In functional medicine we see the patient as a whole, and search for underlying causes why they have developed their various ailments. These underlying causes may be difficult to find, and require a thorough investigation and a sound reasoning to reveal the true origin. One field in functional medicine which is considered increasingly important in the generation of ailments is the gut flora, and rightfully so. We have to days date only started to scratch the surface on understanding the role our flora plays in our health.
Our gut flora consist of a wide range of bacteria and fungi. and if unfortunate, viruses and parasites Yikes! Even so, most of what constitutes the flora are bacterias. To give you an image of the vastness bacterias in the gut, there are about ten times as many bacterias in our gut than there are cells in our entire body. Most of the flora is either considered to be harmless og beneficial to our health, and they live in harmony with each other. This picture may be a bit too romantic, as some say there is a constant battle in the gut flora between the various inhabitants, where the weapon they use are toxins designed to kill opposing flora. In this way this makes sure that the various bacteria/fungi is kept in check, by the surrounding flora.
Studies have revealed the importance of diversity of the various bacterias, where more diversity often lead to less immune reactions and hypersensitivity reactions such as allergies. Therefore, in our time and age, when antibiotics is frequently overused, we tend to damage our gut flora. This is may lead to less diverse flora and overgrowth of certain bacterias og fungi. These bacteria/fungi may then go from harmless beneficial flora living in harmony with the surrounding flora, to generate too many toxins, causing harm to the host. Disease may occur when we get an overgrowth of certain harmful bacterias/fungi, releasing too many toxins in the system.
Nonetheless, most of the flora is considered friendly. We know that these small helpers are essential for breaking down foods such as starches, producing essential vitamins and minerals such as vitamin B12 and vitamin K, balancing and training our own immune system, and so on.
Between 70-80 % of our immune system constitute around the gut. The intestinal system might be considered a tube where food and nutrients come in one end and poop comes out the other end (around 80-85% of this is bacteria). In the meantime digestion takes place, and excretion of waste particles are released into the intestinal tract. To prevent all of the gut contents from leaking into our body, we have the gut lining, which is only about 4 mm thick. Also, the gut lining is folded up many times, into what we call villi and microvilli. This is done to vastly increase the surface area for which nutrients can be absorbed. If we are to unfold the entire gut lining into one smooth surface the surface area would constitute the area of around 1-1 1/2 tennis courts. In contrast, the surface area of our skin is about 2 square meters, and is much thicker and robust than the gut lining. We may now grasp why our immune system greatly prioritize the gut, as it may also be the most vulnerable part of our body.
When we get a dysbiosis (dys=causing disease, biota=flora), it is primarily due to the lack of beneficial bacteria to keep the unwelcome flora in check, or due to infection of a particularly harmful pathogen that may establish even if the beneficial flora is in perfect order. Symptoms range from a multitude of ailments, both located in the gut and in other areas of the body.
What we who work with functional medicine is particularly aware of is how chronic ailments, where there may not be an obvious reason, may in fact stem from a gut flora imbalance. There is increasing evidence that diseases such as obesity, chronic fatigue syndrome, depression/anxiety, inflammatory bowel disease and many more may all be related to a dysbiotic flora. Also, because the gut flora plays such an important role in the immune system, a dysbiosis is thought to be a major reason for the various auto-immune disorders, such as arthritis, Sjotrens/SLE, Bechterew and many more .
During my 10 years of practice as a doctor in this field I have learned how important it is to take propper care of the gut flora. This is a key aspect to take care of ones health. How to treat the gut flora, and how to best take care of our gut I will tell you about in later articles.