Understanding Digestion – Its Role in Chronic Disease

Whole Systems Healthcare

Synopsis

  • The Stomach in Chinese Medicine is responsible for the suppression of indigestible toxins, chemicals, emotions, and experiences.
  • The digestive system is a major source of inflammation and plays a major role in the development of chronic inflammation, and thus chronic disease.
  • Treating chronic disease must involve restoring the microbiome, regulating inflammation, and releasing stored trauma.

In part 1 I introduced the concept of the Stomach from a Chinese Medicine perspective. Part 2 and part 3 began a discussion on the regulation of the digestive system via the endocrine and nervous systems, as well as establishing the gut-brain connection. Part 4 was about the role of the microbiome and how it is also encompassed by the Chinese Medicine Stomach. Now that the stage is set, let’s examine the connection between the Stomach and chronic disease.

The Stomach Suppresses

In my post on Heat in the Blood I made a connection between blood heat and systemic inflammation. Because chronic inflammation is at the root of potentially every chronic disease examining heat in the blood is incredibly important. Dr. Hammer has written at length about how where this heat comes from and its impact on the body, especially the Liver (1). He writes that heat comes from obstruction of the smooth flow of qi and blood, often because of the suppression of emotion. As the Liver attempts to move the obstruction heat is generated. This heat is circulated around in the blood as the body attempts to discharge it, and when these compensatory mechanisms begin to fail disease results.

I have come to understand that the main mechanism of this emotional suppression is via the Stomach. The role of the Stomach is to take in, contain, and digest. Emotions are automatically taken in, and the Stomach is then tasked with containing them and digesting them. If difficult emotions, traumatic experiences, or other “indigestible” things are taken in, the Stomach will contain them without properly breaking them down. These turn into obstructions in the smooth flow of qi and blood, and thus begin to generate heat as explained by Dr. Hammer.

There is no biomedical model to fully explain how this suppression is created, but there are a few ideas. Our understanding of trauma is that unresolved experiences or emotions are held in the nervous system. More specifically the activation of the limbic system then influences the sympathetic nervous system (SNS), setting up patterns of inappropriate responses to stimuli that are falsely viewed as threatening. The parasympathetic nervous system (PNS) is very influential in relaxing this inappropriate arousal, and it is heavily involved in regulating the gut. This creates a potential connection to the Stomach, and suggests that lack of digestion by the Stomach could be part of how the body suppresses.

A potential biomedical explanation for how chemicals or toxins are suppressed lies in how many of these substances are stored in adipose tissue. Because water soluble compounds are easily eliminated in the urine any chemicals that remain in the body often accumulate in the fat. Fat, as a major mechanism for storing nourishment, is closely connected to the Spleen and Stomach. Thus, storing toxic substances in the adipose tissue can be seen as another way the Stomach “suppresses” indigestible material.

Inflammation from the Stomach

As a Yangming organ the Stomach is responsible for internalizing yang qi. Chronic or systemic inflammation can be seen as yang qi that is not internalizing and has “escaped” to travel around the body. The job of the Stomach is to keep all that heat contained. The picture is not necessarily this simple, localized heat or even systemic blood heat can be primarily related to other organ systems. However, treatment to contain this heat often relies on the ability of the Stomach.

There are many biomedical correlations between the digestive system and chronic inflammation. As I outlined in part 2 and part 3 the enteric nervous system and the associated endocrine hormones can regulate inflammation and autoimmune processes. The PNS in particular plays a large role in down-regulating inflammatory processes via the vagus nerve (2).

The microbiome also has roles to play in the development of chronic inflammation. In part 4 I introduced the idea that the microbiome has a large role in immune system modulation. The authors of The Completed Self argue that misregulated inflammation stems (in part) from an incomplete union between human and microbiome, and that this occurs at a very early age. Disruptions in the gut microbiome stemming from infections can also lead to increased inflammation, and increased inflammation can actually promote the growth of more pathogenic microbes (3). This leads to a vicious spiral of increasing inflammation and microbiome imbalance. The movement of microbes from the gut to other parts of the body appear to be linked to systemic inflammation and a number of chronic diseases. The theory is that stressors cause a certain amount of “leaky gut”, allowing bacteria to enter the body. This corresponds with the breakdown of the Stomach’s ability to contain, leading to pathogens entering the body and creating inflammation.

In both traditional naturopathic medicine as well as Chinese medicine it is said that all disease comes from the gut. The digestive system is the source of all our nourishment and the entry point for many toxic or pathogenic substances. The importance of keeping our digestive system healthy and functioning well cannot be overstated.

Treatments
Restoring the Microbiome

Once heat has “escaped” from the Stomach other organ systems become involved in the management of this heat (inflammation). When beginning treatment often these other systems must be optimized before coming back to address the Stomach. However, in almost all chronic disease the Spleen and Stomach have to be addressed. As we’ve seen this involves restoring the natural balance of microbes in the gut.

The restoration of a normal gut microbiome is not as simple as taking probiotics. A recent review did not find that probiotics created much change in the composition of gut flora, as measured by analyzing the stool of healthy adults (4). There has been some evidence that probiotics work by stimulating the gut immune system, and that they help in specific diseases such as IBS, or Crohn’s (5). But, if the probiotics don’t permanently change the gut microbiome taking them isn’t actually a cure, but only a temporary solution. To completely heal we have to work with the regulatory systems of digestion: mainly, the enteric nervous system, the endocrine system, and the immune system. Instead of trying to comprehend every little detail it is much simpler and more effective to study the functional systems of Chinese Medicine. As the previous parts of this series have shown, using the Stomach as a starting point gives us a broad understanding of the gut in a way that is difficult from the reductionistic perspective of biomedicine.

Regulating Inflammation

I say that inflammation must be regulated and not necessarily reduced. Inflammation in the body is always in response to some perceived threat or injury, and to simply tamp down on the body’s healing process only suppresses the problem. In Chinese Medicine excess heat must be released in some way, either through the skin, through the urine, or through the bowels. The heat must be mobilized, typically by moving, nourishing, and cooling the blood. Depending on each individual’s situation utilizing some or all of these routes may be appropriate. Helping to resolve any inflammatory processes that are “stuck” is also important. Chronic inflammation always has a measure of deficiency, so tonifying the right organ systems is also part of this process.

From a biomedical perspective inflammatory processes must be resolved by promoting the healing response. This response will have to include stimulating the nervous system or endocrine system in the right way, often by supporting the adrenals or the thyroid. Proper elimination is necessary to get rid of metabolic end-products; water-soluble substances like the metabolites of neurotransmitters are eliminated through the urine, whereas fat-soluble substances like cholesterol are eliminated through the bile and bowels. In some cases suppressing inflammation is important for comfort or survival, but eventually allowing the body to complete the healing process is the only way to truly heal.

Releasing Trauma

In many, if not most cases, chronic inflammation is the result of suppressed trauma (whether physical or emotional). Since inflammation is the body’s response to a threat, the presence of chronic inflammation is a sign that there is some ongoing danger to the system. Perhaps this danger is a slow, latent infectious process, such as with lyme disease. Or it is a traumatic experience that has created a pattern of over-arousal in the nervous system. Whatever it may be, the suppression must be released.

This release can be accomplished in different ways. The most productive are typically some form of body-oriented therapy, combining a conscious recognition of the issue with hands-on stimulation of the body (including acupuncture). Essentially, “talking” to the body while engaging the mind to stay in the present. For traumatic experiences this does not necessarily mean re-experiencing the event; it simply means staying present with the felt experience of the body while changes occur. Non-body oriented techniques are also effective (such as homeopathy), but every person will eventually have a body-centered experience in the process of release.

This ends the series on the Stomach. I’ll be exploring some of the other organ systems involved in digestion soon, such as the Small Intestine, the Large Intestine, the Spleen, and the Lung.

Author

  • Dr. Kye Peven, ND, DSOM, EAMP, earned a B.S. from UC Berkeley in Materials Science and Engineering, with minors in Nuclear Engineering and Energy Management, believing that applying his interest in technology would help make the world a better place. He then completed a Doctorate of Naturopathic Medicine (ND) and a second Doctorate of Science in Oriental Medicine at the National University of Natural Medicine (NUNM). Dr. Peven serves as Director of the WSHC Clinical Care Initiative and is the founder and Clinic Director of the WSHC Seattle Clinic.