The Comprehensive Digestive Stool Analysis - Part 1
Proper gastrointestinal (GI) function is critical to adequate nutritional status and can impact ALL ASPECTS of body function. Approximately one-third of daily caloric expenditure is required to drive the digestive, assimilative and immune functions while maintaining the gastrointestinal tract.
A large amount of the body's total lymphatic tissue is located in the gut, and the gastrointestinal system is the ONLY organ system of the body with its own independently working lymphatic and nervous systems. Only a system of prime importance to overall health would have such a large number of total-body resources dedicated to it.
EVERY disorder that pertains to the gut has the potential to manifest as a factor in nutritional deficiencies.81
I often tell my patients that the gastrointestinal tract is much like a
carburetor in a car. Your digestive tract tract must take gasoline (your food),
and then mix it with air (enzymes and other digestive juices). If this mixing
process goes well, your car runs and doesn't cough or sputter. How efficiently
your fuel burns determines to a large extent how many years you're going to get
out of your car. Although a rather crude analogy, this principle does hold true
for the human digestive tract. There are many points along the digestive where
some "burning" process can go awry and cause seemingly unrelated problems
elsewhere in the body. This article will discuss those various places and give
you a very good detail of what can go wrong.
Gastrointestinal disorders have a major impact on health. One recent
study found that during a three-month period nearly 70% of American households
experienced one or more gastrointestinal symptom.1
Maldigestion, malabsorption and abnormal gut flora and
ecology, as well
as many complex chronic illnesses and symptoms, lie at the root of most
common GI complaints. Thus, nutrition and digestive processes are central
to long-term health. Great Smokies Comprehensive Digestive Stool Analysis
(CDSA) provides clinicians with a critical tool for evaluating the status
of the GI tract.
This test helps pinpoint imbalances, provide clues about current symptoms
and warns of potential problems should the imbalances progress. With an
accurate assessment, custom-tailored treatment can be easily applied,
greatly increasing the chances for therapeutic success.
The CDSA is used in the evaluation of various gastrointestinal symptoms
or systemic illnesses that may have started in the intestine.
Because illnesses are often not discernable from symptoms, the CDSA
is a valuable means of identifying critical imbalances previously unsuspected.
As most food molecules cant be absorbed or utilized in their native
state, a primary function of the gastrointestinal system is to break down
molecules and absorb nutrients. This is a complex process taking place
primarily in the gastrointestinal mucosa, where the battle for healthto
absorb nutrients and exclude toxinsis fought. The gastrointestinal mucosa
does this through a combination of physical barriers to diffusion, mucosal
fluids and active immune processes.2
Bloating, belching, burning and flatulence immediately after
Sense of fullness after eating
Indigestion, diarrhea or constipation
Systemic reactions after eating
Nausea after taking supplements
Weak, peeling or cracked fingernails
Dilated capillaries in cheeks and nose (in nonalcoholics)
Chronic intestinal infections parasites, yeast, bacteria
Undigested food in stool
Table 1 (ref. 6,7)
Teeth break up food and mix it with saliva. Saliva in turn helps form
a bolus and protects the pharyngeal and esophageal
mucosa, primarily with secretory IgA antibodies. Saliva also helps remineralize the teeth with
calcium salts. The enzymes lingual lipase, salivary amylase and ptyalin
initiate fat and starch digestion.3
The stomach mechanically churns food, breaks up and emulsifies fats
and exposes molecules to additional enzymes. In doing this, it produces
one to two liters of gastric juices per day.4
Gastric juice has several components:
- Hydrochloric acid is secreted by the
parietal cells. It activates pepsinogens to convert to pepsin and renders some minerals (e.g. calcium
and iron) more absorbable. Stomach acid prevents bacterial overgrowth
by creating an essentially sterile environment. (A potential exception is Helicobacter pylori which is implicated in the cause of ulers).
- Mucus forms an acid- and pepsin-resistant coating of the stomach lining.
- Gastric lipase begins the hydrolysis of fats.
The Small Intestine
Most digestion and absorption takes place in the small intestine and
is mediated by pancreatic enzymes and bile.4
The process involves several steps:
1. Secretion of pancreatic juices (about 2.5 liters/day) is controlled by
the vagus nerve and the duodenal hormones secretin and cholecystokinin.
Hormone production, in turn, is stimulated by the presence of fat, protein
and acid chyme.
2. Bicarbonate begins the process of neutralizing stomach acid.
3. The proteases trypsinogen, chymotrypsinogen and procarboxypeptidase
are activated to trypsin, chymotrypsin and carboxypeptidase. These enzymes
digest proteins to oligopeptides and amino acids.
4. Amylase splits starch to maltose.
5. Lipase hydrolyzes diglycerides and triglycerides, producing long chain
6. Bile secreted by the liver (about 700 ml/ daily) is stored in the gall
bladder. Bile salts solubilize and emulsify fats, enabling enzymatic hydrolysis.
The Crypts of Lieberkuhn of the intestinal mucosa also produce
and small amounts of digestive enzymes such as peptidase and disaccharidases.
The Large Intestine
A primary role of the large intestine is absorption of waterabout one
liter daily. The large intestine also provides an environment for microbial
fermentation of soluble fiber, starch and undigested carbohydrates.
Anaerobic colonic fermentation results in production of short chain
fatty acids, the main energy source for colonic epithelial cells. It is
largely these SCFAs, in combination with amines derived from protein degradation,
that provide buffering and create the slightly acidic pH of fecal matter.
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