Dr. Justin and Evan discuss the root causes of gut pain, emphasizing a functional medicine approach to identify and treat issues like H. pylori and food sensitivities.
Dr. Justin Marchegiani: Hey guys, it's Dr. Justin Marchegiani. Welcome to the Beyond Wellness Radio podcast. Feel free and head over to justinhealth. com. We have all of our podcast transcriptions there, as well as video series on different health topics ranging from thyroid to hormones, ketogenic diets, and gluten. While you're there, you can also schedule a consult with myself, Dr.
Dr. Justin Marchegiani: J, and or our colleagues and staff to help dive into any pressing health issues you really want to get to the root cause on. Again, if you enjoy the podcast, feel free and share the information with friends or family. Hey guys, Dr. Justin Marchegiani here with Evan Brand. Today we're going to be talking about stomach pain or gut pain.
Dr. Justin Marchegiani: What is the root cause and why are you in pain? We're going to talk about it from a functional medicine holistic perspective. Evan, my man, how you doing brother? Evan Brand Hey, doing great,
Evan Brand: man. Let's jump into. Let's get going. Take care. Bye. Bye. I'm going to go straight for H. pylori as a big cause of gut pain, you know, 51 percent of the population.
Evan Brand: It could be higher, but that's what I found online. 51 percent of the world population has H. pylori. So this is not a rare problem. We're talking about billions of people be with, you know, B for billion, billions of people on this planet walking around with this bacteria that damages the parietal cells of your gut and can create not only pain, but nausea, It could create anxiety.
Evan Brand: If you look up in the literature, H. pylori and mood issues, there's a link to mood issues as well. So, if you're walking around with stomach pain or you have reflux for example, the guy at the gym, the guy at the front desk, somehow we got on the topic of his gut. He's 20 years old and he's been to like 10 doctors and nobody can figure out what's wrong with his gut.
Evan Brand: I'm like, dude, you probably have H. pylori. Let's run a stool test. So, we're gonna see if we can help him. But. This thing affects people as young as 18 months old. We've had people that are bringing their children that are two and three years old to me and saying, Hey, they're saying, mommy, daddy, my belly hurts.
Evan Brand: You know, my oldest daughter summer, when she was two, she had H pylori and she was saying belly hurt, belly hurt when she was two years old. So I just want to make sure people know that this is not something that just affects 60 and up. Like when you think of. A 70, 80 year old person who's complaining of gut pain.
Evan Brand: You think, oh, you're old, and you just blow it off, but you could be two years old walking around with this bug damaging your gut. Dr. Justin
Dr. Justin Marchegiani: Marchegiani 100%. You gotta get to the root cause. I mean, when we look at gut pain, there's a handful of reasons why. So obviously, you have microbes, so we can highlight For instance, H.
Dr. Justin Marchegiani: pylori and the gastritis kind of stomach area. So this is on a mirror image mode. So it may look like the right side, but this is the upper left quadrant right here, even though they look right, upper left quadrant, and your stomach's going to be, you know, for the most part, you draw a line right down here.
Dr. Justin Marchegiani: where your sternum is, and then you draw a line like this way here. It's gonna be in this upper left hand quadrant area. And so, when you have pain there, it's usually gonna be H. pylori. There's gonna be maybe some stomach acid imbalances. A lot of people don't realize that lower stomach acid tends to create inflammation in the gut because you don't have the ability to break down your proteins and fats as well.
Dr. Justin Marchegiani: And then essentially acids and acidity, they also disinfect the gut, and they also close down the esophagus. So when you don't have enough acid, it allows microbes to grow, it prevents the esophagus from closing down so things can rise up, and then the foods in your stomach ferment. And then there's rotting in acids from the fermentation process that rise up on top of that as well.
Dr. Justin Marchegiani: So it's kind of dual factorial. And so when we look at it, we try to like get to the root cause of all that. Because you can't just say, well, it's H. pylori. Yeah, H. pylori can lo can Raise the pH, lower stomach acid levels because it produces an enzyme called urease. Urease hits the protein that's being metabolized in the stomach, which creates urea.
Dr. Justin Marchegiani: That urease hits urea, spits out CO2 and ammonia. Ammonia's got a pH of 11, so it's very alkaline. And then when they give you the urea breath test, they're looking for that increase in CO2 that's coming off of that urea. So they, the high level of CO2 triggers a positive on the H. pylori breath, but you're, you're raising your stomach acid you're lowering it, you're raising the pH.
Dr. Justin Marchegiani: So high pH means lower stomach acid. They're kind of inverse, right? And so that means you're not gonna break down your food as well. That means you're not gonna close down that esophageal sphincter as well. And that means you're not going to disinfect your gut as well. Disinfection, digestion, and closing the esophageal sphincter are the first things that poor gut function and H.
Dr. Justin Marchegiani: pylori cause. Well
Evan Brand: said, and you can get this via your partner. So boyfriend, girlfriend, husband, wife. I mean, even if it's not intimate contact, this is a pretty contagious factor. Yeah, even just with your kids,
Dr. Justin Marchegiani: just sharing drinks or, you know, just like non intimate kisses, right? That can eat sometimes be enough.
Evan Brand: Yeah. And we've seen it. I mean, I've tested families where there's three, four, five, six kids, and usually the whole family, husband, wife, and all the children have it. So. If you and one of your children are suffering, or you and your husband, or you and your wife are suffering, it's likely that you need to work on both of you all.
Evan Brand: And of course, it can get a little bit pricey if you're testing five, six, seven different family members to do a whole functional medicine workup. And so sometimes we'll try to just. Do a spot treat, if you will, and just give some of the similar herbs to the other family members and say, Hey, look, this is your insurance policy.
Evan Brand: They probably have it as well because they have these symptoms you're describing for yourself. You tested positive. So here you go. And we'll implement a protocol across the family. And the results are amazing. Now, I guess we shouldn't ignore food sensitivities, though. My daughter. My oldest
Dr. Justin Marchegiani: she brought it's all connected.
Dr. Justin Marchegiani: It's all. It's very rare that you just have one issue. So people are listening. People tend to get myopic on one thing. A lot of time. It's a bunch of things. So I always tell patients you have the right to have more than one issue going on at the same time.
Evan Brand: Yeah. So You know how it is end of school year, kids are getting junk at school.
Evan Brand: They're bringing home junk. So they're bringing home like crackers, cupcakes, any of the conventional food and almost all the conventional cheap garbage that's going to be served at birthday parties, school luncheons, et cetera. It's typically going to be gluten and dairy. And my oldest, she knows that if she eats those things, her belly hurts, but she tries to forget and say, No, I'm fine.
Evan Brand: Gets the cupcake or whatever. My belly hurts. Oh, what'd you have at the school party? Oh, it was a cupcake. Oh, what's that? Gluten and dairy. That's why your belly hurts. And so these food sensitivities cannot be ignored.
Dr. Justin Marchegiani: Oh, a hundred percent. It's the ongoing kind of like, kind of like back and forth my wife has with I like when we have little issues with the kids, you know, they'll go out and they'll have a little something that maybe is off their eating plan, which is fine.
Dr. Justin Marchegiani: They're kids. I want them to live a little bit. But then she'll look at me and be like, Oh, you know, Hudson's got this pain. And she looks at me like there's some crazy stuff going on. And I'm like, well, he ate some junk today, so get him back eating good. And we'll see where he's at in three days. But that's my answer every time.
Dr. Justin Marchegiani: And. 99. 9999 percent of the time, he's, it's fine in a few days. So it's like, I always start with the foundational stuff. There's no reason to, to go deep into like some like, oh, it has to be this crazy thing. It's like, no, we'll start with the food. Start there first.
Evan Brand: Yeah, and you know, if you've suffered for a while, maybe there is some level of health anxiety you have and you think, okay, I've got gallstones or I've got Kidney stones.
Evan Brand: Like there are some more severe cases and there are some cases where you do need to go get checked out. So don't let us, you know, blow off those things. Like if you feel like it's severe, you know, if you really like can't even get out of bed with stomach pain, you need to go get an ultrasound, maybe a CT scan, like you need to see a conventional doctor, maybe a gastro first to rule out some crazy things.
Evan Brand: Cancerous polyps in the colon. Like there are some major things that could justify going further investigation from conventional medicine, but we're speaking to the people who've likely already been to 10 doctors, and they've already had all that pathological stuff ruled out. Now we're focusing on the dysfunctional phase of gut issues, and that's where we come into help.
Evan Brand: Dr. Justin
Dr. Justin Marchegiani: Marchegiani Yeah, I mean, I'll be straight, most people that have already come and seen me and you, most have already kind of been through a general gastro workup, right? And they, I just saw a patient, you know, 30 minutes before this podcast, right? We were chatting. And she's had IBS her entire life.
Dr. Justin Marchegiani: And all she's had thrown at her, antidepressants off label for motility, antispasmodics, acid blockers. laxative. That's it. Like, there's not a lot of options. And, you know, IBS, basically, it's a diagnosis of exclusion. So you're already ruling out like, you know, cancer and like bleeding and ulcers and like bowel disease.
Dr. Justin Marchegiani: So all those things are, you know, tend to be ruled out. When we run chronic stool tests, we can usually rule out a lot of those things too, because we're running calprotectin and eosinophil X. And if we don't see any crazy amount of inflammation, that could A lot of times can rule that out, especially if we don't see blood.
Dr. Justin Marchegiani: So that's usually a good, like, okay, at least the big stuff already crossed out. But people that usually already see us, they've already gone that road, at least for a general workup, and they've already had the big stuff ruled out. And so, when they come to us, they really want to get to the root cause.
Dr. Justin Marchegiani: Kind of, that's the next leading step, right? Evan Brand
Evan Brand: Yeah. And parasites, we'll throw those in the mix here. So food sensitivities the H. pylori, and you said microbes. So when we say microbes, we're talking anything from citrobacter to Klebsiella. There's maybe a dozen or more that you and I test for via stool and urine.
Evan Brand: But then, you know, the parasites are always a big one as well. And just to be clear, this is not like you had to travel to Mexico. You don't have to go to Bali. You don't have to go to anywhere. Like exotic, you know, just being in America, you can get exposed to these things through the food supply, through water, freshwater, lakes, rivers, creeks, streams, which those are all fun things to do.
Evan Brand: But most freshwater in the U S you're going to get exposed to potentially Giardia Cryptosporidium. You'll see occasionally there'll be some outbreak in the news swimming pool, a hundred cases of diarrhea and it's crypto that did like somehow got in a swimming pool. Maybe they didn't do enough, you know, disinfectant or, or.
Evan Brand: Salt or chlorine and you'll see an outbreak every couple years where they close a pool but beyond that parasites are this thing that sound very exotic and You have to get an infectious disease doctor involved and but for you and I they're not that exotic I mean we see this stuff every day. So we're kind of almost just numb to it.
Evan Brand: I guess you'd say so if I see Two three four parasites. I'm like, oh, yep. Glad we found your answers for your gut pain
Dr. Justin Marchegiani: Oh exactly. And you know, i'm a little jaded because I have seen over the years, you know, a thousand patients come into me, they go to their GI doc, and their GI doc, they kind of look at a lot of these conditions as like almost third world or type of tropical diseases.
Dr. Justin Marchegiani: And so they don't really acknowledge that it really is a big deal here. And it's not that it is the big deal, it's just the whole milieu of everything happening together. So like, I mean, I can just tell you a patient that I saw last week, right? She came in, and she's been going on for a decade, and she had C.
Dr. Justin Marchegiani: diff. She had pathological E. coli 8, you know, 0157 E. coli. She had C. diff toxin A and B. She had significant levels of Candida. Significant levels of Candida. There was a parasite issue. And then also 100x to 1000x levels of Citrobacter and Pseudomonas. And it's like, NH pylori. It's like, there's like five or six things there.
Dr. Justin Marchegiani: And it's like, plus there's food allergy. plus there's biliary insufficiency, plus there's not enough stomach acid. So it's like, man, there's like eight different things. And like, even if you were just like the microbe guy and you picked up a microbe, it's like, well, did you get all of them? And did you fix the gut?
Dr. Justin Marchegiani: And did you fix the digestion? And then there's also motility issues. And it's like, there's so many things that have to be addressed. You really have to have like a program where you layer everything in, or it gets very overwhelming for the patient. But And the practitioner too. So it's like, and then also if there's a lot of pain issues, okay, we have to calm down the gut because maybe the gut can't even handle stomach gas, right?
Dr. Justin Marchegiani: We're talking about gut pain. You, you may need stomach acid, but you may not be able to handle it. And so we may need to be focusing on bitters or enzymes or like, you know, your, your gut restore product or my GI restore product that has the glutamine and the aloe and the, and the zinc. Zinc is shown to be very anti inflammatory.
Dr. Justin Marchegiani: It helps the gut permeability, you know, the DGL, the okra, the vitamin U. We may also be needing to add in like the ginger tea with the manuka honey. So many things that we may have to stage in and layer in and sometimes you can't do it all at once. You kind of have to have a program where you, you focus over the next three to six months and how we get everything addressed.
Dr. Justin Marchegiani: Evan Brand Yeah,
Evan Brand: well said. And if you were to go the conventional route, just to quickly compare and contrast, let's just say they sent you over to the infectious disease doc and then they got you on antibiotics. They had you on anti parasitic medication. Maybe you get better, but what's the collateral damage of that?
Evan Brand: Now you have these rebound infections from the antibiotics. If you're doing triple therapy for H. pylori or quadruple therapy now.
Dr. Justin Marchegiani: Dr. Justin Marchegiani Yeah. I mean, like big thing out of the gate is the stool test and they tend to use as an insensitive. It's more stool antigen base where they put a a stain on there and they look at it under the microscope.
Dr. Justin Marchegiani: If they see antamoeba histolytic or Giardia, great, then they can treat it. But a lot of times it can be tough for them to even want to do that test. They're more than likely to just throw drugs at you for a couple of months first trying to control the symptoms. And let's say they get some relief. Well, the root cause may still be just sitting there and festering for a long period of time and then years later, now that microbe is at a higher level, and then now they say, okay, now we need to start looking deeper.
Dr. Justin Marchegiani: So they may just try to cover up the root cause in the beginning with just some drugs. And you have to be aware of that. That happens all the time. Evan
Evan Brand: Brand Yep.
Dr. Justin Marchegiani: Well,
Evan Brand: this is something that people can get tested and figure out the answers within two to three weeks. So, if you're suffering, if you're like, okay, I've suffered for a year or a decade, you can reach out.
Evan Brand: We can get these labs done pretty much anywhere in the world. I mean, we have international distributors all over. There's some in the UK. There's one in Australia we can use. So, your location on the planet doesn't matter. And you don't have to go wait in an office and read a boring magazine and sit next to a box of Kleenex and listen to the lady next to you coughing her head off to get seen.
Evan Brand: You can do this from the comfort of your home. So I would advise you reach out. I got to run because I'm going to go jump on to another presentation. But Dr. J, I'm gonna let you keep ripping it and I'll just tell people evanbrand. com is my site. So if people want to reach out or Dr. J, that's justinhealth.
Evan Brand: com. But man, if you want to keep ripping, go for it. I'm going to jump off.
Dr. Justin Marchegiani: Dr. Justin Marchegiani Yeah, I appreciate it, Evan. Thanks for being here for a little bit and sharing some insight. Feel free to head over to Evan's site as well. Evan, my man. We'll be in touch, brother. Evan Brand All right, I'll see Alright, take care.
Dr. Justin Marchegiani: Alright guys, so just me and you here, so in general, when we look at gut pain, we have to look at the root cause. It can get a little bit complicated, so it's good to get ruled out by your conventional family medicine doc or, or if you have to go to a gastro, it's good to at least get, you know, looked at and have them cross some big boxes up.
Dr. Justin Marchegiani: I think that's, that's helpful. I think it makes people feel better, makes them feel like they're not, you know, missing any big stuff. But just know that 95 percent of the time, it's going to be here's. medication to control that symptom. And then now you're, now you're like, what do you do next? Right? And that's most people that I see, you know, over my last 15 years of experience, 5, 000 plus patients.
Dr. Justin Marchegiani: That's what I see day in, day out. It just repeats over and over again. You go see a conventional medic. Let's say we're focusing on gut pain right now. Let's say you go see your conventional medical doc or a gastro. It's going to be all right. Well, let's do you have any ulcers? Maybe they run an occult blood.
Dr. Justin Marchegiani: in a stool test, see if they have any occult blood. We have that on our general screening too. They may throw an acid blocker at you because they're just assuming there's probably some gastritis. Maybe some reflux, maybe some silent reflux they may give you Gaviscon or some kind of a coating agent to kind of coat the gut a little bit to, to give it a little bit more resiliency.
Dr. Justin Marchegiani: If you have a really good gastro, maybe they run a SIBO breath test, a lactulose breath test where they have you blow in a tube, give you a lactulose solution and every 20 minutes you blow in that tube afterwards and they look at the methane and hydrogen and maybe even urea gases and see what happens there.
Dr. Justin Marchegiani: And then they can make assumptions that you have methane or hydrogen dominant SIBO based on those gases being overly high at certain time frames within that 2 3 hour period. That may happen next. And then after that, if they don't diagnose you with Irritable Bowel Disease, right, there's like no ulcer, there's no IBD, like there's no Crohn's or Ulcerative Colitis, then for the most part, and like you don't have any like crazy cancer history.
Dr. Justin Marchegiani: in your family, then they would, they'd probably want to do a scope if they needed to go deeper. They may want to do a scope as well if it's chronic, just to rule out the IBD issues. But after that, you know, if you're in that IBD camp, okay, they're going to recommend maybe prednisone, maybe a biologic, maybe Humira.
Dr. Justin Marchegiani: Give you some medications to control some of the symptoms, whether it's an SSRI for motility, whether it's an antispasmodic, whether it's a laxative or a stool softener, they're gonna just come in there and and just try to spot treat with the symptoms. They're gonna get the pain down by either a prednisone or they're gonna give you an acid blocker and a Gaviscon to work on the coating of the stomach, but that's it.
Dr. Justin Marchegiani: You get none of this fixes the root cause. There may be some root cause if they, let's say, do a neomycin refaximin to knock down some of the SIBO, but A lot of times, there's more stuff than just a SIBO. They very rarely work on the beneficial probiotics on the backside. They very ra rarely work on like the butyrate and the prebiotic fibers as well.
Dr. Justin Marchegiani: They very rarely work on actually up regulating your digestive function by improving acid levels, enzymes, and bile salts. When you look at how most drugs work, most drugs work by inhibiting enzymes or inhibiting different reuptake ports in the body. And so, they're just controlling symptoms, where on the functional medicine side.
Dr. Justin Marchegiani: We're trying to upregulate physiology and allow the body systems to work better. Now, acutely, there may be a place for an acid blocker if I'm in a, in a gastritis flare. There may be a place for a tiny bit of prednisone if I'm in an ulcerative colitis flare. There may be a place for these things. The problem is, there may be a short window for a allopathic drug.
Dr. Justin Marchegiani: The problem is, if that, that window then tends to be, if it worked once, it tends to be expanded chronically, and that's where you're at forever. And then the, the doses of drugs go up over time, or they change to stronger drugs over time. That's the problem. You get on this conveyor belt of polypharmacy, symptom management, and then you're managing the side effects of the drugs that were first used to begin with.
Dr. Justin Marchegiani: And it becomes a vicious cycle. So I always want patients to think like, all right, if I go to this doctor, what are they going to do? What do they think the root cause is? Don't make the assumption that they know anything about nutrition, supplements, functional medicine functional tests natural medicine, anything like that.
Dr. Justin Marchegiani: They tend to be really good at diagnosing a pathology and then using a very specific treatment to address that microbe. If they can catch it, if their tests are sensitive enough, and then it's going to be symptom management for everything else. And the symptom management does not fix the underlying root cause.
Dr. Justin Marchegiani: A lot of times, Functional medicine symptom management tends to be a little bit better because it's actually supporting digestion. It's enhancing motility. It's gently nudging microbes down. Maybe it's some bitters that are helping digestive secretions or helping to nudge motility in the right direction while we do other testing and work on the adrenals, work on the parasympathetic nervous system response, work on the diet, work on the lifestyle.
Dr. Justin Marchegiani: So there's so many different things that can be done on the functional medicine side that's just outside of the head of your gastrointestinal or family medicine doc. And the reason why is because I sit down with a patient, we're talking about things for an hour, we're looking at a food log, we're really diving in, in a five minute visit.
Dr. Justin Marchegiani: with your family med or gastrodoc, which is all the insurance is going to pay. And there's probably a three month waiting list or six month waiting list to even get in, right? That's it. So, you're, you're just kind of handcuffed. So, I always just tell patients, go into it with a realistic perspective. I think it's good to get ruled out by your conventional or gastro person.
Dr. Justin Marchegiani: I think it's great to rule out the big stuff. I think it gives you peace of mind. It prevents that, like, That neurosis of going like, what if it's this? What if it's that? It's good to kind of cross those things off. And then it's like, all right, good. So this is more of a functional issue. Now let's work on getting to the root cause.
Dr. Justin Marchegiani: So I hope that helps here out of the gate. If you have questions here, put them in the chat. Love to go through it with you guys and hit some things on this as well. Could Candida also be a cause with gastritis? I mean, typically you're going to see H. pylori and more stomach issues, but could Candida be a stressor?
Dr. Justin Marchegiani: in your gut. Yeah, you could have SIBO overgrowth. You could have candida or small intestinal fungal overgrowth as well. All these things could be at play. Now, of course, you could have low stomach acid, low enzymes, low bile salts. All of these things could be happening in the background as well. So you really, really want to look at this holistically and say, what is the underlying issue?
Dr. Justin Marchegiani: Now, the question is, I get this all the time. So when I have stomach pain, or let's say gastrointestinal pain, what do I do? So the first question is, where's the pain? The pain's by the belly button, it's probably the small intestine. If the pain's like in the lower quadrants, like either like the sigmoid or the descending sigmoid colon.
Dr. Justin Marchegiani: So the colon leaves on the left leaves left. So your sigmoid and your descending colon on the left on your right, it's going to be your ileocecal valve where your small intestine from your ileum goes into the cecum part of the cecum. colon, its last large intestine. And then up the right side, again, it's gonna look opposite here in my video, but you're gonna have your ascending, your transverse, your descending, and then you're gonna have your, your sigmoid colon as it goes into your rectum and your anus.
Dr. Justin Marchegiani: And so, if you have pain down in that lower left quadrant, right, that could be more sigmoid descending. If it's at the end of your rectum, that could be more hemorrhoids. The veins in that, in those hemorrhoid areas and the anus rectum are inflamed, usually because of that extra bearing down or that valsalva kind of internal abdominal pressure because the stool is not moving properly because either dehydration or there's a lot of indigestion there, not enough stomach acid or enzymes, the stool needs to be softened, softened, right?
Dr. Justin Marchegiani: So all those things could be at play there. There could be just general inflammation in the small intestines if it's more in the belly button area. So, on a comprehensive stool test, we're gonna look at calprotectin, that's gonna be a really good marker for stomach inflammation, or I should say it's gonna be a good marker for small intestinal inflammation, or we'll run eosinophilic protein.
Dr. Justin Marchegiani: EPX to see what's going on more large intestine base. So we can run some of these markers and that gives us a good window. I had a patient last week where she was 650 or so on Calprotectin back to like 10 or 20. So that's an amazing, you know, 650 is like, you know, that's your like a Crohn's patient right there.
Dr. Justin Marchegiani: And so she was back to like 10, 15, 20 right now, almost single digit area. So that's a major, major drop in inflammation. So I love seeing that. So we can look at these inflammation markers. Again, I don't, I don't jump after those markers, but I want to see if our treatments helping. We're going to add in healing, soothing nutrients to work on the gut lining.
Dr. Justin Marchegiani: We're going to be adding in, you know, my GI restore, right, glutamine, aloe, and be adding in DGL licorice, we're going to be adding in okra pepsin, or we'll be adding in some okra, vitamin U, very good for the gut lining. We're going to be adding in ginger tea. And some Manuka honey. We may be insta potting our foods, just to really decrease the fiber, allow the motility to be really easy, take out, you know, make the nutrients so absorbable and so broken down.
Dr. Justin Marchegiani: Maybe bone broth as well. Get a lot of those amino acids to be very liquid and mucilaginous and very good for that gut lining. Again, we're gonna be dialing in enzymes and acids, maybe bitters, maybe HCL is not even the right thing right now. I tell patients, my analogy I've been using for a decade is, hey, you You go out, you get a sunburn, you may have back pain, but because you got a sunburn, that massage therapist or that chiropractic adjustment's gonna create too much pain for you.
Dr. Justin Marchegiani: So you may have to work on something more gentle or use more aloe in in, in soothing nutrients on the skin before someone actually touches you. Well, it's the same thing with gastritis or gut pain. You may need to bring the inflammation down a lot more before you do anything more invasive. Even though that invasive thing is the right thing, it just may not be at the right time.
Dr. Justin Marchegiani: And so the timing of everything is so, so important. You really want to look at everything holistically and get the timing of everything dialed in. And then when you're dealing with small intestinal issues, Digestion starts in the stomach. So, I always want to make sure food is chewed up well. I want to make sure we look at microbes.
Dr. Justin Marchegiani: I want to make sure we have the enzymes and the acids and the bile salts dialed in. As we start to consume things and our food goes from our stomach to our small intestine, good pancreatic output, good bile output, and making sure our stomach did the good job is what sets us up for better digestion in the small intestine.
Dr. Justin Marchegiani: And so if I can start with good digestion in the stomach, that sets the small intestine up for a much better place in where we're going to be able to break things down and absorb things so much better out of the gates. And then, of course, we're going to do testing. I want to see where the inflammation levels are.
Dr. Justin Marchegiani: Do we have blood in the stool? And if we have blood, most blood is usually from hemorrhoids, by the way. And so, or, yeah, mostly hemorrhoids, I would say. If a woman's on their period, you know, sometimes there can be a little cross contamination there too. But, you know, mostly hemorrhoids. We want to take all that into consideration as well.
Dr. Justin Marchegiani: So, alright guys, I hope you enjoyed today's podcast. If you did, please let me know. Again, Evan was on here for the first bit. Head over to EvanBrand. com to reach out to Evan. Again, Dr. J. JustinHealth. com. We see patients worldwide. If you want that good functional medicine support, get to the root cause, let us know.
Dr. Justin Marchegiani: We'll put a link down below of the different products and supplements that we use. If you want to support us, please do. And there'll be a link to register review as well. And if you guys enjoyed it, please subscribe. I'll be responding to comments here. I'm checking my phone daily on comments. So I will be responding to you.
Dr. Justin Marchegiani: So if you want to get my take on things, leave me a comment below guys. All right, have a phenomenal day. You take care. Bye now.
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