Questions About the Digestive System ? Get clear and concise answers to common inquiries about how this vital system works to keep you healthy.
Questions About the Digestive System
Today we’ll talk about the intestines. We’ll discuss why we need such a long organ and what role it plays in the digestion process, whether it’s true that everyone has intestinal parasites, whether we need to do cleanses and buy probiotics.
1. Is it true that the intestine is the longest human organ?
Yes, it is. In an adult, the intestines are 4.5 to 6 meters long. In the abdomen, they are folded into loops that overlap each other, and due to this, they fit into a relatively small abdominal cavity.
The length of the intestine is determined by its purpose. Active processes of food absorption occur in the small intestine: proteins, fats, carbohydrates, vitamins and minerals from food are broken down into smaller molecules, absorbed by the mucous membrane and enter the blood.
Also in this section, disinfection continues, which begins in the stomach. Bile enters the small intestine and helps eliminate harmful microorganisms that managed to survive in hydrochloric acid.
In order for all the nutrients to be absorbed, the area of the organ must be really large. That is why the length of the small intestine is from 3 to 5 meters, and its inner lining is densely covered with villi – mucous outgrowths that further increase the absorption surface.
After the small intestine, food enters the large intestine. There, nutrients are practically not absorbed, except for the remains of some vitamins . The length of this section of the intestine is only 1.5 meters. The organ is mainly responsible for the formation of feces. Excess fluid and electrolytes are absorbed from the food lump – chyme – after which it becomes feces and is excreted from the body.
2. Why do you want to go to the toilet when you’re worried? Are emotions connected to your intestines?
In fact, emotions affect many body systems, and the digestive system is no exception. The gastrointestinal tract is very sensitive because it has many nerve endings. There is even a group of pathologies associated with psychological causes – functional diseases. This is when there is no damage in the stomach and intestines, everything is perfect according to the tests, but the person constantly experiences some kind of discomfort .
This may be due to increased sensitivity of receptors. Hyperexcitable nerve endings of the digestive tract send incorrect signals to the brain, which interprets them as danger and creates a feeling of pain or heaviness, affecting intestinal motility.
For many people, stress, anxiety or depression can cause the body to perceive the normal digestive process as a threat and can cause chest pain, abdominal heaviness, belching, nausea and vomiting.
If we talk about one-off stories , which are called “bear disease”, then this is due to the “fight or flight” reaction. When a person senses danger, his autonomic nervous system prepares the body to fight or flee. And if you are going to flee, it is better to throw off the ballast.
3. Is it true that the condition of the skin depends on the intestines?
Some people believe that the intestines are to blame for all health problems, from the condition of the skin and hair to obesity and insomnia , and turn to a gastroenterologist. This is as strange as going to a cardiologist with a complaint of poor vision.
Skin is an organ that has its own diseases. Clinical guidelines for the treatment of acne, rosacea, seborrheic dermatitis do not necessarily recommend sending patients to a gastroenterologist. But for some reason, many dermatologists do this and believe that we can somehow help.
Yes, some studies have found a link between the specific makeup of your gut microbiome and acne symptoms. But the microbiome affects the entire body, so it’s not surprising. Besides, there’s nothing we can do about it.
There are more than a thousand different species in the intestines . In clinical practice, we do not even have the tools available to find out that something is wrong with the microflora. Neither stool for dysbacteriosis , nor chromatography-mass spectrometry according to Osipov answer these questions. These are absolutely useless tests.
But even if we learned to detect some violations, it is not clear what to do with it next. Drink some probiotic? It contains an insignificant number of bacteria compared to the populations that live in the intestines. For some reason, people think that these few aliens will be able to rebuild the work of the established microbiome, but this is not so.
Treating skin diseases by changing the microbiome is very promising and interesting, but it is not yet applicable in real practice. Microflora may affect the condition of the skin, but we can’t do anything about it.
But we have scientifically proven ways to deal with skin diseases. Acne is also perfectly treated with adapalene, azelaic acid, systemic retinoids. These drugs help, there is an effect, everything is super. And there is no need to reinvent the wheel and look for problems in the intestines.
4. Do I need to cleanse my intestines?
We cleanse the intestines only if a colonoscopy is required . There is no other need for such procedures. Our liver and kidneys cleanse our body of toxins, and removing feces from the intestines does not affect our health.
There is a myth that feces can accumulate in the intestines and poison the body. But even if you do not have a bowel movement for seven days, there will be no toxic effect . Feces consist of liquid, fiber, bacteria and bile pigments. They do not contain harmful toxins that will be absorbed in the intestines, enter the blood and cause poisoning.
So, colon cleansing is absolutely useless and even dangerous. When a person does an enema, water gets into the colon and washes out not only feces, but also mucus, in which bacteria live.
If a person cleansed the intestines with a laxative or did an enema once every 10 years, nothing terrible will happen. But if such procedures are done regularly, it can cause harm : injure the intestines up to perforation – through damage to the wall, disrupt the electrolyte balance of the body, harm the microbiota and increase the risk of intestinal infections. If a person uses not just water in an enema , but other liquids, such as coffee or vinegar, this can lead to inflammation of the intestinal mucosa.
5. Should I take pharmacy probiotics to keep my intestines healthy? What about yogurt and kefir?
As I have already said, the benefits of pharmaceutical probiotics are questionable, since the number and diversity of bacteria in the intestines are too great for the drugs to make a significant contribution to the composition of the microbiota. Yogurt and kefir may actually be more useful, because what enters the body as part of food is usually better absorbed.
At the same time, the benefits of probiotics are very vague. Is it useful? Yes. Can we cure any pathologies with it? No.
For some problems we can use them as additional help, but this is also questionable. And for bacteria to cure, for example, ulcerative colitis or irritable bowel syndrome – this cannot happen.
There is evidence that some types of probiotics, such as Saccharomyces boulardii, can reduce the risk of antibiotic-associated diarrhea. But, again, it is not guaranteed to protect a person from this problem, but to slightly reduce the risk. And because these effects are not super significant, such drugs are not recommended for everyone .
You can prescribe a probiotic to people who have intestinal problems from the start, or to elderly, weakened patients. But for young and healthy people, this is not necessary, regardless of what antibiotics they take and how long they have been taking them.
The only recommendation for supporting microflora is not probiotics and dietary supplements, but a balanced, varied diet. That’s all.
6. Is it true that antibiotics will kill intestinal microflora?
Definitely won’t die. One antibiotic won’t kill all the bacteria in the intestines, although it can shift the microflora in some bad direction. Fortunately, this is temporary. Even if a person has some complications while taking antibiotics, such as diarrhea or abdominal discomfort, everything will return to normal within a month without any probiotics.
There is only one truly serious intestinal disease that occurs due to taking antibiotics and does not go away on its own. This is clostridial colitis – a serious microflora disorder in which the bacterium Clostridium produces toxins and provokes inflammation of the intestine. The disease occurs as an acute intestinal infection – with fever, pain, repeated diarrhea – and can occur in anyone after taking any antibiotic.
But of course, vulnerable categories are at greater risk: patients with serious chronic diseases, the elderly. Fortunately, clostridial colitis is treatable. And, oddly enough, also with an antibiotic. If the drug does not work, a fecal transplant may be needed.
7. Do people get transplanted with other people’s feces?
Yes, fecal transplants are effective for clostridial colitis and autoimmune inflammatory bowel diseases. It is possible that fecal transplants may also help with other conditions, such as irritable bowel syndrome. However, because this is a new treatment, there is not enough research on its effectiveness and safety for other conditions.
A fecal transplant is done as follows: a donor is found – a healthy person without intestinal problems, feces are taken from him and cleaned so that mainly useful microorganisms remain. What is obtained is placed in a capsule.
Then the patient simply drinks this remedy as a regular medicine. Of course, it is possible to transplant the donor bacteria directly into the intestines, for example, using an enema or colonoscopy. But with capsules it will be easier and more pleasant.
This procedure is not yet available everywhere; it is offered by medical centers in large cities.
8. How to eat to keep your intestines healthy?
There are principles of healthy eating that are suitable for most people. The World Health Organization provides guidelines that describe how to limit sugar and salt intake, how much fruit and vegetables to eat, and what foods to include in your diet.
There are also very simple and clear schemes, such as the plate rule. This method allows you to quickly assess how balanced your meal is. Half of the plate should be filled with fruits and vegetables, a quarter with cereals, bread or pasta, a quarter with protein sources such as fish, seafood, eggs, meat, dairy products.
First of all, balance is important in nutrition. We do not deprive a person of sugar, chips and other products for pleasure, because this can disrupt eating behavior, but at the same time we try to shift the balance towards healthier food. Roughly speaking, if most of the diet consists of vegetables and fruits, and chips represent only a small part, everything will be fine.
In addition, healthy eating mostly consists of plant foods. European countries are guilty of high amounts of animal fats and meat. Of course, this is an important component of food, but plant foods are still healthier. And we have a deficit of them. Many people do not like to eat fruits and vegetables or are simply not used to doing so regularly.
This is a problem, and the Western scientific world is now striving to turn the diet towards plant-based whole foods and reduce the amount of red meat and fast food. Not to eliminate it completely, but to change the proportions.
Vegetarian diet is one of the healthy options. It is not worse than a diet with meat. It may be a little more difficult to maintain a balance of nutrients, but in the end, the health of the intestines will be better.
9. How do you know if your intestines are healthy? Can you tell by your stool?
The normal frequency of stool is from three times a day to three times a week. That is, it is not necessary to poop every day. But here it is also important to look at the consistency: is it a soft sausage, loose stool or too hard feces. For example, if a person says that he goes to the toilet every day, but at the same time sits there for a long time, strains and cannot poop because of too hard feces, this is constipation. Even despite the fact that the stool is regular.
In general, the condition of your intestines can be assessed by the presence of symptoms. If you feel pain in your stomach, notice stool disturbances, bloating , this bothers you and occurs regularly, you should see a doctor. This is not always associated with any dangerous diseases and may be a consequence of a functional disorder. Nevertheless, it is worth checking.
Another point is that there are problems that do not cause discomfort. These are various tumor formations that can proceed without symptoms for a long time. Some unpleasant sensations appear only when the neoplasm becomes malignant and reaches a severe stage.
For example, a person may develop polyps – growths on the lining of the large intestine. As a rule, they are very small in size, rarely exceeding one centimeter and do not cause any discomfort. But if polyps degenerate into a malignant neoplasm, the tumor begins to rapidly increase in size, can block the lumen of the intestine and grow deeper. Cancer cells can penetrate the lymphatic system and spread throughout the body with the lymph flow.
If polyps have grown in the intestines during life, starting at the age of 40–45, they can turn into a malignant neoplasm. And if they are removed before degeneration, this will greatly reduce the risk of colorectal cancer, an oncological disease that ranks second in mortality among malignant neoplasms in men and women.
That is why screenings were invented. In Russia, as part of a medical examination, all people aged 40 to 64 must undergo a stool test for occult blood once every two years, and from 65 to 75 years old – once a year. If the result is positive, the doctor can prescribe a colonoscopy – a test that allows you to study the intestinal mucosa.
But I believe that the fecal occult blood test is not a full-fledged replacement for colonoscopy. It was introduced for economic reasons. Simply put, this test is cheaper than a colonoscopy, but it is not as sensitive. Therefore, if you only do the fecal occult blood test , there is a risk of missing neoplasms that can eventually degenerate into malignant ones.
Colonoscopy is the gold standard in detecting colorectal cancer, and no other tests can replace it. In Europe and the US, this test is expensive, but here it is quite affordable. Therefore, if you have the financial means, it is worth undergoing this test once every 10 years, starting at age 45.
When talking about intestinal problems, all sorts of pseudo-nutritionists also often mention parasites. Such “experts” claim that everyone has worms and they must be poisoned. This will supposedly solve all health problems, from hair loss to diarrhea. But this is all obscurantism.
In fact, parasites are rare among Russians. Their presence can be indicated by various symptoms: nausea, abdominal pain, diarrhea, blood in the stool, fever. If something like this is present, a person needs to see a doctor – he will prescribe tests and find out the cause.
And if there are no symptoms and any suspicious deviations in the tests, we do not look for parasites. For example, lamblia can live peacefully with us and not cause any discomfort. Then we do not treat anything, let them live. If there is no clinical picture, then there is no harm.
10. Can a person gain weight due to intestinal problems?
Most often, excess weight is gained due to a surplus of incoming energy. In other words, because a person eats more than he spends. Why he does this is another question. But I have not come across any serious studies that would prove the connection between appetite and intestinal microbiota.
In diseases of the gastrointestinal tract, people, on the contrary, lose weight. Because if we have poor absorption of nutrients in the intestines, weight will go away. This can happen, for example, with celiac disease – an allergy to gluten , when the intestinal villi are destroyed and food cannot be properly absorbed. In this case, the patient can eat normally, but will still lose weight.
If a person gains weight, it means that everything is being digested perfectly and all the calories are being used.
Balanced nutrition and physical exercise help to lose weight. Or some really serious drugs prescribed according to indications. Neither dietary supplements, nor decoctions, nor prebiotics have proven effectiveness. Or it is so insignificant that it cannot replace the lifestyle.