If you have “heartburn”, or feel heavy for hours after eating, or can’t hold your breath for 40 seconds, you may have a hiatal hernia. A hiatal hernia is a retrograde pouching up of the top of the stomach through the hole in the diaphragm. The purpose of this hole is only to allow the esophagus to pass through to the stomach. The diaphragm is a large, dome-shaped muscle that separates the heart and lungs from the digestive organs. Corrective surgery attempts to tighten this hole, but should be a last resort. Many people are told to take anti-acids, or sleep with the head of their bed elevated, or only eat small meals. These suggestions may help, but they don’t cure the problem.

Studies have found the incidence of hiatal hernia is 32 percent in folks over age 50 and 89 percent in those over age 90. They can appear at all ages, including in children.

Taking anti-acids long term has serious consequences because stomach acid is absolutely vital for many reasons. One, the stomach is designed to secrete acid, which is the first protective barrier against pathogens moving down into the absorptive surface of the small intestine. In other words, stomach acid sterilizes the food before it passes more deeply into the body and, ultimately, into the bloodstream. Two, strong acid is required to properly begin the digestion process, particularly of protein. Protein must be “digested” down into the micro-molecules, amino acids, essential fatty acids and glucose, before absorption. Three, unless the bolus of food mixed with stomach secretions moving into the duodenum (upper small intestine) is nice and acidic, the release of the pancreatic enzymes (from the pancreas) and the release of bile (from the liver) is not stimulated, thus further compromising digestion.

A better strategy to reduce hiatal hernias is HEEL THUNKS.

Drink a glass of room temperature or slightly warm water first thing in the morning when you get out of bed (no coffee, tea, juice or cold water – just warm water). Then, while standing, bring your arms straight out to our sides and bend your elbows so your hands are touching your chest. Next, stand up on your tip toes as high as possible, and drop down so that you get a pretty good jolt. Do this about 10 times in a row. Then, while standing with your arms up, pant short quick breaths for 10 to 15 seconds. That’s all! Repeat every morning and as needed during the day whenever you feel heartburn.

Why this works is because the water acts as a weight in your stomach (makes your stomach a water balloon temporarily). Being warm, the water won’t cause your stomach to cramp; instead you stomach relaxes. Spreading your arms stretches the diaphragm and opens up that hole in the middle. Dropping down on your heels will jerk the stomach out of the hole. Panting tightens up the diaphragm muscle to close the hole. Stick with this morning routine until you never suffer from heartburn any longer.

Lastly, don’t over stuff with too much food, especially not if you plan on slumping in an easy chair after dinner. The food your stomach is churning and digesting will have nowhere to go but into that hole. Ideally take a gentle walk for ½ hour after your main meal of the day.

Two friends, Linda and Jenna, who work at Rainbow Foods in beautiful downtown Juneau, Alaska, agreed to pick out a few quirky popular requests from customers and pass them along to me. “It’s amazing how often people want to know about probiotics.  A lot of folks really don’t know what that means,” said Jenna.

Probiotics can sometimes be understood as the “opposite” of antibiotics, but really the term covers much more territory.  In the mucous-membrane covered tube that runs from your mouth to your rectum live a host of healthy bacteria which helps you to break down and assimilate your food.

The stomach, near the top of the tube, is designed to be very acidic, especially right after eating.  The pH (acidity) of the stomach should reach 1 or 2 (like vinegar) when filled with food for several reasons.  First, the acid helps to break down protein into amino acids, which are the building blocks of all bodily compounds (cells and tissues).  Second, the stomach acid helps sterilize food so pathogenic bugs don’t infect the gut or get into the bloodstream.  Third, without a nice acidic bolus of food passing into the upper small intestine, the pancreas is not adequately triggered to secrete pancreatic enzymes (amylase and lipase), nor the neutralizing bicarbonate of soda (the broken down food must be neutral in pH — around 7.4 — before it can be absorbed into the blood), nor does the pancreas secrete insulin properly without adequate stomach acid.

Acid-loving probiotics (such as the most famous of them, Lactobaccilus acidophilus) live up high in the gastro-intestinal (GI) tract.  Further down the GI, the pH becomes increasingly more basic.  By the time we get to the colon (also known as the large intestine, a 6 foot long upside down “U” shaped wide gauge hollow organ which resorbs water and compacts waste) the pH is about 9, and thus harbors a completely different species of probiotics: the bidifo bacterium.  Unfortunately many antibiotic treatments (given by prescription for bacterial infections) will kill not only the target “bad” bugs but also the “good” bugs that live in the GI.

Killing off the healthy probiotics not only compromises the ability to properly digest and absorb nutrients from your food, but also promotes the overgrowth of fungal species (such as Candida albicans) that lives in the GI.   A certain amount of Candida is normal in the gut; but it must be kept in balance with the probiotics.  Health is almost always about balance and moderation.

Look for complete probiotics (multiple species) containing billions of microorganisms per dose.  Many good probiotics also contain FOS (fructo-oligosaccharides) which “feed” the probiotics and help get them established in your gut, or my prefered pre-biotic, Lactoferrin, which is thought to not feed any lurking bad bugs.

Linda said, “Lots of people come in wanting to know more about “cleansing” and often I realize they are just embarrassed to admit they are constipated.”  There are many types of herbal laxative products, and they can be fairly harsh.  The active ingredient of bowel stimulants is often a phytochemical called anthraquinone, and is found in Cascara sagrada, Senna, Aloe and Rhubarb.

I am a big fan of regular bowel movements.   Ideally 2 or 3 daily, but at least one-a-day to prevent building up waste.   I will often teach patients the concept of “adult potty training” which means learning proper bowel habits all over again.  You must make time to defecate – even if the urge is not spontaneous and strong.  You simply must prioritize time in your life to “relax” into this important daily occurrence.  Squatting is a much more natural position for opening the bowels than sitting.   To simulate squatting, place your feet on a low stool (or “Welles” step) and lean forward onto your thighs.  Stay well hydrated.  Find time either after breakfast or after dinner every day and sit there, with reading material if necessary, for at least 20 minutes until your body “gets it.”

If no bowel movement is produced with adequate water intake (yes, 6-8 cups), relaxed time on the potty, some form of daily exercise and a high fiber diet, then it’s time to bring on the laxatives.   If you feel as though the bowel movement is stuck down low, a Fleet enema or glycerine suppository may be all that is required to help the BM slide out.

By the way, if it sinks right to the bottom of the toilet bowl, it has been in there too long.  The ideal stool is dark brown, half floating and half sinking, passes easily and doesn’t smell too bad.

If you feel constipated higher up, the laxative probably needs to come down from the top.  On any day not having a bowel movement consider taking some kind of laxative at bedtime to ensure a movement the next day.  Please do not go more than 2 days without pooping.   I prefer soaked prunes or figs (just soaked in plain water and kept, covered, in the fridge as a tasty dessert) to anthraquinone laxatives but some folks will prefer a capsule or to avoid the intense sweetness of the re-hydrated dried fruit.

Some seekers of “cleansing” are looking for a detox program — but that generally starts with bowel elimination since this is our major way to detoxify daily.  There are many excellent cleansing programs available in fine healthfood stores, and most will offer bowel as well as liver, lymph, lung, kidney and skin cleansing phases.

Your healthfood store employees, particularly those who have been working in the industry for at least a few years, will often have tried these products themselves, or work with local nutritionists or naturopaths to choose a range of high quality products — so they are good resources in providing guidance for your quest to better health.  Just one word of caution.  A healthfood store employee is definitely not trained to diagnose disease, and you should be cautious, and not make therapeutic decisions based on any such pronouncements.

Linda also said.  “We sell a range of Chinese herbs (at Rainbow Foods) and I hear two phrases from people who use acupuncturists.  They come in saying they need to “build their blood” or that they have “stagnation.”   I’m not exactly sure what these mean.   Can you translate?”

Blood building, in Traditional Chinese Medicine (TCM) refers to reversing anemia.  Often a woman who menstruates heavily will become anemic.  Of course more serious causes of blood loss, such as internal hemorrhage, can quickly cause anemia and must be treated as an emergency.

Blood is created in the bone marrow, and requires optimal intake of iron-rich foods including meat, spinach, kale, sea vegetables, sardines, red grapes and the herb Yellow dock (Rumex crispus).  Plant tannins, found in high concentration in black tea, will bind iron and should be avoided if you are anemic and trying to build your blood.   Supplemental iron, about 25-50 mg daily, is also very helpful.   I prefer liquid forms of iron as they tend to constipate less than the drugstore ferrous sulfate variety.  If you are only mildly anemic, you can cook in cast iron cookware or take supplemental iron during your menses only.  Do not take iron unless you have a proven iron-deficiency because excess iron can promote viral infections.  People with HIV or Hep C should be cautious about supplementing with iron.

“Stagnation” is the principal pathology in TCM.   Health is “flow.”   Disease, or lack of health, is thought to be caused by stagnation.   In TCM, the stagnation is generally “Qi” stagnation, but you can think of this as impedance in the flow of blood, or nerve conductivity, or gastric juices, or just a broader concept of
internal energy stagnation.   The main purpose of acupuncture needles is to re-stimulate the flow of Qi (pronounced “chee” and meaning Vital Force, or as naturopaths call it, the “Vis”, short for Vis Medicatrix Naturae — Latin for the healing power of Nature.)

I hang out at the healthfood store near my office on a regular basis.   Not only can I get all my vibrant organic produce, bulk staples and trans-fat and artificial-colorant free treats there, but I learn a lot about what folks are doing day to day to commit to improved health and wellness.   And this fills me with hope
and affection for my fellow humans.

A: Sounds like you may have “Irritable Bowel Syndrome” or IBS. This is not so dire a problem as ulcerative colitis or Crohn’s disease, but the classic IBS symptoms of abdominal cramping, alternating bouts of diarrhea and constipation, bloating, gas, and mucus in the stool can certainly be uncomfortable and annoying.

Since IBS has received more airplay in the past decade, of course drug companies have rushed in to produce quick-fix pills.  These will not work.  IBS is not a disease, but a very common constellation of symptoms due to poor digestive function, which leads to reduced nutrient absorption and resultant low energy, over-eating and the blood sugar roller-coaster.  Some of the drugs “approved” for IBS (such as Alosetron for diarrhea and Tegaserod for constipation) have serious side effects, including decreased blood flow to the colon.

Optimal functioning of the digestive system starts in the mouth, and what you put into your mouth.  Remember that up top you have teeth, and these should be used, with every single bite of food, to render the food “soupy” before swallowing.   Blenderize your food with your saliva in your mouth before it goes down the pike.  This tip alone will take care of many cases of IBS.   Chew your food 30-50 times per mouthful!  Slow down!  Don’t multi-task while eating!   Turn off the TV, even if you are eating alone.   Sit down.  Say a little “grace” before eating.  Another tip: do not drink more than a few ounces of water or other liquid during your meal.  You want to have your digestive juices work full-strength on the food.  Gulping water or tea or wine during a meal dilutes the digestive enzymes.  Do your drinking up to 1/2 hour before meals and then wait until 2 hours after a meal to resume beverages.  Water is always the best choice of beverage!

Once you have thoroughly and calmly masticated your bite of food and swallowed, the soupy food goes into the stomach and provokes secretion of stomach acid.  You absolutely need your stomach acid for optimal food, especially protein, digestion.  Please avoid acid-blockers, such as Tums, Nexium, Prevacid etc.  If you are taking acid-blockers because of heartburn (GERD) see a naturopath to help cure that problem.  Stomach acid is NOT the problem — you may have an H. pylori infection, or a diaphragm (hiatal) hernia, or stress ulcers and these can all be cured.

If you are not sufficiently helped by the simple suggestions above, you may need digestive enzymes with meals.   I prefer an enzyme “multi” that contains some amylase for the starch, lipase for the fat and protease for the protein component of food.  A good enzyme multi may also contain lactase for dairy products and cellulase for the fiber in food.  These enzymes add to the potency of your own natural enzymes in your saliva, stomach, pancreas and liver which all get secreted into the gastrointestinal tract (GI) during the process of digestion.

There are also a number of helpful carminative herbs.  Carminative means helping with digestion, or literally “carrying gas from the alimentary canal.”   A strong small cup of peppermint tea after meals, especially if you have a warm or hot metabolism, can be very effective — unless you have heartburn, in which case an enteric coated peppermint capsule is better, so the peppermint volatile oils get past the lower esophagus without irritation.   If you are treating a hiatal hernia, strong peppermint, coffee and chocolate should be assiduously avoided until the condition is resolved.  If you are a chilly person, then a strong small cup of ginger tea can be a delightful digestive aide.  You could also chew on a few fennel or caraway seeds after a main meal to stimulate optimal digestion.

Once the food gets past the stomach, into the small intestine with its thousands of slender, finger-like “villae” then the nutrients can be absorbed.   This requires good health of the villae and there are numerous potential impediments to absorption.  First, the food needs to be alkalinized before it is taken up into the blood, which has a mandatory neutral pH.  The pancreas is in charge of secreting juice very much like a baking soda slurry into the upper small intestine to begin the alkalinization process.  If part of your GI trouble is left side or central discomfort, up under the ribs, after eating, please see your naturopathic physician to evaluate your pancreatic function.  If you get stitching, sharp pains in the middle part of your belly that may extend to the sides, that is probably gas.  Gas is formed by carbohydrates fermenting or proteins putrefying.  The foods are just sitting there because they are having difficulty breaking down, and are actually starting to rot.  As a reminder — one of the very best ways to prevent gas is to thoroughly chew your food before swallowing.

To determine which foods your body accepts as nutritious, and which will present difficulty digesting, the very best way is to undertake an elimination and challenge diet.  I have details about this process elsewhere on this website.  The basic idea is that you eat very carefully for 2-4 weeks, avoiding alcohol, caffeine, corn in all forms, dairy products, eggs, peanuts, red meat, shellfish, all soy products, tomatoes and wheat.   This will cover most people’s food sensitivities.   However, I have not infrequently seen problems with aspirin and other NSAIDS, chocolate, citrus fruits, garlic, and any gluten-containing grain.  You may look at this list and think “what can I eat then??”

You can enjoy delicious vegetable recipes — time to get a new vegetarian cookbook.  Steamed cauliflower, baked yams, grilled red peppers, steamed asparagus, chopped red cabbage and shredded carrots, sauteed onions and mushrooms.  Yum yum yum!  Oats and rice are almost always “safe” foods for everyone.  Fruits and seafood (except the crustaceans) are generally extremely health-promoting for everyone, with the exception of large tuna and swordfish which unfortunately contain more mercury than is safe to eat.  After enjoying a delicious clean diet for a few weeks, carefully “introduce” the ingredients listed above, in 3-day increments.

This means, get organized with your calendar about which food is going to be introduced, and eat plenty of it over a 3-day period, without adding any of the other possible allergens yet.   Carefully observe any changes in your skin, mood or bowel function.  If, for example, you are re-introducing wheat into your diet after 4 weeks of abstaining, you may have toast in the morning, a bagel at noon and a bowl of wheat pasta in the evening.  If you notice hives or rashes or an outcropping of pimples, or a mood shift to sad, irritable or angry, or if your stomach hurts or your bowel function changes, take note. You could try the experiment again, or you could decide that wheat just doesn’t sit well in your body.  If that is the case — join the ranks of up to 30% of the US population for whom wheat is a small intestine irritant.  The extreme form of wheat sensitivity, which is a reaction to all gluten-containing grains, is called celiac disease, and is considered still to be one of the most under-diagnosed GI problems.

Take your time introducing the potentially offending foods into your diet in 3-day increments.  If you decide that, for example, wheat is bad for you, please don’t force yourself to eat it 3 times daily for 3 days. Just wait out the 3-day period and try the experiment again with the next item.   Be methodical!  This is the only way to get definitive answers about which foods “work” for your body and which do not.

If you have had irritable bowel symtoms for a while (more than a year) you will most likely benefit additionally from a high quality pro-biotic 2 to 3 times a year for 1-4 weeks depending on the potency of the probiotics.  I like brands that contain not only the well-known lactobacillus species, which work higher up where the GI environment is more acidic, but also the bifido species, that prefer a more alkaline environment, such as in the colon (large intestine).  Look for a probiotic that also has a “pre”-biotic such as lactoferrin (ideally) or FOS (fructo-oligosaccharides).   The pre-biotic is food for the probiotics.

Besides chewing and using carminative herbs, you may want to experiment with “priming” your stomach with an acid stimulant.  For example, you could take a half ounce of “Swedish Bitters”, available in most health food stores, usually featuring Gentian and other bitter tasting herbs, to stimulate secretion of hydrochloric acid in the stomach just before meals.  You could also try a small amount of vinegar-honey water (equal parts vinegar and warm water with 1/3 tsp of honey).  The juice of 1/2 a lemon in a 1/4 cup of water works just as well.

Everyone has heard the phrase “real food takes time.”  Avoid eating haphazardly.  Plan ahead.   Make time to buy fresh produce, ideally grown nearby in organic soil.  Respect your body and feed it the finest “fuel” available.  Be willing to engage with healthy eating as a commitment and a pleasure, as opposed to an exercise in deprivation.   There are many healthy choices out there, although sometimes the junk food advertising screams louder!

Yes, if you:
Smoke
Are regularly exposed to environmental toxins
Drink less than a litre of water daily
Drink soda pop, coffee or alcohol
Eat processed foods such as white flour baked goods and candy
Crave junk food
Are tired, constipated, bloated and lack focus
Have sticky or malodorous bowel movements
Have pasty skin or dark circles under your eyes
Have blood sugar problems
Have unstable emotions
Have unsatisfactory libido or sleep
Are over or under-weight
Use prescription or recreational drugs regularly

If you peruse natural health news, you certainly have read the word “detox” lately.  You may have heard about how “body burden” of unnatural chemicals is higher than ever before. Industrial run-off into our rivers, pharmaceutical pollution flushed down toilets, burning fossil fuels belching into the air, fake food, plastic everywhere — all of this and more comprises an enormous burden for our internal self-cleansing systems.

The amazing human body has several mechanisms by which to rid itself of non-nutrients which come in daily through our nose and mouth.We process food across the entire mucous membrane from the mouth to the rectum.  The enzymes in our saliva, the all-important stomach acid, the pancreatic enzymes, and the bile from the liver all prepare our food for digestion then absorption into the bloodstream.  Elements of our meals which are deemed unsatisfactory for absorption will be eliminated, via the large intestine.  In case you haven’t heard: pooping at least once daily is crucial to optimal health.  It is unhealthy to allow waste products to linger in the colon. Once in the bloodstream, we have several other methods of screening for “toxins” which is defined as anything our cells can’t use for energy.  As the blood passes through the kidneys, they are “strained” by hundreds of super fine sieves.  Of important job of the kidneys is to remove nitrogen from the blood, which we pee out as ammonia. The lymphatic system, which has a vast network traveling alongside the blood vessels all over the body, also picks up “goop” in the blood and funnels it to the “master” lymph node, called the cisterna chyle, which is located between the heart and the left kidney.  From there, the lymphatic fluid passes into the renal system (kidneys). Last, but not least, the skin is a large and important organ of elimination embedded with sweat glands.  Ideally, strenuous exercise would induce free-flowing and non-odorous perspiration.  Smelly sweat and drenching sweats at rest are signs of elimination difficulties.

Other signs of toxic congestion (and therefore need for “detox”) include constipation, bad breath, irritable skin, fatigue after eating, poor sleep quality and moodiness. A body which eliminates properly will stay healthy.  It’s as simple as that.  I approach “detox” with my patients as an opportunity to change bad dietary habits, and to become enamored of feeling great.  The first order of business is to open the “emunctories” which is an old naturopathic word meaning the portals of elimination.

Start with the skin: I encourage everyone to take up the habit of dry skin brushing every morning.  This is a marvelous “bath” which removes the outer layer of dead skin and not only cleanses but invigorates.  Brush the entire body, fairly firmly, except the face, always towards the heart.  See the sidebar for a more detailed description.

Next, the renal system:  during cleansing it is advisable to drink lots of water.  Pure water is the very best drink.  I don’t agree with the idea of alcohol being “therapeutic”.  It is toxic to the heart, liver and kidneys.  Sure, it will help some folks relax — but there are better ways to relax!  And if you are after the deep pigments of red wine, for example, you can take resveratrol in capsule form or simply eat lots of deeply colored fruits and vegetables.

Do whatever it takes to enjoy the daily poop.  Three times a day, after each meal, is ideal, but many of us just can’t make time for that.  I like using a stool, or “Welles step”, under my feet while at the toilet because it helps simulate a squatting position, which is how we were designed to poop. Cold stewed prunes (just put some prunes and water in a small covered jar and keep in the fridge) or 500 mg of Magnesium at bedtime are simple, non-addictive laxatives.  Avoid cascara sagrada — it is too harsh.  Digestive aides such as fennel seed, ginger root and mint leaves, in teas or whole form, can help improve digestion and elimination.

I advise my patients to avoid cleansing or fasting during cold weather, when we are directing energy towards staying warm..

It’s a good idea to cleanse or fast with at least one “buddy” if possible — so you can cheer each other and help maintain your mutual commitment to optimal health.  I advise against advertising to all your friends and family that you are undertaking a cleansing project because they might not all be supportive.  If they ask, you can tell.  Figure out a good time and how much time you can commit.  Remember, this is not a crash diet.  It’s a chance to open the emunctories, enjoy some deep internal cleansing, and explore the possibility of healthy eating and healthy living every day for the rest of your life.  The most important part of detox is coming off the program.  Your stomach will be smaller and your internal organs more sensitive to “junk.”

Please go slowly in the week after a detox program.  Do not plan or attend a gastronomic extravaganza soon after cleansing.

Three Day Plan
This is an all-fresh fruit cleanse.  Fruits are high in water, fiber and slow-releasing sugars.  They are tasty!  Neither juice nor dried fruit is allowed — too concentrated.  Eat whatever fruits appeal to you, one serving every two hours while awake.  A serving means 1 large or 2 small apples, 6 apricots, 1 medium banana, 1-2 cups berries, cherries or grapes, 2 oranges or nectarines, 1 cup of pineapple, 1 large pear, 2 kiwis, 3 plums or tomatoes, 2 cups of cubed melon.  Mix it up!  Eat only fruit.  For a complete description see “Fruit Flush” by Jay Robb.

Seven Day Plan
This involves 2 days of preparation, 3 days of “fasting” and 2 more days of slowly re-introducing your regular (but hopefully transformed) diet.  During the first 2 days, eat only raw food: mixed salads, fruit, steamed veggies.  Drink plenty of water between fruit or veggie meals.  Avoid juices.  However, during the 3 “fasting” days you will drink diluted juices and broths and tea and plenty of water.  No solid food because the idea is to give the digestive system a rest.  Sip on fluids all day long.  Fresh juices are best.  Green drinks or protein powders are fine.  The last 2 days are like the first 2: raw fruits and veggies only.  I recommend fruit only in the morning and veggies after noon.  For a complete description, see “Prescription for Nutritional Healing” by James and Phyllis Balch.

Fourteen Day Plan
This allows 3 days of preparation with raw food only, and also using a bulking drink (1 T psyllium husk or other fiber such as ground flax seeds, mixed with water) three times daily, ½ hour before eating.  Next follows 5 days of liquid only: broths, fresh juices, tea, water.  You should be able to go to work and do your normal day, you will have good energy, but don’t plan extra activities.  Allow for more rest in your schedule.  If no stool is produced during the liquid-only days, an enema is strongly recommended.  Colonics are fine too if you are squeamish about giving yourself the treatment!  The last 6 days are the most important.  You will SLOWLY re-introduce foods one day at a time.  For a complete description of this plan see “The Fasting Diet” by Dr. Steven Bailey.

Twenty Day Plan
This is a slightly longer but less rigorous cleansing plan.  The rules are simply to eat foods high in beta-carotene (sweet potato, carrots, spinach, cantaloupe, pumpkin, kale, winter squash) and high in Vitamin C (citrus fruits, broccoli, strawberries, tomatoes, melons, potatoes, bell peppers, Brussels sprouts, cabbage) for 20 days.  Additionally you will drink plenty of water between meals and snacks.  You are allowed to eat anything in moderation except for the following:
Wheat and other gluten-containing grains        
Milk and dairy products        
Eggs, meats or farmed fish        
Sugar        
Artificial sweeteners        
Alcohol        
Caffeine        
Soft drinks        
Foods containing artificial flavorings, colorants or preservatives        
High-fat foods        
Salty foods

The idea is, you will feel so good after this program that you’ll decide to eat this way for the rest of your life!  For a complete description see “The 20-Day Rejuvenation Diet Program” by Dr. Jeffrey Bland.
Detox Super-Tool:

Skin Brushing

Brushing your skin with a long handled dry skin brush (I like Bass or Yerba Prima brushes) each morning before or instead of showering is the finest “bath” your body could ask for.  Nearly 80% of ordinary household dust is shed skin cells from the outermost layer, a completely natural process.  Brush in long firm strokes towards the heart.  I start standing next to a chair or bathtub so I can put one foot up at a time.  Brush firmly under the sole of the foot then up and all around the leg.  Repeat on the other foot and leg.  Then gently brush the hips and buttocks, which should turn a bit pink.  Brush the hands and up the arms.  Stroke the belly in a clockwise direction (to follow the flow of the colon) and up the side ribs.  Brush up under the breasts (and, ladies, be aware of the consistency of your breasts as you do this).  Brush under the chin and down the top ribs, then reach behind with the long handle and scrub the back as thoroughly as possible.  Don’t forget the shoulders.  You may want to get a small soft brush for your face.  This feels absolutely divine and is marvelous for your skin.
Detox Reactions

When you give your body a rest from the daily onslaught of processed food, elimination begins to progress immediately.  This can “stir up” toxins that have been stored in the colon or in fat cells and create a variety of reactions such as depression, headaches and fatigue.  Your skin may break out as toxins are eliminated.  Here are several ideas that can help:

1) drink more water to flush toxins through the kidneys more quickly

2) increase Vit C to up to 10 grams for tissue repair and to hasten the ridding of toxins

3) use bentonite (clay) baths to pull toxins out through the skin.  These baths may be taken twice daily: use ½  cup liquid clay in a tub of warm (not hot) water and soak for 20 minutes

4) eat steamed organic beets, which will turn your stool deep purplish.

The modern use of milk thistle extract began in 1949 when animal studies showed that it could protect the liver against carbon tetrachloride poisoning.  Since then over 100 clinical trials have been performed on this miraculous medicine and it is carried in the Emergency Department pharmacies of most major European hospitals.  Milk thistle has successfully saved lives by reversing acetaminophen (Tylenol) and Amanita mushroom (one of the most deadly) poisoning. 

Milk thistle is thought to work in three main ways: first as an antioxidant, “quenching” free radicals created from poisoning or environmental pollution.  Folks living in a smoggy area are well advised to take 600-750 mg daily of standardized milk thistle.  The best quality milk thistle is standardized to contain 70% by weight of the major ingredient silybin.  The other mechanisms of action are by protecting the cell membranes (most studied in liver cells) and by stimulating production of new liver cells (hepatocytes).

While the most prevalent uses of this potent plant medicine are for liver diseases (including all type of hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease and liver toxicity) milk thistle is also useful as a venous tonic (protects and strengthens weak veins), including, for example, reducing bleeding tendency in folks with thin gums or nasal passage mucous membranes.  

If your gums bleed when you brush your teeth, you may need more Vitamin C, and folic acid (1000 mcg daily) and CoQ10 (100-200 mg daily), but milk thistle will also help.  For nose bleeds, have your doctor check if you have an open blood vessel that needs cauterization (very easy and quick fix); otherwise extra Vitamin A (25,000 IUs daily) plus milk thistle may help reduce the sensitivity of nasal mucous membranes. 

Milk thistle is also helpful to promote circulation, particularly in the pelvis, so would be good for many aspects of PMS (cravings, bloating, irritability).  Because one of milk thistle’s actions is “anti-fibrotic” it can help to improve blood flow through fibrous tissue, such as in fibrocystic breasts.  It is important to remember that fibrocystic (lumpy) breasts are completely normal — almost all women have them.  This does not put you at higher risk for breast disease or breast cancer.  However, fibrous breasts may be more tender premenstrually.  Vitamin E also helps with PMS breast tenderness.  

Milk thistle is especially useful to women because it can reduce or prevent organ prolapse after childbirth.  Milk thistle also stimulates breast milk production (along with goat’s beard, fennel and hops).  Milk thistle is well tolerated and very safe, with no known contraindications.  It may produce darker or slightly looser stools, since it stimulates the flow of bile in the liver.  Furthermore, many chronic skin disorders are due to suboptimal liver clearance of toxins, “bad” fats and excess hormones. 

Milk thistle is often key to resolving pesky skin problems ranging from acne to eczema to psoriasis.

One the most important uses of milk thistle in my office is to support patients going through chemotherapy.  While chemo can save lives, it is very toxic and can permanently damage heart, kidneys, brain, bone marrow and the liver.  Using milk thistle during and after chemo is not thought to undermine the effectiveness of the chemo drugs, and has been shown to reduce likelihood of permanent organ damage

References:
Ogletree RL and Fischer RG “Physician’s and Pharmacists’s Guide to the Top 10 Scientifically Proven Natural Products”, Natural Source Digest, 1997

Tilgner S “Herbal Medicine From the Heart of the Earth”, Wise Acres Press, 1999

For an acute episode of diverticular disease, a liquid diet may be indicated for several days, along with natural anti-inflammatories, to allow the colon wall to heal. Then, a high-fiber diet must be slowly introduced, and maintained, to prevent further episodes. The following remedies are useful in maintaining good bowel health after the acute phase is resolved.

Oat Bran (Avena sativa)

The very best treatment for early diverticulosis, and for prevention of the disease, is oat bran. Wheat bran provides bulk, but does not lower cholesterol, an additional benefit of oat bran. Oat is hypoallergenic, whereas many people have wheat sensitivities. It doesn’t matter so much whether the fiber is soluble (such as from fruit pectins and legumes) or insoluble (such as bran and cellulose, such as from celery) but that you get a variety of fibrous foods in your diet daily. Fiber’s purpose in the gut is primarily to hold water, which makes the stools softer and easier to pass. This is particularly important as we age and the gut walls become less elastic. Adequate fiber intake may also help prevent conditions such as gallbladder disease, colitis, colon cancer and high cholesterol. Beware of “fiber-enriched” refined grain foods, especially breads; some contain harsh sawdust products. One note of caution: fiber can interfere with mineral absorption and should be taken several hours away from supplements. Take 2-3 tablespoons daily stirred into yogurt, oatmeal, soups or juices.

Flaxseeds (Linum usitatissimum)

This amazing food not only provides a good source of fiber, but is also the only vegetable food high in the healing Omega-3 essential fatty acids, alpha-linolenic acid. Omega-3 fatty acid are necessary for proper infant brain development, and have been implicated in healing a wide variety of disease such as hypoglycemia, arthritis, asthma, allergies, eczema, cancer and bowel disorders. It has potent anti-inflammatory properties as well as providing an exceptionally nutritious source of fiber, which, when finely ground, will gently clean out any pouches that trap bacteria in the gastro-intestinal tract. It also acts as a lubricant for the GI tract because it holds 3-4 times its bulk in water. Golden flax is far superior to the brown flax seeds, which are grown primarily for the paint and solvent industries. Golden flaxseed is a hybrid specifically intended for food and medicinal use due to its higher Omega-3 content. Take 2-3 ground tablespoons daily, in water is fine, but my favorite is in pineapple juice.Why have I not mentioned psyllium seed husk? Glad you asked. Psyllium is considerably harsher than flaxseed or oat bran and can actually, with long-term use, scrub away the absorptive surface of the small intestine. Nutrient absorption happens through the villi (fingerlike projections) which line the upper intestine. Long-term use of psyllium (such as Metamucil) can severely compromise a person’s nutritional status; particularly an elderly person. Please let your parents and grandparents know that oat bran and flax seeds are much safer. It’s fine to use psyllium seed husks for “cleansing diets” up to 6 weeks during a year. Just don’t make a habit of it…

Bifido Bacterium

Most of you are familiar with L. acidophilus, the “healthy” intestinal microbe that helps with digestion and maintaining an optimal “microflora” in the gut. Acidophilus is great for the upper small intestine, but as the pH of the gut rises as it moves along towards the colon (becoming more alkaline) different species of beneficial flora optimally live along the gut lining. The most important species for the large intestine, where diverticula occur, is the Bifido species, namely B. bidifum, B. infantis, and B. longum. These should be included in your probiotic blend, or taken separately if you already have a good acidophilus product, for a total of 500-1000 mg (depending on your weight) of healthy microflora (so-called “probiotics”) daily. Bifido bacterium will not only help with proper bowel function, it will help to heal infected diverticula. A good probiotic blend should always be taken in the case of needing antibiotic therapy, for at least 10 days beyond the course of antibiotics.

B-Vitamin Complex

All the B vitamins are critical for proper functioning of the enzyme systems that allow for optimal digestion. These complex biochemical pathways which turn your food into the building blocks for tissue repair are universally dependent on B vitamins. Even if you have a particular need for one B vitamin, it’s best to take a B-complex along with that particular nutrient. In the case of diverticular disease, functional digestion is critical, so that fecal matter will not become impacted in the colon. Please take a good B multi that delivers in the range of 100 mg of each of the main Bs (B1, B2, B3, B5 and B6) as well as 500-1000 mcg of B12 and 400-500 mcg of folic acid. When you are in the first phase of treatment for diverticular disease, you should consider taking this high-potency B multi 3 times daily for several months. Don’t take B vitamins too close to bedtime as they can slightly stimulate the central nervous system. B6, in particular, can give vivid dreams. B vitamins are water soluble, so can be taken away from food, but are better absorbed taken with a meal. The B2 (riboflavin) will turn your urine yellow.

Enzymes

Enzymes are tiny protein units found in live food including fungi which catalyze all the biochemical pathways in the body. High heat, thus most cooking methods, destroys enzymes. While gently cooked food is easier to digest than raw food, I recommend some raw food (apple, sprouts, carrot stick) every day, even in the winter, to keep enzyme levels high in the body.When extra help is needed with digestion, such as with diverticular disease, supplemental enzymes are required. If you seem to have trouble with protein digestion (sharply malodorous gas – sulfurous, or egg-smelling) then pancreatic enzymes are your best bet. Look for a product that contains Pancreatin USP (6X concentrate) which gives about 150 mg per serving, and take that with each meal for several months. Ideally the pancreatic enzyme supplement would also contain ox bile extract, since bile helps digest not only fat, but protein. You can increase the flow of your own bile by regularly eating steamed, organic beets. The other critical nutrient for protein digestion is hydrochloric acid. Contrary to popular medical belief, most people have insufficient stomach acid. It is very rare that stomach acid needs to be reduced (i.e. with TUMS or Tagamet or Protonix). Much more usual is to have low stomach acid – you can ask your nutritionally oriented doctor or naturopathic physician to help you evaluate your stomach acid levels. It is generally safe to say most people will be helped with acidifying the stomach at meal times. You can either can an enzyme product that has HCl (hydrochloric acid) about 300 mg per serving, with the pancreatic enzymes, or you can squeeze a half lemon into a small amount of water and take just before main meals. If you seem to have trouble with digestion in general, you might try a multi-enzyme complex (protease, lipase, amylase plus pancreatin) with meals for several months. Most enzyme products will have clear directions on the label as to how many caps to take with meals. If you feel a “burning” in your stomach after taking enzymes, reduce the dose slightly.

Besides the five major remedies discussed above, there are a few more items for helping diverticular disease. One is good old garlic, a potent anti-microbial agent which will get rid of unwanted parasites and bacteria while promoting healthy digestion. Add lots of garlic to your cooking (3-5 cloves daily) or take a yeast-free formula, 2 caps with each meal. According to Bernard Jensen, chiropractor and natural health pioneer, believed that the only needed remedy for many bowel disturbances is alfalfa sprouts. They provide bulk, chlorophyll to oxygenate the tissues and magnesium to relax colicky intestines. A small handful daily, or start with less if they produce gas, should soon help produce regular and normal bowel movements. Another important nutrients for the cells of the gut wall is L-Glutamine, which is critical for fat and sugar metabolism as well as being an important brain detox agent (for ammonia, in particular). L-Glutamine is best taken on an empty stomach, 500 mg twice daily with water or juice (not milk) and combines well with B-vitamins. If protein digestion is still a problem even with extra enzymes and stomach acid, you may benefit from taking free-form amino acids in powder form for awhile until your digestive function improves.

Well absorbed protein is critical for cell healing. Consider also the spice turmeric (Curcuma longa), which turns rice and stews an attractive golden color. This east Indian spice has been used for centuries as a potent anti-inflammatory, and it is especially effective in combination with enzymes. Sprinkle turmeric liberally in your home-cooked soups and stews, and also sprinkle some on all savory meals – keep a shaker full at the table.

Bibliography

• Balch JF, Balch PA, Prescription for Nutritional Healing,
  Avery Publishing, 1997, pp 234-236.
• Carlson KJ, Eisenstat, SA, Ziporyn T, The Harvard Guide to Women’s Health,
  Harvard University Press, 1996, pp 213-214.
• Doress-Worters PB, Siegal DL, The New Ourselves, Growing Older,
  Simon & Schuster, 1994, pp 58-59.
• Gerras,C, Hanna JE, Feltman J, Bingham J, Golant J, Moyer A,
  The Encyclopedia of Common Diseases, Rodale Press 1976, pp 494-500.
• Jensen B, Tissue Cleansing through Bowel Management,
  (self published), Escondido CA, 1981, pp 103-104.
• Murray M, Pizzorno J, Encyclopedia of Natural Medicine,
  Prima Publishing, 1998, pp 142-143.

Constipation means all or any of the following: difficulty passing stool, incomplete passage of stool, or infrequent bowel movements. Ideally people would poop shortly after each meal, just like cats. The two main reasons few Americans have 3 easy-to-pass, formed, darkish brown, half-floating/half-sinking poops daily (the ideal) is because of chronic dehydration and a low-fiber, high refined-food diet. “Sinkers” mean the fecal matter has been in there too long and has become compacted, dense and heavy. The optimal “transit time” is 18 to 24 hours. Beets or corn are useful foods for evaluating how long it takes to go the several dozen feet from your mouth to your anus.

Many of us have been admonished to drink 8 cups of water daily. This may not be enough for some folks! I prefer to advise more individually: divide your weight by 16 and that will give you an approximate best number of 8 ounce cups to drink daily. Another way to look at the equation, if you’re not metrically challenged (!), is one ounce of water per kilo of weight. For example, if you weigh 130 pounds (or about 60 kilos), you need about 7.5 cups, or nearly 2 Litre bottles, of pure water daily. If you weigh 230 pounds, you need 14.5 cups, or close to 4 Litre bottles. Other forms of liquid refreshment simply don’t count. It takes at least a cup of pure water to offset the impact of a cup of coffee on the system. Soda pops are extremely nutrient depleting and dehydrating; it probably requires 3 to 4 cups of water to offset the negative impact on the system of drinking a Coke, which contains not only caffeine, but 12 teaspoons (YUCK!) of refined white sugar.

The best sources of soluble fiber are fruits and vegetables, especially crisp ones like apples, beets, carrots, celery, cherries, and greens. Whole grains are also good sources of fiber, especially if they are rotated (try not to eat wheat every day, for example), as are some seeds (sunflower, pumpkin) and seed husks (flax). Beware of seeds if your doctor has told you you have, or may have, diverticulitis. This condition involves little distended sacs in the colon which can collect fecal matter, causing inflammation and pain.

Constipation is not a disease, but the symptom of an underfunctioning digestive system. It may be remedied by more water, better diet and “adult potty training” or it may accompany a more serious underlying disorder. If your bowel habits don’t improve with regular exercise and adequate water intake, make sure to consult a doctor to rule-out structural, metabolic or endocrine problems (such as low thyroid hormone levels).

What I mean by adult potty training is quite simple. First, never repress the urge to defecate. Please don’t train your body that it’s OK to hold it for prolonged periods. Next, consider sitting on the toilet for up to 20 minutes after breakfast with some good reading material. If no stool is produced, take that as a signal to get exercise, drink plenty of water, and avoid refined foods today. If your schedule permits, try to poop again after lunch and again after dinner. The rest of the article will outline tips for helping regular elimination beyond the basics discussed above.

Most everyone has heard of using bran, or psyllium, or Metamucil (all bulking agents) to help produce wonderfully regular poops. This approach works well for a lot of people, but for some just means more “gas.” If bulking agents work for you, great! Take that as an indication that you need to also stay well hydrated (the large intestine squeezes as much water as it can out of our food for reabsorption) and avoid refined foods (food items with multiple ingredients that come packaged).

Many people, on the other hand, don’t need help bulking up their stool. They need help with their intestinal tone. What keeps the poop moving along nicely is the rhythmic, wave-like action of the large intestine called peristalsis. The nerves which activate this muscular action can become blunted for a variety of reasons. A few favorite herbal to promote regular elimination are Cascara Sagrada, Senna, Aloe Vera, Rhubarb and Yellow Dock. (Please read the post Foods That You Can’t Digest Tend To Linger In The Colon for additional suggestions on how to improve the digestion and assimilation of your food).

Cascara Sagrada and Senna are strong purgative herbs, available commercially in a variety of forms, usually tea. Traditional Medicinals makes a tea called “Smooth Move” which contains Cascara and generally takes overnight to live up to its name. Luci LaBeau has a variety of “dieter’s” teas that feature Senna. Both these herbs are very effective short-term, but can become habit-forming. Beware!

For a serious case of constipation (3 days and no pooping) don’t delay in consulting a trusted health care professional. For emergencies, I cautiously share this cathartic mix which is almost guaranteed to evacuate your bowels, and likely quite forcefully. In 1 cup of dilute pineapple juice put 1 tablespoon of Epsom salts (Magnesium sulfate) and 1 teaspoon of Aloe Vera juice (as pure as possible). Drink quickly while standing, then lie down and rest. For a milder concoction, omit the Epsom salts.

Rhubarb is an effective laxative, and a favorite purgative in Traditional Chinese Medicine. If it’s not summer and you don’t have rhubarb growing up all around your neighborhood you may be able to find it in the stores, as whole stalks or in juice form. The stalks should be cut into inch-long pieces and simmered for a 1/2 hour with plenty of water (to generously cover the cut up plant matter) and a squeeze of lemon and a few dollops of honey. You’ll get a soupy brew that can be taken at bedtime – not more than a cup. This brew can be frozen in small batches and stored for up to 2 years.

Yellow dock is a favorite herbal ingredient in herbal pregnancy formulas because it is such a safe and gentle, but effective, laxative. You should be able to find it in capsule or tincture form at your local health food store.

An Ayurvedic blend of 3 herbs (”Triphala”) is another increasing popular laxative and is sometimes found in “cleansing” formulas. Triphala is a blend of Indian Goosebery (Emla), Beahera fruit and Tropical Almond fruit. Two colon cleansing herbal blends that I like, both of which contain Triphala as well as probiotics, are “Super Cleanse” by Nature’s Secret and “Blue Heron” by NF Formulas, Inc. The “Super Cleanse” does contain Cascara Sagrada, so may cause intestinal cramping in susceptible individuals. The main ingredients of “Bue Heron” are ground Borage, Flax and Psyllium seed, as well as some bentonite clay (a drawing, detoxifying agent), prune fruit, fenugreek seed and slippery elm root.

References

• The New Holistic Herbal, David Hoffman. Element Books, Inc., 1990
• Taber’s Cyclopedic Medical Dictionary, F.A. Davis. Eliot Books, Inc. 1981
• Encyclopedia of Natural Medicine, Michael Murray, ND and Joseph Pizzorno, ND. Prima Publishing, 1990.
• Eat Right for Your Type, Peter D’Adamo. Putnam Publishing Group, 1996.

1. Chew your food thoroughly; make it a slurry in your mouth, mixed well with the saliva before swallowing.
2. Eat sitting down with no other distractions except light conversation.Please do not read the paper, or watch TV, or argue, while eating. Besides being uncivilized, these other activities are not conducive to priming the parasympathetic nervous system. Eating and digesting don’t mix with adrenaline pumping (sympathetic nervous activity)
3. Eat breakfast
4. Eat at regular intervals
5. Get done with dinner 2 hours before bedtime (another way of saying don’t eat late!)
6. Eat right for your type. For those not familiar with the work of Peter D’Adamo, ND (”Eat Right for Your Type”, Harper Collins) here’s a thumbnail sketch:
   • Type O: protein at every meal, but NO WHEAT. Focus on meat, veggies and fruits
   • Type A: soy and fish for protein; avoid DAIRY and red meat. Plenty of veggies
   • Type B: dairy is OK in moderation; avoid CORN, CHICKEN and SOY.
   • Type AB: (rare) fish and veggies, roatate grains, most like Type A.