Chiropractic, Nutrition & Digestive Function

Dr Joseph Olejak

ANJC Meeting, March 1, 2012

Lecture Notes

Dr. Olejak – Bio & ContactDr. Olejak is a chiropractor and applied clinical nutritionist with 23 years of clinical practice experience. A Palmer graduate, he has been speaking on nutrition and public health since 2002. He is the co-author of Synergistic Therapeutics: Herbs and Whole Food Nutrition for 50 Common Ailments. Currently Dr. Olejak is adapting a textbook to be used as a teaching guide for the Whole Food Nutrition Certification Course he authored in 2009

Mobile Phone: (518) 301-5717

Office Phone: (518) 439-5077 x17

Email: drjoseph.olejak@gmail.com

Letitia’s Story

Case History• Chronic gastritis & diarrhea for over 6 months• Internist and gastroenterologist ordered numerous

blood tests and a colonoscopy. All normal initially then later test showed abnormal blood sugar and increasing Blood Urea Nitrogen (BUN)

• GP had prescribed generic Naproxen for arthritis and patient had been using OTC Tylenol for years to manage pain.

• Medical solution was to monitor kidney function and put patient on blood sugar meds. (metformin)

• No one looked for the obvious mucosa damage

The Mucus Membrane of Stomach c. Cardiac glands. d. Their ducts. cr. Gland similar to the intestinal glands, with goblet cells. mm. Mucous membrane. m. Muscularis mucosæ.

m’. Muscular tissue within the mucous membrane.

Definition• Gastritis is a condition in which the stomach

lining—known as the mucosa—is inflamed– Stomach lining contains special cells that produce acid

and enzymes, which help break down food for digestion, and mucus, which protects the stomach lining from acid. When the stomach lining is inflamed, it produces less acid, enzymes, and mucus.

• Other factors: – Traumatic injury– Regular use aspirin or NSAIDs– Drinking too much alcohol

• Source:http://www.mayoclinic.com/health/gastritis/DS00488

Definition

• Gastritis may be acute or chronic. – Acute: Sudden, severe inflammation of the

stomach lining

– Chronic: Ongoing Inflammation • If chronic gastritis is not treated, it may last for years or

even a lifetime

• Source:http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis

Definition

• Erosive gastritis– Often does not cause significant inflammation but

can wear away the stomach lining

– Causes bleeding, erosions, or ulcers

– Acute or chronic• Source:

http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis

Definition

• The relationship between gastritis and symptoms is not clear – The term gastritis refers specifically to abnormal

inflammation in the stomach lining

– People who have gastritis may experience pain or discomfort in the upper abdomen, but many people with gastritis do not have any symptoms

• Source:http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis

Differential Diagnosisof Upper Abdominal Pain

• The term gastritis is sometimes mistakenly used to describe any symptoms of pain or discomfort in the upper abdomen

• Many diseases and disorders can cause these symptoms

• Most people who have upper abdominal symptoms do not have gastritis

• Source:http://digestive.niddk.nih.gov/ddiseases/pubs/gastritis

Other Diagnoses toConsider

• Inflammatory: – Gastroenteritis – Appendicitis – Gastritis– Esophagitis– Diverticulitis– Crohn's disease – Ulcerative colitis– Microscopic colitis

• Digestive: – Peptic ulcer – Lactose intolerance– Celiac disease – Food allergies

• Bile system:– Inflammatory cholecystitis– Cholangitis

• Obstruction:– Cholelithiasis – Tumors

• Liver inflammatory: – Hepatitis– Liver abscess

• Pancreatic inflammatory– Pancreatitis

Other Diagnoses toRule Out

• Vascular: – Embolism

– Thrombosis

– Hemorrhage

– Sickle cell disease

– Abdominal angina

– Blood vessel compression

• such as celiac artery compression syndrome

• Obstruction: – Hernia

– Intussusception

– Volvulus

– Post-surgical adhesions

– Tumors

– Superior mesenteric artery syndrome

– Severe Constipation

– Hemorrhoids

Etiology

• Underlying etiologic agents– Helicobacter pylori– Bile reflux– Non-steroidal anti-

inflammatory drugs [NSAIDs]

– Autoimmune response – Alcohol use (excessive)– Allergic response

• H. pylori infiltration is stained genta blue

Bile Reflux

• Injury of the gastric mucosa by reflux of bile and pancreatic secretions into the stomach– This is due to incomplete closing of the pyloric

valve.

Stomach & Pyloric Valve

H. pylori• H. Pylori secretes urease

breaks down urea (which is normally secreted into the stomach) to carbon dioxide and ammonia.

• The ammonia is converted to ammonium by taking a proton (H+) from water, which leaves only a hydroxyl ion. Hydroxyl ions then react with carbon dioxide, producing bicarbonate which neutralizes gastric acid.

• The survival of H. pylori in the acidic stomach is dependent on urease.

• Causes a chronic low-level inflammation of the stomach lining and is strongly linked to the development of duodenal and gastric ulcers and stomach cancer.

• Over 80% of individuals infected with the bacterium are asymptomatic.

Source: D T Smoot, H L Mobley, G R Chippendale, J F Lewison and J H Resau. Helicobacter pylori urease activity is toxic to human gastric epithelial cells. Infect Immun. 1990 June; 58(6): 1992-1994

Autoimmune Gastritis

• Once referred to as Type A gastritis. – Involves the fundic and corpus of the stomach. – It is an autoimmune disease because the body

produces autoantibodies to the gastric parietal cells and/or the intrinsic factor.

– Patients with this disease may have varying degrees of atrophy of the stomach.

– Clinically, patients may have pernicious anemia with achlorhydria, vitamin B12 deficiency, and hypergastrinemia.

NSAID Adverse Reactions

• NSAIDs cause a dual insult on the GIT: – The acidic molecules

directly irritate the gastric mucosa

– Inhibition of COX-1 reduces the levels of protective prostaglandins.

How NSAIDs Damage

• Inhibition of prostaglandin synthesis in the GI tract causes increased gastric acid secretion, diminished bicarbonate secretion, diminished mucous secretion and diminished trophic effects on epithelial mucosa.– Source: Simone Rossi, ed

(2006). Australian medicines handbook 2006. Adelaide: Australian Medicines Handbook Pty Ltd.

NSAID 3rd Leading Cause of Death

Figure 1. U.S. Mortality Data for Seven Selected Disorders in 1997. A total of 16,500 patients with rheumatoid arthritis or osteoarthritis died from the gastrointestinal toxic effects of NSAIDs. Data are from the National Center for Health Statistics and the Arthritis, Rheumatism, and Aging Medical Information System.

NSAIDsAnnual Sales in Billions

Alcohol Use Excessive

• Alcohol irritates and erodes the stomach lining, which makes your stomach more vulnerable to digestive juices

• Excessive alcohol use is more likely to cause acute gastritis– Source: Altman C, Ladouch A,

Briantais MJ, et al. Antralgastritis in chronic alcoholism. Role of cirrhosis and Helicobacter pylori. PresseMed 1995;24(15):708-10 [in French].

Effect of Alcohol on Mucosa

• Mucous cells secrete products that are rich in glycoproteins and water

• Ethanol is a solvent– It is miscible in water

– It will dissolve mucus • Leaving stomach unprotected

– Distilled spirits are more damaging than beer or wine

• % of ETOH per volume

Allergic Reactions

• Some researchers have suggested that food allergies or intolerance may cause gastritis.

• In one double-blind trial, people with proven food sensitivities showed clear evidence of irritation of the stomach lining (including swelling, bleeding, and erosions) when given foods to which they were known to react.– Source: Aiuti F, Paganelli R. Food allergy and

gastrointestinal diseases. Ann Allergy 1983;51(two Pt 2):275-80 [review]

– Source: eimann H-J, Lewin J. Gastric mucosal reactions in patients with food allergy. Am J Gastroenterol1988;83:1212-9.

Gastritis and Vitamin A

• The antioxidant beta-carotene, found in whole carrots along with 200 other phytonutrients– Eating foods high in beta-carotene (Carrots) has been linked to a

decreased risk of developing chronic atrophic gastritis. Moreover, people with active gastritis have been reported to have low levels of beta-carotene in their stomachs

– Sources:1. Spirichev VB, Levachev MM, Rymarenko TV, et al. The effect of

administration of beta-carotene in an oil solution on its blood serum level and antioxidant status of patients with duodenal ulcer and erosive gastritis. Vopr Med Khim 1992;38(6):44-7 [in Russian].

2. Palli D, Decarli A, Cipriani F, et al. Plasma pepsinogens, nutrients, and diet in areas of Italy at varying gastric cancer risk. Cancer Epidemiol Biomarkers Prev 1991;1(1):45-50.

3. Zhang ZW, Patchett SE, Perrett D, et al. Gastric mucosal and luminal beta-carotene concentrations in patients with chronic H pylori infection. Gut1996;38(suppl 1):A5 [abstract W11].

Allergic Response

• This type of gastritis is related to a food allergy or sensitivity. – Elimination diet to rule in/out allergen then

remove from diet permanently.

Symptoms & Signs

• Pain in the upper abdomen is the most common symptom. – Pain is usually in the upper central portion of the

abdomen, the "pit" of the stomach.

• Gastritis pain can occur in the left upper portion of the abdomen and in the back. – The pain seems to travel from the belly to the back.

– The pain is typically vague, but can be a sharp pain.

Symptoms & Signs

• Belching either doesn't relieve pain or only relieves it for a moment.

• Vomit is either clear, green or yellow, has a bloody streak in it, or is completely bloody, depending on the severity of inflammation.

• Bloating and a feeling of fullness or burning in the upper abdomen are also signs of moderate gastritis.

Diagnosis

• Diagnosis can be made upon symptoms alone• Other methods to arrive at a diagnosis are:

– Testing for anemia– Tesing for H. pylori, & pregnancy– Liver, kidney, gallbladder, and pancreas function tests– Urinalysis may be used, or a stool sample taken, to

look for blood in the stool. – X-rays may be ordered, as well as ECGs. – Endoscopy

• A flexible probe with a camera on the end is sent into the stomach to check for stomach lining inflammation and mucous erosion

Food Advice forGastritis

• Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.

• Avoid refined foods, such as white breads, pastas, and sugar.

• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.

Foods Advice forGastritis

• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.

• Avoid beverages that may irritate the stomach lining or increase acid production including coffee (with or without caffeine), alcohol, and carbonated beverages.

• Source:http://www.umm.edu/altmed/articles/gastritis-000067.htm

Role of WaterOften Overlooked, Very Necessary

Foods Advice forGastritis

• Drink water away from mealtimes to prevent dilution of HCL

• Drink enough water to obtain a straw colored urine

• Identify and eliminate food allergies.

• Use healthy oils, such as extra virgin olive oil, sesame seed oil or nut oils.

Conventional Treatments

• Acid reducing drugs (histamine 2 (H2) blockers) such as: – Cimetidine, ranitidine, nizatidine or famotidine that help reduce

the amount of acid the stomach produces • Proton Pump Inhibitors

– Block the activity of acid secreting parietal cells– These meds include omeprazole, lansoprazole, rabeprazole, and

esomeprazole.

• Omeprazole is often combined with the antibiotics clarithromycin and amoxicillin (or metronidazole in penicillin-hypersensitive patients) in the 7-14 day eradication triple therapy for Helicobacter pylori.

PPIsDamage Digestive Function & Immunity

• Effects: • 1. raise pH• 2. reduce conversion

of pepsinogen to pepsin

• 3. reduce effectiveness of acid barrier in immunity

Recurrance Rate after H. pyloriEradication with antibiotics

• The 12-month recurrence rate varied among the different studies from 0 to 41.5%.

• A few studies showed 18- 24 month recurrence rates, which ranged between 0 and 21.4%.

• Limited data, obtained using molecular fingerprinting techniques, have shown that inmost cases recurrence is due to recurrence of the original strain; a few cases appear to be due to reinfection with a new strain.

• Recurrence is most likely during the first 12 months after apparent eradication.

– Source: Hua-Xiang Xia, Nicholas J. Talley, Conor T. Keane and Colm A. O''Morain. Recurrence of Helicobacter pylori Infection After Successful Eradication (Nature and Possible Causes). Digestive Diseases and Sciences. Vol 42. No. 9. Sept 1997. pp 1821-34

Phytonutrients and the H. pylori

• Anti-microbial and Mucosal Support– Golden Seal

Golden Seal

• Key Ingredients: • Golden seal root. Active constituents

are berberine and hydrastine.

• Action:• Antibacterial, antifungal, antiprotozoal

• Cytotoxic and acts directly on the bacteria

• Clinical Indications:• H. pylori infection

• Trophorestoration of the mucus membrane

• Mucosa damage from alcohol, meds or infection

Golden SealBerberine & Hydrastine Anti-bacterial

Probiotics Protect Mucosal Barrier

SUMMARY: – Probiotic bacteria are used to treat disturbed

intestinal microflora and increased gut permeability which are characteristic to many intestinal disorders

– Source: S. Salminen, et al. Clinical uses of probiotics for stabilizing the gut mucosal barrier: successful strains and future challenges. Antonie van Leeuwenhoek. Volume 70, Numbers 2-4, 347-358

Nutrition and the Stomach

• Whole Food Vitamin A and immune function– Vitamin A is commonly known as the anti-infective

vitamin, because it is required for normal functioning of the immune system

• The skin and mucosal cells (cells that line the airways, digestive tract, and urinary tract) function as a barrier and form the body's first line of defense against infection

– Source: Semba RD. Impact of vitamin A on immunity and infection in developing countries. In: Bendich A, Decklebaum RJ, eds. Preventive Nutrition: The Comprehensive Guide for Health Professionals. 2nd ed. Totowa: Humana Press Inc; 2001:329-346.

Whole Food Vitamin A

• Key Ingredients: • Carrot (root), calcium lactate, defatted wheat (germ), bovine

kidney, oat flour, nutritional yeast, rice (bran), magnesium citrate, alfalfa flour, mixed tocopherols (soy), ascorbic acid, and soybean lecithin

• Actions: • Vitamin A also helps the skin and mucous membranes

function as a barrier to bacteria and viruses– Source: Harbige LS. Nutrition and immunity with emphasis on

infection and autoimmune disease. Nutr Health 1996;10:285-312.

• Clinical Indications:• Susceptibility to gastric infection

Therapeutic Strategy

Eliminate the source of problem

Iatrogenic Disease

• Best therapeutic strategy is to have patients eliminate the source of the problem.

• With drugs; Have patients consider reducing or eliminating OTC pain medications as these cause damage to the stomach mucosa– NSAIDs– Aspirin

• Source: Green, Ga (2001). "Understanding NSAIDs: from aspirin to COX-2". Clinical cornerstone 3 (5): 50–60.

Common Denominator

6 Ailments

One

Disordered Gut Ecology

Evaluation

• Case history

• System survey form (group 6)

• Clinical signs – Thoracic involvement, + Ridler point, pain during

or after a meal

Areas To Support

• Gastric Mucosa

• Gut Flora

• Gut Immunity

Gut Mucosa Protocol

• Gastric Mucosal Support– Acute gastric support

– Chlorophyll (fat soluble factors)

– Whole Food Vitamin C complex

– Okra with Vitamin E3

Acute Gastric Support

• Key ingredients: – Okra (fruit), bentonite (montmorillonite), Tillandsia

usenoides, anise (seed), bovine liver, porcine stomach, choline bitartrate, alginic acid, calcium lactate, porcine duodenum, allantoin, defatted wheat (germ), exsiccated disodium phosphate, oat (straw) extract, para-aminobenzoate, and porcine brain with niacin, B6 and Vitamin C

• Action:– Supports mucus membrane, reduces acidity of the

stomach and supports gastric function• Clinical indications:

– GERD, gastritis and occasional heartburn

Chlorophyll

• Key Ingredients: • Vitamin A (as Beta-carotene), fat soluble extract (from

sesame [seed], alfalfa [whole plant], sunflower [seed], carrot [root], Tillandsia usneoides, buckwheat [leaf], and pea [vine])

• Actions:• Coats and soothes mucus membrane• Supports blood, tissue oxygenation and healing• Source of vitamins A, D, E & K

• Clinical Indications:• Damage to mucus membrane and burning in

stomach

Chlorophyll & Wound Healing

• A preliminary study of chlorophyll in various ointment bases in over 200 experimentally induced lesions in guinea pigs showed acceleration of healing of approximately 25 per cent of the time in 71 per cent of the chlorophyll topically treated lesions.

• Source: LW Smith, AE Livingston. Wound healing:: An experimental study of water soluble chlorophyll derivatives in conjunction with various antibacterial agents. The American Journal of Surgery, 1945

Whole Food C Complex

• Key Ingredients: • Veal bone extract, bovine adrenal, dried buckwheat (leaf) juice,

buckwheat (seed), nutritional yeast, dried alfalfa (whole plant) juice, alfalfa flour, mushroom, magnesium citrate, bovine bone, defatted wheat (germ), calcium acid phosphate, echinacea (root), carrot (root), veal bone, mixed tocopherols (soy), and rice (bran).

• Action:• Vitamin C is essential for mucin production, necessary for collagen

synthesis, blood formation, and plays a role in RBC oxygen delivery

• Clinical Indications:• For supporting mucus membrane epithelium

Okra With Vitamin E3

• Key ingredients: • Okra (fruit), fat soluble extract (from alfalfa [whole plant],

sunflower [seed], carrot [root], Tillandsia usneoides, buckwheat [leaf], and pea [vine]), bovine orchic extract, pepsin (1:10,000), carbamide, alginic acid, and allantoin

• Action:• Supports small intestine absorption and cleansing of bowel• Allantoin, a primary ingredient in Okra with vitamin E3, has been

known to promote epithelium health. • Clinical indications:• Irritable bowel, constipation, malabsorption syndromes and mucus

colitis• Avoid with peptic and duodenal ulcers

Gut Flora Protocol

Weekends (SAT & SUN) for 8-10 weeksGut Flora ReEstablish Product

Herbal Anti-oxidant

Weekdays (Mon - Fri) for 8-10 weeksPrebiotic

Probiotic

Gut Flora ReEstablish

• Key ingredients: – Anise fruit– Andrographis herb – Phellodendron stem bark – Oregano leaf essential oil,

• Action:– Re-establishment of normal gut flora

• Clinical indications:– Candidiasis, GI tract toxicity, toxemia, adjunct to

antibiotics where there is loss of healthy gut flora.

Herbal Anti-Ox

• Key Ingredients: – Rosemary leaf 5:1 extract from Rosmarinus officinalis– Green Tea extract from Camellia sinensis leaf – Turmeric rhizome extract from Curcuma longa

rhizome – Grape seed extract from Vitis vinifera seed

• Action:– Astringent

• Clinical Indications: – Need for antioxidant support– Bacterial overgrowth of gut

Pre-biotic

• Key Ingredients: – Chicory root, magnesium and calcium

Action:– Source of FOS (fructoligosaccharides)

– Clinical Indications:

– Support commensal gut bacteria and epithelium

• Clinical Indications: – Bowel dysbiosis

Multiple Pro-biotic

• Key Ingredients: – Probiotic Blend of Bifidobacterium, BB-12®, L.

acidophilus, LA-5®, L. paracasei, L. casei 431®, and S. boulardii (4 billion cfu) with InulinGalactooligosaccharide (GOS)(milk)

• Action:– Supports normalization of gut flora

• Clinical Indications:– Disordered gut ecology (Bacterial [Klebsiella or

Clostridia] or Fungal [candida])

Research on S. boulardi

• Google scholar search finds 6,340 articles • http://scholar.google.com/scholar?hl=en&as_sdt=1,33

&q=s.+boulardii

Multi Probiotics & IBD

• The multispecies probiotics mixture of 8 strains seems effective in the maintenance of remission in pouchitis. – Irritable bowel syndrome is a functional bowel disorder

manifested by chronic, recurring abdominal pain or discomfort associated with disturbed bowel habit in the absence of structural abnormalities likely to account for these symptoms. Recently conducted appropriately powered studies with different (combinations of) probiotics show positive results on reduction of symptoms

– Source: Dirk Haller, et al. Guidance for Substantiating the Evidence for Beneficial Effects of Probiotics: Probiotics in Chronic Inflammatory Bowel Disease and the Functional Disorder Irritable Bowel Syndrome. J. Nutr. March 2010 vol. 140 no. 3 690S-697S

Gut Immunity Protocol

• Gut Immune Complex

• Echinacea purpurea & angustifolia

• Epithelial glandular extract

Gut Immune Complex

• Key Ingredients: – Vitamin C, Calcium, Zinc, Dried Yeast Fermentate (EpiCor®),

Maitake Mushroom Extract (MaitakeGold 404®), Maitake Mushroom Powder, Turkey Tail Mushroom Powder, Calcium lactate, cellulose, zinc rice chelate, acerola (berry),and manioc (root).

• Action:– Enhances activity of innate and adaptive immunity. – Supports immune response

• Clinical Indications:– Leaky gut syndrome, auto-immune disorders, IBS, Crohn’s,

and IBD

Echinacea Purpurea/Angustifolia

• Key Ingredients: – Echinacea from Echinacea angustifolia root containing

alkylamides– Echinacea from Echinacea purpurea root containing alkylamides

• Action:– Active in immune modulation including anti-viral activity and

resistance to infection via hormetic effect• Clinical Indications:

– Lowered immunity and frequent infections related to overtraining

• Therapeutic Dose: – 2.1 mg alkyl amides 2-3x per day

Epithelial Glandular Extract

• Key Ingredients: – Bovine epithelial tissue extract and magnesium

citrate

• Action:– Nucleo-protein support for epithelial tissue– Supports mucus membranes

• Clinical Indications: – Tissue damage to epithelial tissue – Mucus membranes, arterioles, and skin

Spine/GutConnection

• Dorsal Rami and Cervical ganglion affect digestive tone

Chiropractic & Dyspepsia

• Conclusion– Patients with chronic idiopathic dyspepsia may benefit

from conservative chiropractic management in terms of decreased symptom frequency and severity over a 3-month period and dependence on palliative pharmacological interventions. The pilot study offers scope for a larger controlled trial to investigate efficacy.

• Source: Martin F. Young. et al. .Chiropractic manual intervention in chronic adult dyspepsia: A pilot study. Clinical Chiropractic. Volume 12, Issue 1 , Pages 28-34, March 2009

Additional Enzymatic Support For Digestion

3 Things To Know

Enzymes & The Stomach

• Enzymatic Support for Digestion– Multiple enzyme formula

– Adult enzyme formula

– Digestive support with probiotic

• Clinical Note: Not advisable to use HCL containing products as these can further irritate the mucus membrane.

Adult Enzyme Formula• Key Ingredients:

– Glutamine, kale and beet root – Digestive enzymes include acid maltase, alpha-galactosidase, amylase,

bromelain, glucoamylase, invertase, lactase, lipase, peptidase, protease 3.0, protease 4.5, protease 6.0

• Action:– Supports healthy digestion and maximize absorption of nutrients.– Supports intestinal mucosal function– Can be depleted by stress – steroid hormones like cortisol can deplete

glutamine stores. Depletion can slow the healing process.• Clinical Indications:

– Vegetarian multiple enzyme blend for patients with insufficient digestion resulting in gas, bloating, burning, or abdominal discomfort after meals

– This formula is for patients who have difficulties with digesting different kinds of starch. Not a protein digestion formula

Adult Enzyme Formula

• Because the Standard American Diet (SAD) is weighted toward carbohydrates this product contains: – 6 Carbohydrate enzymes– Amylase, glucoamylase, acid maltase, and alpha-

galactocidase

• 4 Protein enzymes– Bromelain and Protease 3.0, 4.5 & 6.0 to support

protein breakdown at different pH’s through digestive tract

Adult Enzyme Formula

• Also contains glutamine and Kale– Glutamine

– Supports glutathione levels, supports and protects healthy intestinal tissue especially where there is reduced glutaminase activity)

• Kale– Contains a number of organosulfer compounds

– Antiseptic for the gut, supports detoxification and provides Vitamin A precursor molecules

Multiple Enzyme Formula

• Key ingredients– Fig (fruit), defatted almonds, pancreatin (3x), fatty acids,

bromelain, lipase, cellulase, papain, and amylase

• Action:– Digestive support for carbohydrates, fats and proteins– Papain is a cysteine protease hydrolase enzyme present in

papaya and used to break peptide bonds.

• Clinical indications:– Gas, bloating and feeling of fullness– Weak ability to digest proteins, carbs, & fats– Clinical Note: Use in the HCL sensitive patient

Enzymes With Probiotic

• Key Ingredients: – Maltodextrin, amylase, protease, cellulase, lipase,

Lactobacillus acidophilus, and Bifidobacteriumlongum.

• Action:– Provides digestive enzymes along with probiotics to

balance gut flora and aid in digestion of fats, carbs and protein

• Clinical Indications:– Post H. pylori infection – Aid digestion and support normal bowel flora

Bile Related Dyspepsia

• Purified Bile Salts

• Beet root and beet leaf

• Globe artichoke

Purified Bile Salts

• Key ingredients: – Collinsonia (root) and purified bovine bile salts

• Action:– Supports emulsification of fats and normal fat

metabolism

• Clinical indications:– Patients with no gall bladder, stones or gravel

reducing bile flow and cramping when eating fats

Beet Root & Leaf

• Key ingredients: – Carrot (root), beet (root), oat flour, dried beet (leaf) juice, defatted

wheat (germ), calcium lactate, magnesium citrate, bovine liver, nutritional yeast, bovine kidney, bovine prostate, alfalfa flour, bovine orchic extract, bovine liver fat extract, flaxseed oil extract, mixed tocopherols (soy), and soybean lecithin with vitamins A, B6 and iodine

• Action: – Supports fat metabolism – Mild liver / GB de-congestant– Thins and mobilizes bile– Assists in the conversion of blood fat to sugar

• Clinical Indications:– Bloating after eating a fatty meal– Most helpful for biliary duct stasis

Globe Artichoke

• Key Ingredients:– Globe Artichoke leaf 1:2 extract from Cynara scolymus

leaf• Actions:

– support normal bile production and secretion– support healthy liver function and tissue integrity– support gallbladder function– Strongly hypolipidemic

• Clinical Indications:– High cholesterol with an overlay of digestive distress

related to liver and gall bladder dysfunction

Chiropractic, Nutrition & Digestive Function

Dr Joseph Olejak

Info at:

drjoseph.olejak@gmail.com

Lecture Notes