Restricted accessResearch articleFirst published online 2018-08
Challenging Case in Clinical Practice: Implementation of a Functional Medicine Detox Food Plan Results in Lower Levels of Alanine Transaminase Enzymes and Resolves Chronic Gastrointestinal Symptoms Related to Gastro-Esophageal Reflux Disease
Dietary patterns such as the Detox Food Plan from the Institute for Functional Medicine™ (IFM™) that incorporate plant-based whole foods can have a beneficial influence on health. Diets rich in colorful fruits and vegetables, replete with natural antioxidants and polyphenols, have been shown to be effective for upregulating hepatic metabolic detoxification pathways. Increased toxic burden can affect liver health and function, thereby causing gastrointestinal (GI) symptoms. As illustrated in this case study, liver dysfunction and related GI symptoms can be improved using the IFM™ Detox Food Plan. In this case report, the client (hereinafter referred to as S.H.), a 53-year-old female, presented with recently discovered elevation of alanine transaminase (ALT) and GI symptoms related to gastro-esophageal reflux disease (GERD), with the latter initially diagnosed at the age of 24. Symptoms and complaints included reflux, heartburn, nausea, vomiting, GI distress, bloating, gas, inability to tolerate fatty foods, and mucus in stools. S.H. had difficulty sleeping due to the aforementioned chronic symptoms. A Detox Food Plan was implemented with the goal of optimizing liver function and health. After completion of the four-week Detox Food Plan, objective and subjective improvements included a decrease in ALT, resolution of GERD symptoms, and improvement in lipid digestion.
Get full access to this article
View all access options for this article.
References
1.
NewberryC, LynchK. Can we use diet to effectively treat esophageal disease? A review of the current literature. Curr Gastroenterol Rep, 2017; 19.
AndersonLA, WatsonRP, MurphySJ, et al.Risk factors for Barrett's oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study. World J Gastroenterol, 2007; 13:1585–1594.
5.
ZhouH, HylemonP. Bile acids are nutrient signaling hormones. Steroids, 2014; 86:62–68.
6.
HofmannA.The continuing importance of bile acids in liver and intestinal disease. Arch Intern Med, 1999; 159:264–7.
De Aguiar VallimTQ, TarlingEJ, EdwardsPA. Pleiotropic roles of bile acids in metabolism. Cell Metab, 2013; 17:657–669.
9.
StaelsB, HandelsmanY, FonsecaV. Bile acid sequestrants for lipid and glucose control. Curr Diabetes Rep, 2010; 10:70–77.
10.
Kullak-UblickG, MeierP. Mechanisms of cholestasis. Clin Liver Dis, 2000; 4:357–385.
11.
JacksonA.Nutrition and liver health. Digest Dis, 2017; 35:411–417.
12.
MofradP.Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology, 2003; 37:1286–1292.
13.
KontogianniM, TileliN, MargaritiA, et al.Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease. Clin Nutr, 2014; 33:678–683.
14.
GodosJ, FedericoA, DallioM, ScazzinaF. Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection. Int J Food Sci Nutr, 2016; 68:18–27.
15.
AbenavoliL, GrecoM, MilicN, et al.Effect of Mediterranean diet and antioxidant formulation in non-alcoholic fatty liver disease: A randomized study. Nutrients, 2017; 9:87–0.
16.
SofiF, CasiniA. Mediterranean diet and non-alcoholic fatty liver disease: New therapeutic option around the corner?. World J Gastroenterol, 2014; 20:7339–7346.
17.
KaplanM.Alanine aminotransferase levels: What's normal?. Ann Intern Med, 2002; 137:49–51.
18.
DoulberisM, KotronisG, GialamprinouD, et al.Non-alcoholic fatty liver disease: An update with special focus on the role of gut microbiota. Metabolism, 2017; 71:182–197.
19.
19. The Institute for Functional Medicine™. Detox Food Plan. Federal Way, WA: The Institute for Functional Medicine.
20.
20. The Institute for Functional Medicine™. Detox Food Plan Comprehensive Guide, Version 5. Federal Way, WA: The Institute for Functional Medicine, 2015.
HodgesRE, MinichDM. Modulation of metabolic detoxification pathways using foods and food-derived components: A scientific review with clinical application. J Nutr Metab, 2015; 2015:76068–9.
23.
ThomsonCD, ChisholmA, McLachlanSK, CampbellJM. Brazil nuts: An effective way to improve selenium status. Am J Clin Nutr, 2008; 87:379–384.
24.
KiddR.Results of dental amalgam removal and mercury detoxification using DMPS and neural therapy. Altern Ther Health Med, 2000; 6:49–55.
25.
25. The Institute for Functional Medicine™. Medical Symptoms Questionnaire, Version 2. Federal Way, WA: The Institute for Functional Medicine.
26.
ManachC, ScalbertA, MorandC, et al.Polyphenols: Food sources and bioavailability. Am J Clin Nutr, 2004; 79:727–747.
27.
CrespoI, García-MediavillaM, AlmarM, et al.Differential effects of dietary flavonoids on reactive oxygen and nitrogen species generation and changes in antioxidant enzyme expression induced by proinflammatory cytokines in Chang Liver cells. Food Chem Toxicol, 2008; 46:1555–1569.
28.
OhT, LeeJ, AhnB, et al.Oxidative damages are critical in pathogenesis of reflux esophagitis: Implication of antioxidants in its treatment. Free Radic Biol Med, 2001; 30:905–915.
29.
LeeJ, OhT, AhnB, et al.Involvement of oxidative stress in experimentally induced reflux esophagitis and Barrett's esophagus: Clue for the chemoprevention of esophageal carcinoma by antioxidants. Mutat Res, 2001; 480–481:189–200.
30.
JiaoL, KramerJR, RuggeM, et al.Dietary intake of vegetables, folate, and antioxidants and the risk of Barrett's esophagus. Cancer Causes Control, 2013; 24:1005–1014.
31.
KuboA, LevinTR, BlockG, et al.Dietary antioxidants, fruits and vegetables, and the risk of Barrett's esophagus. Am J Gastroenterol, 2008; 103:1614–1624.
32.
PetrickJL, SteckSE, BradshawPT, et al.Dietary flavonoid intake and Barrett's esophagus in western Washington State. Ann Epidemiol, 2015; 25:730–735.e2.
33.
KaniA, AlavianS, EsmaillzadehA, et al.Effects of a novel therapeutic diet on liver enzymes and coagulating factors in patients with non-alcoholic fatty liver disease: A parallel randomized trial. Nutrition, 2014; 30:814–821.
MussoG.Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis. Hepatology, 2003; 37:909–916.
36.
36. Floreani, Baragiotta, Martines, et al. Plasma antioxidant levels in chronic cholestatic liver diseases. Aliment Pharmacol Ther, 2000; 14:353–358.
37.
BlockG, PattersonB, SubarA. Fruit, vegetables, and cancer prevention: A review of the epidemiological evidence. Nutr Cancer, 1992; 18:1–29.
38.
CuiL, LiuX, TianY, et al.Flavonoids, flavonoid subclasses, and esophageal cancer risk: A meta-analysis of epidemiologic studies. Nutrients, 2016; 8:35–0.
