Gastrointestinal Disorders and Adrenal Fatigue – Part 1

By: Dr. Michael Lam, MD, MPH; Dr. Justin Lam, ABAAHP, FMNM



Pain is a common sign of gastrointestinal disordersIt is said that a healthy gut leads to a healthy life; but around 70% of Americans suffer from gastrointestinal disorders or related symptoms. With modern populations chronically stressed out and processed food now a staple in the everyday diet, statistics like this are rather unsurprising.

More and more researchers are discovering just how much our gut health affects our overall health. Many believe that supporting gut health and restoring the integrity of the intestinal barrier should be a priority in terms of health goals for the 21st century.

For many decades, companies have been developing and mass-producing food-like products that hardly resemble the whole foods from which they were originally derived. Most of the water, fiber and nutrients have been replaced with ingredients like seed oils, corn syrup, MSG, and artificial flavorings, colorings, and sweeteners that do not exist in nature. These products are scientifically designed to stimulate our taste buds and induce cravings, leading to overconsumption and, of course, higher profits for food manufacturers. Boxed, canned, or wrapped in plastic – processed foods now dominate our grocery store shelves, and the effects have been detrimental.

Eating a diet that impairs the integrity of your gut will ultimately impair the integrity of your health. Unhealthy lifestyles are taking a toll on the collective health of the nation.

In order to understand the relationship between gastrointestinal (GI) disorders, Adrenal Fatigue Syndrome (AFS), the NeuroEndoMetabolic (NEM) Stress Response, and achieving optimal health, we must first understand why the gut is such an influential part of the body.

The Importance of the Gut in Maintaining Health

The primary purpose of the gut (gastrointestinal or digestive tract) is to absorb nutrients from food – but what people don’t realize is that the gut is also an integral part of our body’s immune system. The gut produces three quarters of the body’s neurotransmitters, contains two third’s of the body’s immune tissues, houses a genome that is one hundred times larger than the human microbiome, and has ten times the amount of bacteria than the rest of the human body combined.

Gastrointestinal disorders affect the gastrointestinal tract, including the esophagus, stomach, small intestine, large intestine, and rectum, along with organs that aid in digestion, such as the liver, pancreas and gallbladder.

An Overview of Digestion

When you take a bite of food (a mix of macronutrients, micronutrients, water and fiber) and begin to chew, this commences the breakdown process of the food into smaller pieces. Enzymes in your saliva start to break the carbohydrates down into simple sugars, and once you swallow, the food is now in your stomach where proteins are tackled by digestive enzymes. The stomach signals to your brain that you’ve eaten and that more energy can be used. Next, your stomach sends the food, mixed with digestive enzymes, to your small intestine where it is further broken down by pancreatic enzymes and bile salts.

Having healthy gut bacteria can reduce the risk of gastrointestinal disordersThe small intestine is extremely long – if stretched out, it would be the length of a tennis court. But more importantly, the small intestine is the most valuable component of the digestive tract. It serves as a holding tank while food is properly digested and absorbs vital nutrients for your body. Basically, the semi permeable intestinal membrane functions similarly to our skin (but on a much larger scale) in that it’s meant to keep the good stuff in and the bad stuff out. This lining acts as a barrier between your insides and the outside world, and is therefore, it is of utmost importance to your immune system.

Once all of the food has been adequately broken down, the most useful nutrients are absorbed through the intestinal barrier to ultimately end up in the bloodstream where they can be transported throughout the body. The remainder of the food passes through the large intestine, where some water and nutrients are further absorbed, and finally, the solid waste is excreted via defecation.

It is important to note that the contents of the small intestine are technically still ‘outside’ of the body, as nothing has actually ‘entered’ the body until it passes through the wall of the small intestine into the bloodstream – essentially the digestive tract is just one hollow tube from mouth to anus. Anything eaten that isn’t absorbed into the bloodstream will pass right through the system. A functioning gut prevents pathogens from entering the body.

Factors in Gastrointestinal Disorders

In determining gut health and factors leading to gastrointestinal disorders, we must understand these closely related variables: the immune system, gut flora or intestinal microbiota, and intestinal permeability.

Gut-associated lymphoid tissue (GALT) is the gastrointestinal tract’s immune system that works to protect the body from invasion by harmful pathogens. The small intestine contains the largest amount of lymphoid tissue in the entire body; the GALT has various kinds of lymphoid tissue that boast many different kinds of immune cells, like T and B lymphocytes (white blood cells). These T and B cells are a vital component of the immune response, working to identify invaders and generate responses to eliminate malicious pathogens or pathogen-infected cells.

The gut is home to a large and dynamic bacterial population of around 100 trillion microorganisms – this bacterial community is known as the gut microbiota or gut flora. While many of these bacteria are still to be described, there are at least 1000 known species containing over three million different genes, which is 150 times greater than human genes.

Microbiota can weigh up to two kilograms collectively; one third of these bacteria are typical to most humans, however the remaining two thirds of the microbiota are unique to each person. In fact, it’s likely that crime scene investigators will eventually be able to identify people based on unique bacterial footprints left behind in the absence of their DNA.

Gastrointestinal disorders can be avoided by maintaining healthy gut flora.The gut flora has three major functions, including metabolic activities, trophic effects, and protective activities. Often referred to as our hidden metabolic ‘organ’ because of its exceptional benefits to our wellbeing, gut flora are able to salvage energy and absorbable nutrients by fermenting non-digestible dietary residues to release short-chain fatty acids (SCFAs) and vitamin K. The SCFAs regulate epithelial cell proliferation and differentiation within the colon to prevent neoplasia from developing. Microbiota have significant nutritional benefits (trophic effects) on intestinal epithelia and immune system function.

Gut flora also have a barrier effect: they protect the colonized human host against invasion by harmful alien microbes. Resident bacteria (the good guys) help by providing resistance against colonization by malicious pathogenic microbes (the bad guys).

It’s obvious that these bacteria in our gut can be incredibly effective in promoting our health, but to avoid gastrointestinal disorders, we need to take extra special care. According to an article published in Therapeutic Advances in Gastroenterology, “disruption to the gut microbiota has been linked with gastrointestinal conditions such as inflammatory bowel disease and obesity”. Another study linked gut flora disruption to colon cancer and multisystem organ failure.

There are a number of things that can disrupt your gut flora. For example, when you’re sick and take antibiotics, it can take up to three months for your gut microbiota to return to normal. Antibiotics can lead to something known as dysbiosis, which is when you have a microbial imbalance in your body – poor diet choices and overconsumption of alcohol can also cause dysbiosis. Allergenic foods, toxins from medications and the environment, and infections such as those from bacterial overgrowth, parasites and candida overgrowth can also cause dysbiosis.

The relationship between a human host and his/her microbiota significantly impacts the immune system, as they exchange chemical signals to communicate. This helps the immune system to determine potentially harmful bacteria from the good bacteria, and thus resulting in an anti-inflammatory response as the immune system works to fight off these pathogens.

Adrenal Fatigue Syndrome and Gastrointestinal Disorders

With regards to AFS and gastrointestinal disorders, the common denominator boils down to one thing: stress. The ability to deal with stress is pertinent to human survival, and in this day and age, the amount of stress on the average person has become astronomical. Whether it’s emotional, mental, work-related, physical, or environmental stress, tremendous strain on the body can lead to imbalances in our NEM stress response.

Our bodily stress regulation systems are controlled by the adrenal glands, and when they’re consistently overworked, they become dysfunctional, leading to a host of maladies as the body loses its ability to effectively cope with stress. If this continues, the NEM stress response system can also become deregulated. The NEM stress response system is how your body deals with stress.

Reducing sugar can help you avoid gastrointestinal disordersGastrointestinal disorders can lead to AFS. Stressors such as chronic disease, chronic infection, malabsorption, maldigestion, toxic exposure from foods, excessive sugar in the diet and general chronic stress are all variables that can lead to AFS.

And vice versa, AFS can be the cause of certain gastrointestinal disorders. Particularly in the more advanced stages of AFS when the adrenal glands are exhausted, the body does not function properly. Adrenal fatigue forces the body into maintenance mode, struggling to maintain balance and wreaking further havoc. AFS symptoms can include dyspepsia, constipation, and diarrhea.

Read Part 2

© Copyright 2016 Michael Lam, M.D. All Rights Reserved.


Stomach discomfort can be brought on by gastrointestinal disorders




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2 Comments

  • sharon says:

    Dr. Lam: my doctor wants me to take antidepressants to help my body cope with adrenal fatigue. I am not comfortable with doing this, am I wrong?
    Sharon california

    • Dr.Lam says:

      Anti-depressants do have their place when needed. In a setting of AFS however, I have found it to be seldom needed.

      Dr Lam