It All Started with Hippocrates

By Teresa Alasio

Welcome to Mindful Medicine! Let this column serve as a resource for you on your journey toward a healthier more balanced life. In a world that often moves at breakneck speed, it is even more important these days to pause and become aware of our bodies and the impact that our lifestyle and environment has on our mental and physical health. In this and future columns, I invite you to explore with me a multitude of topics in this space and the impact they have in our lives.

Let’s start with the gut.

Hippocrates, the father of modern medicine, is quoted as saying “All disease begins in the gut”. That was over two thousand years ago. Today, it seems like everywhere you look or read, someone is talking about the gut – the gut microbiome, leaky gut, inflamed gut, gut dysbiosis, etc. What does all this mean and why is gut health so important?

First, a few facts about the gut:

1. The gut includes the entire digestive tract from the mouth to the anus. Think of it as one long convoluted tube that communicates with the outside environment but runs through our bodies. It is formed from the endoderm layer during the third week of embryonic development, and its development continues throughout fetal and postnatal stages.

2. Our gut is inhabited by over three trillion bacteria, more cells than in our entire bodies! Beneficial bacteria, such as Bacteroides fragilis, Enterobacter, Enterococcus, among others, are present in greater numbers in a healthy gut. In cases where opportunistic bacteria, such as Streptococcus or Staphylococcus, are present in greater numbers, the microbiome is out of balance, and this is known as “dysbiosis”. In dysbiosis endotoxins are released by these bacteria, leading to an increase in gut permeability, or “leaky gut”. It’s called “leaky gut” because toxins “leak” into the bloodstream from the gut and cause systemic inflammation throughout the body.

3. The gut has its own nervous system, called the enteric nervous system, and it communicates directly with the brain (central nervous system). It also regulates neurotransmitters such as serotonin, dopamine, nitric oxide and acetylcholine. This is sometimes referred to as the “gut-brain axis”.

4. The gut has its own specialized immune system, called the Gut Associated Lymphoid Tissue (GALT), which defends against bad bacteria, viruses and fungal organisms. Since the gut communicates directly with the outside world, it needs to have a specialized defense system.

With all that going on you can begin to understand why gut health is so vital to our overall well-being!

How do we keep our gut healthy? One way is to feed it probiotics and prebiotics. Probiotics stabilize the gut microbiota and the intestinal permeability barrier by decreasing the immunogenicity of enteric antigens, which counters the progression of inflammation. They also have a role in reducing anxiety by altering GABA receptors in the brain, as well as influencing cortisol, often dubbed the “stress hormone”. This is the gut-brain axis at work. Probiotics need to be consumed on a regular basis from the environment because they do not colonize the gut. You can take them as supplements, but they are also found in yogurts and fermented foods (sauerkraut, kimchi, pickles, kombucha, kefir). Prebiotics are types of carbohydrates, mostly fiber, that can be found in fruits, legumes, garlic, leeks, onions, oats, bananas, berries, asparagus, dandelion greens, among other foods. Prebiotics are what feed the probiotics, and, in feeding the probiotics, they allow the probiotics to do their job.

This all too brief exploration of gut health has unraveled the complexities of this essential part of our anatomy, revealing its profound impact on our mental and physical health. Armed with the knowledge that our gut is not simply a digestive organ but a key player in our immune system and neurological balance, we understand the significance of nurturing it for a healthier life. As we continue this mindful journey, future columns will delve into various aspects of health, providing insights, tips, and practical wisdom to empower you on your quest for a balanced and vibrant life. So, here’s to the journey ahead, filled with discovery, well-being, and the joy of mindful living!

*This column is for educational purposes only and is not meant as a substitute for medical advice. If you have a specific medical concern that you need addressed, please see your doctor.

Teresa Alasio, MD is the Medical Director and Owner of Intentional Self Aesthetics in New Canaan. She lives in New Canaan with her husband, two teenage sons, three guinea pigs and one very energetic 7-month-old Wheaten Terrier. She somehow manages to take care of all of them, run a business, find time to exercise and maybe sleep a few hours.

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