A Functional Medicine Approach to Healthy Gut in Older Adults

Gut health, and the health of the trillions of microbes that live in the gut, have a tremendous impact on overall health and disease. The gut microbiome influences the risk of chronic illnesses like cardiovascular disease, obesity, diabetes, inflammatory bowel disease, and cancer. With chronic diseases like cardiovascular disease, cancer, and diabetes as the leading causes of death in the United States, gut health should be an important area of focus for older adults wanting to reduce their risk for these chronic health conditions.

Changes in gastrointestinal health are common with age, so it's essential to know how to support the gut in a way that maintains a healthy microbiome and promotes overall well-being. 

A patient-centered functional medicine approach to a healthy gut in older adults focuses on natural and lifestyle-based therapies. In this article, we'll cover the gut microbiome, signs of an unhealthy gut, what causes digestive disorders in older adults, what functional laboratory tests identify the root causes of gut issues, and which conventional and natural treatments are used to treat gut disorders. 

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What is Gut Microbiome?

We often think of microbes as harmful and associate them with illness. However, not all microbes are harmful. Trillions of microbes reside in the gastrointestinal tract, many of which are very beneficial for human health. We collectively refer to this collection of bacteria, viruses, yeast, and other microorganisms as the gut microbiome. The gut microbiome plays a significant role locally for gut health but also systemically for overall health and wellness. 

The gut microbiome supports our health in many ways. It contributes to the production of various vitamins, essential amino acids, and compounds called short-chain fatty acids (SCFA), a primary energy source for the cells that line the gastrointestinal tract. The microbiome also protects against pathogens, regulates the integrity of the gut lining, and supports a healthy immune function.

It's easy to see the importance of the gut microbiome when we see how it influences the risk for many chronic diseases, including diabetes, cancer, cardiovascular disease, obesity, and inflammatory bowel disease (IBD). Seeing these connections makes it ever more apparent that supporting our gut health and microbiome is vital for a healthy aging process.

Signs of an Unhealthy Gut

Signs and symptoms of an unhealthy gut include constipation, diarrhea, abdominal pain, abdominal cramps, gas, bloating, gastroesophageal reflux, urgent need to have a bowel movement, feeling of incomplete bowel emptying, mucus or blood in stool, abnormal stool color, undigested food in the stool, nausea, and vomiting.

What Causes Digestive Disorders in Older Adults?

As we age, we change. Our lifestyles, cellular health, and body functions change, leading to digestive disorders in older adults. Decreased appetite is common in seniors, resulting in malnutrition and dehydration. Dehydration can cause constipation, among numerous other health problems. 

Aging impacts gastrointestinal function by impacting motility through the gastrointestinal system, secretion of enzymes and hormones, and how well we digest and absorb our food. These impaired functions can have negative consequences that result in digestive disorders that are common in older adults, such as infection, constipation, ulcers, and gastritis. Small intestine bacterial overgrowth (SIBO) is common in the elderly and is a common cause of malabsorption.

Lifestyle plays a significant role in the development of these changes that contribute to digestive disorders. The Canadian Society of Intestinal Research points to several lifestyle factors contributing to gastrointestinal problems in the elderly, including low-fiber diets, sedentary lifestyles, medication side effects, stress, and inadequate sleep.

Functional Medicine Labs to Test for Root Cause of Digestive Disorders

Functional medicine practitioners utilize labs to help determine the various root causes of digestive disorders. Here are some of the most tested labs to assess gut health in older adults.

Comprehensive Stool Test

A comprehensive stool analysis offers a non-invasive in-depth way to assess gastrointestinal health in seniors. This test provides a wealth of information that can indicate what aspects of gastrointestinal function are impaired.

The Genova Diagnostics GI Effects® Comprehensive Profile is a stool test that assesses digestive function, the gut microbiome, inflammation, and immune function. Zonulin is a marker that can be added to this test to identify whether there is increased intestinal permeability (often called "leaky gut"). 

The unique aspect of this specific test is that it also offers microbial sensitivity testing of detected pathogens to determine which prescription drugs and natural agents will effectively restore balance. Older adults are often on medications, and their overall health is more frail, making an effective and targeted approach to treating these pathogens of the utmost importance.

Intestinal Permeability Testing

A protein called zonulin can be tested to indicate whether there is increased permeability of the gut lining. Zonulin can be tested by adding it to a comprehensive stool test or with a blood test. Zonulin testing in the blood can be performed with the Advanced Intestinal Barrier Assessment or Advanced IBA. This test measures several markers associated with intestinal permeability, including zonulin.

Breath Test

Small intestine bacterial overgrowth (SIBO) is a common cause of malabsorption in the elderly. Another non-invasive testing option, a breath test, is used to evaluate this condition. The Genova Diagnostics SIBO test involves drinking a sugar solution and collecting measurements of methane and hydrogen by breathing into tubes at specified timing after ingesting the solution. 

Conventional Treatment for Older Adults with Digestive Issues

Conventional treatments for older adults with digestive issues often include medications, such as proton pump inhibitors (PPI) and antibiotics. Unfortunately, these medications often fail to address the root cause of the digestive issue and often come with dangerous side effects. PPI drugs increase the risk of osteoporosis, interstitial nephritis, pneumonia, and Clostridium difficile colitis. Antibiotics are known to have a negative impact on the gut microbiome, causing dysbiosis (an imbalance in the microbial communities that live in the gut).

Functional Medicine Treatment for Digestive Health

Functional medicine treatment for digestive health includes lifestyle factors that can support a healthy microbiome. Exercise has excellent benefits for overall health for older adults and also is shown to promote a healthy gut microbiome. 

Gut Healthy Foods

Eating gut healthy foods is a simple way for older adults to improve their gut health and overall health. Gut-healthy foods include anti-inflammatory, high-fiber foods like fruits, vegetables, nuts, seeds, and legumes. Probiotic-rich foods such as yogurt, vinegar, sauerkraut, and kimchi help support a healthy gut microbiome.

The Mediterranean diet is a style of eating that's helpful for a healthy gut as it contains anti-inflammatory, high-fiber, and antioxidant-rich foods. Foods commonly consumed in a Mediterranean diet include olive oil, fruits, vegetables, nuts, seeds, legumes, whole grains, legumes, poultry, fish, and red wine in moderation.

Supplements for Healthy Gut

Supplements can support a healthy gut by improving digestive function, reducing inflammation, improving gut barrier function, or promoting a healthy microbiome. 

Digestive Enzymes

Digestive enzyme supplements provide the enzymes your stomach, pancreas, and small intestine make naturally. When your body isn't producing or releasing enough of these enzymes naturally, it does not properly break down your food, and absorption of your food's nutrients is reduced. Digestive enzyme supplements help support the body's digestive process to break food down properly and maximize absorption and utilization of your food's nutrients. 

L-Glutamine

L-glutamine is an amino acid that is the primary fuel source for the cells that line the gut. Because it supports a healthy gut lining, it is helpful for conditions in which the gut lining is compromised, such as Crohn's disease, Celiac disease, gastritis, and ulcers. It can be taken in powder or capsule form; however, therapeutic dosages (15 to 45 grams per day for at least five days) may be difficult to obtain with capsules, making powder a convenient option.

Aloe

Aloe is well known for its wound healing and anti-inflammatory benefits. When aloe is taken internally, these properties can also result in gut healing. Aloe can be helpful for conditions like gastritis (inflammation of the stomach), gastroesophageal reflux (GERD), ulcers, and Irritable Bowel Syndrome (IBS). 

Probiotics

Probiotics are supplements containing beneficial strains of bacteria and yeast that support a healthy gut microbiome. The beneficial bacteria commonly found in probiotic supplements include various strains of Lactobacillus and Bifidobacterium and the beneficial fungi Saccharomyces. 

Prebiotics

Prebiotic supplements are insoluble fibers fermented by bacteria in the large intestine, producing short-chain fatty acids (SCFA), a source of energy for the microbiome. Prebiotics are known to increase the abundance and diversity of the microbial communities in the gut, improving gut health.

Oil of Oregano

Oil of oregano is a supplement that can be very beneficial for gut health with its anti-inflammatory, antioxidant, and antimicrobial properties. Often taken in liquid tincture or gel capsule form, it's shown to be effective in treating SIBO and candida infections. 

Complementary and Alternative Medicine

Acupuncture is a Traditional Chinese Medicine healing modality that uses tiny needles placed at various points on the body to restore well-being. Acupuncture has shown to be effective in reducing GERD-related symptoms, Irritable Bowel Disease (IBD), IBS, nausea, and vomiting.

Mind-body therapies, such as diaphragmatic breathing, mindfulness-based stress reduction (MBSR), relaxation therapy, hypnotherapy, and cognitive behavioral therapy, show benefits for various gastrointestinal conditions. These lifestyle-based therapies are wonderful options for seniors looking for non-invasive, non-pharmacologic treatments to improve gut health.

Summary

Gut health plays a vital role in overall health and well-being. As we age, it becomes even more important to be intentional about supporting a healthy gut to prevent the increased risk for digestive disorders and chronic diseases that come with an imbalanced microbiome. 

A functional medicine approach to a healthy gut in older adults includes identifying a root cause for any issues and using natural supplements and therapies along with lifestyle modifications, including exercise, eating gut-healthy foods, and mind-body techniques like diaphragmatic breathing.

Talk to your functional medicine practitioner about ways to support your gut health as you age!