By BERNARD JENSEN D.C., Nutritionist




In order to better familiarize the reader with the scope of this book, the following discussion is provided. Proper bowel management does not require one to be a bowel expert. It is helpful, however, to understand the basics of bowel anatomy and physiology in order to more fully com-prehend the message I have to share with you concerning good bowel management. The bowel responds ideally to the laws of right living as outlined in this book. One must be aware of these laws and persevere to follow them. The rewards in health and freedom from disease are more than worth the effort.


When food has passed through the stomach by way of the mouth and esophagus, it enters the long, coiled tube called the small intestine. Here is where about 90% of the absorption into the bloodstream of all food constituents takes place. By the time it reaches the small intestine, food from the mouth has been reduced by the action of chewing and digestive juices into a liquid known as “chyme.” Digestion of carbohydrates starts in the mouth with saliva. Further digestion takes place in the stomach. Proteins are broken down into short chains of amino acids (the essential ingredi-ents of protein formation) in the stomach, while further reduction takes place in the small intes-tine until the molecules can be properly absorbed. When chyme has been thoroughly mixed and broken down by the stomach, the pyloric sphincter muscle valve opens and allows the food to enter into the uppermost portion of the small intestine or duodenum. Here in the duodenum, the first of three portions of the small intestine, the chyme is again thoroughly mixed by the contrac-tion of the muscular walls. The longitudinal and circular muscles of the intestinal walls are capable of performing three different types of movements, each serving a different purpose. The tube of the small intestine is divided by the circular muscles. These contract, segmenting the food as it passes. Further con-traction of the muscles between these segments occurs, making smaller segments, then the first set of muscles relax. This action results in a sloshing motion called rhythmic segmentation and takes place 12 to 16 times a minute. As a result of these movements, the chyme is thoroughly mixed with digestive juices. A wave of contraction known as peristalsis flows from the duode-num through the jejunum, or middle portion of the small intestine, all the way to and through the ileum, third and final portion. Peristalsis is the motion caused by the rhythmic coordination of the muscles and propels the chyme through the small intestine. Normal muscular activity of the intes-tine is not usually felt, although toxin-producing bacteria may cause violent and painful spasms to be felt. Diarrhea and vomiting are both reactions to irritations of the stomach and bowel..13


Chyme entering into the duodenum from the stomach is highly acidic. It contains a concen-tration of hydrochloric acid and enzymes which are required to break down the larger molecules so that absorption becomes more prolific. The small intestine secretions contain bicarbonate, an alkaline substance which causes a neutralization of the stomach acid. Special cells in the intestinal wall secrete these substances and are combined with juices flowing from the gall blad-der (bile) and pancreatic juices which flow by way of the pancreatic duct into the duodenum. Bile salts, produced in the liver and stored in the gall bladder, once in the intestine act like a detergent to emulsify the fatty acids and glycerides, making very small particles to be absorbed into the walls of the intestine. By way of hormonal secretions, the small intestine is able to control the digestive processes.


The small intestine is so constructed that nutrient absorption is most efficient. A large inner surface area is provided by the accordion-like folds of the intestinal wall. Lining the wall are finger-like structures called villi. They project into the interior of the tube from all directions. The average adult has a small intestinal area of approximately 200 sq. ft. The small molecular par-ticles of the broken down food are able to pass into the cells lining the villi and are taken up by the tiny blood capillaries and eventually find their way into the hepatic portal vein where they are carried to the liver and reduced even further. From the liver, digested food substances are deliv-ered to other cells in the body to support life-giving cellular activities. VILLI ARE FINGER-LIKE STRUCTURES THAT LINE THE WALL OF THE SMALL INTESTINE.14 VILLI ARE FINGER-LIKE STRUCTURES THAT LINE THE WALL OF THE SMALL INTESTINE. Fatty food products do not enter the bloodstream as do other foods. They are taken up from the intestine through ducts in the villi called lacteals. Lacteals connect with the lymphatic system whereby these fatty molecules eventually drain into the thoracic duct. The thoracic duct empties into the vena cava in the neck area. This process allows the fats to enter the bloodstream where they pass through the liver for metabolic rearrangement. In the ileum of the small intestine are found the nodules of lymphoid tissue known as Peyer’s patches. These lymph tissues contain scavenger cells or lymphocytes which have a protective function by attacking and destroying unfavorable bacteria that find their way into the intestines. The small intestine averages 20 to 22 feet in length and is from 1-1/4 to 1-1/2 inches wide throughout this distance. The ileum terminates at the base of the large intestine in the right lower section of the abdomen.


Within 8 to 10 hours of eating, the food has passed through the small intestine and is mostly digested. It then enters the large bowel for the final digestive processes and elimination. The colon is divided into the following sections: the cecum, ascending colon, transverse colon, descending colon, sigmoid and rectum. Altogether it is approximately 5 feet long and 2-1/ 2 inches in diameter. The cecum is a blind pouch whose open end joins the ascending colon as it ascends up-ward toward the first bend called the hepatic flexure. Here at the cecum is found the ileo-cecal valve, a sphincter muscle which controls the flow of food materials from the small intestines into the large intestine. Situated at the extreme end of the cecum is the worm-like sac called the appendix. It is about 3 inches long and is often the source of inflammation resulting in a condition known as appendicitis. The colon, unlike the small bowel, has a mucous lining or membrane which is smooth and void of villi. Surrounding thus mucous layer is a muscular coat consisting of circular internal muscles and longitudinal external muscles as found in the small bowel. The colon is shaped into bulbous pouches called haustras. These haustras are made up of muscles which contract to gather the colon up into a puckered appearance and which allow considerable expansion. The colon terminates in the rectum and anus, the exterior opening. The anus is held closed by the anal sphincter muscle. The mucus membrane inside the rectum is striated in length-wise segments giving it a fluted appearance. Generally the nerve supply to the colon is sparse and therefore sensory im-pulses are very weak. Colonic muscular activity is largely unfelt as a result. An exception is found in the rectum where nerve endowment is greater and thus there is the pain associated with hemorrhoids or other rectal disturbances..15


Through the ileo-cecal valve, chyme is passed into the cecum from the small intestine. At this stage, the chyme consists of undigested or undigestible food substances, secretions from the liver, pancreas, small bowel and water. In the cecum, the water is mostly removed, reducing the chyme to a semi-solid consistency which is now called feces. To provide lubrication for the passage of the feces, numerous cells line the walls of the bowel and secrete a mucus substance. As a result of haustral churning, a constant sloshing effect finishes the digestive process of the chyme. Under mass peristalsis, the feces are pushed toward the rectum and anus where they are eventually eliminated from the body. This movement is caused by the presence of food in the stomach. This activity empties the cecum and makes it ready to receive new chyme from the small intestine.


When the bowel is healthy there is very little bacterial action in the small intestine. The large intestine, however, lilterally swarms with billions of these microscopic organisms. Bacterial action in the large intestine plays a major role in nutrition and digestion. These friendly bacteria synthesize valuable nutrients by digesting portions of the fecal mass. Among others, vitamin K and portions of the B complex are produced. This aspect of digestion is not completely understood and is undergoing further study. Any remaining proteins are broken down by the bacteria into simpler substances. By products of bacterial activity are numerous, such as indole, skatole, hydrogen sulfide, fatty acids, methane gas and carbon dioxide. Some of these substances are very toxic and odorous, hence the accompanying smell of feces. The brown color of feces is a result of bile pigments coming from the liver. When feces are not brown, but have a chalky appearance, there is a problem in bile secretion and digestive ability. When feces reach the rectum they are about 70% water; 30% by weight of the mass repre-sents bacteria while the remainder is made up of food residues, cellulose, undigestible materi-als and dead cells discarded by the body. The time it takes for chyme at the cecum to turn into feces and travel to the rectum depends upon the amount of roughage in the food and the water content. Bulkier feces travel faster as they provide substance for the bowel muscle to work upon. Otherwise a soft, fiberless stool becomes very difficult for the colon to move along. The longer it takes, the more water is ab-sorbed, making feces compacted and hard so that it becomes difficult to eliminate them. Neglecting the urge to eliminate, as well as eating foods low in roughage, will lead to consti-pation. Laxatives, taken as an aid in elimination, either act to increase the amount of liquid retained in the feces, or act as a lubricant to allow for easy passage. Oftentimes laxatives are compounded to be an irritant or poison and stimulate the muscle walls to cause abnormal con-tractions to expel the irritating substances. It is very easy to become dependent upon these drugs and thereby permanently destroy normal bowel function. The expulsion of liquid feces or diarrhea, can be produced by excessive use of laxatives, nervous stress, infection or the presence of toxic substances in the bowel..16 Proper bowel management enhances the natural flow and rhythm of the digestive organs providing regular, painless and efficient functioning as described in this chapter.


A healthy, normally functioning bowel is shaped as seen in the illustration on the next page. The cecum is located in the lower right abdomen. From there the bowel rises up into the ascend-ing colon until it reaches the first turn toward the left. This turning point is called the hepatic flexure because of its proximity to the liver. From there the bowel travels across the abdomen beneath the stomach until it reaches the second turn called the splenic flexure. This section of the bowel, the transverse colon, is the only organ within the body that makes a transit from right to left. In a normal bowel the transverse colon makes a slightly upward grade to the splenic flexure. From the splenic flexure, the bowel moves down as the descending colon until it reaches the sigmoid colon just above the rectum. Here in the sigmoid is the holding place for feces waiting to be eliminated. The rectum continues from the sigmoid and makes an ‘s’-like bend into the anus where the anal sphincter muscle is found.