How Your Gut Actually Works – Part 1 – Oubre Medical

How Your Gut Actually Works – Part 1

(Part 1 of 4)

We decided to sit down and have a chat with our practice owner and MD, Dr. Philip Oubre, and functional nutritionist, Aubree Steen.

We really wanted to breakdown the how the gut works, and the entire process from simply visualizing the food to eliminating it. It’s a pretty magical process, but there’s quite a lot of decisions our body has to make when breaking down and absorbing food. We broke this up into 4 different categories to touch base on the big picture in each segment. While this process is intricate in nature, we hope to breakdown into a really palatable and digestible picture. You see what I did there.

Feel free to watch the video, or read our transcript below.

Philip Oubre (00:00):
Okay, guys. So today we want to help clarify the upper and lower digestion. We always talk about digestion, gut health and all that. But one of the things people frequently miss is they say, “Oh, my stomach this, my stomach that,” and what we’re going to talk about today is that the stomach is not just from rib cage down to pelvis. There’s multiple organs in your stomach.

Philip Oubre (00:20):
So today, when we refer to the stomach, we’re actually talking about the actual stomach that’s in the upper part of your rib cage. But we want to go through this whole digestive process north to south, meaning starting at your mouth, all the way to the anus, and what exactly happens. Because we like to think that we just eat whatever food we want to, and then that food gets magically digested, and we magically absorb everything, and everything goes perfectly until we poop it out.

Aubree Steen (00:42):
That’d be great.

Philip Oubre (00:42):
That would be great, right? But it is an extremely complicated process from north to south. And if any one process goes wrong, the rest goes wrong. So we want to dive into exactly this north to south process. So Aubree, one of the things you’re always harping on our patients is, what is the north most process?

Aubree Steen (01:02):
Your brain, your brain.

Philip Oubre (01:04):
How is that involved in eating?

Aubree Steen (01:05):
How is it? So everything happens with sight, smell and taste, right? So you have to think about is that-

Philip Oubre (01:10):
Say that slower, because I mean, you just say it all the time, but for them sight, you got to see the food, smell, you smell it.

Aubree Steen (01:18):
And taste. You have to think of your body as registering that it’s about to eat food. So I know that sounds like a simple concept, but in today’s society, we’re on the phone and we’re driving and we’re on the computer and we’re trying to get our kids jumping off of our shoulders, things like that.

Philip Oubre (01:34):
That and the microwave. Since when can you ever take raw food to cook in 90 seconds?

Aubree Steen (01:38):
I know. That should be abolished forever.

Philip Oubre (01:40):
Yeah. Don’t use microwaves. Please don’t use microwaves.

Aubree Steen (01:42):
I hate microwaves.

Philip Oubre (01:44):
It’s a strong word. We don’t use hate.

Aubree Steen (01:45):
Okay. I despise… sorry.

Philip Oubre (01:48):
I don’t know that that’s a better word.

Aubree Steen (01:49):
Okay. But anyways, right, so the main thing that we forget is that we’re not getting our brain online with the fact that we’re eating food. And I think most people don’t realize that your brain is the main signaling aspect for your stomach and all your digestive organs to start prepping to get food. You know how you feel really sick when you’ve been hungry all day and you literally just inhale food, and immediately after it… Yeah, I mean, we’ve all done it, right? But then you feel awful and you’re sitting there, and you’re like, “I shouldn’t have done that.” There’s a reason because of that.

Aubree Steen (02:23):
So your brain is the first thing that tells your body, “Hey, we’re eating. Y’all better get ready and prep for this food and digest it, because we need to break it down.” Because it is an intricate process. It takes a lot.

Aubree Steen (02:33):
So the first thing is actually isolating and sitting with your food, and saying, “Okay, I’m smelling it.” It’s kind of like when you smell your mom’s cooking and you start to salivate, that’s actually a digestive response. Your body’s preparing to have enzymes in your saliva break down your food. So I mean, long story short, you need to sit with it, and you need to tell your body, “We’re going to eat this food.” Plus we should be more mindful with everything that we’re doing, especially food. So brain is the first thing. Sight is seeing it. Smell is actually getting the senses, the smell from the food, and then taste. They all play together and they all start the digestive cascade, essentially.

Philip Oubre (03:14):
And taste is kind of a big one, sight and smell also of course, but in the modern era of shakes and blending everything up, and drinking them down, there’s a couple senses that can be missed. And you want to make sure you at least think about that. And you think about the shake, because if you’re going to ignore one of the senses, you probably need to heighten one of the other ones. Think of Daredevil. He’s blind, so his other senses went-

Aubree Steen (03:35):
Oh, that’s good.

Philip Oubre (03:35):
Yeah, you know what I’m talking about. So the problem with the protein shake is, you’re not really cooking anything. There’s not really a lot of smells that come from it. You’re often blending it and it’s ready in just a matter of a minute or two. And then the food is already chewed. You blended it up, so you’re also skipping that chew step.

Philip Oubre (03:51):
So be careful if you’re putting a lot of stuff in your shake, you may need more digestive support with a shake. Whereas if you had cooked the food and smelled it for 30 minutes as you cooked it, that’d be a different scenario. So not ignoring the north most part, because once again, the scenario I use, and the metaphor I use in the office all the time is if you’re going to build a Ferrari, but the guy that’s building a frame is terrible or drunk on the job, then it can look like a Ferrari, it can sound like a Ferrari, but chances are, the thing’s going to fall apart. So if the frame doesn’t work, nothing else is going to work. So the first stage of digestion is that brain getting that in line matters a lot.

Philip Oubre (04:25):
So one of my favorite things to talk about, because Aubree is always talking about the brain, sight, smell, and taste thing. My favorite part is to talk about the stomach, because after you swallow the food, you now have zero control over it until it reaches the anus, and you get to choose when you go poop. For the most part, hopefully you get to choose when you go poop. Otherwise that’s a whole nother process.

Philip Oubre (04:44):
So after you swallow the food, the food gets to the stomach, and there’s a very important piece of the puzzle that must happen. And when we talk about stomach, we mean the upper part of the digestion, the very first organ before the intestines. So that stomach has to break down the food using stomach acid. And this is one of the common things we find in functional medicine is that your stomach does not make enough stomach acid, and we’ll talk about dysfunction in another video. This video is more about the function, how is it supposed to work. And then once you understand how it’s supposed to work, then we can talk about dysfunction more.

Philip Oubre (05:16):
So the stomach is supposed to make stomach acid. And the stomach acid is designed to break the food up into smaller and smaller molecules, because your intestines don’t absorb whole beef and whole rice or whatever you ate. It’s going to absorb molecules, tiny atoms and molecules. So your stomach is supposed to take really large things, so you chewed up your food as much as possible, hopefully, and then your stomach acid is supposed to take it down to a smaller level, and then the intestines take it down to an even further level.

Philip Oubre (05:45):
So that stomach requires stomach acid. And if the stomach requires stomach acid, how does the stomach not digest itself? It must make a mucus lining. So if you’re having any kind of heartburn, reflux, anything like that or stress, you don’t have enough stomach acid, or you could not have enough mucus lining. And if you don’t have enough mucus lining, your stomach isn’t going to make any stomach acid, because it’s going to damage itself and it’s not going to destroy itself. So one of the most key critical parts of digestion is getting enough stomach acid to break the food down to small enough components, so that then it can move into the small intestine.

Aubree Steen (06:18):
Right. And so the sight, smell, and taste is the first trigger to tell your stomach, we need to produce that acid so it can digest the food.

Philip Oubre (06:28):
So after the stomach dumps its contents, I’ll let you handle what’s the next trilogy stage, and we’re still talking about the upper digestive components. So we’re going to split these two videos into upper digestion ends at liver, gallbladder, pancreas, lower digestion is small intestine and below.

Aubree Steen (06:43):
Yeah. So kind of in a quick summary of it, basically that acidity of your food is a triggering mechanism for also your pancreas, your liver and your gallbladder. Your pancreas is one thing that’s automatically triggered as well, as you release digestive enzymes, enzymes that help break down your food. I love enzymes, because they kind of get the nitty-gritty.

Aubree Steen (07:05):
Your hydrochloric acid is responsible for mainly breaking down proteins and fats, but it breaks down everything a little bit further. It prevents it from becoming a basically undigested molecule in your system. It gets the bulk of it. But sometimes we need a little bit more help. And that’s where enzymes come in. They’re on the microscopic level.

Aubree Steen (07:24):
So that acidity triggers the pancreas, and then the pancreas also releases something called sodium bicarbonate, which also changes the acidity from when it’s super acidic in your stomach to going into your intestines, you have to change that acidity, or else you would literally damage your intestinal lining. So that sodium bicarbonate is changing the pH, and so your intestines can actually handle it. And that’s really the main function of the pancreas in the digestive tract at least.

Aubree Steen (07:51):
Of course, the pancreas helps manage your blood sugar and insulin and glucose, and how food is absorbed essentially. But that’s the main cascading effect that happens. And then… Yeah, go ahead.

Philip Oubre (08:04):
Well, I was just going to add that the stomach and pancreas are really intricately connected, because if there’s not enough stomach acid entering that section of the duodenum, that upper intestine, then the pancreas doesn’t release enough enzymes, or even if it does release enzymes, it needs that stomach acid to even activate the enzymes, because the enzymes released by the pancreas are inactive. I forget the term for it, it starts with a Z of some sort. But those inactive proteins, if they’re not activated, they’re literally useless.

Philip Oubre (08:29):
Now when you take digestive enzymes, you take activated digestive enzymes. So that’s why those don’t really need a stomach acid to work. And then the final part of that is of course, bile comes down from the liver or the gallbladder, and that’s also further to neutralize the stomach acid and start to break those fats up into smaller and smaller molecules.

Philip Oubre (08:48):
We like to believe, and this is, at least, I don’t know the percentages, but we like to believe that chewing your food is about 20% of the digestive process. Everything before you swallow is about 20% of the digestive process. That stomach acid is responsible for 60 to 70% of it, to get it down to those somewhat kind of thick molecules stuck together. And then the digestive enzymes, that last piece to cleave molecules into actually absorbable components.

Philip Oubre (09:15):
So that’s kind of the summary of the upper digestion part of, just to rewind, the brain, the sight, smell and taste, chewing your food, swallowing it, and the stomach acid, stomach acid, stomach acid. Aubree said hydrochloric acid, same thing. Betaine is the supplement version of hydrochloric acid. Then it enters the small intestine, triggers the pancreas, gallbladder and liver to release their components, to finish the digestive process. And then we’re going to talk about lower digestion, which is mainly absorbing all those nutrients, and what happens to the leftovers. I want you to end with, undigested food… what’s the three-

Aubree Steen (09:50):
Mm-hmm (affirmative). So if you don’t properly have that cascade, which of course we’ll dive into in a little bit, carbohydrates can ferment, disgusting, I know.

Philip Oubre (09:59):
Sounds gross.

Aubree Steen (09:59):
Yeah. Fats can rancidify.

Philip Oubre (10:02):
That sounds grosser.

Aubree Steen (10:02):
And proteins can putrefy.

Philip Oubre (10:04):
That’s disgusting.

Aubree Steen (10:05):
So if you think of those words, and the face that you make when you hear them, that’s what’s happening in your body.

Philip Oubre (10:09):
If you don’t digest your food.

Aubree Steen (10:10):
Yeah. And so this, of course, is a very oversimplification of how it works, and with every person, it’s definitely bio-individual. But we wanted to tell you this, because we do have patients who are very confused sometimes at like, “Well, I’m getting bloating. Why do I need to care about my stomach acid? Or why do I need to care about the pancreatic support?” And so we really wanted to say, it does start from up here, and it’s a whole north to south process. But yeah, we’ll dive into lower GI.

Philip Oubre (10:37):
That’s next.

Aubree Steen (10:37):

Philip Oubre (10:38):
See you next time.

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