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Bowel Disorders - Working Out the Root Causes

  [ 21 votes ]   [ Discuss This Article ]
By Dr. Sarah Myhill, MD* • • January 12, 2011

In bowel disease, the environmental approach is much more logical than the conventional approach

It is astonishing that conventional medicine almost entirely ignores the role of food and diet in the diagnosis and treatment of bowel disorders. Serious diagnoses such as cancer obviously need to be excluded, but then the ‘environmental approach’ should be used to work out the root cause of gut symptoms.

Bowel symptoms are not very helpful in diagnosing causes.

This is because pain in the gut is poorly localized, and many symptoms can be caused by different disease processes.

For example, nausea can be caused by motion sickness, pregnancy, food allergy, chemical sensitivity etc. Bloating may be a symptom of gall bladder disease, food allergy, gut dysbiosis or constipation. Symptoms may give useful clues about what to tackle first.

The environmental approach is to look for causes.

There are three common threads to follow in the treatment of most gut problems. Namely:

• Diet (allergy and hypoglycemia),

• Poor digestion of foods and

• The fermenting upper gut or gut dysbiosis (wrong bugs in wrong place).

If things get complicated, often all threads are involved!

In order of probability, the causes are:


The gut evolved over thousands of years dealing with a “Stone Age Diet.”  [Heavy on what could be caught or foraged for – meat/seafood & eggs, veggies, fruits such as apples and berries, nuts and seeds.]

This is what we should all eat! Issues of diet include hypoglycemia and allergy.

Hypoglycemia (low blood sugar). Stimulates acid production (when you feel hungry, the stomach rumbles!). Sugar, alcohol and caffeine all cause low blood sugar. If there is no food to mop up this acid, it will damage the lining of the gut. Again this is a clinical diagnosis which is usually easy to make if the patient is honest about what he/she consumes. See “Blood Sugar and Hypoglycemia – the Full Story.” 

Allergy to food. There are tests for food allergy but they are not very reliable with many false positives and negatives. The most reliable way to diagnose is to do elimination dieting. Start with the Stone Age Diet.

Gut Dysbiosis – i.e., the Wrong Bugs in the Wrong Place

The upper gut should be sterile like a dog's gut to digest protein and fat, and the lower gut should be fermenting, like a horse's gut, to digest fiber. This versatile gut allows humans to eat a wide range of foods and partly explains the success of Homo sapiens! However, Western diets, high in sugar and refined carbohydrate, lend themsleves to upper gut fermentation which causes many digestive problems!

See “Fermentation in the gut and CFS” [for an overview of how some bacteria, yeasts and parasites will flourish, invade and do damage should needed bacteria populations in the large intestine decline.]

Gut dysbiosis can be tested for by a gut fermentation profile, comprehensive digestive stool analysis, fecal microbial analysis stool test to see which bugs are present, urine test for hydrogen sulphide, or breath testing for Helicobactor pylori, and others.(1)

Hypochlorhydria (Lack of Stomach Acid)

See “Hypochlorhydria – Lack of Stomach Acid – Can Cause Lots of Problems”

Poor Eating Habits

The gut is a creature of habit. It learns when to expect foods and prepares accordingly (think of Pavlov's dogs). Regular eating patterns are important with adequate amounts of food which requires digestion to "mop up" the acid produced in the stomach.

Take time to chew - digestion of food starts in the mouth. Indeed chewing produces saliva which contains endothelial growth factor - this stimulates the gut lining to stay tight and prevent leaky gut.


Caused by too little fiber in the diet, or the wrong foods (dairy allergy is a common cause), too little water, insufficient bugs in gut or wrong bugs (E. coli ferments to produce serotonin - essential for normal gut movement), or not enough exercise. Exercise is a great laxative - ask any runner!

This is a clinical diagnosis. A normal person on a good diet should open their bowels daily (on average) and effortlessly (no straining)… See “Constipation” with a discussion of its most common causes.

Drug Side Effects (e.g., Aspirin-like Drugs, Steroids)

Post mortem studies suggest that 17% of people taking aspirin-like drugs are bleeding from their gut. Consider doing a Comprehensive Digestive Stool Analysis (CDSA) test.

Digestive Enzyme Deficiency - Failure to Digest

This can be tested for by a Comprehensive Digestive Stool Analysis which does the basics. You could also ask for fecal elastase (measure of pancreatic function), bile salts and salivary VEGF for Hypochlorhydria.

Poor digestion may lead to absorption of short chain polypeptides which can act as hormone mimics causing a wide range of symptoms. These can be measured by the short chain polypeptides test, which is also a test for leaky gut.

Other often overlooked causes of gut symptoms include:

• Free radical damage - in the case of pancreatitis - see “Antioxidants and Free Radicals – What They Are and What They Do”

• Poisoning - pesticides (cause gastritis)

• Poor blood supply to the gut - see “Arteriosclerosis.”


1. Individuals in the UK can, with a doctor’s referral, directly order many of these diagnostic tests by obtaining kits from and mailing samples to Dr. Myhill. See test list and details. Similarly, kits for many of these tests are available from labs in the US that list selections online.

* Dr. Sarah Myhill, MD, is a widely recognized UK-based nutritionist and GP in private practice who specializes in preventive health, fatigue issues, and patient education. The following is excerpted with kind permission from her highly regarded patient website ( ® Sarah Myhill Limited, Registered in England and Wales. Registration No. 4545198. Registered Office: Upper Weston, Llangunllo, Knighton, Powys, Wales LD7 1SL, UK. Tel 01547 550331 | Fax 01547 550339.

Note: This information has not been evaluated by the FDA. It is generic and is not meant to take the place of one’s physician and is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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