DAY 229 - Core Strengthening: Close but Not the Whole Story

photo courtesy istolethetv

Core strengthening has been such a hot topic in the fitness world for many years. And no question, there is value to it. But, like most things in the universe, just a little closer look affords us more of what we dearly want.

One definition of core strengthening is “the balanced development of the deep and superficial muscles that stabilize, align, and move the trunk of the body, especially the abdominals and muscles of the back.”

Low back pain may be the most common reason that individuals seek to strengthen their core.

Now, let’s break it down.

There is nothing more “core” to the torso than the digestive tract. Though most advocates of core strengthening are focused on skeletal muscle function, it is critical to understand that the muscles of the back and abdomen are markedly influenced by the function of the digestive tract through neural pathways referred to as viscerosomatic reflexes. When the digestive tract is distressed by food allergies, constipation, antibiotics, imbalanced gut flora, or spinal joint aberrations, muscles of the back and abdomen are negatively affected, and pain can result.

Strength is not all it is cracked up to be. Many remember in their youth, their first exposure to martial arts, and their amazement at seeing larger, stronger opponents thrown to the mat by smaller, weaker individuals who had mastered greater skill. Ultimately, the greatest function in the torso is attained through integration and coordination of all components, visceral and skeletal.

It is often overlooked that during “core strengthening”, at least two other beneficial influences are being affected on the back and torso. While performing strengthening exercises, spinal dynamics are improved as a result of vertebral joints being moved through ranges of motion, and the digestive tract is benefited by contraction and relaxation in the abdomen which improves movement of the contents through the tract.

While some folks exercise the heck out of their abs and back muscles, and have their back pain go away, others will get no relief, and neither group will necessarily be exploring their gut core. I have had the opportunity to evaluate a number of patients who swore that core strengthening had taken care of their back problems. Clearly, for some of them it did reduce or resolve their pain. But it was obvious during physical examination that many had excessively tight back muscles, stiff spinal joints, and a gut that was tender to touch.

My advice to all would be to remember that coordinated, fluid motion trumps strength; and if you want to get to the core of back pain, or any other health problem, don’t forget your gut, it affects everything.

DAY 154 - Free: Not Just Gluten-free

This isn’t really too deep; I just want to say that while I have been gluten-free for 2+ years, there is a freedom that comes with being gluten-free that is more than a simple food choice.

While never having experienced symptoms that I could connect to my consumption of gluten (a class of proteins found primarily in wheat, rye and barley), I have had a lifetime of mild to moderate digestive tract problems. Only through the good fortune of having chosen a professional life as a doctor, have I been fortunate enough to learn that gluten sensitivity is both a common problem, and one that is often not recognized. 2+ years ago I finally ordered testing on myself and learned that I am gluten sensitive.

For those who are gluten sensitive, or have the more serious form, celiac disease, the advice of experts is that we eat no gluten whatsoever; none.

Over the last two years, and with some frequency, conversations with patients and others, have lead me to be told that is isn’t really possible to avoid gluten, living in our culture. I am also often told how bleak a gluten-free life would be. In most cases, the individual filling me in on his views, states them as though they were universal truths. Nowadays, after listening carefully, I state that I have been 100% gluten-free for more than 2 years, and explain that it has not been a major challenge in my life, that I continue to eat large amounts of delicious food, and that I am happy to be able to make this change which is predictably improving and protecting the quality of my life.

I like the fact that no single food owns me! I also like being free; free to be healthy!

DAY 40 – Reflux: A Euphemism for Vomiting

This is not a joke about puking. This is serious; and you would be wise to read it.

Much of America is vomiting weakly, and regularly. Thanks to euphemisms like “reflux”, and to doctors and patients alike who rarely stop to think about what is going on in the body, Americans are simply taking prescription drugs like Prilosec and Prevacid, or over-the-counter antacids to suppress gastric symptoms.

Merriam-Webster defines “reflux” as, “a flowing back”. One need not be a gastroenterologist to know that what is flowing backward, in this case upward, are the contents of the stomach. When the contents of the stomach are forcefully ejected into the esophagus and out through the mouth, we call that vomiting. When ejection is weak, only able to move a small amount of the stomach contents into the esophagus, or possibly the throat, we call it “reflux”.

To review simple gastrointestinal physiology, ingested foods that are perceived by the body as non-harmful, are accepted and moved down through the digestive tract from the mouth to the anus. One need not be a doctor to know that when the body perceives ingested foods as a threat, the contents of the stomach are moved in reverse, up, and out.

You have probably not thought about it, but children, relatively speaking, vomit much more frequently than adults. The exception would be adults that drink excessive amounts, or unfortunate combinations of alcohols. We might say that children grow out of it, but in reality, the gastrointestinal tract becomes weary from multitudes of perceived threats, and is less able, in adulthood, to mount a forceful response; to vomit.

WebMD, a web-based service that claims to provide “valuable health information, tools for managing your health, and support to those who seek information”(http://www.webmd.com/heartburn-gerd/guide/acid-reflux-symptoms) tells us the following about acid reflux and gastroesophageal reflux disease (GERD):
-More than 60 million Americans [1/5 of all Americans] experience acid reflux at least once a month.
-Heartburn, regurgitation, and dyspepsia are a few of the most common acid reflux symptoms.
-Making a few lifestyle changes and using over-the-counter antacids usually are all you need to control acid reflux symptoms.
-GERD is severe or chronic acid reflux that can lead to complications, such as cancer.

When your gut tells you that it would like to empty itself, it is not wise to simply take a drug, prescription or over-the-counter, to stop the symptoms and block your natural defenses. Common sense dictates that you pause to understand why your digestive tract is running in reverse.

Finally, and don’t miss this one, the most common cause of “reflux” is the ongoing consumption of foods to which one is allergic or intolerant. And dairy products are one of the most common offending foods.

DAY 16 – Can Farting Cause Hearing Loss?

So, I’ll cut to the chase, while there is no scientific evidence that farting (flatulence) can directly cause hearing loss, there ARE known factors that can cause both farting and hearing loss; and I’m going to tell you about them. While farting is not usually a serious medical condition, and hearing loss won’t kill you, an underlying condition that can cause both, is a serious risk for all forms of chronic degenerative disease.

But first, it is important to know that our culture and most physicians believe that hearing loss is caused primarily by either exposure to loud noise or “getting old”. Loud noise can be a cause. “Getting old” is not. Everything wears out as we age, but have you ever noticed that some folks have hearing aids at age 40 and others die at 85 never needing them? Age is not a cause.

The serious underlying condition that I want you to know about is chronic inflammation of the digestive tract caused by eating foods one is either allergic to or intolerant of. Through a variety of mechanisms, these food irritants create an inflammatory state that can affect the digestive tract or the entire body.

When the digestive tract is inflamed, excessive intestinal gas is common. When the entire body is inflamed, it is possible for sensitive nerve endings in the ears to be damaged, resulting in hearing loss.

I would encourage you to go to YouTube and watch "Treatment of Hearing Loss" featuring Dr. Katz (EarNoseandThroatMD) at http://www.youtube.com/watch?v=Qior3h5xvWA . In this video Dr. Katz states that after determining that loud noise has not caused the hearing loss in a patient, the doctor must move on using a medical history and examinations to determine the cause. The first causal possibility that he suggests is inflammation, and he then suggests that steroids (anti-inflammatory) would be an effective treatment. Note also that he states that individuals with diabetes, and those with cardiovascular disease are at greater risk to develop hearing loss. Inflammation is an integral factor in the causation and progression of both these diseases. It therefore makes sense that the systemic (body-wide) inflammation associated with each of these serious diseases, could also damage nerves in the ears.

I want to be sure to leave you with two important points: 1) that it is possible for food allergies or intolerances to cause systemic inflammation that could cause hearing loss, and 2) farting may be caused by food allergies or intolerances, and may be linked to serious health conditions through the mechanism of inflammation.

Not so funny, eh?

DAY 14 – Looking for a Cure for Your Anxiety?

First off, more often than not, what is considered a “cure” is that which makes symptoms go away. In American culture, the “cure” infrequently comes with any understanding or information about the “cause”. That means we fix things without knowing what’s broken. A bit like magic. And it sells.

For those of you who are either apprehensive of, or frankly dislike the approach of covering symptoms  with that kind of “cure”, and waiting for the inevitable resurfacing of the problem/illness, let’s take a look at common causes of anxiety and some effective approaches to really fixing it.

Interestingly, the American diet is deficient in the mineral, magnesium, and can be a cause of anxiety. Whole grains and green leafy vegetables are common sources of magnesium, but are uncommon parts of the American diet. Magnesium calms and relaxes the body. Muscle tightness, spasming and twitching can be signs of magnesium deficiency. While deficiency can be corrected in some cases by increasing dietary sources of magnesium, or taking epsom salts baths, many individuals need to take magnesium supplements. In my 27 years of practice experience, I have found magnesium glycinate to be the most effective oral form. Simple, safe, rational, and often effective.

Two other deficiencies that lead to anxiety are that of aerobic exercise and stretching. The lack of either can result in anxiety. Of the two, the greatest lack in America is that of stretching. A few of us walk for aerobic exercise, but real stretching is rare. When quizzed, the occasional few who claim to stretch, report that they stretch for 5 minutes, or “throughout the day”; these are not real stretching. As a part of the treatment of anxiety, 30 minutes of walking and 30 minutes of serious stretching (yoga-like) per day are called for.

Most people who experience anxiety, fear, or worry (and that’s most of us), feel it in our gut, or sometimes in our chest. This is a clue. Everyone with anxiety needs a thorough evaluation of their digestive tract, with particular attention to associated conditions such as constipation, loose stools, intestinal gas, indigestion, reflux, or irritable bowel. Evaluation must include a skilled palpatory examination of the abdomen to rule out focal or generalized tenderness. Food allergies are an extremely common cause of gut irritation, and are therefore a common cause of anxiety.

A critical thing to understand is that anxiety about an event or circumstance can cause gut discomfort or dysfunction, and the reverse is true; gut discomfort or dysfunction can cause anxiety.

My final warning on the gut-anxiety connection is that an absence of gut symptoms does not mean that anxiety is not arising from the gut. The internal organs of our chest, abdomen and pelvis are profoundly insensitive to irritation or damage that occurs gradually. Remember that it is common for large tumors to develop in the abdomen with no early signs. So, don’t trust symptoms. If you experience anxiety, have your digestive tract evaluated by a knowledgeable health care provider.

Note: Q: What kind of health care provider should one see for digestive tract evaluation of anxiety?
         A: A provider that understands the connection between the gut and anxiety. Don’t assume that a gastroenterologist would necessarily be the best. A chiropractor, an MD, a naturopath, or an acupuncturist can be excellent guides if they understand the connection.