GI Functional Disorders

Dr. Aaron Hartman

December 6, 2022


All health starts in the gut.

This is a mantra that was first echoed in Ayurvedic medicine 4000 years ago. This ancient healing tradition considered the gut as the primary source of disease.
4000 years later, with all of our advances in medicine, we have finally come full-circle to acknowledge that the ancients were correct. Health does actually begin in the gut.

The Many Important Functions of the GI Tract

A list of the many jobs of your GI tract would include:

  • Processing hormones
  • Detoxifying chemicals
  • Digesting food
  • Regulating your immune system

The GI tract has an incredibly important role when it comes to hormonal health.

  • 90% of serotonin, your body’s happy neurotransmitter, and 50% of dopamine is made in the GI tract.
  • 25% of thyroid hormone is converted from its inactive form to its active form in your GI tract.
  • As if that weren’t enough, all of your estrogen and progesterone hormones are detoxified through your liver into your gut.



Your GI Tract Does Not Function in Isolation

We can now see how health does indeed begin in the gut. But when we consider gut health – or even a part of the gut like the stomach, small or large bowel, etc – alone in isolation, we are missing the big picture. We also need to consider the brain, the heart, the liver, and the immune system as these all both affect and are affected by gut health.
You’ve probably heard me mention the Gut-Brain-Axis, how gut health and brain health are interrelated, and how 90% of the communication between your gut and brain is actually from the vagal nerve TO your brain, not the other way around. We’re also now learning about the Heart-Gut-Axis and how the gut communicates with the heart and vice-versa.
So, for example, when considering inflammatory bowel disease, esophagitis reflux, food allergies, etc, we need to take a holistic approach. How is the immune system being affected? How is the brain being affected? Does this person with GI tract issues have any neurological issues like anxiety or depression? Do they experience heart palpitations? Gut health can impact the heart, causing palpitations and a racing heart, which can then feed into the the neurological system and affect things like anxiety and sleep.
So now when someone has a gut issue, we look at all these systems and how they interact.

An Elimination Diet as a Tool to Improve Gut Health

A simple elimination diet is one of the basic things we do to start addressing gut issues. Food toxins and allergens can cause all kinds of issues that affect everything we’ve mentioned above.
A simple elimination diet, which you can find on our website, can be a great tool to start working on your gut health. The 6-Food Elimination Diet for Eosinophilic Esophagitis (EOE) which eliminates wheat, dairy, eggs, nuts, soy, and seafood has been shown to treat over 70% of all EOE. Most cases of irritable bowel syndrome (IBS) are improved with a simple elimination diet.

A Shifting Definition of Autoimmune Disease in the Gut

In inflammatory bowel diseases like ulcerative colitis and Crohn’s disease, the immune system is inflamed, and the body makes antibodies against itself. We have to take treatment to the next level once autoimmune disease has begun. Some of the current literature is now looking at inflammatory bowel disease with diarrhea as an autoimmune spectrum disorder and there actually are tests you can get through Quest Labs that look for antibodies that your body makes against itself. So why don’t we call this an autoimmune disease? I believe that, in time, we will also classify diarrhea-predominant IBS as one of the “newer” autoimmune diseases.




A Functional Medicine Approach to GI Functional Disorders

As a Functional Medicine practitioner, my first step in dealing with disorders of the GI tract is to clean up the diet.
We also deal with stress and consider the environment. We do advanced stool testing and take a deep dive into what’s going on in the gut. We seek answers to the questions: How are you processing your food? Is your pancreas making enough enzymes? How well is your body absorbing fats? Is there an overgrowth of bacteria and viruses in your GI tract? Are there inflammatory markers?
These are all great tools that we can then leverage to help the individual with their health. And of course we use the foundations of functional medicine like diet, lifestyle, exercise, sleep, stress reduction, patient history, and environment all along the way.
If you’d like to learn more about gut health, we have a list of great books by some of the top GI doctors in the country ranging from Harvard to Hopkins. Check it out and you’ll find a great read that can help you get started in leveraging your gut health.
Since 2010, Richmond Integrative and Functional Medicine has been helping people to restore their health and hope with an integrative approach to conventional and alternative medicine that’s entirely science-backed. We at RIFM believe everyone is made for health. We offer a comprehensive, in-person patient membership program to ensure you get access to the care you need to thrive.


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