Integrative Treatment Options for Common Large Intestine Disorders and Diseases: Specialty Testing, Nutrition, Supplements

The large intestine is an organ residing in our abdomen. This organ is five feet long and plays an imperative role in the digestive process, including the final absorption of nutrients and excretion of waste products. This article will discuss the large intestine's role in the body and explore health conditions that may involve the large intestine. We'll then discuss functional medicine testing and complementary and integrative options, including diet, supplements, and herbs. 

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What is The Large Intestine's Role in The Body?

The large intestine is an organ of digestion. This organ comprises one long tube that begins after the small intestine and terminates at the anus. The large intestine has four sections: the cecum, colon, rectum, and anus. The cecum is the entryway for food into the colon. When food enters the cecum, movement is triggered in the colon. As food enters the colon, remaining water and electrolytes get absorbed, so by the time food waste reaches the end of the colon, it is solid. Mucus is released into the food waste for lubrication to aid in its movement. Food stays within the colon for around 24 hours. The microbiome, a collective group of bacteria, viruses, fungi, and yeast, is housed here. These microbes will aid in the last part of the processing of food, metabolizing any last carbohydrates and creating short-chain fatty acids (SCFAs) and vitamins. SCFAs themselves are metabolically active, entering into the bloodstream and supporting the cardiovascular, musculoskeletal, integumentary system, and more. When food waste enters the rectum, it is made up of indigestible fibers, dead cells that shed from the inner layers of the large intestine, and a minimal amount of food and water; this food waste is in the shape of and has the consistency of what we would refer to as a stool. As this stool enters the rectum, it causes the person to feel the urge to push. This begins the final descent of the stool out of the body. Stool entering the rectum causes the internal sphincter, which acts as a door of the anus, to relax, letting stool enter. The stool will then exit the body through the external sphincter. 

What are the Top Large Intestine Health Issues Addressed With Integrative Approaches?

There are many health conditions associated with the large intestine. Here are some large intestine health conditions that may be addressed with integrative approaches. 

Ulcerative Colitis

Ulcerative colitis (UC) is a type of irritable bowel disease (IBD). It only affects the large intestine, which differs from the other type of IBD, Crohn's disease. UC affects only the inner layer of the large intestine tissue. Inflammation and ulceration of this inner layer characterize this condition. UC usually begins in the rectum and then advances into the colon. Symptoms of UC may include mucus and/or pus-filled diarrhea, rectal bleeding and pain, abdominal pain and cramping, constant urge to have a bowel movement even when bowels are empty (tenesmus), weight loss, fatigue, and fever. Factors that may contribute to UC include genetics, immune function, environment, and dysbiosis, which is an imbalance in the good and bad microbes of the gut microbiome. Small intestine bacterial overgrowth (SIBO), a condition where bacteria from the microbiome translocate into the small intestine, has also been implicated as a factor in UC. 

Crohn's Disease

Crohn's disease is the other type of IBD. Crohn's can affect the entire gastrointestinal tract, from the mouth to the anus. In Crohn's disease, all layers of the intestinal tissue are involved, and the hallmark "skip lesions" are found; patches of inflamed tissue between healthy tissue. Symptoms may include pain in the lower right area of the abdomen, bloating, gas, bloody diarrhea with mucus, lack of appetite, and mouth sores. Symptoms may manifest outside of the GI tract and include joint pain and arthritis, kidney stones and urinary tract infections, skin rashes, and inflammation of the eyes. Factors that may contribute to Crohn's disease include genetics, environmental factors, lifestyle factors, intestinal permeability, SIBO, and dysbiosis in the gut microbiome. 

Diverticular Disease

Diverticular diseases are conditions that involve an outpouching of the lining of the intestinal tract, referred to as diverticula. When there are many diverticula that do not cause problems, we refer to this as diverticulosis. When the diverticula become inflamed or infected, this is then called diverticulitis. Symptoms of diverticulitis may include pain, rectal bleeding, and bowel movement changes. If the diverticula perforate or rupture through the bowel wall, or there is obstruction or blockage in the bowel, or if the intestinal tract connects into another organ, we refer to this as complicated diverticular disease. Factors that may contribute to diverticular diseases include alcohol consumption and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or opioids. Dietary factors, including a lack of fiber in the diet and constipation, can lead to diverticular disease. Gut dysbiosis and SIBO can also increase the risk of diverticular disease. Lastly, those who are obese, over the age of 40, smokers, and males are also at an increased risk for diverticular disease. 

Functional Medicine Labs That Can Help Individualize Approaches for Patients with Large Intestine Disorders

Many functional medicine labs can help to assess disorders of the large intestine. The most commonly used tests include:

Comprehensive Stool Test

Comprehensive stool tests assess markers of the gastrointestinal tract that can give insight into digestion, absorption, inflammation, and immune functioning. Additionally, these stool tests often give great insight into the microbiome: a collective group of organisms, including bacteria, viruses, yeasts, parasites, and fungi, that live within our large intestine. The microbiome plays a significant role in our health, as it aids in digestion and absorption, creates certain vitamins, regulates the immune and inflammatory response in the gut, aids in certain hormone metabolism, and more. 

Dysbiosis, or an imbalance in the gut bacteria, has been implicated in UC, Crohn's disease, and diverticular diseases. Thus, a test such as GI360 by Doctor's Data may be a helpful choice in these conditions, as this test assesses numerous bacteria, viruses, yeast, and fungi of the microbiome. 

Small Intestine Bacterial Overgrowth (SIBO) Test

SIBO consists of having larger amounts of bacteria in the small intestine. These bacteria consume food and release gasses and enzymes that may cause symptoms such as bloating and gas. SIBO can increase the risk of certain conditions, including IBDs and diverticular diseases. The SIBO tests consist of assessing breath samples after ingestion of a sugar solution, looking for the presence of certain gasses that would be made from the consumption of the sugar solution by bacteria. Most lab companies look for two gasses, but the Triosmart test by Gemelli Biotech assesses three different gasses. Knowing which gas is present can help to identify the type of bacteria and aid in forming the appropriate approach. 

Micronutrient Testing 

A micronutrient test includes numerous vitamin and mineral levels in one convenient test. Micronutrient deficiencies, including vitamin D, calcium, iron, magnesium, zinc, folate, and vitamins B6 and B12, have been implicated in Crohn's disease. While iron, vitamins D, A, and E are often low in UC. The Micronutrient Test by SpectraCell Laboratories encompasses 31 essential vitamins and minerals to help practitioners identify and balance deficiencies.

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Complementary and Integrative Approaches for Large Intestine Disorders

Complementary and integrative approaches for the large intestine include nutrition, supplements, and herbs. Let's take a look at some of the most commonly considered therapies. 

Best Nutrition for Large Intestine Health

Determining the most appropriate diet for these conditions involving the large intestine may be difficult. Here are some of the most considered diets for specific conditions based on evidence that can help ensure patients are meeting their body's nutritional requirements.

Nutrition for Ulcerative Colitis 

The Specific Carbohydrate Diet (SCD) may be an option for those with UC. The SCD eliminates grains, sugars, processed foods, milk, many dairy products, and certain carbohydrates, including tubers such as potatoes and turnips. This diet can be incredibly restrictive and should be utilized under the care of a professional. For UC, studies have shown that the SCD may help the patient into remission in as little as two months and help maintain remission for up to two years. 

Nutrition for Crohn's Disease

The elemental diet may be a good choice for Crohn's disease. The elemental diet consists of replacing meals with a nutritional and caloric-dense, hypoallergenic, predigested formula, thus lessening the workload of the GI and allowing the GI to rest. The elemental diet is considered a first-line option for Crohn's disease due to the amount of research supporting its potential benefits. 

Nutrition for Diverticular Diseases

To support diverticulosis, an anti-inflammatory diet may be the best option. The Mediterranean diet is an anti-inflammatory diet consisting of fresh fruits, vegetables, herbs, fatty fish, olive oil, nuts, seeds, beans, legumes, and minimally processed whole grains. It places an emphasis on eating seasonally and locally for the highest amount of nutrients in the food. The avoidance of processed foods and sugars, refined grains, and refined seed oils is recommended. 

Top Supplements and Herbs for Patients with Large Intestine Disorders

There are many supplements and herbs that may be considered in the support of large intestine disorders. Here are some of the most common: 

Probiotics for Disorders of the Large Intestine 

Probiotics are supplements that contain strains of microbes with the aim of helping the microbiome. The strains found in the probiotics will vary from supplement to supplement and can depend on what condition is being addressed. Probiotics may be beneficial for UC both in the disease stage and in order to help maintain remission. For UC, probiotics seem to support the immune response and may help manage the chronic inflammation found in this condition. Probiotics may also reduce the risk of developing diverticular diseases. 

Dose: Will be dependent upon what condition is being addressed 

Duration: Will depend on symptoms and lab markers

Magnesium for Diverticular Diseases

Magnesium is used in over 300 different reactions in our body. Thus, magnesium may be helpful for many conditions, including diverticular diseases. Magnesium has been shown to lessen the number of intestinal spasms and cramping in diverticular diseases and may help prevent constipation.  

Dose: Up to 350 mg/day 

Duration: Until symptoms improve or lab markers regulate

Vitamin D for IBD 

Vitamin D is a fat-soluble vitamin important for many physiological functions in the body. It may be helpful in the support of IBD. Vitamin D deficiency in those who have IBD is more likely to have flares, hospitalizations, and surgeries. They also tend to not respond to pharmaceutical interventions and have a poorer quality of life. For Crohn's disease specifically, vitamin D supplementation has been shown to help manage markers of inflammation. 

Dose: Dependent upon the testing level

Duration: Will depend on improvements and testing level 

Oregano for Diverticular Diseases

Oregano is a commonly known culinary herb, but it also possesses properties that may support health. Oregano has antimicrobial effects and may be useful in the support of SIBO and, thus, possibly diverticular disease in cases where SIBO is a contributing factor to the diverticular disease.

Dose: 150-300 mg/day in 2- divided doses

Duration: 6 weeks

Curcumin for IBD

Curcumin is an active component of the culinary herb turmeric. Curcumin is used in the support of both UC and Crohn's disease due to its anti-inflammatory, antioxidant, and immune-modulating effects and has been shown to significantly reduce symptoms in these conditions. 

Dose: 1,500-8,000 mg/day 

Duration: Until symptoms improve or markers stabilize 

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Summary

The large intestine plays an essential role in the digestive system, finishing the absorptive process and forming waste products for final excretion. Additionally, the importance of the microbiome, held in the large intestine, cannot be understated. Its effects are far-ranging, and imbalances can have implications for the body. Functional medicine testing can assess the microbiome, as well as other markers of digestion that can affect conditions of the large intestine. Complementary and integrative approaches offer a wide array of options to support the patient and help manage symptoms.