Article 7 of 12 T HIS SERIES OF ARTICLES IS DEVOTED TO THE IMPORTANCE OF RECOGNIZING WHEN VISCERAL DYSFUNCTION PRODUCES INVOLUNTARY MUSCLE CONTRACTION, WHICH IN TURN REDUCES JOINT RANGE OF MOTION AND PRODUCES STRUCTURAL MISALIGNMENTS AND ASSOCIATED PAIN AND DISCOMFORT. We have previously detailed a simple, quick, AND CONVENIENT EXAM THAT I SUGGESTED YOU PERFORM ON THOSE PATIENTS WHO ARE NOT RESPONDING TO TREATMENT QUITE AS WELL AS YOU EXPECTED. We ALL ENCOUNTER THOSE CASES THAT CAUSE US TO WONDER WHETHER WE NEED A NEW TECHNIQUE, PROCEDURE, OR PERHAPS A NEW DEVICE OR MODALITY THAT COULD HELP US. My suggestion lias been to perform the 60-sccond chiropractic screening exam following your treatment and before the patient leaves your office. In particular, for this article and the previous two. I am referring to palpating across the top of the shoulders (universal stress point) and then checking for Pottengcr"s saucer (loss of normal thoracic kyphosis). Both arc evidence of involuntary muscle contraction that can be caused by visceral dysfunctions in the digestive system (and elsewhere). The Importance of Stomach Acid to the Biliary System My last two articles featured the importance of stomach acid formation and biliary function. I placed a great deal of emphasis on the use of proton pump inhibitors and H2 blockcrs. I suspect you may already be aware that main studies have shown that patients with \ ague digesth c complaints Iuiyc insufficient stomach acid to initiate protein digestion in the stomach. Adequate stomach acid is needed to stimulate the flow of bile so that lipids present in the chyme can be emulsified. This is essential so that the pancreatic enzymes can perform their functions. Enzymes simply do not penetrate fats unless they have been dispersed (emulsified). All food high in fat must be emulsified. Bile does not contain any digestive enzymes. Bile is simply a degrcascr. Foods such as peanut butter and salad dressings arc difficult to digest because of their oil content. Enzymes cannot penetrate the oil to digest the food unless the oil is degrcascd. Bile is necessary to expose the bonds within the food that the enzymes need to break. This is an important step in the digestive process. A large amount of gas will be formed if the action of bile is not adequate. Between meals, secreted bile is stored underneath the liver in a small sac known as the gallbladder, which concentrates the bile by absorbing salts and water. During a meal, the gallbladder contracts and a concentrated solution of bile is released into the small intestine. The presence of sodium and water added to the bile to neutralize stomach acid is equally important. When there is an insufficient amount of acid coming from the stomach, sodium and water arc extracted from the bile and put back into the blood. For this reason, gallbladder problems and stomach acid deficiencies arc often synonymous. It is important to remember that predigestion of protein in the stomach by food enzymes creates acidity by breaking the amino acid bonds and releasing acid molecules, thus improving the How of bile. When water and sodium are reabsorbed from the bile into the blood, the bile is thickened and its How is very sluggish. This allows the formation of gallstones. They grow very slowly, but the symptoms of gas. bloating, pain, and constipation gradually become overwhelming. The digestion of fat in the small intestine requires special processes to emulsify (degrease) fat molecules. This is performed by bile salts (detergent molecules) that arc secreted by the liver into the bile ducts, which then move on to join the pancreatic duct and ultimately empty into the duodenum. Here arc two fascinating facts concerning the digestion of lipids: A mixture of the lower glyecrides with bile salts and fatty acids furnishes the best medium for the cmulsification of fats. You might wonder how this can be accomplished and the answer is by predigestion in the stomach, but that is a subject for a different article. After the initial digestion of a small amount of fat to mono- ordiglyceride and fatty acids, these compounds combined with bile salts will emulsify the remaining fat. The emulsified fat may be more easily digested because of the vast surface area available. However, a great deal of it remains as emulsified triglyccride. Pancreatic lipase docs not completely digest fats. The triglyccridcs are digested to di- and monogh ecrides and fatty acids. Lipid digestion occurs rapidly at first, but the rate slows down before 30% of the fatty acids have been liberated. This is because only the initial flow of pancreatic juice is high in lipase. Thus, at least 50% of the fat is presented for absorption as a mixture of fatty acids and mono-, di-. and triglyccrides. These digestive end products are dissohed in the lipid portion of the bile acid micelles. Micelles arc elongated submicroscopic particles that penetrate the "brush border" of the intestine. Any dysfunction of the above processes will cause involuntary muscle contractions across the top of the shoulders and loss of normal thoracic kyphosis. Recall that the stomach and pancreas arc innervated from T5 to T9 and synapse with the greater splanchnic nerve and ecliac ganglion. However, recall that the spinal nerves from Tl to T4 synapse with the superior cervical ganglion and that accounts for the many cases of chronic muscle-tension headaches associated with digestive complaints. Stomach Acid and Hormonal Secretions from the Duodenum Cholccystokinin is a peptide honnonc in the mucosal epithelium of the small intestine and secreted in the duodenum. It causes the release of bile from the gallbladder and digestive cn/ymes from the pancreas. Sccretin is a hormone secreted by the cnpts of Lieberkuhn^ in the duodenum. It helps regulate the pH of the duodenum by inhibiting the secretion of stomach acid and stimulating the production of bicarbonate and water from the pancreas. This is necessary to activate the pancreatic enzymes. The Pancreas The honnones fonned in the wall of the duodenum also signal the pancreas as to exactly how much pancreatic secretion of enzymes and bicarbonate will be needed to digest the amounts of the four major food components—protein, sugars, starches, and lipids—that arc leaving the stomach. Pancreatic protease digests the long protein chains found in meat. eggs, and cheese, etc.. into smaller protein chains that can be absorbed across the gut wall into the blood stream Pancreatic amylasc digests starch and glycogen. but not cellulose, to fonn the simple sugars, namely lactose (dairy), maltose (grains), and sucrose (white sugar) Pancreatic lipasc digests neutral fat into glycerol (to be converted into glucose) and fatty acids. The Effect of Chronic Stress on Digestion One of the major effects of the stress reaction is to increase blood flow to the muscles and reduce blood flow to organs not essential for the stress response and that includes the digestive system. Our 60 Second Chiropractic Screening Test locates involuntary muscle contraction and it is up to the clinician to determine the cause, be it structural or visceral. The test incudes Postural Analysis and the Sitting Exam with passive shoulder abduction and palpation of the Universal Stress Point. Pottcrnger"s Saucer and Hcmipch is. Any form of prolonged stress can create this diagnostic dilemma and I have delineated the specific cascade of physiological events involved with chronic stress and detailed win-it doesn't matter if the stress is structural, emotional or caused by visceral dysfunction. Muscle contractions and loss of range of motion arc always involved regardless of the source. The key is to find the cause because when it is known the required therapy becomes obvious. Dr. Howard Loomis has an extensive background in enzymes and enzyme supplements. He is the founder and president of Enzyme Formulations®, Inc. His knowledge of physiology, biochemistry, and enzymol- ogy has made him a sought-after speaker and a prolific writer. Dr. Loomispublished'ENZYMES: The Key lo Health//; 1999. Contact info: 6421 EnterpriseIxine, Madison, WI53719, customerservice@ loomisinstitute.com
