When a patient comes to the Hughes Center for Functional Medicine in Naples with eczema, the center’s founder, Dr. Pamela Hughes, has an approach that may sound surprising. She asks about the patient’s digestion.
“Most people don’t realize that digestive problems wreak havoc on the entire body,” Hughes says. “They can cause allergies, arthritis, autoimmune issues, acne, chronic fatigue—the list goes on and on. It’s also been linked to Parkinson’s disease and Alzheimer’s. We now know that our digestive system is linked to our body in many ways. Having a healthy digestive tract is so important. It’s central to our entire health. When someone comes to my office with a rash, the first thing I’m going to do is heal their digestive tract. I’ll have them remove the typical foods the immune system will respond to. It’s amazing how rashes and eczema will go away once you remove foods that are causing the intestinal lining to be inflamed and the immune system to be dysfunctional and allow the lining of the intestine and immune system to recover.”
As her initial step in healing, Hughes puts all of her patients on an elimination diet. Depending on their symptoms, she focuses on specific foods.
“If it’s eczema, the first thing to remove is dairy,” she says. “If it’s joint pain, then we take out gluten. Within three or four weeks, most people’s symptoms are better. If not, we dig deeper to see why they are not better.”
In addition to taking problematic foods out of the diet, Hughes adds in certain gut-boosting beneficial elements such as a probiotic supplement, which increases healthy gut bacteria, and glutamine to calm inflammation.
“It’s pretty incredible how in less than a month people can get significantly better,” she says.
The focus on the digestive tract as a way of healing the entire body dates as far back as ancient Greece. Hippocrates, the Greek physician who practiced medicine in the 5th century B.C., famously said, “All disease begins in the gut,” and it seems as if we’ve been forgetting and relearning that basic lesson for centuries. Today, the National Institutes of Health estimates between 60 and 70 million Americans are affected by digestive disorders, which can be as wide ranging as irritable bowel syndrome to ulcers. Recently, the focus on the digestive tract has had a resurgence in popularity, beginning with the anti-gluten trend of the early 2000s.
Liz Shaum, 34, who lives in Fort Myers, discovered her own digestive sensitivities around that time.
“I had cystic acne for years,” Shaum says. “Nothing was clearing it up. We have celiac disease in my family, so I went and got tested for celiac, which came back negative. But the doctor who I saw said, ‘Listen, you don’t have celiac but I think you have a problem with wheat.’ At the time there weren’t great tests for wheat intolerance, so my doctor was like, ‘Cut out wheat and see what happens.’”
Shaum decided to take her doctor’s advice, but giving up wheat wasn’t easy.
“There’s a lot I missed,” Shaum says. “Pizza, fried chicken, bagels. Soy sauce is one that a lot of people don’t realize has wheat in it, and a lot of Asian food is made with soy sauce. Cakes, cookies—a lot
of stuff.”
But, ultimately, eliminating wheat from her diet made a big difference to her digestive health and her overall body health.
“When I cut out wheat, my symptoms cleared up,” she says. “My skin cleared up, and I felt like my mental clarity improved.”
Which would come as no surprise to Hughes. In fact, wheat is among the items to be cut in her basic elimination diet. So are soy, dairy, eggs, yeast and corn. From there, she helps patients determine if they react to any other foods.
“All of my patients go on some version of an elimination diet,” Hughes says. “Then we have to watch how people respond and make adjustments, and we can do food sensitivity testing and stool testing if the issues are not improving. It goes beyond food sometimes. We start looking at infections and toxin overload that includes heavy metals, stress, and more. Often emotional stress presents with digestive disorders.”
How does a person know if he or she is having gut issues? Problems in the digestive tract manifest in a variety of ways. Some obvious indicators include heartburn, bloating, gas, diarrhea and constipation.
“If you’re not having a bowel movement every day, that’s not healthy,” Hughes says. “You need to keep the intestines from backing up as that can allow toxins to re-circulate into your blood and lymphatics.”
Some less obvious symptoms of digestive distress are rashes, headaches, acne, depression, brain fog, joint pain, obesity and neuropathy.
Before digestive issues cause problems, there are a number of steps people can take to ensure that their gut is functioning optimally. Start by eating real food. The less prepackaged, processed food people put in their bodies, the better. Fiber intake is crucial, so it’s essential that everyone ingest enough. This doesn’t have to come in the form of a fiber supplement, however. Foods like vegetables, nuts and seeds include plenty of fiber. A balanced diet is also key, but people should eat more vegetables than meat. If possible, both meat and vegetables should be organic. Drink plenty of water. Spring water is best, but filtered water is also good. There are certain supplements which can help maintain a healthy gut. These include probiotics, digestive enzymes, omega-3, glutamine, zinc, aloe, licorice and magnesium. Finally, to test whether common foods are causing gut distress, try an elimination diet. For 21 days, eliminate gluten, dairy, yeast, corn, soy and eggs.
While food insensitivities are often the underlying cause for digestive distress, other factors might be at play. Dr. Bradley Trope, an integrative gastroenterologist at Associates in Digestive Health in Cape Coral, has studied both food’s affect on whole-body health as well as the mind-body connection as related to digestion and digestive health. His approach includes a focus on food as medicine—how his patients’ diets play a role in controlling inflammation levels, balancing blood sugar, regulating cardiovascular health (including blood pressure and cholesterol levels) and helping the digestive organs process and eliminate waste.
“What is becoming well understood in the last few years is that there’s a very strong connection between nutrition and health, as well as a link between the brain, the gut and health,” Trope says. “This sort of mind-gut axis is increasingly understood as one of the mechanisms to disease prevention.”
His goal is to help patients achieve optimal digestive health and wellness as well as disease prevention.
“The greatest threats to a healthy gut, from a mind-body standpoint, are chronic stress and poor diet,” Trope says. “Chronic stress makes people sick. Stress began as an adaptive mechanism. We evolved using stress as a survival technique. We needed acute stress in the same way that we needed acute pain—to survive as a species and deal with immediate threats. But when stress becomes chronic, it’s maladaptive. We evolved to have an immediate stress response to when we see a tiger in the jungle; we didn’t evolve to have a tiger follow us 24 hours a day, seven days a week. From an integrative gastroenterology perspective, the question becomes: What can one do to allay stress?”
As it turns out, according to Trope, there are simple ways to approach stress reduction. He suggests yoga and meditation as good places to begin.
“With the mind-body practices, sometimes just making a start is the important thing. Everyone needs to find their comfort level and see what they want to introduce into their lives. At its most basic, the goal is to introduce these things to people in a way that is not intimidating so that it can become a healthy lifestyle habit. There are excellent yoga teachers in Naples and Fort Myers, and with meditation people can start with a simple sitting meditation. The sitting meditation requires no equipment. It requires, essentially, a chair. One sits in a comfortable position with one’s back upright, and for a period of time focuses on breathing and enjoyment of the few moments of quiet in our crazy chaotic lives.”
Trope says these techniques can benefit people with a range of digestive disorders as well as people looking to maintain their current health.
“Even people with Crohn’s disease or ulcerative colitis, if the stress component is managed it is a huge help in getting people in remission.”
He is careful to point out that with conditions like Crohn’s or ulcerative colitis, stress-management techniques should be performed alongside a traditional medical approach, not instead of it. Still, mind-body practices alongside good nutritional habits can go a long way in promoting better overall health.
“To quote Dr. Andrew Weil, ‘We spend a lot of time managing disease in the world we live in. We don’t spend a lot of time managing health,’” Trope says. “Managing stress, managing nutrition are really fundamental basics to cover in managing health.”
