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Improving GI Health

There is no question that shift work is bad for the gut. Gastrointestinal dysfunction in the form of ulcers, constipation, diarrhea, bloating, excess gas, gastric reflux and intestinal pain are often cited as primary complaints in shift workers and occur more frequently in shift workers than the general population. These symptoms can lead to diagnoses of esophageal reflux disease, irritable bowel syndrome, colitis and Crohn’s disease. Considering how critical gut health is to overall health, this is an alarming issue. But the diagnosis does not address the underlying cause. As discussed in previous articles there is a well documented circadian rhythm that governs many of the major biological functions of the human body. Disruption of this rhythm (as in shift work) which controls appetite, insulin response, digestion, renal and bowel function can inevitably lead to gut problems. Combine this with the bad diet choices often made by shift workers (try to find a healthy meal at 3:00 am) and you begin to see why these problems occur.

Here is a basic program that has made a big difference and takes a functional approach instead of a clinical approach – that is it works at treating the underlying cause instead of suppressing the symptoms.

The 4R Model

The 4R model asks four primary questions with respect to GI health:

1. What may need to be removed from the diet to support healthy GI function? This refers primarily to foods or additives that result in allergic or intolerant responses. Often we have a sense of what foods do not ‘sit well’ with us. But we may also deal with symptoms such as diarrhea, excess gas, cramping and canker sores without attributing it to something suspect in our diet. I recommend experimenting by eliminating foods to see if a difference is noted. There is a formal elimination diet that takes the diet right down to some very basic foods, (rice based which are typically very well tolerated by most people) allowing the gut to settle and then foods are slowly re-introduced to see if the symptoms recur. We can also undergo allergen testing which may help identify the food(s) or ingredient(s) that is the culprit. Identifying the offenders and eliminating them from the diet can have a very positive impact on gut health.

2. What may need to be replaced to support healthy GI function? Replenishing enzymes and other digestive factors which may be lacking or limited can show immediate results. If you notice you feel bloated after eating, or have excess belching or flatulence (ask your partner) this can be symptomatic of insufficient stomach acid or digestive enzymes. Experiment with a digestive enzyme that includes protease, lipase, amylase and lactase taken just before a meal to see if symptoms abate. As we get older, we secrete less stomach acid. Taking betaine HCL tablets (to augment the hydrochloric acid our stomachs normally produce) just before we eat may be helpful to relieve these symptoms.

3. What may be needed to re-inoculate the GI system in order to restore a healthy balance of micro flora? This refers to the reintroduction of desirable bacteria or 'probiotics' into the intestine. There are many species of bacteria that inhabit our intestine that perform a variety of functions from protecting us against pathogens, to promoting regeneration of the cells that line our intestines. You may have also heard of ‘prebiotics’ which selectively promote the growth of beneficial bacteria in the gut. Many soluble fibres perform this role such as inulin, fructo-oligosaccharides and gums such as gum acacia and xanthan gum. I absolutely recommend a probiotic in the diet and tend to favour those with a high CFU (colony forming units) count of over 10 billion if you are experiencing a bad gut. Taking a good probiotic for a two week period can produce remarkable results and help restore a proper bacterial balance.

• Research has shown that when people with serious IBS (irritable bowel syndrome) were placed on a high CFU (over 60 billion) probiotic regime, a significant reduction of symptoms was reported after a three week period. Restoring and maintaining a proper bacterial balance is critical to gut health.

1. What may be needed to support regeneration and repair of a healthy mucosal layer? This refers to the thin layer of cells that line the intestine. Part of the support for healing comes from removing insults that continually re-injure the mucosal layer. We have spoken to these already in terms of removing the foods causing irritation as well as restoring proper gut bacterial flora. The integrity of the mucosal layer is critical as science has shown that increased intestinal permeability (often referred to as leaky gut) can lead to increased inflammation within the intestine which in turn can lead to immune dysfunction.
• Nutrients that play a pivotal role in GI mucosal cell health include glutamine, essential fatty acids and zinc. Fish oil is an excellent example of a fatty acid with proven anti-inflammatory properties and I certainly recommend including it in the supplements that need to be taken.

Gut health is paramount to overall health, as a bad gut can manifest in so many different ways throughout our bodies. Managing our gut in a purposeful way must be a priority especially among shift workers. Hopefully the 4R model will help you do this and if you have questions, don’t hesitate to Ask the Expert.

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