A Functional Medicine approach

to correcting a huge problem.

NY Health Solutions
326 Walt Whitman Rd, Suite 201
Huntington Station, NY 11746
631-673-1001
www.nyhealthsolutions.com
2014 Dr. Michael Gruttadauria
Heartburn, Diarrhea &
Constipation
(Reflux, GERD, Irritable Bowel
Syndrome, Celiac Disease)
If you are living with one or more of these issues, you are
probably taking something to treat the symptoms and
reduce the discomfort.
BUT, if there was a way to identify the cause and actually
correct the problem, wouldnt you want to know about it?
GI Disease vs. GI Dysfunction
Patients that seek our care usually have already seen at least one other
doctor prior to getting to us. This generally means that certain
diagnostic testing (lab tests, endoscopy, colonoscopy, etc.) has been
performed. These tests are done to rule out disease processes like
ulcers, infections and tumors. If we are the first to see a patient, we
want to rule these out as well and we will make appropriate referrals
when necessary.
Most of the time, we work with patients who have seemingly tried
everything and nothing has worked. This usually points to a
dysfunction in the gut that does not show up on standard testing. In
addition to a careful case history and clinical examination, we will
order specific tests that will help us define exactly what is happening.
Why Do So Many
People Suffer
With These
Problems?
Statistics
Prevalence: 60 to 70 million people affected by
all digestive diseases
1
Ambulatory care visits: 104.7 million (2004)
2
Hospitalizations: 13.5 million (2004)
2
Mortality: 236,164 deaths (2004)
2
Diagnostic and therapeutic inpatient
procedures: 5.5 million12 % of all inpatient
procedures (2006)
3
Ambulatory surgical procedures: 20 million
31% of all ambulatory procedures (2006)
4
Costs: $141.8 billion (2004)
2
$97.8 billion direct medical costs (2004)
2
$44 billion indirect costs (e.g., disability
and mortality) (2004)
2
http://digestive.niddk.nih.gov/statistics/statistics.htm
You are uncomfortable,
so you turn to medication
Antacids for GERD ($1.2 Billion in sales 2010)
Mylanta, Maalox, Tums, Rolaids, Pepto-Bismol, Alka-Seltzer,
Prilosec, Prevacid, Aciphex, Nexium, Protonix
Laxatives for constipation ($400 Million annual sales)
MiraLAX, Dulcolax, Metamucil
Anti-spasmodic, antidepressant, anti-diarrheal, laxative
for IBS (Annual sales ??)
GI PROBLEMS ARE A HUGE INDUSTRY!
Gastrointestinal disorders are a prominent component in the overall disease burden of the
worlds most developed economies, and a lack of effective long-term treatments and limited
etiological understanding is continuing to exacerbate the impact of such conditions.
http://www.scribd.com/doc/6452849/The-Gastrointestinal-Market-Outlook-to-2012 below
http://www2.wholefoodsmarket.com/blogs/jmackey/2009/08/14/health-care-reform-full-article/ 3-18-11
At least 51% and as much as 100% junk
Stomach Problems
Many times we find that a persons diet causes their issues. But
commonly our patients feel that their diet is good and they still have
stomach problems.
GERD - Gastroesophageal Reflux Disease
Causes, incidence, and risk factors
When you eat, food passes from the throat to the stomach through the esophagus . Once
food is in the stomach, a ring of muscle fibers prevents food from moving backward into
the esophagus. These muscle fibers are called the lower esophageal sphincter, or LES.
If this sphincter muscle doesn't close well, food, liquid, and stomach acid can leak back
into the esophagus. This is called reflux or gastroesophageal reflux. This reflux may cause
symptoms, or can even damage the esophagus.
The risk factors for reflux include hiatal hernia (a condition in which part of the stomach
moves above the diaphragm), pregnancy, obesity and H. Pylori infection. Studies have
found that people who are overweight or obese may be up to six times more likely to have
gastroesophageal reflux disease (GERD) than people who are of normal body weight.
Both obesity and GERD raise the risk of developing esophageal cancer, the incidence of
which has also been rising in the last few years.
GERD
Tight sphincter = NO REFLUX
Antacids
A staggering 113.4 million
prescriptions for proton
pump inhibitors (prescription
antacids) are filled each year,
making this class of drugs, at
$13.9 billion in sales, the 3
rd
highest seller in the US.
1
Arch Intern Med. 2010;170(9): 747-748.
extract below
http://www.bewellbuzz.com/general/suffer-
acid-reflux-heartburn/ 3-6-11
Antacids can be hurting you!
Antacids neutralize stomach acid, raising the pH level from very acidic (2.0) to between 3 and
4, which destroys about 99% of the stomach acid. When this happens, you completely throw
off the balance of bacteria in your intestinal tract and give the bad bacteria the upper hand.
To sum it up, antacids are literally killers of probiotics (good bacteria) in your gut. And it doesn't
stop there.
The hydrochloric acid in your stomach not only digests food--it also acts as a protective barrier
for your body. Every day you ingest food and other organisms that have the potential to make
you sick or even kill you. Your stomach acids typically destroys these dangerous invaders
before they can cause you harm. But when your stomach acid is neutralized, the protective
barrier isn't there and the invaders can get into your intestinal tract. If your gut has mainly bad
bacteria to begin with, you've got a great chance of getting REALLY sick.
* The idea that too much stomach acid causes these problems is very flawed and
simple testing can determine if you actually have too much or too little. The
treatment is VERY different.
Rebound acid hypersecretion
Treatment with proton pump
inhibitors (PPIs) for eight weeks
induces acid-related symptoms
like heartburn, acid
regurgitation and dyspepsia
once treatment is withdrawn in
healthy individuals
http://www.gastro.org/wmspage.cfm?parm1=7371
below
I was healthy before the acid blocker
REBOUND HYPERSECRETION!
Long-term use of
medications like Axid,
Pepcid, Tagamet, and
Zantac may increase the
risk of mental decline in
later life.
http://www.webmd.com/alzheimers/new
s/20070803/acid-blockers-linked-to-
mental-decline below
Intestinal Problems
ELIMINATION ISSUES CONSTIPATION
AND/OR DIARRHEA
IBS Irritable Bowel Syndrome
What Is Irritable Bowel Syndrome?
While most people experience digestive troubles once in a while,
what sets IBS apart is belly pain and diarrhea or constipation that
comes back again and again. IBS affects 10% to 15% of people in
North America.
Symptoms of IBS
The main symptoms of IBS are abdominal pain accompanied by
constipation, diarrhea, or both. Gas and a visibly bloated belly are
also common. The condition does not damage the digestive
system, but persistent pain and frequent trips to the bathroom
can interfere with everyday life.
IBS: Who's at Risk?
IBS is twice as common in women as in men and it is also more
likely to affect people who have a family history of IBS. Symptoms
usually begin when people are in their late 20s and can sometimes
co-exists with depression or anxiety.
IBS and Stress
Stress can be particularly problematic for people with IBS. IBS
symptoms can cause stress, and stress can make the symptoms
worse, leading to a vicious cycle.
IBD Inflammatory Bowel Disease
What Is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) refers to chronic conditions
that cause inflammation in some part of the intestines. The
intestinal walls become swollen, inflamed, and develop ulcers,
which can cause discomfort and serious digestive problems. The
exact symptoms depend on which part of the digestive tract is
involved.
Types of IBD: Crohn's Disease
Crohn's disease is a form of IBD that can occur anywhere along
the digestive tract from the mouth to the anus. It affects the
deeper layers of the digestive lining and can occur as "skip
lesions" between healthy areas. Crohn's often involves the small
intestine, the colon, or both.
Types of IBD: Ulcerative Colitis
Unlike Crohn's disease, ulcerative colitis only involves the colon
and rectum. Inflammation and ulcers typically affect only the
innermost lining in these areas, compared with the deeper
lesions seen in Crohn's disease.
Symptoms of IBD
Abdominal pain or cramping
Diarrhea multiple times per day
Bloody stools
Weight loss
Celiac Disease
Celiac Disease (CD) is a lifelong inherited autoimmune condition
affecting children and adults. When people with CD eat foods that
contain gluten, it creates an immune-mediated toxic reaction that
causes damage to the small intestine and does not allow food to be
properly absorbed. Even small amounts of gluten in foods can affect
those with CD and cause health problems.
Even if you do NOT have Celiac, you may still have a problem with gluten
called gluten related enteritis. Many people incorrectly think that once
Celiac is ruled out, that gluten is not a problem.
Increased prevalence and mortality in
undiagnosed celiac disease.
We investigated the long-term outcome of undiagnosed CD and whether the
prevalence of undiagnosed CD has changed during the past 50 years.
This study included 9,133 healthy young adults at Warren Air Force Base (sera
were collected between 1948 and 1954) and 12,768 gender-matched subjects.
The prevalence of undiagnosed CD between the Air Force cohort and recent
cohorts was compared.
The prevalence of undiagnosed CD seems to have increased dramatically in the
United States during the past 50 years. During 45 years of follow-up,
undiagnosed CD was associated with a nearly 4-fold increased risk of
death.
In the past 50 years, Celiac disease went from 1 in 700 people to 1 in 100!
Gastroenterology. 2009 Jul;137(1):88-93.
Its Worse Than You Think
Not only do these issues cause you pain and
discomfort, they are affecting every aspect of your
health and can actually be creating systemic disease.
We need to look for
Stool Testing Is Critical
You have no idea whats happening inside unless you test!
Wide ranging effects
Wide Ranging Effects of GI Problems
GI dysfunction causes
Immune System Consequences
Compromise
Allergies
Auto-immune issues
Neurological Consequences
Behavior Consequences
Toxicity Problems
Nutritional Deficiencies
Gut on firebrain on fire
Are you ready to get to the root
cause of your gut problems and
do something about them?
If so, call our office to set up
an appointment.
631-673-1001
www.nyhealthsolutions.com