Weak and Irregular Digestion

The stomach produces about two liters of digestive secretions per day. Insufficient activity of the nerves that control the stomach can cause a reduction in the production of stomach acid and pepsin (protein digesting enzyme), which causes a major slowdown of food digestion. Sometimes even the mechanical churning of the stomach is slowed. Stress can cause this, because in times of stress its important for blood to flow to the muscles for “fight or flight.” But long term stress can definitely slow down digestion to the detriment of your health

Stomach acid and pepsin are strong substances that can turn a piece of meat to liquid, and are important to destroy incoming bacteria mixed with foods.   The reduced stomach acid hampers digestive function, incapacitating hormones and digestive enzymes.

When levels are low, patients often report feeling like the food sits in their stomach “like a lump.”  This reaction causes a loss of appetite, nausea, and distended abdomen.  From a diagnostic standpoint, the tongue is often puffy and swollen, and is sometimes pale or has a thick white coating.

Weak digestion can sometimes cause paradoxical symptoms of stomach burning, perhaps due to irritation or a weak or sensitive stomach lining, in which case the standard Western practice of treatment with acid-blocking drugs can be very harmful over time. Digestion tends to weaken as we age, in part due to reduced hydrochloric acid secretion. For this reason, I always pay special attention to digestion when working with my elderly patients.

Weak digestion is a basic health problem that can become very serious, and is often the cause of many seemingly unrelated diseases. According to holistic physician Jonathan Wright, MD,  weak digestion can contribute to arthritis (rheumatoid and degenerative), childhood asthma, acne rosacea, bursitis, chronic fatigue syndrome, depression, diabetes (types 1 and 2), gallbladder attacks, lupus, macular degeneration, multiple sclerosis, osteoporosis, shingles (herpes zozter), and many cases of cancer.  He also warns us that even this list is by no means complete.  According to the same report, Japanese researchers found poor digestion to be the reason why some people do not respond to herbal remedies (reported in Wright, 1999).

Pancreas,  Liver and Lymph

After the digestive process in the stomach is completed, food substances are released into the duodenum, where most digestion and absorption takes place.  If (and only if) there is sufficient acid in the duodenum, the body releases two other digestive hormones, secretin and cholecystokinin. These hormones stimulate the gallbladder to secrete bile and the pancreas to release its digestive juices. In other words, poor initial digestion hinders everything further down the line (Wright, 1999).

Depending on signs and symptoms, it may be important to use herbs that regulate bile flow, such as dandelion root, bupleurum root, beet rootturmeric root, fringe tree bark (Chionanthus virginicus),  and rhubarb root.

These herbs are used when there are signs of a sluggish liver, such as poor digestion, fatigue, elevated liver enzymes, nausea, hightened sensitivity to foods or pharmaceutical medications, and poor elimination.

The pancreas produces enzymes that digest protein, fat and carbohydrate, as well as sodium bicarbonate, an alkalizing agent. These are secreted directly into the small intestine through the pancreatic duct. The alkaline bicarbonate neutralizes the acidic chyme produced in the stomach.

When these enzymes are low, they can be supplemented with herbs that have enzymatic action, such as bromelain. Naturopathic and holistic physicians use a wide variety of enzymes for a multiplicity of probems. Within the membranes of the intestinal tract is a rich network of sub-mucosal lymphoid tissue, called the GALT (Gut associated lymphoid tissue).

These compartment-like tissues behind the intestinal membranes are critically important in immune function, both for the intestinal tract, and for the body as a whole (Muira et al., 1998). For example, food particles and immune cells intermingle here, and the GALT maintains a diverse population of mature lymphocytes capable of responding to foreign antigens (Galperin and Gershwin, 1997).

Indigestion, malnutrition or inflammation can adversely affect this tissue (even causing to to atrophy) resulting in a wide variety of immune and inflammatory disorders (DeWitt and Kudsk, 1999). Dietary fat intake is closely associated with health of both the GALT and the intestinal mucosa, so care in using only high quality fats in proper quantity can be important in both prevention and treatment of intestinal diseases by maintaining barrier integrity (Miura et al., 1998). These facts illuminate why herbalists through the centuries have strongly focussed on intestinal health issues when treating problems in other areas of  the body.

Dysbiosis, imbalance in the gut microbiome  is a major cause of irregular digestion. I cover this in detail in a separate article here.

Strengthening Digestion

Herbs that strengthen digestion include trikatu, the famous Ayurvedic combination of black pepper, long pepper and ginger root. You can make a variation of this at home by simply combining ground black pepper with ginger powder. Mix it with honey until a paste is formed, and take 1/2 teaspoon before meals.


These peppers may be too hot in conditions where the stomach membrane itself is weak or, of course, if acidity is actually too high.  You can often determine this in advance by asking the patient about any cravings for warm drinks and spicy foods. In the absence of such cravings, you may want to start with an anti-inflammatory digestive aid like papaya or bromelain instead of the peppers.

Warming bitter herbs such as turmeric root or freshly ground fenugreek seeds are also useful in these cases. They stimulate digestion by activating the bitter taste receptors on the tongue, stimulating the nerves to secrete more digestive juices. Sometimes, however, coating therapy is needed (see below).

White atractylodes is perhaps the most commonly prescribed TCM herb for treating poor appetite and digestive weakness with signs of fatigue and diarrhea, a condition called Spleen Qi deficiency. We often use it in our clinic before resorting to the stronger digestive herbs such as trikatu or pancreatic digestive enzymes. It seems to help gently restore digestive energy rather than simply substituting the missing enzymes.

TCM doctors often prescribe white atractylodes with ginseng root, pinellia tuber, tangerine peel, poria mushroom and licorice root in a classic TCM digestive formula called Six Gentlemen Decoction. Elderly patients with weak digestion often benefit dramatically from ginseng root or ginseng-based digestive formulas.

Some patients do not digest oils properly, and when we use omega-3-rich oils like flaxseed oil or fish oils, the patients will report that they repeat back. Sometimes there are no obvious signs beyond this, and other times there are problems with dryness, such as dry eyes, dry skin etc. In such cases, in addition to the herbs mentioned, pay attention to using foods that emulsify and thus help digest oils, mentioned in the nutrition section in the section on oils.

When treated promptly, poor digestion will usually respond very well to herbal treatments. However, when treatment is delayed, or symptoms are masked by the use of acid-blocking drugs or other symptomatic treatments, digestive problems can progress to more serious conditions.