-: Mouth, cavity, chewing.
That's essentially what we're doing.
So here's where we get into the assessment part.
If we are not chewing the food enough,
you know, eating too fast,
we may get delayed stomach emptying
because essentially that food
is having to sit in the stomach longer
before it's gonna be digested enough
to be acceptable to be released by the stomach.
So we might get upper abdominal bloat
and discomfort post meal,
kind of like very high underneath, okay?
We might get a delayed or decreased fullness response.
So you can get fullness,
like not being able to eat very much
because your stomach's not emptying.
But you can also be in that weird scenario
where you are full but also hungry
because your stomach is full,
but your body was expecting sustenance.
So it's like, "Where's the glucose
and the proteins and all of the stuff?"
So you can be full and hungry at the same time
if we're not digesting our food up high enough
that essentially you're getting
like the stretch reflex of the stomach
that's saying, "Yeah, no more eats,"
but your blood sugar's like, "Food, glucose please."
So you can be in that situation.
You can also get reflux, heartburn, vurping.
I guess I'll explain that in case, I don't know,
maybe vurping is a slang term for, you know,
the US or Midwest maybe.
But vurping is where you burp,
but also there's a little bit of vomit, you know?
A little bit biley, so it's that gross burp
shortly after eating.
So that will happen when you're not able
to properly move things south
is where we will start to see that.
So then when we get to the stomach, okay.
Our gastric juices are essentially
made of three components, right?
So we have the mucosal lining
that's gonna protect the lining of the stomach
from the acid so that your stomach doesn't
literally digest itself, okay?
And then we have pepsinogen and then hydrochloric acid.
So pepsinogen is basically your first layer
of protein digestion, right?
So pepsinogen converts to pepsin
when hydrochloric acid is present.
So if you don't have good stomach acid production,
you could have plenty of pepsinogen,
but that enzyme is not gonna be
actively converted into pepsin, which is gonna be the thing
that actually is going to start
breaking down those proteins.
You have to have the acidity there.
So if you're not producing enough hydrochloric acid,
that could be an issue, okay?
The other thing is that pepsinogen is stimulated
by the presence of gastrin in the blood.
So this is where, like the chewing and stuff, you know,
that whole hormonal response.
So actually chewing your food can help improve gastrin,
which can then help improve our production of pepsinogen,
which can then become pepsin if we have enough of the HCl.
But if you're just inhaling your food, you may be like,
one, you're already throwing food in that's harder to digest
and you're taking away the signal to produce the thing
that's next in line to do that digestion of those proteins.
So especially when we're talking about proteins,
like meat and stuff, you really got to chew that stuff up
for the stomach's sake.
When it comes to like veggies and stuff like that,
not chewing those foods is probably gonna have
more intestinal issues because you're gonna be getting
a lot more fiber and plant roughage
that's undigested in the digestive tract.
So a couple of things to note here is that hydrochloric acid
is one of the most expensive things to make
in terms of the amount of energy,
like the amount of biochemistry that it takes to make it,
because it's very acidic.
So what you got to think of it is like, you know,
we need to be concentrating protons essentially
to be able to make something acidic,
which is hard to do from a cellular and biochemical level.
So it takes a lot of work
for our bodies to make hydrochloric acid.
So if you are overstressed, overdoing a calorie deficit,
anything that might negatively impact
your energy production,
any sort of micronutrient deficiencies,
those things can then lead to HCl issues,
which can then lead to even worse digestion
and even poorer nutrition from your diet.
So this becomes circular.
And that's why sometimes
this is where we just have to put out the fire.
You may have to put the intervention.
Because let's say, like for instance,
let's say you are low in zinc
because you don't eat a lot of quality foods.
Like everything you eat is processed or whatever.
Zinc is an important factor
for being able to produce hydrochloric acid.
Your hydrochloric acid goes down.
You need hydrochloric acid
to be able to break down most foods
to get to the point where you can get the zinc
out of the foods.
So the zinc deficiency makes you more zinc deficient
by leading to lower HCl.
So in that scenario, that's like,
"Well okay, I have to get that HCl back up
so that I can start getting the zinc out of my food."
And that's where maybe then
direct supplementation of that is important.
But the root cause of that was
"I need to eat a cleaner diet."
You could say the same thing.
What if it was a stress issue, right?
So I'm stressed, okay?
Energy production goes down.
All of a sudden digesting food enough.
Now I'm not getting as many of the minerals
and maybe I'm not getting as much magnesium
and now I'm having more anxiety and more stress.
So I make even less HCl.
So it's like, "Well, I could take HCl,
But if I don't deal with the stress,
then the problem is always gonna be there."
So you see how this stuff
is really going to kind of overlap with a lot of things.
And I wish there was an "If then, do this" approach
to gut stuff, but you're just gonna have to think
when it comes to the gut.
And that's why I'm gonna try and give you guys
as many principles and focus on keeping it simple.
And then, I mean,
I'll go through my evolution of thought process.
That's kind of the conclusion of this talk.
So I'm just gonna stop there so I don't keep rambling.
So we're at the stomach.
If we do have poor HCl production,
what would be some symptoms of that?
We could have delayed stomach emptying.
So the same thing, so if you're chewing your food well
but you still have delayed stomach emptying,
it could be more of a lower HCl thing.
So again, it's kind of that upper abdominal bloat
or discomfort after a meal.
Also reflux, heartburn, vurping.
So the actual sphincter at the top of your stomach
that basically closes off your stomach
from your esophagus is pH sensitive.
So if you don't have proper pH in the stomach,
that muscle kind of relaxes
and then it makes it easier for
basically the juices to get up into your esophagus.
And that's what kind of gives you the heartburn.
Or it's one possible cause of heartburn.
So there's also stomach ulcers.
But when we look at esophageal-based heartburn,
a lot of times that is caused by low stomach acid.
Now the stomach acid still burns our esophagus
because it's still a low pH
for what the esophagus should be, right?
Like it's like drinking vinegar.
It's just not low enough
to help the stomach function properly
and to keep those muscles closed.
So basically when we start getting
our stomach pH closer to like four, five-ish,
which five is basically vinegar, right?
That's when we can start actually start being, you know,
getting acid up into the esophagus.
So it's actually low HCl that's giving us,
it's low acid that's giving us the burn
because of the way that muscle functions,
the way that sphincter at the top.
So in some cases actually supplementing with, you know,
a betaine HCl product can take away somebody's heartburn.
But you do need to rule out stomach ulcers
before you do that.
And I mean, I don't talk a lot about, like,
we don't get deep into supplements in this lecture.
We talk more principle-based.
But if somebody has stomach ulcers,
zinc carnosine is kind of my go-to product for there.
And so there's lot of combo products out there
that are decent, decent for that.
But zinc carnosine is gonna be a big ingredient
for the healing there.
So other symptoms, we've got that burping,
belching shortly after a meal,
bad breath, bad taste in mouth,
because when our stomach is not producing enough acid,
we can actually get pathogen overgrowth
in the stomach and around there.
And so also if you may not be getting the liquids coming up,
but you may be gases getting coming up from the stomach
and that can give you that bad breath
or bad taste in the mouth.
Increased illness or infection.
If we're not killing pathogens at the entry of the GI tract,
that means more of them are getting into the GI tract
and have a chance to actually infect us systemically.
So if we are somebody that gets sick a lot,
has infections a lot, maybe this is something to rule out.
And then poor tolerance to food volume
would be another sign, right?
Because if you're not digesting,
if you're not getting that food digested early,
you're not gonna be able to tolerate large volumes of food.
If you have a poor mucosal lining in the stomach,
that's where we're gonna get ulcers,
because essentially that's where
your digestive juices and your acids
will actually start breaking down the stomach lining,
causing those ulcers.
So you need a healthy mucosal lining
to be able to protect the stomach.
And that also is gonna be negatively impacted by stress.
So we can also have early gastric emptying.
The GI tract can be emptying too quickly.
And when this happens, this is when you can get
those urgent bowel movements post meal.
So you eat, and then all of a sudden, "I got to go!"
You get intentional-
Or intestinal bloat, not intentional bloat.
Sorry, typo.
Intestinal bloat shortly after the meal.
So it wouldn't be that really high bloat.
It would be a lower bloat,
but it comes on very soon after you eat.
And also you can be hungry shortly after meals
because essentially if you haven't digested
that food very well, and you're pushing it down
your digestive tract really fast,
you won't be getting much out of it
in terms of the amino acids and the glucose.
And so you might actually have
like a sweet craving after that, right?
And there's a couple of things that can be going on here
with early gastric emptying in terms of what you can do.
One of the things that you can do
to kind of try and delay gastric emptying
is to add more fiber to those meals
to try and kind of give them a little bit of bulk,
a little something to slow them down.
I mean, so something as simple
as adding some psyllium husk type stuff.
But a lot of times when have early gastric emptying,
it can be that we have an issue going on with GLP-1,
which is a component of insulin sensitivity
and insulin response to foods.
So a lot of times, improving overall health markers,
reducing stress, improving micronutrition,
those type of things can be corrective
for early gastric emptying.
But one thing you may try in these scenarios
is changing up the types of foods.
You know, maybe you experiment
with doing something that's maybe, you know,
a little bit more fiber bulky.
You can experiment with, you know,
if you're trying to work on an insulin thing,
you can try it one of the low carb methodologies.
You could go, short term you could try
some carnivore keto-y type thing
and see if then you can't get that corrected
and then start adding the carbohydrates back in.
Obviously adjust your training accordingly.
So now we're gonna be into the input stage.
So we have our gallbladder.
Again, gallbladder produces and releases the bile.
The bile is very important for emulsifying the fats, right?
And by emulsifying,
we're talking about the mayonnaise thing.
So think of it this way.
You would have oil and water
if mayonnaise was not emulsified, right?
And anybody that's ever taken too much MCT oil
knows what happens when you put too much liquid oil
into the digestive tract, right?
It's just a slip and slide all the way through.
Not a good time.
So we need that bile in there to be able
to emulsify that fat and slow down its transit time
so it doesn't just work its way right out of us
faster than we can actually absorb or utilize it.
Okay.
The bile also, it's important for absorbing the toxins,
getting us to that elimination portion of detoxification,
and it helps in the neutralizing of the stomach acid.
So basically between the bile
and the bicarbonate that comes from the pancreas,
that is what's going to neutralize the stomach acid
and protect the rest of your intestinal lining.
And that's one of the possible mechanisms
for why, when we empty the stomach too fast,
that we get those urgent bowel like, "I got to go!"
And that's because likely what we're doing is
we're just pouring a lot of
very just straight liquidy acid stuff
into the digestive tract that we can't efficiently
slow down or alkalize.
And essentially the only way then to protect ourselves
is to push a bunch of water
through the intestinal lining into the digestive tract
to try and dilute the acid.
And if you throw a bunch of water in there,
basically you liquefy everything
and therefore it is gonna move through really fast.
And that's what's gonna give you those urgent
or even loose stools post meal
is when we get that premature emptying of the stomach.
We basically are pouring the acid into the intestinal tract
at a rate that it can't neutralize,
and the only way to respond to that is to protect ourselves
by throwing a bunch of water into the digestive tract.
And that's why you would get the intestinal bloat.
Especially the very quick intestinal bloat,
because like fermentation type bloat, like from SIBO,
like the gassy type bloat is a little bit slower
than the, "Oh shit, we better dilute this
before we burn a hole in our intestines," bloat.
Now you can see how the opposite side of this equation works
is that if I just simply am not creating enough bile
or my pancreas is not releasing enough bicarbonate,
I could have a perfectly normal gastric emptying
into the intestinal tract
and still end up with the same symptom
of water coming into the digestive tract to protect it,
leading to bloat and urgent stools or diarrhea.
So chicken or the egg scenario here.
This is why our timing can kind of matter
and then also just kind of being able
to check off those things.
You know, so first thing would be
are we chewing our food properly?
And then work your way down.
Okay, what can we look at for the stomach health, right?
Can we try supplementing with HCl
before we determine that maybe
somebody's got a bad gallbladder or a bad pancreas?
So when we look at gallbladder, I'm gonna break this up
into low production and overproduction.
So symptoms of low production
are gonna be poor fat digestion,
and one way to look at poor fat digestion
is like floaty or greasy stools.
So the more fat you have in a stool, fat floats,
so you'll actually get float.
If you have fat-based diarrhea,
basically it floats around
and then it leaves the film on the tank.
I know this is everybody's favorite thing.
I hope you guys are all eating after this.
And then also fatigue after higher fat meals.
So essentially,
if you're having trouble producing gallbladder, right?
After HCl, gallbladder is gonna be
another very expensive thing for a body to make.
So if we're eating higher fat meals,
we can experience fatigue because of the energy
we have to invest in making that gallbladder.
Loose stools from higher fat meals
and also very dark stools.
So gallbladder, or I'm sorry, bile is yellow, right?
I mean, if you've vomited,
you know what color bile is, right?
So when we look at stool color,
a very dark stool can be assigned
that we are not creating enough bile at the gallbladder.
But it can also be,
there can also be liver issues associated with dark stool.
So now let's look at the overproduction.
So why would we be producing too much gallbladder?
Usually if we're producing
an excessive amount of gallbladder,
it means that we're producing poor quality gallbladder-
Poor quality bile, right?
We're not overproducing gallbladder.
The gallbladder's overproducing bile and it's poor quality.
So you might have yellow or sandy stools
which could be from poor activation.
So we're having to push out.
So it could be where the liver's
not quite doing what it's supposed to do.
And so that's why we're getting a lot.
It could be we have a high toxic burden.
And so we're actually getting more production
from the liver and it's pushing out more stuff.
And then there's also gallstones is another obvious symptom
of the gallbladder not necessarily working properly.
Now with gallstones, the formation of gallstones
is likely gonna come from the high toxic burden
or poor energy production.
So I'm gonna skip a little bit of the digestive tract.
And if we look at the lower portion of the digestive tract,
we have the ability to reabsorb bile and kind of recycle
some of the nutrients and constituents of that bile.
So when we are in a low energy state,
like we're in too much of a calorie deficit,
too much stress, we're eating poorly or digesting poorly,
what we will do to try and conserve energy
is to absorb more of the bile.
Now, if we're trying to use the bile
as basically a taxi cab or Uber
to Uber out the the toxins for us,
and we just keep bringing that guy back
before he drops the person off,
we're essentially reabsorbing a lot of those toxins.
And so if we're doing that,
and essentially we're restocking dirty bile, if you will,
is kind of a way of looking at it.
That's one possible mechanism for us developing gallstones.
All right, the pancreas.
So first, the most important role of the pancreas
when it comes to the digestive portion
is the release of bicarb to neutralize
the acidity from the stomach.
Now you might be like, "Well, but it's for digestion.
Why aren't the enzymes more important?"
It's because the enzymes are pH dependent.
So if we can't neutralize that acidity coming down,
then we could be making tons of enzymes,
but they aren't able to do their job.
So basically when we look at enzymes,
a lot of enzymes will function at a specific pH range.
And if you take them out of that,
they go from maybe like doing something like 10,000-fold
to now doing it only like tenfold or something.
They become very...
The speed in which they can act drastically decreases
if you start taking them out of their optimal pH
because pH actually changes the shapes of protein folding.
So essentially the enzymes,
it's like if you had two keys, right?
And one key works at 85 degrees.
And then the other key works at 70 degrees.
You know, it's like the key that works at 85 degrees,
if it gets 75 degrees, it would start changing and shifting,
like some of the things would be moving
and it would no longer fit the lock.
That's kind of how enzymes function
when they change shape at different pHs,
is they're no longer able to actually interact
with the molecule that they're supposed to
and have the function they're supposed to.
So we need that pH change to happen,
not only from a safety perspective
for the intestinal lining,
but from a functional perspective for all of the enzymes
that are going to be released by the pancreas.
So the main things are pancreatic amylase,
which is going to continue digesting starch, carbohydrates.
Trypsin, which is going to be protein.
And then lipase for fats, lipids.
So now symptoms from a pancreas perspective.
So again, we can have multiple causes.
So if it's poor at alkalizing the gastric juices,
we're gonna get that delayed bloating
that's not like, it's not stomach bloating
but it's intestinal bloating.
And one thing that may kind of help you separate that
from like a SIBO-based bloating
is it doesn't seem to be directly correlated
to the food type or volume.
So if your issue is that
"Man, I'm just not able
to alkalize very well at the pancreas' level,"
then the type of food that you eat may not make an issue
or the volume, neither of which may affect that.
It might just be like,
"Well it doesn't matter if I have a snack.
I get the same issues as if I have a full meal."
If it's more food dependent or volume dependent,
I would say volume dependent,
maybe that's a better chance that it's a stomach issue
and that it's the rate of which we're emptying things.
And if it's a type, then it might be more
of a like SIBO bacterial overgrowth issue.
That's not for sure always gonna work out that way,
but maybe if you have enough of this picture in your head,
that kind of helps you choose a better starting point
or a better intervention to trial and error.
So yeah, it's going to that same place.
post meal urgent bowel movements are happening there.
If we have poor enzyme production,
we may have slow bowel transit time
because it's simply just taking us longer
to break that food down.
That's where we might be starting to develop SIBO
because if we're not digesting the carbohydrates,
that means that the bacteria that are supposed to be
in the lower GI tract are gonna start slowly migrating up.
You know, they're gonna go where there's food.
And so if there's a lot of undigested carbohydrate
and fermentable stuff,
they will slowly work against the grain,
swimming upstream, if you will.
And you'll start to see that overgrowth
in the upper GI tract where we do not want
a high concentration of that fermentable bacteria
or fermenting bacteria.
And then also post meal fatigue.
And then this would be not specific to fat.
So if you only get post meal fatigue with high fat,
it's likely a gallbladder issue.
If you get post fatigue with, you know, high protein,
then I would say then we're probably looking
more so at a pancreatic enzyme issue.
Moving to the small intestines,
which ironically are longer than the large intestine.
The small, large thing refers
to the diameter of the intestine, which is reflective of the
one, how fast the stool, chyme, food
should be moving through there,
but also the concentration of the bacteria, right?
There's just simply more houses on the Monopoly board
in the large intestine than there is the small intestine.
And we're kind of compacting things as we push them through.
Whereas the small intestine is supposed to be
like no traffic, open lane,
we can kind of move things through,
the large intestine is supposed to be
kind of like bumper to bumper traffic.
So we open up more lanes
so that we can accommodate more vehicles.
Okay, so this is where absorption of simple nutrients
is gonna be at its highest organic.
We've got enzymatic digestion of carbohydrates,
and absorption of small and short chain fatty acids, MCTs,
further enzymatic digestion of peptides and amino acids.
You know, basically this is where
the finer points of breakdown and absorption occur
in the greatest magnitude, right?
And this should be where...
It's pretty much our, we'll say
the human organism is the one doing the digestion,
whereas we move to the large intestine,
it's a lot of our symbiotic flora
that is doing a higher percentage of the digestion.
So small intestine issues, very bad stool odor
can be one.
Undigested food in your stool can be a sign
that either things are moving
through the small intestine too fast,
but that could also be a pancreatic enzyme thing,
or it could all be all the way up
to just chew your food, right?
So you've got to eliminate all the top things first.
If you're having a lot of large bowel movements daily
and it's not necessarily food volume associated,
then there may be a small intestine issue.
Frequent diarrhea, loose, watery stools,
small intestinal issue.
But again, you have to think up and above, right?
So that diarrhea could be
because too fast of gastric emptying
or not enough buffering by the gallbladder and the pancreas.
So the small intestinal irritation and inflammation
is leading to the frequent loose stools
and watery, loose stools.
But it's not the small intestine's fault.
So that the symptom is occurring
because of the inflammation at the small intestine,
but you have to work your way up, right?
So a lot of these things, you know, I pull
from different functional medicine courses and stuff
in terms of looking at what the symptoms are.
But when I'm looking at these, I'm always trying to think,
"Okay before I just assume like,
'Okay cool, this person's got diarrhea.
It's a small intestine issue.
So what should we do there?
Should we give them like, you know,
some slippery elm and a probiotic or...'
Or wait, maybe we should think further upstream first."
That's kind of where my thought process goes
the majority of the time.
Or it's like, "Well, or maybe their digestive system
is just moving really fast because right now
they're anxious or they're stressed or something like that."
Bowel movements shortly after eating, within one hour.
Again, you know, look above.
Excessive gas and bloat from fiber, carbohydrates, FODMAPs.
That's where we're thinking like the SIBO scenario, right?
Is like maybe we have too much
intestinal bacterial overgrowth going on there.
(low rumbling)