Small Intestines

Anatomy and Physiology

The small intestine is the largest part of the gastrointestinal tract and is composed of the duodenum, which is about one foot long, jejunum (5-8 feet long), and ileum (16-20 feet long).

The duodenum is the major portion of the small intestine where enzyme secretion takes place. The small intestine secretes sucrase (breaks sucrose into glucose and fructose); maltase (breaks maltose into glucose); and lactase (breaks lactose into glucose and galactose, lactase is missing in a good percentage of people). It also secretes petidase to split peptides (from protein) into amino acids, and lipase to break down fat into glycerol and fatty acids.

The duodenum receives bile from the liver and gallbladder, to decrease the surface tension between the large fat globules and water, and break them into smaller globules that can be acted upon by lipase. Lipase, amylase, trypsin, chymotrypsin and sodium bicarbonate are received from the pancreas upon hormonal signals from pancreozymin and other hormones (produced in the small intestine) and neural signals from the vagus nerve.

Epithelial cells in the small intestine secrete over ½ gallon of a neutral fluid daily to supply a watery substance to mix with the chime and provide a substance to aid in electrolyte and vitamin absorption through the villi.

Brunner’s glands in the duodenum secrete mucus in response to secretin, vagal stimulation, and direct stimulation of food in the small intestine. This mucus protects the duodenal wall from the digestive juices. Goblet cells in the mucosa also produce mucus. In general the duodenum isn’t as well protected with mucus as is the stomach and is more prone to ulcers. A deficiency of pancreatic juices to neutralize the acid chime from the stomach, or stress causing sympathetic inhibition of enzyme secretion can lead to duodenal ulcer formation.

Approximately ½ the carbohydrate digestion is performed by amylase from the pancreas, 40% from the saliva, 10% from intestinal amylase. Ninety five percent of the fat digestion is performed by pancreatic lipase and 5% from intestinal and stomach lipase.

Almost 90% of our daily fluid intake is absorbed in the small intestine. The small intestine is covered with villi and microvilli. They increase the surface area of the intestinal wall exposed to chime by 60,000%. The increased surface area makes the small intestine very efficient in absorption. Capillaries in the villi absorb amino acids, glucose, fructose, and galactose while lacteals absorb fatty acid and glycerol to travel through the lymphatic vessels.

As chime enters the small intestine, the acidity of it causes secretion of the hormone secretin, which signals the pancreas to secrete alkaline juices to neutralize the chime. The chimes also initiate a type of small intestine contraction known as segmentation, which helps to mix and chop the chime, and propel it along. These contractions occur about once every 5 seconds in the duodenum but only half as fast in the ileum. Peristaltic waves also occur and aid in chime propulsion. It takes about 2-3 minutes for the chime to advance 1 inch, and all together food can remain in the small intestine between 3-10 hours normally. Eating and stomach distention both can increase peristalsis in the small intestine. Harmful irritants reaching the small intestine can initiate what is called a peristaltic rush, which can empty the entire small intestine into the colon within a few minutes. Food you are allergic to can also do this and lead to diarrhea due to the lack of time for fluid absorption.

Symptoms of Small Intestine Dysfunction

1) General symptoms of small intestine dysfunction include abdominal bloating and pain, gas, diarrhea, nausea.

2) Lactase deficiency can cause gas, nausea, bloating, cramps, diarrhea, asthma, congestion, on ingestion of dairy products.

3) It is felt by many that congestion in the lacteals and lymphatic of the small intestine contributes to narcolepsy.

4) Symptoms of duodenal ulcers include midmorning and middle of the night pain relieved by eating. The pain lasts for 1-3 weeks at a time and then subsides.

Causes of Small Intestine Dysfunction

1) Some causes are really primarily with the liver, pancreas, gallbladder, and stomach, all affecting digestion in the small intestine. The cause must be determined.

2) Nerve pressure in the lower thoracics can affect small intestine function (see Appendix A).

3) Stress can alter enzyme secretion and cause dysfunction.

4) Antibiotic therapy (for infections, etc.) can kill off helpful bacteria in the small and large intestine and can cause an alkaline gut where harmful gas producing bacteria will proliferate. Lack of HCl will contribute to this also.

5) Spices, alcohol, caffeine, can cause irritation and a resultant over-secretion of mucus in the small intestine. This can "plug" the villi and decrease vitamin and mineral absorption leading to various deficiencies. In this case even a healthful diet won’t be assimilated properly.

6) Causes of duodenal ulcers:

a) Increased HCl secretion in the stomach up to 1500% of normal (see stomach chapter for causes).

b) Stress causing increased sympathetic nerve flow and decreasing secretion of mucus from Brunner’s glands.

c) An overworked pancreas from overeating, eating between meals, etc., not secreting enough bicarbonate.

7) Eating any food you’re allergic to can cause disturbances in the small intestine.

Other Indications of Small Intestine Dysfunction

1) One of the following muscles may test weak on manual muscle testing in the presence of small intestine weakness: quadriceps, rectus and transverse abdominis (see Appendix C and figures 13.1, 13.2, 13.3).

Prevention and Treatment of Small Intestine Dysfunction

1) Avoid spicy food, caffeine, alcohol, refined carbohydrates (sugar, white flour, white rice) so you won’t over secrete mucus and decrease your absorption.

2) Make sure your liver, pancreas, gallbladder, and stomach are functioning properly (see respective chapters).

3) Eat lots of raw fruit and vegetables to promote growth of healthful bacteria.

4) Garlic will kill harmful intestinal bacteria and promote the growth of beneficial acid producing bacteria.

5) Charcoal tablets and anise tea both is effective in relieving gas.

6) If you have food allergies causing upset, go on the adrenal recovery diet and at the same time avoid the suspect food. Do the allergy desensitization technique (see Appendix D). Check and correct the following if needed: adrenals, thymus, pituitary, thyroid, stomach (mainly hypochlorhydria). Always keep sweets to a minimum. If your body is missing lactase, this technique won’t correct it, but we have seen allergies to wheat, gluten, beef, corn, soy, potatoes, tomatoes, peanuts, yeast, etc. clear up with the technique and with fixing the malfunctioning organs. Symptoms such as asthma, hyperactivity, congestion, diarrhea, decreased concentration span, irritability have disappeared.

7) Slippery elm tea is reported to be beneficial for inflammation of the small intestine.

8) See a good chiropractor if you suspect nerve pressure to be a contributing cause (see Appendix A).

9) Two reflex areas are helpful. The first is located along the border of the 8th-11th ribs and cartilage. The second is along the upper third of the thigh half way between the front and inside. Both should be vigorously rubbed for 1 minute every other day. In cases of narcolepsy or Crohn’s disease do it twice daily for 3 minutes.

10) For duodenal ulcers try 4 ounces of fresh raw cabbage juice 4 times daily, drink lots of water, golden seal tea, and flax seed tea. Decrease your stress level. Sugar should be avoided. Comfrey leaf tea may also be beneficial.

11) If you have eaten too many irritating foods and suspect your villi to be "plugged" and your absorption decreased, two things may be helpful. Take a mixture of comfrey leaves and papain (papain is the milky white sap from the stem of the papaya and is also plentiful in green papayas). The papain will dissolve the mucus while the comfrey will heal the membranes. Do this for 1 week, once daily (¼ cup).

Also15 minutes before each meal take ¼ teaspoon of high silica clay to "scrub" out the mucus. If there is mucus in you stool from this treatment, don’t be concerned.