Article 8 of 12 t his series of articles is devoted to the Second Factor in Chiropractic™. That factor is the recognition of visceral dysfunctions that cause involuntary muscle contractions, which perpetuate and prevent correction of structural misalignments. The resulting loss of joint range of motion and associated DISCOMFORT ARE OFTEN DIAGNOSED AS HAVING A STRUCTURAL CAUSE. If THE REAL CAUSE IS NOT ACCURATELY IDENTIFIED, THE PATIENT DOES NOT RECEIVE THE BENEFIT OF THE CHIROPRACTIC CARE THEY DESERVE, ft" DOESN'T MATTER IF THE STRESS IS STRUCTURAL, EMOTIONAL, OR CAUSED BY VISCERAL DYSFUNCTION. INVOLUNTARY MUSCLE CONTRACTIONS AND LOSS OF RANGE OF MOTION ARE ALWAYS INVOLVED, REGARDLESS OF THE SOURCE. THE KEY TO SUCCESS IS FINDING THE CAUSE BECAUSE WHEN THE CAUSE IS KNOWN, THE REQUIRED THERAPY BECOMES OBVIOUS. I have previously suggested that before the patient leaves the treatment room, you ask him or her to be seated and perform the 60-sccond chiropractic screening test. The purpose of the screening is to identify if stress, from either a structural or visceral source, remains after your adjustment. No doubt, the structural problems have been relieved, if not removed, and what probably remains is involuntary muscle contraction from a visceral source. Picking up from where we left off last month, we now follow food as it moves from the stomach into the duodenum. The Alkalinity of the Duodenum By the time partially digested food reaches the bottom of the stomach (pylorus), it should be quite acidic. It drips through the pyioric valve onto the wall of the upper portion of the small intestine (duodenum). The valve is never completely closed, but certainly is more constricted when the sympathetic nervous system is stimulated, as it is when the patient suffers from acute or chronic stress. Acid drips onto the mucosal surface of the duodenum and stimulates the production of choice) stokinin and secretin. I discussed the relationship of these hormones and the stomach last month. Cholecy stokinin is a peptide hormone in the mucosal epithelium of the small intestine and secreted in the duodenum. It causes the release of bile from the gallbladder and digestive enzymes from the pancreas. Secretin is a hormone secreted by the crypts 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. Recall that 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, such as the digestive system. A critical point to remember here is that the ingredients for stomach acid and the bicarbonate mixture that accompanies the pancreatic enzymes must be spared by the blood. In other words, if the stress in the patient's life is alkalizing, then the blood will not spare acid (carbon dioxide) in sufficient amounts. Whereas if the stress in the patient's life is acidifying, the blood will not spare bicarbonate needed by the blood to remain within the pH range needed to maintain homeostasis. The exocrine portion of the pancreas secretes digestive enzymes specific for each of the three classes of food components: protein, carbohydrates, and fats. These enzymes enter the small intestine through a duct leading from the pancreas to the duodenum. The more predigestive work that is done in the stomach, the less work the pancreas is required to do. This is incredibly important to us because an increasing amount of enzymc-dcficicnt and genetically modified food is included in our diets. The Jejunum and Sugar (Disaccharide) Digestion The main tasks of the jejunum arc as follows: Enzymatic cleavage of nutrients and absorption of lipophilic nutrients (proteins, fats, cholesterol, and the fat-soluble vitamins A. D. E. and K). Absorption of water, which induces an osmotic gradient leading to transport of electrolytes, carbohydrates, and amino acids. As food moves from the duodenum to the jejunum, actions started by the protein and fat-digesting enzymes from the pancreas will continue to work, and the digested molecules of food will be ready for absorption—all but the sugars, that is. The jejunum is an organ that is as special as the duodenum for digestion. The jcjunal membrane is lined with microvilli that arc packed with high concentrations of enzymes on the surface for the breakdown of carbohydrates. Thus, microvilli not only increase the cellular surface area for absorption, they also increase the number of digestive enzymes that can be present on the cell's surface. As you know, pancreatic amylasc cannot complete carbohydrate digestion. It only breaks carbohydrate molecules to the disaccharidc stage, which is two simple sugar molecules bonded together as follows: Lactose (from dairy products) Maltose (from grains) Sucrose (from white sugar and flour) These sugars must be digested further in order to be available to the body as nutrients. If these disaccharidases cannot be made in adequate amounts, or if excessive amounts of these sugars are ingested, then problems result in the bowel movements of the individual. First, lactose and maltose cannot be absorbed unless digested. Their presence in the undigested state creates painful gas and diarrhea. Second, sucrose can be absorbed directh across the gut wall. Since sucrose cannot be turned into energy, it will cause problems in the blood by stressing the kidneys as well as producing constipation. This is an incredibly common occurrence in your practice and it is often overlooked. Since the jejunum and ileum are innervated through the cc-liac ganglion from T9 to LI. there will always be substantial involuntary muscle contraction in the lower abdomen as well as in the dorsolumbar spine. The Jejunum and lleum There is no line of demarcation between the jejunum and the ileum. However, there arc subtle histologieal differences, such as: The jejunum lias less fat inside its mesentery than die ileum. The jejunum is typically larger in diameter than the ileum. The villi of the jejunum look like long, finger-like projections and are a histologically identifiable structure. The entire length of the intestinal tract contains lymphoid tissue, but only the ileum has abundant Pcycr"s patches, which arc uncncapsulatcd ly mphoid nodules that contain large numbers of lymphocytes and immune cells. Absorption of Nutrients The final stages of digestion and absorption occur in the small intestine. The end products of digestion arc now able to cross the layer of epithelial cells that line the intestinal wall and enter the blood and/or lymphatic system. The motility of the small intestine mixes the contents of the lumen with the various secretions and brings the contents into contact with the epithelial surface where absorption takes place and slowly advances the luminal material toward the large intestine. Involuntary Muscle Contractions Dysfunctions that arise within the small intestine cause muscle contractions in the abdominal muscles, particularly those of dorsolumbar flexion, but no less including dorsolumbar rotation and lateral bending. These muscles may have spinal inncn ations from T5 to L1. as opposed to those involving the psoas muscles, which arc innervated from L1 and L2. Muscle contractions associated with poor carbohydrate and lipid digestion center around the umbilicus, especially in babies suffering from colic. However, infants arc not the only ones suffering from the symptoms of gas. bloating, and flatulence. Of course, these areas of stress arc often found in inflammatory conditions within the digestive tract, such as irritation of the mucosal lining in the stomach and duodenum, as well as irritation in the lower bowel due to so-called "leaky gut." In that regard, we will continue our discussion of visccrosomatic problems next month as we move past the ilcocccal valve and into the large intestine. We expect to find pelvic and hip misalignments related with dysfunctions of the colon. 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 souglu-afler speaker and a prolific writer. Dr. LoomispublishedENZYMES: The Key lo Heallh/« 1999. Contact info: 6421 Enterprise Lane, Madison, Wl 53719, customerservice@ loomisinstitule.com
