestion:
In order to better understand how to deal with GI disorders and food allergies I will first provide a brief overview of digestion. Digestion of a meal begins in the mouth, which functions to mechanically break up the food into smaller particles. The mouth also secretes amylase, which is an enzyme that hydrolyzes carbohydrate chains into smaller chains.

The nutrients then are transported down the esophagus via longitudinal and segmental contractions of the smooth muscle of the esophagus. These contractions act to mechanically break up the food into smaller particles and move the food down the digestive tract where it then empties into the stomach.

Not much digestion occurs in the stomach other than digestion of longer protein chains by pepsin, which is secreted by the stomach cells and acts to break up long proteins into smaller peptides (short chains of amino acids).

The stomach also acts as a storage unit for nutrients and acts to regulate the rate at which nutrients empty into the small intestine. The small intestine is where most digestion occurs. When nutrients empty into the small intestine, the pancreas is stimulated to release digestive hormones into the small intestine by hormones such as CCK.

	What Does CCK Mean? A hormone released by the duodenum that appears to send a "stop eating" message to the brain.

These digestive enzymes include enzymes that hydrolyze proteins such as pepsin, trypsin, chymotrypsin, and exopepsidases, as well as lipase, a hormone that digests lipids, and amylase, which digests carbohydrates.

When these macronutrients are broken down into smaller chains, they can then be absorbed into the mucosal cells. The mucosal cells contain brush boarder enzymes, which are very specific for certain small peptides and saccharides (carbohydrate) molecules.

An example of a brush boarder enzyme would be lactase, which breaks lactose, a disaccharide, into two monosaccharides;

• Glucose
• And galactose.

The single amino acids and monosaccharides are then transported to the liver via the portal vein where they may be utilized by the liver for various processes or released into the bloodstream.

In an ideal world, the digestion process would work with 100% efficiency, unfortunately this is not the case and there are several disorders and allergies that can reduce digestion and absorption of nutrients.

Common Disorder - Lactose Intolerance:
One very common disorder is lactose intolerance. Individuals with lactose intolerance cannot properly digest lactose due to problems with the lactase enzyme.

The problem is not normally due to lactase deficiency, but rather it is caused by reduced lactase activity. Since lactase cannot split the lactose molecule, it cannot be absorbed across the mucosa and therefore remains in the small intestine.

Symptoms:
This increases the concentration of solutes in the small intestine, which in turn causes water to be pulled into the small intestine to dilute the concentration of solutes, which causes extreme bloating, abdominal pain, and possibly diarrhea. The high concentration of lactose in the small intestine will also cause bacteria present in the small intestine to ferment the lactose, producing carbon dioxide, which will cause flatulence (aka FARTING).

Recap - Lactose Inolerance:
So let's recap here, so far we have gas, diarrhea, abdominal pain, and bloating. All you wanted to do was have a freaking glass of milk for crying out loud!

Fortunately there are things you can do to fix this problem. The simple solution is to avoid dairy products; however this eliminates many good protein sources from the diet. Another option is to take the lactase enzyme as a supplement with meals containing dairy. Lactase is fairly inexpensive and can be purchased at most health food stores. A more long-term solution to lactose intolerance is to try and make the lactase enzymes your body produces more active.

	How Often Do You Drink Milk? Once A Week. Once Daily. Twice Daily. Three Times Daily.

Lactase is an inducible enzyme, which means that if it is not used for a period of time, its activity becomes reduced. This is why many people who don't consume dairy products for a period of time and then try to drink a couple glasses of milk experience the symptoms I referred to even though they did not have previous problems with lactose digestion.

On the same token, more frequent exposure to lactose usually results in increased lactase activity. Thus, individuals who experience lactose intolerance may want to try consuming small amounts of dairy everyday for a period of time, and increase this intake as their body allows.

For example, a person may try consuming ? cup of milk everyday and once their body can tolerate that, they could try consuming 1 cup of milk per day. Once their body can tolerate that, they can move up to 1.5 cups per day and so on until they reached a desired level of dairy intake.

This method won't be successful for all, and you should consult your physician before attempting it, but it is frequently successful in people with mild lactose intolerance.

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Common Disorder - Celiac's:
Celiac's disease is another somewhat common digestive disorder. Celiac's is caused by an allergic reaction to glidian, a small peptide component of gluten, which is a protein found in wheat, oats, rye, and barely. For some reason, people who have Celiac's have what is called a "leaky gut" and this allows this peptide to enter into circulation.

The body does not recognize this protein and initiates a rapid inflammatory immune response to it. This inflammation damages the mucosal cells and thus reduces the absorption of other nutrients.

Symptoms:
Symptoms may include diarrhea, fat malabsorption, and weight loss. It may also cause lactose intolerance as a secondary effect of the damage to the mucosal cells.

In order to control this disease, individuals afflicted with it will want to avoid products containing gluten. Many bread and oat companies now make "gluten-free" products that you can find at grocery or health food stores.

During allergic flair ups, you may also want to supplement with vitamin B12, iron, and folate which can become depleted due to lack of uptake by the mucosal cells during allergic responses.

Other Food Allergies: Example - Lactalbumin
Celiac's disease is not the only food allergy that can be caused by a leaky gut. Many individuals often have allergic reactions to certain proteins. In particular, the lactalbumin (alpha and beta) proteins found in the whey fraction of milk protein, and casein proteins (also found in milk) can cause bad allergic reactions.

Symptoms:
Symptoms are very similar to Celiac's disease with an additional skin reaction and occur very rapidly after ingestion.

This allergy is a particular problem since many people choose to supplement with a whey or casein supplement. In the case of casein, there is not much that one can do other than avoid products that contain it.

In the case of the lactalbumins found in whey, there are a few solutions. The lactalbumin peptides must be a certain length of amino acid residue in order to cause an allergic response.

Therefore, if these peptides are hydrolyzed into smaller components, there will be no allergic response. Pre-digested proteins such as whey protein isolate and hydrolyzed whey employ such a strategy.

Whey protein isolate is made by hydrolyzing the large peptides into smaller peptides. For individuals with a mild allergy to the lactalbumins whey protein isolate is probably a suitable replacement for whey protein concentrate. The downsides to whey protein isolate are it generally tastes somewhat bitter, and is generally more expensive than whey protein concentrate.

For individuals that have a more severe allergy to the lactalbumins, they may want to instead purchase hydrolyzed whey protein. Hydrolyzed whey protein breaks down the larger peptides into even smaller peptides than whey protein isolate.

The downsides to hydrolyzed whey are taste (it is generally very bitter) and price, as it is considerably more expensive than whey concentrate or whey protein isolate.

Maximizing Digestion - General Guidelines

I have covered several common digestive disorders but there are many others that I have left out simply because they are rather uncommon and if I explained them this entire article would be about 80 pages long, and hey lets face it... that's a lot of ink for The Bull to spend money on! I will leave you with a few general guidelines to help maximize digestion and absorption efficiency.

General Guidelines:

• Eat a diet high in fiber (>50g per day). Fiber increases bulk and makes it easier to move food down the digestive tract. Fiber also lowers cholesterol, and decreases the risk of colon cancer.

• Avoid eating large amounts of high-risk foods in a single setting. It may be ok to drink 64 oz of milk per day if you spread consumption over several meals. However, if you drink all 64 oz in one sitting, I can almost guarantee your stomach will talk to you, and if your stomach doesn't talk to you, your ass will certainly sing to you.

• Give yourself enough time to digest your pre-workout meal. Eating 1000 calories and giving yourself only 30 minutes to digest the meal will not only make you feel uncomfortable while working out, it will slow and may reduce digestion and absorption of nutrients.

	Food Nutrient Database. Find out how many grams of protein, carbs and fat are in the foods you eat, along with the full vitamin and mineral profile. [ Click here to learn more. ]

Working out activates the sympathetic nervous system and reduces the activity of the parasympathetic nervous system, which is responsible for activating the muscles of the digestive tract. To avoid this problem, give yourself 2-3 hours to digest your meal before going to the gym.

• Avoid eating large amounts of sugar alcohols (found in sweeteners and protein bars) such as malitol, sorbitol, and glycerol. These sugar alcohols are easily fermented by the bacteria of the gut and can cause gas and uncomfortable bloating.

• If you have the money, get screened for food allergies. You may have one and not even realize it.

• Supplementing with glutamine may also be beneficial for those individuals who experience severe food allergies that cause inflammation and atrophy of the mucosal cells. Now those of you who know me, know that I am as anti-glutamine as they come.

However, because glutamine is the primary fuel for the mucosal cells it does not enter systematic circulation but it does have use for those individuals who suffer from inflammatory GI disorders as it will help the mucosal cells recover from atrophy.

References

1. Fox, S. Human Physiology (Eighth edition). McGraw Hill. Boston: 2004.
2. Escott-Stump and Mahan. Food, Nutrition, & Diet Therapy. Saunders Publishing. Philadelphia: 2004.