Health and Disease Begin in the Gut

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A Bloated Gut Is Not Normal

There is no Health without a Healthy Duodenum and Intestines

How well our digestion works directly determines how well our body and brain function. The old adage "we are what we eat" appears to hold true.

At the center of it all is the duodenum. The duodenum is the initial section of the small intestines. It controls many aspects of food passage (stomach) and absorption (small intestines) and holds the keys to the most important control mechanisms of our living body biochemistry.

A duodenum that is healthy and functions properly governs multiple actions and functions of stomach, pancreas, liver, and gallbladder. Moreover, the duodenum directly affects much of our life-supporting nutrient absorption (including all-important calcium).

A duodenum that is inflamed no longer can fulfill these central control functions. Damage to the duodenum most often is induced by allergenic and inflammatory foods: sugars and alcohols, wheat (gliadin and other grain gluten proteins), and many other food allergens.

Inflammation throughout the intestines affects the intestinal mucous lining. This is the very tissue that hosts the majority of our body’s lymph and immune system cells. They affect the body’s nutrient and mineral absorption, auto-immune defense capability, toxin drainage ability, pH balance and anti-parasitic properties, defense from non-communicable and communicable diseases.

Increasingly, research identifies strong links to underlying non-celiac and/or celiac gluten sensitivity. Other signs of compromised duodenal activity are: chronic or acute inflammation, bloating, gas, constipation or diarrhea, dysbiosis (leaky gut syndrome), as well as the diagnoses of mineral deficiencies or imbalances, such as anemia, hypocalcemia, and conditions such as lazy stomach, liver and gallbladder inflammation, pancreatitis, irritable bowel (IBS, IBD), Crohn’s, other gastrointestinal conditions, even elevated cholesterol levels, anxiety, neurological disorders, and more (see chart).

The Duodenum's Multi-Tasking

Following are a few of the many functional and biochemical tasks that a healthy and properly functioning duodenum is designed to complete.

Control of…

  • how much and how often food is released from the stomach for further digestion and absorption in the intestines (feelings of fullness or hunger).
  • bile release from the gallbladder and several other digestion-related liver functions (gallbladder and liver disorders[1]).
  • enzyme release from the pancreas (pancreatitis,[2] leaky gut syndrome).

Role in the...

  • control of insulin production (link between non-celiac and/or celiac gluten sensitivity and insulin dependent diabetes).[3]
  • iron[4] absorption (anemia, villus enterocytes).[5]
  • gastrointestinal circadian rhythm shifts.[6]

Absorption of...

  • calcium (calcium-magnesium imbalance, calcium phosphorus ratio imbalances, blood and tissue pH control failures).[7]
  • many other minerals and nutrients[8] (deficiencies).

Production of...

  • vitamin K (which then is stored in the pancreas and is responsible for calcium to remain in the bones and being kept out of the arteries!!).[9]

Attachment to the...

  • diaphragm via the ligament of Treitz,[10] (possibly leading to signs of shortness of breath, GERDs,[11] heartburn, tiredness, restless or light sleep, anxiety, etc.).
  • anterior lumbar spine (affects iliosacral alignment, sciatica, muscle weakness, ataxia, unstable gate).

Latter has lead to recommendations to osteopaths, chiropractors, body workers and their patients to look for underlying celiac disease seen in an inflamed, bloated gut, overall puffiness and fluid retention whenever low back,[12] sacroiliitis,[13] and pelvic alignments "don’t hold" after repeat treatments.

Telling Intestinal Inflammation

A bloated tummy indicates intestinal inflammation. But, how do you tell?

Lie down flat on your back on a firm surface:

  • If you feel a bulge or tightness indicating the proverbial "beer-belly" or "spare tire" above the belly button: think insulin resistance: pancreas, liver and duodenum inflammation.
  • If you are able to jiggle your tummy below the belly button or experience bloating or gas on a fairly regular basis: think intestinal inflammation, leaky gut syndrome or other gastro-intestinal disorders such as underlying non-celiac and celiac gluten sensitivity.

Inflammation is the source of most aging disorders. Inflammation anywhere in the body causes an acidic environment and triggers the calcium buffering mechanism: calcium is forced to leech from bones and teeth into the blood stream in order to balance the pH value and "dowse" the inflammation.

Leeched (free) calcium plays a major role in bone loss (osteoporosis), various forms of subsequent calcium build-up (arthritic changes[14]), heart disease (hardened arteries, high blood pressure / hypertension), GERD’s (gastric reflux symptoms[15]), brain fog, vision issues,[16] fibromyalgia, chronic fatigue syndrome, and many other conditions.

The "Proof is in the Pudding"

Need more "proof"? Gastric bypass surgery is offered to obese and diabetic patients. It "bypasses" part of the stomach, the duodenum, and part of the jejunum. 90 to 95% of the patients who undergo this procedure no longer show signs of diabetes - hypothetically, because the inflamed duodenum no longer gives off "wrong" signals.

On the other hand, after bariatric surgery the same mineral deficiencies show up that a celiac individual with heavy duodenum involvement typically would expect - hypothetically, due to the lack of duodenal absorption.

In typical and radical mainstream medicine manner, the most prominent problems are "cured" by eliminating the control switch, such as by surgically removing the duodenum’s ability to (mis-)control body biochemical functions.

It is baffling though that many health professionals neglect to prominently stress to those patients:

  1. that gastric and gastrointestinal inflammation can be avoided by following a non-inflammatory diet that excludes allergenic trigger foods.
  2. that even after gastric bypass surgery, they will have to change their food intake and food choices.

In short, our food choices and lifestyle directly determine health and function, or inflammation and dysfunction of the duodenum and its many control mechanisms.

In order to become proactive in disease prevention let’s start by acknowledging that most of us are bloated and show signs of gastro-intestinal inflammation.


[1] Clin Gastroenterol Hepatol. 2007 Jan;5(1):63-69.e1. Epub 2006 Dec 8. Celiac disease and risk of liver disease: a general population-based study.

[2] Clin Gastroenterol Hepatol. 2007 Nov;5(11):1347-53. Epub 2007 Aug 16. Risk of pancreatitis in 14,000 individuals with celiac disease.

[3] J Immunol. 2011 Oct 15;187(8):4338-46. Epub 2011 Sep 12. Sensitization to gliadin induces moderate enteropathy and insulitis in nonobese diabetic-DQ8 mice.

[4] Indian J Pediatr. 2011 Oct 11. [Epub ahead of print] Association of Celiac Disease with Aplastic Anemia. 

[5] Am J Physiol Gastrointest Liver Physiol. 2006 Jan;290(1):G156-63. Epub 2005 Aug 4. Comparative studies of duodenal and macrophage ferroportin proteins.

[6] J Physiol Pharmacol. 2011 Apr;62(2):139-50. Gut clock: implication of circadian rhythms in the gastrointestinal tract.

[7] Arch Osteoporos. 2011 Dec;6(1-2):209-213. Epub 2011 Jun 15. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease.

[8] J Clin Endocrinol Metab. 2012 Feb;97(2):E292-300. Epub 2011 Dec 7. Loss of enteroendocrine cells in autoimmune-polyendocrine-candidiasis-ectodermal-dystrophy (APECED) syndrome with gastrointestinal dysfunction.

[9] Eur J Clin Nutr. 2012 Apr;66(4):488-95. doi: 10.1038/ejcn.2011.176. Epub 2011 Oct 5. Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease.

[10] Ned Tijdschr Geneeskd. 2011;155(18):A2879. [Treitz and his ligament].

[11] Neurogastroenterol Motil. 2012 Apr;24(4):350-e168. doi: 10.1111/j.1365-2982.2012.01880.x. Epub 2012 Feb 2. Duodenal lipid-induced symptom generation in gastroesophageal reflux disease: role of apolipoprotein A-IV and cholecystokinin.

[12] Rheumatol Int. 2010 Feb;30(4):455-60. Epub 2009 Jun 6. Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study.

[13] Rheumatol Int. 2010 Feb;30(4):455-60. Epub 2009 Jun 6. Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study.

[14] J Rheumatol. 1987 Jun;14(3):466-71. HLA antigens in seronegative spondylarthropathies. Reactive arthritis and arthritis in ankylosing spondylitis: relation to gut inflammation.

[15] Neurogastroenterol Motil. 2012 Apr;24(4):350-e168. doi: 10.1111/j.1365-2982.2012.01880.x. Epub 2012 Feb 2. Duodenal lipid-induced symptom generation in gastroesophageal reflux disease: role of apolipoprotein A-IV and cholecystokinin.

[16] J Neurol Neurosurg Psychiatry. 2004 Nov;75(11):1623-5. Visual disturbances representing occipital lobe epilepsy in patients with cerebral calcifications and coeliac disease: a case series.

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