CHAPTER 15 Digestive Disorders

images Tens of millions of Americans suffer from digestive disorders, at a cost of ninety-eight billion dollars per year in direct payments for doctors, meds, and surgeries and indirect costs of forty-four billion dollars more in lost productivity. The cost in pain and suffering is incalculable. Furthermore, digestive difficulties never exist in isolation. When digestion suffers, the whole body suffers. As Hippocrates put it, “All disease begins in the gut.”

Many alternative MDs and popular health experts recommend the healing of digestive disorders with food, exercise, stress management, and lifestyle changes. While there is much wisdom in the body-mind-spirit approach, much of the nutritional advice dispensed involves low-fat, high-fiber, plant-based diet plans, an approach that is more likely to become part of the problem than the solution. Only rarely do today’s doctors see a significant role for nourishing broth in gut healing. Yet broth’s reputation as a digestive aid and remedy for digestive difficulties goes back thousands of years, and broth is a staple of folk medicine around the world.

Widely Prescribed

In the nineteenth century, broth and gelatin were widely prescribed for convalescents who lacked the strength to digest and assimilate food properly. Florence Nightingale and others recommended it not only as the basis for soups and stews but in the forms of meat teas and aspics. In that era broth was thought to “increase appetite” and “finely distribute the nutrients in food,” meaning increase their digestion, assimilation, and utilization in the body. Broth offered nourishment for people with few or no teeth, not only because it could be swallowed without the risk of choking but because it could begin the digestive process itself with or without the release of amylase and other digestive enzymes from chewing.

Broth and gelatin were also widely prescribed for acid reflux and peptic ulcers because they were thought to either “stop excess gastric secretion” or “fix a good deal of hydrochloric acid” in the process of digestion. Broth was also seen as useful for people with kidney disease who were required to restrict protein consumption.

In Gelatin in Nutrition and Medicine, Nathan Gotthoffer reported on nineteenth-century German studies showing gelatin to be helpful for infant nutrition. Gelatin improved the digestibility of baby formula, was an effective remedy for catarrh (a buildup of mucus in the nose and throat), a soother and even healer of acid reflux and “spit up” tendencies, and an efficient way to restore nourishment and fluids following bouts of vomiting or diarrhea.

Nutrition textbooks of the 1920s and 1930s recommended mixing gelatin into infant formulas to help bring cow’s milk closer to human milk. That recommendation drew on more than thirty years of research studies showing gelatin could improve the digestion of milk and milk products. As Dr. Gotthoffer explained it, “The curd obtained from the coagulation of woman’s milk was softer and more easily digested than that of cow’s milk. However, when gelatin was added to cow’s milk, a curd of equally desirable characteristics was formed. In addition, gelatin exerted a very important influence on the milk fat. It served not only to emulsify the fat but also, by stabilizing the casein, improved the digestibility and absorption of the fat, which otherwise would be carried down with casein in a lumpy mass.” As a result, infants fed gelatin-enriched formulas showed reduced allergic symptoms, vomiting, colic, diarrhea, constipation, and respiratory ailments compared to those fed straight cow’s milk. These clinical observations—along with the modern science that supports them—are reasons why Mary G. Enig, PhD, added gelatin to the homemade baby formula recipes recommended by the Weston A. Price Foundation for mothers who are unable to breast-feed.

Nineteenth- and early twentieth-century writers also noted that convalescing adults who had lost weight and strength because of operations, dysentery, cancer, or other reasons fared better if gelatin was added to their diets. “It is said to be retained by the most sensitive stomach and will nourish when almost nothing else will be tolerated,” wrote Dr. L. E. Hogan in 1909. Gelatin was valued not only because it improved digestion but because it reduced the amount of complete protein needed by the body.

“ Gut Damage from Radiation

Thirty years ago I had three thousand rads of full-torso radiation and for many years was dysfunctional due to frequent bouts of rolling-on-the-floor gut pain. After about a year of making and eating homemade broth, homemade sauerkraut, and homemade kombucha, my gut is starting to heal. After so many years of pain, this is amazing. Today broth helps me to survive, and to calm down when under stress and warm up when cold.

—Carol S., Olympia, Washington ”

Gelatin was also widely recognized in both the popular and medical literature as the best possible food for cases of cholera, typhoid fever, and other infectious diseases marked by severe diarrhea. The scientists proposed various theories for this: Some thought it “neutralized” intestinal poisons; others theorized it provided protection by coating the mucous membrane; still others thought gelatin’s low tyrosine and absent tryptophan prevented buildups of toxins found in troubled GI tracts (such as indole, skatol, indolacetic acid, and indolepropionic acid).

Doctors also valued gelatin for celiac and sprue patients wasting away from diarrhea and malnutrition. In his 1908 textbook On Infantilism from Chronic Intestinal Infection, Christian Archibald Herter, MD (1865–1910), called celiac disease “intestinal infantilism” and noted fat was better tolerated than carbohydrates by celiacs. Most important, he reported the efficacy of gelatin not only in the treatment of celiac disease but for any GI tract infection.

Herter explained, “The use of gelatin as a foodstuff in bacterial infections of the intestinal tract has never received the attention it deserves. The physician is not infrequently confronted with a dietetic problem which consists in endeavoring to maintain nutrition under conditions where no combination of the ordinary proteins with fats and carbohydrates suffices to maintain a fair state of nutrition. The difficulty which most frequently arises is that every attempt to use carbohydrate food is followed by fermentative disturbances of an acute or subacute nature which delay recovery or even favor an existing infection to the point of threatening life. The attempt to replace the carbohydrates in large degree by proteins is blocked by the serious difficulty that all the ordinary proteins, which when given in amounts distinctly in excess of the habitual quantities, afford material for putrefactive decompositions which it is necessary to restrict. A great desideratum, therefore, is a food which, while readily undergoing absorption, shall furnish a supply of caloric energy and which at the same time shall be exempt from ordinary fermentative decomposition. Such a food exists in gelatin.”

Although Dr. Herter thought gelatin had not gotten the attention it deserved, he was hardly alone in his opinion that it could improve digestion. Typical dietary advice of the era was: Creams and blancmanges thickened with gelatin could be better digested by patients than those made with flour. Fruits would be more digestible when served in gelatin desserts. Eggs could be “more easily taken” by patients if thickened with gelatin. Milk swallowed with gelatin did bodies good. Gallbladder patients who were challenged by fat digestion could enjoy creamy desserts without ill consequences if gelatin filled in for some of the eggs and cream.

Not surprisingly, broth was a staple in the stomach-soothing “bland diets.” These were widely prescribed by doctors from the mid-nineteenth to the mid-twentieth centuries for patients who had undergone stomach or intestinal surgery, been poisoned, or suffered from heartburn, ulcers, nausea (including morning sickness), bloating, or flatulence. Doctors lauded broth’s power to “behave like a solid liquid” and give patients a palatable alternative to the soft, pasty, mushy, low-fiber, and unspicy “bland” food staples.

Dr. Francis Pottenger

Perhaps the most significant article ever written on the value of gelatin and health came in 1937, when Francis Pottenger Jr., MD (1901–1967), announced his theories and research at the Annual Meeting of the American Therapeutic Society in Atlantic City. “Gelatin may be used in conjunction with almost any diet that the clinician feels is indicated,” he said. “Its colloidal properties aid the digestion of any foods which cause the patient to suffer from ‘sour stomach.’ Even foods to which individuals may be definitely sensitive, as proven by the leucopenic index and elimination diets, frequently may be tolerated with slight discomfort or none at all if gelatin is made part of the diet.”

Dr. Pottenger thought gelatin had such a “favorable effect on digestion” that pureeing might not be necessary. He found that after even a short trial of gelatin therapy, “raw vegetables, green salads and fruits which are usually taboo may often be given to those patients with impunity.” Dr. Pottenger recited a long list of conditions that could be relieved by gelatin, including slow digestion, nervous digestion, vomiting, diarrhea, gas formation, and heartburn. He found it especially helpful for children with allergies and failure to thrive. Having thoroughly reviewed the literature published up to that time, Dr. Pottenger concluded, “An interesting aspect… is the universal agreement, so rarely encountered in gelatin researches, of all the investigators. Research workers and clinicians, from widely separated points and over an extended period of time, have without exception found gelatin to be of great value in the treatment of these diseases of the digestive system.”

In his experiments Dr. Pottenger analyzed the contents of stomachs after various meals. He found that with gelatin in the mix, the “gluey mass” was “not sour” like the control, showed no acidity until the colloid was broken down, and “under these conditions, digestion is generally distributed throughout the mass rather than layered.”

Dr. Pottenger thought gelatin could compensate for the lack of hydrophilic colloids in most cooked foods and “combat” any digestive disturbances caused by cooking. To condense his main points:

• Gelatin brings about conditions in the stomach during digestion that approach those resulting from the consumption of foods in their natural (that is, raw) state.

• Gelatin can lessen gastric irritation by absorbing the digestive secretions of the stomach so that digestion takes place within a mass of food.

• Gelatin is an “admirable” hydrophilic colloid because of its availability, digestibility, affordability, non-toxicity, and versatility in recipes.

• The amount of gelatin needed will vary from person to person, but it must be of good quality and sufficient quantity.

• Gelatin has proven effective for a variety of gastrointestinal ailments ranging from the atonia of the chronic invalid to the irritation present in patients with gastric ulcer.

Gelatin, broth, and bland diets went out of fashion as “unnecessary” once antacids, anticholinergics, gastrin antagonists, and other pharmaceuticals became widely available. As people adopted modern diets high in bran and other fibers, raw or undercooked vegetables, canned soups, and quick-cooked steaks and muscle meats, traditional bone broth soups, stews, and “meat teas” largely disappeared from diets. Soymilk, tofu, and other soy foods, as well as many processed food products containing soy protein ingredients, also contribute to digestive distress. Although soy is heavily marketed as a complete protein, all soybeans contain protease inhibitors that block the digestive enzymes needed to break down that protein. Over time, the stress on the overworked pancreas can lead to pancreatitis. These dietary changes have driven the market for over-the-counter and prescription drugs. As more and more people recognize the dark side of these drugs, the time is ripe to restore broth to its traditional role of digestive aid and remedy.

Many components in broth contribute to its digestive power. Properly prepared broths, made from bones, cartilage, and skin, are rich in glycosaminoglycans (GAGs), the best known of which are glucosamine and chondroitin sulfate. These provide the raw ingredients needed for the body to produce the healing mucus required throughout the digestive system. While the raw food community spouts the myth that mucus is merely unwanted gunky buildup caused by meat, dairy, and cooked foods, the truth is we need plenty of healthy mucus for optimum digestion, a high-functioning immune system, and the soothing of any GI tract inflammation.

How does mucus help? Let us count the ways. In the stomach, a thick layer of mucus coated with a bicarbonate solution keeps acid from burning the stomach lining. In the small intestines, mucus lubricates the passage of food, nourishes good bacteria, blocks bad bacteria, and plays key roles in immune response. Indeed, the mucous layer—along with the underlying gut-associated lymphoid tissue (GALT)—is our front line of defense against physical and chemical injury from ingested foods, microbes, microbial products, heavy metals, and other toxins.

During acute intestinal infections, mucus is secreted promptly and prolifically throughout the emergency to encase bacteria and otherwise protect the body from invasion. Chronic infections, however, result in the depletion of mucus-secreting cells, alterations in mucous layers, disruption of bacterial colonies, defective immune responses, and overall upset of the intestinal homeostasis. The result is “leaky gut,” a condition that leads to inflammation, injury, and other adverse effects throughout the brain and body.

“ Food Poisoning

I recently suffered from intense food poisoning, possibly brought on by contaminated eggs. Bedridden for three days, I drank only beef bone broth fortified with lacto-fermented vegetable juice and fermented raw milk whey. This cured the diarrhea without any medication. My gut flora seems to be well and happy again, and so am I. Our bone broth slow cooker is working full time.

—René Archner, Warkworth, New Zealand ”

Gut ecology also depends on mucus. Science now recognizes the fact that the microbiome, with its wealth of different microorganisms and their collective genetic material, is metabolically active and plays myriad roles in the body, including the absorption and transport of nutrients across the gut barrier. These bacteria are nourished directly by sugars and protein sugars, including GAGs, and indirectly by the vitamins and minerals concentrated within the mucous matrix. The bacteria hang out in mucus to avoid expulsion from the body, and their presence stimulates the production of additional mucus. This symbiotic relationship builds and maintains a healthy gut for the host while allowing further colonization by the bacteria.

As scientists learn more and more about the complexity of the gut, they talk of developing novel—meaning patentable—therapeutic approaches to the prevention and management of intestinal disease. These include methods to promote or strengthen the intestinal mucous layer or nourish bioactive protective molecules. While these possibilities are intriguing, alternative medical doctors are already healing the gut with protocols that depend on a foundation of good old-fashioned broth.

Broth is a staple in Dr. Natasha Campbell-McBride’s GAPS (Gut and Psychology Syndrome) diet, Dr. Joseph Brasco and Jordan Rubin’s Guts and Glory program, Donna Gates’s Body Ecology diet, and other gut-healing diets. These programs are intended to heal allergies, autism, and immune system breakdown as well as treat obvious gut problems such as candida, parasites, bloating, flatulence, gastrointestinal reflux disease (GERD), constipation, diarrhea, celiac disease, irritable bowel syndrome (IBS), ulcerative colitis, and Crohn’s disease. Essential to this goal is the healing of the condition colloquially known as leaky gut syndrome. Furthermore, glycine and glutamine in broth contribute to the liver’s production of the glutathione needed to detoxify mercury and other heavy metals commonly stored in the gut lining, contributing to gut, brain, and immune system dysfunction.

Why does broth heal the gut? Primarily by feeding its cells the protein sugars known as glycosaminoglycans, or GAGs. Given that leaky gut syndrome is sometimes called the GAG defect, common sense suggests the glucosamine, chondroitin sulfate, and other GAGs found in broth could help the body rebuild the GAG layer. Most of the research to date has shown success with a polysaccharide known as heparin, which is primarily sold as a prescription blood thinner. Patients diagnosed with ulcerative colitis and Crohn’s disease, however, have tested as deficient in the essential sugar N-acetylglucosamine. Glucosamine supplementation might help, but the study results are mixed. As for feeding gut bacteria, Robert Koch, the discoverer of the tuberculosis bacterium, succeeded in growing bacterial colonies in petri dishes when he added gelatin to the mix.

Souper Tip

Although broth is not a source of good bacteria, it provides sustenance for good bacteria in the body. And we can add good bacteria to soup at the table in the form of cultured foods. Sauerkraut can bring zip to bean or cabbage soups, beet kvaas to borscht, and sour cream or yogurt to cream of mushroom, asparagus, or spinach soups. Be sure to add these at the end, when the soup is in the bowl, so that the friendly bacteria they contain are not killed by overheating.

Glycine

The high glycine content of broth and gelatin aids digestion by enhancing gastric acid secretion. While scientists have known for more than thirty years that only proteins stimulate gastric acid secretion, not all amino acids do so. Glycine is one of those that do, a fact first shown in 1925. Researchers in the American Journal of Physiology have already proposed that “glycine may have application in the design of chemically defined diets for patients with gastrointestinal disorders.”

Glycine is the single most important amino acid that must be supplied to children recovering from malnutrition, many of whom suffer from digestive problems, and it is indispensable for rapid growth. Glycine status also serves as an important marker of a healthy pregnancy. Because the glycine needs of mothers-to-be increase throughout pregnancy, endogenous production of glycine may be insufficient. It is thus a good policy for pregnant women to drink plenty of broth. Infants also seem to need glycine. Infant feeding studies have shown that total free amino acids found in plasma increase after feeding, but the ratio of glycine to valine falls.

Glutamine

Broth’s high glutamine content is also critical for gut health. It’s the primary nutrient for enterocytes, the cells that absorb digested food from the lumen and transport the nutrients into the bloodstream. Enterocytes contain glutaminase, the enzyme that breaks glutamine up into glutamic acid and ammonia. Glutamic acid is broken down into adenosine triphosphate (ATP), a key compound in cellular reactions throughout the body, while the ammonia must be detoxed by the liver.

In the 1970s, Herbert G. Windmueller, a pharmacologist at the National Institute of Arthritis, Metabolism and Digestive Diseases of the National Institutes of Health in Bethesda, Maryland, discovered a surprising function for glutamine. In a laboratory experiment that involved keeping a large segment of rat intestine alive, Dr. Windmueller tested the high-glucose solutions used in feeding tubes at hospitals and concluded they were not up to the job. To many people’s surprise, he found glutamine was far more important than glucose, a finding later confirmed in human and animal studies. Without glutamine, the primary fuel of enterocytes, villous atrophy and death occurred. And it’s not just the digestive system that atrophies. Intestinal health is so important to the body that muscles will give up great stores of glutamine to help the intestines handle the stress of illness or accident. Indeed, the body’s continual need for glutamine to turn over mucosal lining cells probably plays a bigger role in muscle wasting than inactivity due to bed rest.

Glutamine also nourishes the GALT (gut-associated lymphoid tissue) layer underlying the mucosa. Insufficient glutamine there contributes to leaky gut, a key factor in allergies, autism, behavioral disorders, and most other physical and mental health problems. Any form of severe stress on the body, whether caused by injury, infection, vaccination, or other trauma, will deplete glutamine, increasing the likelihood of gut weakness, permeability, and other damage.

Glutamine furthermore stems the loss of electrolytes and water from the intestines during either acute or chronic diarrhea, and has greatly benefited patients with IBS, ulcerative colitis, Crohn’s disease, and other severe bowel diseases. Patients who have experienced surgical removal of parts of their small intestines are less likely to suffer malnutrition from short bowel syndrome if tube-fed glutamine along with their other nutrients. Colon cancer patients with colostomy bags have experienced less infection and inflammation thanks to glutamine supplementation. Although most patients who’ve undergone chemotherapy experience side effects of nausea, vomiting, and diarrhea caused by the death of the rapidly growing cells in the intestine, patients taking high doses of glutamine suffer fewer of these side effects.

“ Digestion

I went through a time of extreme stress in my life, which resulted in indigestion, heartburn, and bloating. After incorporating bone broth and fermented foods into my diet, I haven’t had any digestive problems since. I’m a naturopathic doctor, and bone broth and fermented foods are now a regular part of what I recommend to my patients with digestive disturbances.

—Todd Ferguson, ND, Moorhead, Minnesota ”

How else does glutamine serve the digestive system? It may be good for people suffering from peptic ulcers, but one study suggests it could worsen acid reflux. Finally, it feeds the pancreas, particularly the exocrine part that produces enzymes required for digestive and metabolic functions.

Cartilage

John F. Prudden, MD, DSci, the “father of cartilage therapy,” successfully treated severe cases of ulcerative colitis and Crohn’s disease with bovine tracheal cartilage. Because these diseases are autoimmune disorders, he thought cartilage might help. Buttressing his conviction was the fact that two other diseases with an autoimmune component—arthritis and psoriasis—had been dramatically helped by cartilage. Either or both often accompany Crohn’s disease and ulcerative colitis. Later Dr. Prudden would show that cartilage could cure cancer as well, a major consideration for colitis victims, who have a greatly increased risk of developing cancer of the colon. For victims of ulcerative colitis who have lived with their disease for forty years, the odds are about 70 percent.

As per his usual policy, Dr. Prudden worked exclusively with people with severe, supposedly incurable cases. All had suffered from Crohn’s disease or ulcerative colitis for many years and had responded poorly if at all to standard treatments. As reported in Seminars in Arthritis and Rheumatism, Dr. Prudden’s results were good but not perfect. The problem for many patients was that the cartilage itself produced some osmotic diarrhea. Because diarrhea—or rather the lack of it—is how colitis patients judge their progress, the increased diarrhea alarmed them. Even so, their colons were on the mend, as evidenced by sigmoidoscope.

So much so, in fact, that six of the nine ulcerative colitis patients in Dr. Prudden’s study were able to forgo proctocolectomy. Even the so-called failures experienced some gain. For example, a patient whose condition had only improved to “fair” with the cartilage advanced a notch once he began taking prednisone along with the cartilage. Drugs alone had had no positive effect on his condition, but with cartilage, there was a positive synergistic effect.

“ Recovery from Parasites and Antibiotics

My mother-in-law emigrated from Ireland as a young woman and raised eleven healthy children by avoiding the standard American diet. Now in her early seventies, she walks five miles a day, keeps a garden, and takes no prescription medications. Right before Thanksgiving, she came down with gastrointestinal symptoms that sent her to the emergency room for dehydration. The doctors told her it was probably something viral and her symptoms would soon resolve on their own. However, after the holiday, her symptoms worsened and she also realized that no one else around her had developed “something viral.” Her doctor finally did a culture, and we were all surprised to learn she had picked up a waterborne parasite from China! Since she rarely dines out, she was able to name the restaurant where she picked this up in her food.

A round of Cipro antibiotic gave her a clean culture but left her weak. Her doctor told her it could take up to six months for her to fully recover. I decided to print out the benefits of bone broth and bring her two pints from the freezer. She was hesitant, almost resistant, to trying the broth, so we got her to start with a few sips a day. By Christmas several major symptoms had disappeared and she wanted to know the recipe! That night I printed out the directions and sent her three more pints. I’m relieved to report that she is on the mend.

—Roxanne McDaniel, Park Ridge, Illinois ”

Likewise, four severe cases of Crohn’s disease improved. All the patients had been taking prednisone or ACTH in high doses for years. Many had segments of their ileum or colon removed surgically. All had been going downhill steadily with weight loss and malnutrition. Yet with bovine tracheal cartilage they all were able to reduce their drug dosage or eliminate it entirely. None of the patients were restored to complete health, but all gained weight, strength, and optimism. Although there was no control group, Dr. Prudden said that “the course of the disease is clearly an adequate control in these severe and chronic cases.”

“ Digestive Problems

I am sixty-five years old and have suffered from digestive issues for most of my life. About six months ago I started making stock, mostly with elk bones because they are accessible to me, but also beef and chicken bones. Just lately I have started adding about six chicken feet to any kind of stock I make. I drink the stock three times a day and also eat soup made with stock usually twice a day. I love it! My digestive system is healing quickly, and tests show I have very high levels of minerals in my system. Stock is definitely very healing.

—Monica Beauchane, Northwood, North Dakota ”

Why might cartilage work? Dr. Prudden thought the healing component might be the glycosaminoglycans, or GAGs. Proline, glycine, glutamine, and other components probably play a part as well. Cartilage, after all, is a whole food supplement, rich in many bioactive substances. It’s also a key component of any broth cooked from a mixture of bones, cartilage, and skin. That said, Dr. Prudden prescribed 9 grams a day of bovine tracheal cartilage, an amount unlikely to be consumed as food even by the most avid broth drinker. Even so, we have numerous testimonies on how daily broth consumption reversed chronic cases of irritable bowel syndrome, ulcerative colitis, and Crohn’s disease.

Where broth clearly excels is at prevention. When digestive diseases and disorders are already advanced, supplements may speed the healing, but broth should still stand as the dietary foundation. Those who don’t favor diets rich in soups and stews may achieve some of the benefits by adding gelatin powder to foods.

In conclusion, it’s time to trust our guts and know in our hearts that nourishing broth can heal body and soul.