The West is just beginning to catch on to something that the East has known for thousands of years: your gut health is at the center of the action for your health and healing.
Eastern traditions have recognized the abdomen as the “center of spiritual and physical strength” (the hara), “the honored middle” (the onaka), the “elixir field” (the dan tien) and even as housing the center of the “vital life force” (the qi).
Western science is finally catching up.
In the last article, we discussed the good and bad sides of inflammation and the risks of trying too hard to suppress it. Now we’re going to add another piece to that puzzle: what happens to your gut health when you try and suppress inflammation with pain killers, and what happens to the rest of you if your gut health gets screwed up.
One of the ways that Western research has complemented Eastern traditions is by revealing the bizarre symbiosis we have with the bacteria living in our gut, and how essential the right balance of bacteria (called your “gut flora”) is for optimal gut health.
In preindustrial times, our gut health would have largely taken care of itself by the absence of antibiotics, industrial pollutants, and processed foods and by the presence of soil bacteria on produce and the natural fermentation of unrefrigerated foods. Today, all that is flipped on its head. We are full of toxins, drugs and processed foods, and gut health problems abound.
Now, if disruption of gut health were just an issue of having indigestion and being gassy, we wouldn’t need to write this article. But, there are powerful direct links between your gut health and your immune system, and between your gut health and your brain. If you throw off this tender balance of gut flora, you are priming the pump for problems with your nervous system and immune system (which, among other things, can mean problems with healing and recovery).
An effectively functioning gastrointestinal system is necessary for:
- positive feelings
- nutrient absorption
- muscular growth
- and, a lot more.
In fact, the intestines are known as the “brain’s peacekeeper” since the microbiome housed in the gut acts as such an influential communicator to the brain, the nervous system, and the immune system. Concern about gut health is not just for hipsters and their brand-named kombucha anymore. It’s also for athletes and anyone else interested in optimal health and peak performance.
A Slightly Closer Look at Gut Health: What’s Going On Down There?
Our intestines are host to over 1000 different species of bacteria, weighing over 2 pounds. Their combined genetic diversity outweighs yours by 160 to 1. Given how quickly they can evolve, there’s something profound and a little disquieting about that. There’s more of them than there is of you, and they can adapt much faster.
The gut microbiome plus the gastrointestinal barrier compose the mucosal immune system and the enteric nervous system (ENS). The ENS is every bit as strange. If you took all the neurons of your ENS out and balled them up on a scale, they’d weigh more than your brain. It’s alarmingly independent from what you typically think of as your nervous system; and, it’s the only part of your body that makes decisions and gets things done without consulting your brain. It’s an independent operator for almost all major functions of the gut and communicates with the central nervous system more like an equal. These are all reasons why it’s being called your “second brain” and it’s not a metaphorical meaning.
So what does gut health have to do with pain and pain killers?
The short answer: Chronic use of pain killers can seriously harm your gut health.
Now for the long answer: NSAID’s do their job by reducing inflammatory biochemicals, which sounds fine at first blush, but they reduce both the good ones and the bad ones.
If you recall from our previous article, parts of the inflammatory process are essential for healing (arachidonic acid, prostaglandins on the COX-1 pathway, etc). Many functions of the Cox-1 and cox-2 pathways that are suppressed by NSAIDS are vital components to a healthily functioning gut. To cite just one example, the prostaglandins released by arachidonic acid (the fatty acid associated with pain) are vital for keeping the integrity of the lining of the intestinal tract. Without an optimally functioning intestinal lining, you’ll get things like:
- leaky gut (where partially digested food particles and toxins leak into the blood, triggering alarm reactions)
- poor nutrient absorption
- altered mood
- chronic inflammation
- hormone disruption
Left this way long enough, you can even contract autoimmune diseases, when the immune system gets so overwhelmed with foreign substances that it starts attacking you own cells and tissues. Many autoimmune diseases are deadly in the longterm.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, Tylenol, and Aleve are some of the most widely used medications in the U.S. Nearly 20% of Americans use NSAIDs on a chronic basis (to qualify for this group, you have to take an NSAID three or more times a week for at least three months). And, over 100,000 of these chronic users end up in hospitals each year because of serious gut health problems. (Have you read the warning labels on these? They’re pretty serious.)
How NSAIDS Affect Your Gut Flora
Along the Cox2 pathway, if functionality is stopped by the use of NSAIDs, the type and number of bacteria within your intestine is altered for the worse: you can end up with reduced amounts of beneficial bacteria and increase numbers of antigenic bacteria. Then, ironically, chronic inflammation is triggered by pathological bacteria signaling in the intestine.
In other words, when done consistently, your efforts to lower inflammation and pain in one area, using OTC anti-inflammatories, can ultimately result in more inflammation everywhere else. And that new kind of inflammation is the bad kind–it brings no healing agents along with it, but plenty of trouble.
In order to aggressively stop this secondary inflammation, the bacteria in the intestine have to be killed. In the short term, this may not seem to be such a big deal. You can just eat some more probiotics and balance things back out when you are finished taking pain medication, right? Well, scientists are finding that it may not be that simple.
Optimal Gut Health is Not as Simple as Popping More Probiotics
Probiotics have to pass through the small intestine (which is far more acidic) before they are able to reach the large intestine. Compared with the billions of bacteria that live in the large intestine, there are only trace amounts living in the small intestine, and they’re of a very different sort. You don’t want them growing like crazy, and you don’t want the wrong sorts trying to live there. It’s a little like asking a bunch of salt water tropical fish to live for a little while in a fresh water creek. Either they’ll die (in which case you’ve wasted your money on probiotics meant for the colon) or they won’t die, in which case you’ve managed to convince your small intestine to be a little more like salt water. Over time, this can change its environment for the worse. And once colonic bacteria hear the rumor that there’s pristine frontier property in the small intestine, they’ll try to colonize it and remake it in their image. This is a disease state called SIBO (small intestine bacteria overgrowth) and it causes a host of serious problems, including neurological disorders from toxic byproducts that cross the blood brain barrier.
It’s not as well understood, but it is known that it’s two related problems. It’s not just that there’s too many bacteria, there’s also too many of the wrong kind and then the pH balance is thrown off as a result. Scientists are a long way off from understanding all the benefits associated with a healthy gut, and how to repair a gut-brain axis that is malfunctioning.
In the meantime, the straightforward approach is to avoid inflicting damage, as much as possible, to the delicate balance of bacteria and prostaglandins within the intestines.
In short: don’t use NSAIDs unless absolutely necessary. For routine maintenance, manage pain with herbal remedies like dit da jow and keep your gut safe and healthy.
- Alotibi, M., Saeed, A. and Almuzaini, H. (2017). Study of Analgesic Intake among Patients with Chronic Low Back Pain and Their Side Effects. The Egyptian Journal of Hospital Medicine, 69(3), pp.2128-2132.
- Ferranti, E., Dunbar, S., Dunlop, A. and Corwin, E. (2014). 20 Things you Didn’t Know About the Human Gut Microbiome. The Journal of Cardiovascular Nursing, 29(6), pp.479-481.
- HIRSCHOWITZ, B. (1996). Nonsteroidal Anti-inflammatory Drugs and the Gut. Southern Medical Journal, 89(3), pp.259-263.
- Konkel, L. (2013). The Environment Within: Exploring the Role of the Gut Microbiome in Health and Disease. Environmental Health Perspectives, 121(9), pp.A276-A281.
- Roth, S. (2012). Coming to Terms with Nonsteroidal Anti-Inflammatory Drug Gastropathy. Drugs, 72(7), pp.873-879.
- Tallima, H. and El Ridi, R. (2018). Arachidonic acid: Physiological roles and potential health benefits – A review. Journal of Advanced Research, 11, pp.33-41.
- Upreti, R., Kannan, A. and Pant, A. (2010). Experimental impact of aspirin exposure on rat intestinal bacteria, epithelial cells and cell line. Human & Experimental Toxicology, 29(10), pp.833-843.