For individuals dealing with constipation issues, can using an osmotic laxative help treat and prevent constipation?
Osmotic Laxative
Osmotic laxatives can help treat or prevent constipation by increasing the amount of water in the colon, softening stools, and making them easier to pass. Some osmotic laxatives are used for bowel preparation to help clear the colon before a colonoscopy. They are available over the counter and by prescription and can contain different active ingredients, including polyethylene glycol/PEG, lactulose, sorbitol, magnesium citrate, and magnesium hydroxides.
How They Work
Constipation occurs when stools are irregular and hard to pass, as they are usually hard and dry. An osmotic laxative helps relieve constipation by increasing the amount of fluid in the intestines. They pull water from the colon’s wall to the inside, softening stools and making them easier to pass. The term osmotic refers to the movement of fluids through a membrane with the concentration equal on both sides. In individuals with constipation problems, the concentration of water in the colon’s wall and the inside of the colon/lumen is balanced but insufficient to compensate for hard, dry stools. This is especially true of those who don’t drink enough water. Osmotic laxatives alter the balance with substances like salts, sugars, and other organic compounds to encourage water movement into the lumen.
How Are They Different?
Most laxatives are generally used for the treatment of occasional constipation. Osmotic laxatives work differently because they are used to prevent or treat chronic constipation. Other types of laxatives include:
Emollient
These are made with a surfactant called docusate.
Surfactants are substances that draw and spread fats and water.
Docusate increases the passage of water and fats into stools to soften them.
Lubricant
These are made with oily substances, like mineral oil, that help the stool slide through the intestine.
Stimulant
These laxatives relieve constipation by causing the intestines to contract and push out the stools.
Osmotic Laxatives
The common osmotic laxatives are made with different active ingredients that include:
Polyethylene Glycol – PEG
This organic compound is derived from petroleum and can be safely ingested to manage constipation.
Available over the counter.
These include Miralax and GlycoLax.
Lactulose
This is a type of sugar that is not absorbed by the intestine.
Instead, the sugar sits and ferments in the intestines, producing fatty acids that pull water into the lumen.
Available by prescription, including Cephulac, Duphalac, Kristalose, and others.
Sorbitol
This is also a non-absorbable sugar with activation similar to lactulose.
Over-the-counter and prescription versions include Arlex and GeriCare.
Magnesium Citrate
Magnesium citrate is magnesium in salt form combined with citric acid.
The salts help pull water into the lumen.
Over-the-counter versions include Citrate of Magnesia, Citroma, and LiquiPrep.
Magnesium Hydroxide
This milder form of magnesium is sold under the brand Milk of Magnesia.
Milk of Magnesia is also an antacid and is available over the counter.
Potential Side Effects
As with all medications, there can be potential side effects. Most are relatively mild and resolve independently within a few days. Common side effects include:
Abdominal cramping
Bloating
Nausea
Diarrhea
Flatulence
Overusing laxatives can cause dehydration and the loss of electrolytes like sodium, calcium, potassium, minerals the body needs to regulate heartbeat, muscle contractions, and other essential functions. (Tropini, C. et al., 2018) Consult with a healthcare provider to ensure you use any laxative correctly, whether over-the-counter or prescription. For those thinking about using osmotic laxatives, be sure to follow the dosing instructions carefully, avoid complications, and use only when needed. Individuals with chronic constipation should see a healthcare provider so that they can identify the underlying cause. Diet, exercise, and increased fluid intake can sometimes improve the condition. Others may require treatments that extend beyond the use of laxatives.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to create personalized treatment programs. We passionately focus on treating patients’ injuries and chronic pain syndromes. Using an integrated approach to improve ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers if other treatments are needed. Our goal is to relieve pain naturally by restoring health and function to the body.
Poop Testing: What? Why? and How?
References
Tropini, C., Moss, E. L., Merrill, B. D., Ng, K. M., Higginbottom, S. K., Casavant, E. P., Gonzalez, C. G., Fremin, B., Bouley, D. M., Elias, J. E., Bhatt, A. S., Huang, K. C., & Sonnenburg, J. L. (2018). Transient Osmotic Perturbation Causes Long-Term Alteration to the Gut Microbiota. Cell, 173(7), 1742–1754.e17. https://doi.org/10.1016/j.cell.2018.05.008
Emotional challenges like anxiety and depression or digestive disorders can cause individuals to experience a nervous stomach. Can knowing common symptoms, what causes them, and when to see a healthcare provider help manage the disorder?
Nervous Stomach
A nervous stomach is usually nothing to worry about, but it can happen occasionally as a reaction to a new environment, groups of people, foods, stress, and anxiety. Symptoms include indigestion, fluttering stomach/butterflies, or a gut-wrenching feeling. (Anxiety and Depression Association of America. 2023) Causes include underlying psychological and physical health conditions, certain medications, and lifestyle factors. Individuals experiencing chronic or ongoing symptoms should speak with a healthcare provider about their full range of symptoms. Treatments include medication, therapy, and lifestyle changes.
Symptoms
Nervous stomach symptoms can vary. Stress and anxiety can lead to physical symptoms, and physical symptoms may also lead to stress and anxiety. This is because the brain and gut connection communicates which hormones and neurotransmitters will be released and when. Common symptoms include: (Anxiety and Depression Association of America. 2023)
Loss of appetite
Butterflies or fluttering feeling in the stomach
Upset stomach
Indigestion
Bloating
Flatulence
Gut-wrenching feeling
Cramping
Nausea, dry heaving
Increased need to urinate or have bowel movements
Constipation
Diarrhea
Out-of-sync hunger cues
Causes
In most cases, a nervous stomach will come and go. However, it can also be caused by disorders such as anxiety disorder, depression, or gastrointestinal and digestive disorders. Brain health contributes to gut health, and vice versa. The brain is always communicating with the digestive system, and the digestive system is always sending information back to the brain. (Foster, J. A., and McVey Neufeld, K. A. 2013) (University of Chicago Medical Center, 2024) Common causes of a nervous stomach include: (Anxiety and Depression Association of America. 2023)
Over-the-counter and prescription medications can cause a nervous stomach as a side effect. This can happen when taking a single medication or more than one simultaneously. It can also occur in those with food sensitivities or other medical conditions. (Johns Hopkins Medicine, 2024) This is why consulting and updating a healthcare provider on the current list of prescribed and over-the-counter medications is important. Some meds can irritate the stomach, while others can cause constipation or diarrhea, leading to discomfort and nervous stomach symptoms. Common medications that may cause stomach side effect symptoms include: (Johns Hopkins Medicine, 2024)
NSAIDs – non-steroidal anti-inflammatory drugs such as ibuprofen can weaken the stomach lining.
Iron, antacids, and pain meds can cause constipation.
Antibiotics can cause diarrhea.
Home Treatment
Treatment depends on the severity and cause/s. An infrequently nervous stomach may benefit from over-the-counter therapies to calm it and/or lifestyle changes to reduce stress. Tips for reducing stress and anxiety include (Anxiety and Depression Association of America. 2023)
More frequent short breaks during the day
Practicing slow and deep breathing
Listening to guided meditations for stress-relief
Adding exercise to the daily routine
Realizing that stomach problems are part of anxiety and worrying about symptoms may make them worse.
Medical Treatment
Individuals may benefit from additional support treatment options with a healthcare provider (Johns Hopkins Medicine, 2024)
Antidepressant treatment for nervous stomach and/or irritable bowel syndrome.
Cognitive behavioral therapy for stress relief and learning how to manage anxiety.
Medical hypnotherapy
If symptoms are a side effect of medication or certain foods, a healthcare provider can develop an effective treatment plan that includes using another medication that is easier on the stomach or seeing a dietician.
Complications
Left untreated, a nervous stomach can contribute to further symptoms and other health problems. One study looked at the relationship between irritable bowel syndrome and certain psychiatric disorders. (Fadgyas-Stanculete, M. et al., 2014) This does not mean that a psychiatric disorder causes a nervous stomach or that a nervous stomach causes a psychiatric disorder. It is more likely that a combination of chemicals released when stressed can hurt gut health. This creates imbalances known to be risk factors for digestive disorders and conditions. (Anxiety and Depression Association of America. 2023)
Seeing a Healthcare Provider
Most nervous stomach symptoms resolve on their own. However, certain signs and symptoms can indicate that it is time to see a healthcare provider. Discuss symptoms with a healthcare provider who will order lab tests to check for underlying causes like anemia. See a healthcare provider immediately if you notice the following (University of Chicago Medical Center, 2024)
Symptoms are making work and/or normal life challenging.
Chronic or unresolved gastrointestinal issues like heartburn.
Unexplained weight reduction – losing weight without exercising or diet changes.
Blood in stool or blackish, tarry stools.
Vomiting
If there is a medical history of digestive disorders or cancers such as stomach cancer or colon cancer, this will help a healthcare provider. Depending on overall symptoms and family medical history, individuals may be referred to a gastroenterologist and/or a mental healthcare provider, like a counselor or psychiatrist. At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. We work with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal health. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Root Causes of Gut Dysfunction Part 3
References
Anxiety and Depression Association of America. (2023). How to calm an anxious stomach: The brain-gut connection. Anxiety and Depression Association of America.
Triumphing Through Science, Treatment, and Education. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/how-calm-anxious-stomach-brain-gut-connection
Foster, J. A., & McVey Neufeld, K. A. (2013). Gut-brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences, 36(5), 305–312. https://doi.org/10.1016/j.tins.2013.01.005
University of Chicago Medical Center. (2024). Stress and stomach pain: When should you see a specialist? Forefront. https://www.uchicagomedicine.org/forefront/gastrointestinal-articles/2024/january/stress-stomach-pain-when-to-see-a-doctor
Fadgyas-Stanculete, M., Buga, A. M., Popa-Wagner, A., & Dumitrascu, D. L. (2014). The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. Journal of molecular psychiatry, 2(1), 4. https://doi.org/10.1186/2049-9256-2-4
Ness-Jensen, E., & Lagergren, J. (2017). Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best practice & research. Clinical gastroenterology, 31(5), 501–508. https://doi.org/10.1016/j.bpg.2017.09.004
Johns Hopkins Medicine. (2024). Medicines and the digestive system. Health. https://www.hopkinsmedicine.org/health/conditions-and-diseases/medicines-and-the-digestive-system
For individuals who are dealing with constant constipation due to medications, stress, or lack of fiber, can walking exercise help encourage regular bowel movements?
Walking For Constipation Assistance
Constipation is a common condition. Too much sitting, medications, stress, or not getting enough fiber can result in infrequent bowel movements. Lifestyle adjustments can regulate most cases. One of the most effective ways is to incorporate regular moderate-vigorous exercise, encouraging the bowel muscles to contract naturally (Huang, R., et al., 2014). This includes jogging, yoga, water aerobics, and power or brisk walking for constipation alleviation.
The Research
A study analyzed middle-aged obese women who had chronic constipation over a 12-week period. (Tantawy, S. A., et al., 2017)
The first group walked on a treadmill 3 times a week for 60 minutes.
The second group did not engage in any physical activity.
The first group had greater improvement in their constipation symptoms and quality of life assessments.
A gut bacteria imbalance is also linked to constipation issues. Another study focused on the effect of brisk walking versus exercises that strengthened core muscles like planks on intestinal microbiota composition. (Morita, E., et al., 2019) The results showed that aerobic exercises like power/brisk walking can help increase intestinal Bacteroides, an essential part of healthy gut bacteria. Studies have shown a positive effect when individuals engage in at least 20 minutes of brisk walking daily. (Morita, E., et al., 2019)
Exercise Can Help Decrease Colon Cancer Risks
Physical activity can be a significant protective factor in decreasing colon cancer. (National Cancer Institute. 2023) Some estimate the risk reduction to be 50%, and exercise can even help prevent recurrence after a colon cancer diagnosis, also 50% in some studies for patients with stage II or stage III colon cancer. (Schoenberg M. H. 2016)
The best effects were obtained through moderate-intensity exercise, such as power/brisk walking, about six hours per week.
Mortality was reduced by 23% in individuals who were physically active for at least 20 minutes several times a week.
Inactive colon cancer patients who began exercising after their diagnosis had significantly improved outcomes than individuals who remained sedentary, showing that it is never too late to start exercising.(Schoenberg M. H. 2016)
The most active patients had the best outcomes.
Exercise-Related Diarrhea Prevention
Some runners and walkers experience an overly active colon, resulting in exercise-related diarrhea or loose stools, known as runner’s trots. Up to 50% of endurance athletes experience gastrointestinal problems during intense physical activity. (de Oliveira, E. P. et al., 2014) Prevention steps that can be taken include.
Not eating within two hours of exercising.
Avoid caffeine and warm fluids before exercising.
If sensitive to lactose, avoid milk products or use Lactase.
Ensure the body is well-hydrated before exercise.
Hydrating during exercise.
If exercising in the morning:
Drink about 2.5 cups of fluids or a sports drink before bed.
Drink about 2.5 cups of fluids after waking up.
Drink another 1.5 – 2.5 cups of fluids 20-30 minutes before exercising.
Drink 12-16 fluid ounces every 5-15 minutes during exercise.
If exercising for over 90 minutes:
Drink a 12 – 16 fluid-ounce solution containing 30-60 grams of carbohydrates, sodium, potassium, and magnesium every 5-15 minutes.
Professional Help
Periodic constipation may resolve with lifestyle adjustments like increased fiber intake, physical activity, and fluids. Individuals who are experiencing bloody stools or hematochezia, have recently lost 10 pounds or more, have iron deficiency anemia, have positive fecal occult/hidden blood tests, or have a family history of colon cancer need to see a healthcare provider or specialist to perform specific diagnostic tests to ensure there aren’t any underlying issues or serious conditions. (Jamshed, N. et al., 2011) Before engaging in walking for constipation assistance, individuals should consult their healthcare provider to see if it is safe for them.
At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Poop Testing: What? Why? and How?
References
Huang, R., Ho, S. Y., Lo, W. S., & Lam, T. H. (2014). Physical activity and constipation in Hong Kong adolescents. PloS one, 9(2), e90193. https://doi.org/10.1371/journal.pone.0090193
Tantawy, S. A., Kamel, D. M., Abdelbasset, W. K., & Elgohary, H. M. (2017). Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes, metabolic syndrome and obesity : targets and therapy, 10, 513–519. https://doi.org/10.2147/DMSO.S140250
Morita, E., Yokoyama, H., Imai, D., Takeda, R., Ota, A., Kawai, E., Hisada, T., Emoto, M., Suzuki, Y., & Okazaki, K. (2019). Aerobic Exercise Training with Brisk Walking Increases Intestinal Bacteroides in Healthy Elderly Women. Nutrients, 11(4), 868. https://doi.org/10.3390/nu11040868
National Cancer Institute. (2023). Colorectal Cancer Prevention (PDQ(R)): Patient Version. In PDQ Cancer Information Summaries. https://www.cancer.gov/types/colorectal/patient/colorectal-prevention-pdq
https://www.ncbi.nlm.nih.gov/pubmed/26389376
Schoenberg M. H. (2016). Physical Activity and Nutrition in Primary and Tertiary Prevention of Colorectal Cancer. Visceral medicine, 32(3), 199–204. https://doi.org/10.1159/000446492
de Oliveira, E. P., Burini, R. C., & Jeukendrup, A. (2014). Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations. Sports medicine (Auckland, N.Z.), 44 Suppl 1(Suppl 1), S79–S85. https://doi.org/10.1007/s40279-014-0153-2
Jamshed, N., Lee, Z. E., & Olden, K. W. (2011). Diagnostic approach to chronic constipation in adults. American family physician, 84(3), 299–306.
Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?
Food Poisoning and Restoring Gut Health
Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centers for Disease Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.
Foods to Eat
After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)
Gatorade
Pedialyte
Water
Herbal tea
Chicken broth
Jello
Applesauce
Crackers
Toast
Rice
Oatmeal
Bananas
Potatoes
Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)
When Food Poisoning Is Active Foods To Avoid
During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)
Caffeinated drinks and alcohol can further dehydrate.
Greasy foods and high-fiber foods are hard to digest.
Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)
Recovery Time and Resuming Regular Diet
Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centers for Disease Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centers for Disease Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)
Recommended Gut Foods Post Stomach Virus
Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)
Beans
Onions
Tomatoes
Asparagus
Peas
Honey
Milk
Banana
Wheat, barley, rye
Garlic
Soybean
Seaweed
In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)
Pickles
Sourdough bread
Kombucha
Sauerkraut
Yogurt
Miso
Kefir
Kimchi
Tempeh
Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Learning About Food Substitutions
References
Centers for Disease Control and Prevention. (2024). Food poisoning symptoms. Retrieved from https://www.cdc.gov/foodsafety/symptoms.html
Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. https://doi.org/10.1371/journal.pone.0095534
National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Eating, diet, & nutrition for food poisoning. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/food-poisoning/eating-diet-nutrition
Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. https://doi.org/10.1093/cid/cix669
Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. https://doi.org/10.3945/ajcn.115.114769
Ohio State University. Kacie Vavrek, M., RD, CSSD Ohio State University. (2019). Foods to avoid when you have the flu. https://health.osu.edu/wellness/exercise-and-nutrition/foods-to-avoid-with-flu
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. https://doi.org/10.1002/bab.1938
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. https://doi.org/10.3390/microorganisms7010014
Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. https://doi.org/10.1002/jev2.12172
Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. https://doi.org/10.3390/foods8030092
Harvard Medical School. (2023). How to get more probiotics. https://www.health.harvard.edu/staying-healthy/how-to-get-more-probiotics
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Treatment of viral gastroenteritis. Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis/treatment
Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Nutrition Fundamentals
References
University of Arizona Cooperative Extension. Hope Wilson, M. W., Patricia Zilliox. (2019). Prickly pear cactus: food of the desert. https://extension.arizona.edu/sites/extension.arizona.edu/files/pubs/az1800-2019.pdf
U.S. Department of Agriculture. FoodData Central. (2018). Nopales, cooked, without salt. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/169388/nutrients
U.S. Department of Agriculture. MyPlate. (2020-2025). Vegetables. Retrieved from https://www.myplate.gov/eat-healthy/vegetables
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. https://doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. https://doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. https://doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. https://doi.org/10.2337/dc06-2506
Centers for Disease Control and Prevention. (2022). Fiber: the carb that helps you manage diabetes. Retrieved from https://www.cdc.gov/diabetes/library/features/role-of-fiber.html
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. https://doi.org/10.1111/nmo.13986
National Institutes of Health (NIH). Office of Dietary Supplements. (2024). Calcium. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. https://doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. https://doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. https://doi.org/10.3390/nu14051008
For individuals dealing with ulcerative colitis, can acupuncture treatment benefit those with UC and other GI-related issues?
Acupuncture For Ulcerative Colitis
Acupuncture has been used to treat symptoms related to pain and inflammation. Studies suggest it may help reduce inflammation and symptoms like diarrhea and abdominal pain, which could benefit individuals with inflammatory bowel disease. Individuals with ulcerative colitis, an inflammatory bowel disease/IBD affecting the large intestine, may find acupuncture beneficial in managing symptoms, including pain and gastrointestinal symptoms. (Crohn’s and Colitis Foundation, 2019)
The pathways connecting the acupoints generate energy, which contributes to overall health.
A disruption to the energy flow can cause injury, illness, or disease.
When acupuncture needles are inserted, energy flow and health are improved.
Benefits
Acupuncture can be used for the relief of various conditions. Studies have shown that acupuncture can reduce inflammation and disease activity in individuals with an IBD, like UC and Crohn’s disease. It can help with: (Gengqing Song et al., 2019)
Pain symptoms
Gut microbiome imbalances
Gut motor dysfunction
Intestinal barrier function
Anxiety
Depression
Studies suggest the use of acupuncture with heat, known as moxibustion, can improve several GI symptoms including (Crohn’s and Colitis Foundation, 2019)
Studies found the use of acupuncture along with moxibustion reduced inflammation in individuals with Crohn’s disease and ulcerative colitis. (Crohn’s and Colitis Foundation, 2019)
Stress and Mood
Chronic conditions like ulcerative colitis can cause feelings of depression and/or anxiety. Acupuncture may be used to address symptoms related to stress and mood and can benefit emotional health issues that include: (Johns Hopkins Medicine. 2024)
Insomnia
Anxiety
Nervousness
Depression
Neurosis – mental health condition characterized by chronic distress and anxiety.
Side Effects
Acupuncture is considered a safe practice. The most common side effects are: (GI Society. 2024)
Needle shock is rare but more common in individuals:
Who are regularly nervous.
Who are nervous around needles.
Who are new to acupuncture.
Who have a history of fainting.
Who are extremely fatigued.
Who have low blood sugar.
For some, GI symptoms may worsen before they improve. It is recommended to try at least five sessions as this is part of the healing process. (Cleveland Clinic. 2023) However, individuals should contact their doctor if symptoms become severe or last more than two days. (GI Society. 2024) Individuals considering acupuncture to help manage symptoms of ulcerative colitis should speak with their healthcare provider to help determine the appropriate treatment and where to start.
Gastro-Intestinal Dysfunction Treatment
References
Crohn’s and Colitis Foundation. (2019). Acupuncture in Inflammatory Bowel Disease. IBDVisible Blog. https://www.crohnscolitisfoundation.org/blog/acupuncture-inflammatory-bowel-disease
Wilkinson J, Faleiro R. (2007). Acupuncture in pain management. Continuing Education in Anaesthesia, Critical Care and Pain. 7(4), 135-138. https://doi.org/10.1093/bjaceaccp/mkm021
Song, G., Fiocchi, C., & Achkar, J. P. (2019). Acupuncture in Inflammatory Bowel Disease. Inflammatory bowel diseases, 25(7), 1129–1139. https://doi.org/10.1093/ibd/izy371
Harvard Medical School. (2016). Relieving pain with acupuncture. Harvard Health Blog. https://www.health.harvard.edu/healthbeat/relieving-pain-with-acupuncture
Arthritis Foundation. (N.D.). Acupuncture for Arthritis. Health Wellness. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/acupuncture-for-arthritis
Harvard Medical School. (2023). Acupuncture: what is it? Harvard Health Publishing Harvard Medical School Blog. https://www.health.harvard.edu/a_to_z/acupuncture-a-to-z#:~:text=The%20most%20common%20side%20effects,injury%20to%20an%20internal%20organ.
Cleveland Clinic. (2023). Acupuncture. Health Library. https://my.clevelandclinic.org/health/treatments/4767-acupuncture
GI Society. (2024). Acupuncture and Digestion. badgut.org. https://badgut.org/information-centre/a-z-digestive-topics/acupuncture-and-digestion/
Can individuals dealing with gut inflammation be relieved with electroacupuncture to reduce low back pain symptoms & improve gut function?
Introduction
When it comes to the body, the gut system has a very interesting relationship to the various body groups. The gut system works with the central nervous, immune, and musculoskeletal systems as it helps protect the body from harmful bacteria while regulating inflammation. However, when environmental factors start to affect the body and cause the gut system to go haywire, it can cause numerous issues of pain and discomfort to the body. One of the issues that the gut can affect is the musculoskeletal system, causing back pain issues associated with gut inflammation. However, numerous treatments can help reduce the effects of gut inflammation that is causing back pain. Today’s article looks at the gut-back pain connection, how electroacupuncture can be integrated as a treatment, and how it can reduce inflammation. We talk with certified medical providers who consolidate our patients’ information to assess how gut inflammation impacts their bodies, causing back pain. We also inform and guide patients on how electroacupuncture therapy can help reduce the inflammatory effects causing gut and back issues and restore gut function. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating various non-surgical treatments to reduce gut inflammation correlated with back pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Gut-Back Pain Connection
Do you feel muscle aches or pains in your gut or lower back? What about radiating heat in various areas of your body? Or have you experienced any low-energy moments throughout your day? While the gut is known as the second brain since it works with the immune system, one of its crucial roles is regulating the body’s immune system. This is because the gut microbiome houses trillions of bacteria to digest food and protect the body from bad bacteria. When environmental factors start to affect the gut’s delicate ecosystem, it can lead the immune system to be hyperactive, causing the inflammatory cytokines to mass produce, and this effect can ripple throughout the body, thus manifesting into various pain-like symptoms and conditions, including back pain. Since inflammation is the body’s defense response to injuries or infections, it removes the harmful issue in the affected area and helps heal. So when the inflammatory cytokines start to mass produce due to gut inflammation, it can compromise the gut system, allowing toxins and bacteria to enter the bloodstream and travel to different body areas, causing pain. Now, this is due to various environmental factors that lead to back pain development. When the harmful bacteria from inflammation start to cause back pain, they can attach themselves and affect the intervertebral disc homeostasis, causing the immune system to attack the intervertebral disc and cause back pain. (Yao et al., 2023) This is due to the connection of the gut and back through complex nerve pathways that send information from the gut to the back and up to the brain.
So, when inflammation starts to cause issues in the body, it can lead to musculoskeletal problems like back pain. Gut inflammation can cause an imbalance between the composition of the symbiont and pathobiont to decrease the integrity and function of the intestinal gut barriers, induce pain, and increase the inflammatory molecules. (Ratna et al., 2023) The inflammatory molecules can exacerbate pain receptors and muscle tension, leading to discomfort and pain in the lower back. Coincidentally, environmental factors like poor posture, physical inactivity, and poor dietary habits can cause the gut system to induce inflammation of the back muscles. When there is dysbiosis in the gut microbiota, the inflammatory effects can be indirectly associated with visceral pain and central nervous systemic functioning to alter the body and cause it to be in a persistent state of chronic systemic inflammation to induce back pain. (Dekker Nitert et al., 2020). However, there are numerous non-surgical treatments and holistic approaches to reduce gut inflammation and relieve back pain.
Integrating Electroacupuncture As Treatment
When people are experiencing back pain associated with gut inflammation, they will go to their primary healthcare doctor and explain the situation. Given the connection between gut inflammation and back pain, by addressing the environmental factors that cause these overlapping risk profiles, many doctors can work with pain specialists to reduce both gut inflammation and back pain. Pain specialists like chiropractors, acupuncturists, and massage therapists can help strengthen the affected muscles that are causing back pain and provide holistic approaches like anti-inflammatory vitamins and supplements to reduce gut inflammation. One of the oldest non-surgical treatments that can do both is electroacupuncture. Electroacupuncture combines traditional Chinese therapy and modern technology that uses electric stimulation and thin solid needles to be inserted into the body’s acupoint to obtain qi or energy. What this does is that it provides electric stimulation and anti-inflammatory effects to induce cholinergic reflexes in the gut and HPA axis. (Yang et al., 2024) Electroacupuncture can also be combined with other therapies to reduce the inflammatory effects associated with back pain.
How Does Electroacupuncture Reduce Gut Inflammation
Since electroacupuncture can reduce gut inflammation causing back pain, it can help regulate the intestinal flora by promoting intestinal motility and blocking the pain signals from affecting the back muscles. (An et al., 2022) This is because electroacupuncture can help relax the tense muscles causing back pain. Additionally, when people approach this treatment, it is under the guidance of highly trained acupuncturists who can insert the needles correctly while tailoring electroacupuncture therapy to the person’s specific needs and pain. Since electroacupuncture can be combined with other therapies, it can effectively reduce body weight and restore digestion and absorption to shape the gut microbiota. (Xia et al., 2022) This allows individuals to make small changes to their routine and prevent gut inflammation from affecting the body and causing back pain. They can improve their quality of life by incorporating electroacupuncture as part of their health and wellness treatment.
Unlocking The Secrets Of Inflammation-Video
References
An, J., Wang, L., Song, S., Tian, L., Liu, Q., Mei, M., Li, W., & Liu, S. (2022). Electroacupuncture reduces blood glucose by regulating intestinal flora in type 2 diabetic mice. J Diabetes, 14(10), 695-710. https://doi.org/10.1111/1753-0407.13323
Dekker Nitert, M., Mousa, A., Barrett, H. L., Naderpoor, N., & de Courten, B. (2020). Altered Gut Microbiota Composition Is Associated With Back Pain in Overweight and Obese Individuals. Front Endocrinol (Lausanne), 11, 605. https://doi.org/10.3389/fendo.2020.00605
Ratna, H. V. K., Jeyaraman, M., Yadav, S., Jeyaraman, N., & Nallakumarasamy, A. (2023). Is Dysbiotic Gut the Cause of Low Back Pain? Cureus, 15(7), e42496. https://doi.org/10.7759/cureus.42496
Xia, X., Xie, Y., Gong, Y., Zhan, M., He, Y., Liang, X., Jin, Y., Yang, Y., & Ding, W. (2022). Electroacupuncture promoted intestinal defensins and rescued the dysbiotic cecal microbiota of high-fat diet-induced obese mice. Life Sci, 309, 120961. https://doi.org/10.1016/j.lfs.2022.120961
Yang, Y., Pang, F., Zhou, M., Guo, X., Yang, Y., Qiu, W., Liao, C., Chen, Y., & Tang, C. (2024). Electroacupuncture Reduces Inflammatory Bowel Disease in Obese Mice by Activating the Nrf2/HO-1 Signaling Pathways and Repairing the Intestinal Barrier. Diabetes Metab Syndr Obes, 17, 435-452. https://doi.org/10.2147/DMSO.S449112
Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. https://doi.org/10.1111/os.13626
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