Gut Check for Gut Health

You might be wondering why a cardiologist is writing on gut health. I was wondering the same thing three years ago when I began my fellowship in Anti-aging Medicine.

I recall sitting through three or four hours of continuous lectures on topics foreign to me such as leaky gut syndrome, or dysbiosis (microbial imbalances in the body) and the ultimate surprise of all: the connection between the gut and the immune system. Why I had never heard about this material in either medical school or in my three years of internal medicine training. Because it seemed so off from my beaten path, I just said to myself, “No problem. I'll just refer patients with these issues out.”

But then I thought, “To whom am I going to refer these patients?” The truth was, I didn't know anyone who was equipped to handle these issues. All the gastroenterologists whom I knew were well versed in diagnosing patients with structural disease of the gastro-intestinal tract. Such physicians were very qualified in performing endoscopies and colonoscopies, and in diagnosing and treating those with peptic ulcer disease and colon cancer. However, they were not prepared to manage patients with functional disease of the GI Tract. They were completely non-integrative in their approach. So, it quickly became obvious to me that it would become my duty to manage such patients as a board-certified, anti-aging medical specialist. I never looked back from that point on. Indeed, this has become a pet peeve of mine in helping my patients achieve optimal health and wellness.

Let’s take a simple example of those with acid reflux, a disorder of increasing magnitude, affecting persons of all ages and genders. A common remedy is prescribing proton pump inhibitors with drugs such as Prevacid, Nexium and Aciphex among others. Now, these drugs are quite useful in treating erosive gastritis and the symptoms of severe acid reflux, but are generally only indicated for eight weeks duration. In reality, these same drugs are prescribed to many patients on a chronic basis. Side effects include, most notably, malabsorption of calcium. Most folks know how important calcium is in preventing osteoporosis. I don’t care how much calcium a patient takes in the form of supplements. They will never achieve a level high enough to combat osteoporosis as long as they remain on proton pump inhibitors. There are many other side effects including an increased incidence in community acquired pneumonia in the elderly population in those taking proton pump inhibitors on a chronic nature.Gut flora : from Wikipedia

There are viable alternatives to maintain a healthy GI tract, which can help guard against acid reflex. Digestive enzymes can make it easier for our food to be digested and consequently improve gut motility. Probiotics help to maintain a healthy colon. We now know a lot about the protective nature of our intestinal flora, the good bacteria that keep our gut functioning in a healthy manner. Unfortunately, disease and many commonly prescribed medications such as antibiotics can easily wipe out our flora and set us up for poor health.

Wall Street JournalFew people might know that 85 percent of neurotransmitters are made in the GI tract, and not in the brain. I wasn’t aware of this until three years ago. So, a healthy balance of serotonin, dopamine, GABA (gamma-aminobutyric acid) and the like which can affect both brain function and mood depends on healthy gut function. Moreover, nearly 90 percent of the immune system emanates from the gut. Obviously, this is extremely important in helping guard against common infections, cancer and autoimmune disorders.

So, even though I am best known as a cardiologist and an anti-aging medical specialist, I take most pride in being known as the “Medical Advocate,” since my goal is always to motivate my patients, my readers and my audiences to get in the driver’s seat when it come to their health--so that they, in turn, can become their own best medical advocate. My interest in gut health is paramount to our well-being. Therefore, we dedicate April and May as “Digestion Health Months” here at HeartWise to promote healthy gut function in everyone.

Dr. Elkin is a board-certified internist, cardiologist and anti-aging medical specialist.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2012

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