As I focus on nutrition, one of my critical pillars of health (along with rest, movement, and mindfulness), I have been slowly reducing my added sugar intake.

I have always been less concerned about sugar per se and more centered on how it is delivered: Fast delivery (think soda or orange juice) spikes markers of inflammation; slow delivery (my beloved grapes) delivers the sugar more slowly and healthily.

One of the ways I have been better about not adding lots of sugar to things is that my slow reduction has not left me craving more sweetness. I used to add two teaspoons of sugar to my Earl Grey tea; now, I put in a tiny bit of honey, and I am good to go.

1. Honey is a natural antimicrobial

Let’s look at the goodness of honey. Did you know that honey can fight bacteria and fungi? Even as we recognize the variability in effectiveness among honey types, we have evidence of honey’s pathogen-fighting capabilities.

Honey as a medicinal agent dates back to ancient times. Ancient Egyptians frequently used honey as a natural antibiotic and skin protectant. Professor Gene Kritsky, in his book Tears of Re, reports the Egyptian myth that the sun god Ra’s tears fell to earth and transformed into honey bees.

Why does honey have anti-pathogen properties? You may be surprised to learn that it contains hydrogen peroxide. In addition, the high sugar content of honey may inhibit bacterial growth.

“Well,” said Pooh, “what I like best,” and then he had to stop and think. Because although Eating Honey was a very good thing to do, there was a moment just before you began to eat it which was better than when you were, but he didn’t know what it was called.”
― A. A. Milne, Winnie-the-Pooh

Honey has a low pH of approximately 3.5. As a result, the food pulls moisture away from bacteria and causes the microorganism to become dehydrated and die. Honey also has bee defensin, an antimicrobial peptide (AMP).

To use honey as an antibiotic, Healthline.com offers this advice: Apply it directly to the wound or infected area. If possible, opt for raw Manuka honey from New Zealand. The antibacterial substance methylglyoxal (MGO) is only present in certain natural kinds of honey, such as the Manuka type.

I probably wouldn’t go as far as this headline from Scientific American suggests: “You should rub honey on your everywhere.” And one more thing — the honey we use in hospital settings is medical grade; it is sterile and inspected. Don’t treat your wounds with the usual honey that you buy from the local store.

2. Honey contains phytonutrients

Phytonutrients are compounds in plants that help protect the plant from harm. Some phytonutrients keep insects away, while others shield against ultraviolet radiation.

Phytonutrients also contribute to the antioxidant properties of honey and its antimicrobial characteristics. Scientists are investigating whether honey may boost our immune systems or even fight cancer. Let’s not overstate the case: There have been very few clinical studies despite its purported anti-cancer activity.

3. Honey may help with digestion

I have heard that consuming honey can help with gastrointestinal problems such as diarrhea. Let’s take a quick look at irritable bowel syndrome. Mouse studies suggest honey is a natural laxative.

But what about human irritable bowel syndrome? There is not much good research. On the other hand, we have limited evidence that honey may help control a bacteria known as Helicobacter pylori.

H. pylori are bacteria that infect the stomach’s lining. These bacteria can lead to peptic ulcer diseases and duodenal (the first part of the small intestine; it connects to the stomach) ulcers. While natural treatments such as Manuka honey may not eradicate the bacteria, they might help maintain them at low levels. My take? I think we have little high-level evidence.

Honey has some risks

Raw honey can carry harmful bacteria, including Clostridium botulinum. This microbe is especially hazardous for babies. You should never give raw honey to an infant less than a year old.

Healthline.com reminds us of some of the symptoms of botulism poisoning in infants:

• constipation
• slow breathing
• drooping eyelids
• no gag reflex
• head control loss
• downward-spreading paralysis
• poor feeding
• lethargy
• a weak cry

In adults, symptoms may include a brief time of vomiting and diarrhea, followed by constipation and more severe symptoms (for example, blurred vision and muscle weakness). Please consult a doctor if you experience these symptoms after eating raw honey.

Oh, the big reason I use honey? My Manuka honey tastes good. It is sweet enough that I use remarkably little of it in my tea. Do you use honey? If yes, why?

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The small intestine extends from the pyloric sphincter to the ileocecal valve, where it empties into the large intestine. The small intestine finishes the process of digestion, absorbs the nutrients, and passes the residue on to the large intestine. The liver, gallbladder, and pancreas are accessory organs of the digestive system that are closely associated with the small intestine.

The small intestine is divided into the duodenum, jejunum, and ileum. The small intestine follows the general structure of the digestive tract in that the wall has a mucosa with simple columnar epithelium, submucosa, smooth muscle with inner circular and outer longitudinal layers, and serosa. The absorptive surface area of the small intestine is increased by plicae circulares, villi, and microvilli.

Exocrine cells in the mucosa of the small intestine secrete mucus, peptidase, sucrase, maltase, lactase, lipase, and enterokinase. Endocrine cells secrete cholecystokinin and secretin.

The most important factor for regulating secretions in the small intestine is the presence of chyme. This is largely a local reflex action in response to chemical and mechanical irritation from the chyme and in response to distention of the intestinal wall. This is a direct reflex action, thus the greater the amount of chyme, the greater the secretion.

Large Intestine

The large intestine is larger in diameter than the small intestine. It begins at the ileocecal junction, where the ileum enters the large intestine, and ends at the anus. The large intestine consists of the colon, rectum, and anal canal.

The wall of the large intestine has the same types of tissue that are found in other parts of the digestive tract but there are some distinguishing characteristics. The mucosa has a large number of goblet cells but does not have any villi. The longitudinal muscle layer, although present, is incomplete. The longitudinal muscle is limited to three distinct bands, called teniae coli, that run the entire length of the colon. Contraction of the teniae coli exerts pressure on the wall and creates a series of pouches, called haustra, along the colon. Epiploic appendages, pieces of fat-filled connective tissue, are attached to the outer surface of the colon.

Unlike the small intestine, the large intestine produces no digestive enzymes. Chemical digestion is completed in the small intestine before the chyme reaches the large intestine. Functions of the large intestine include the absorption of water and electrolytes and the elimination of feces.

Rectum and Anus

The rectum continues from the sigmoid colon to the anal canal and has a thick muscular layer. It follows the curvature of the sacrum and is firmly attached to it by connective tissue. The rectum ends about 5 cm below the tip of the coccyx, at the beginning of the anal canal.

The last 2 to 3 cm of the digestive tract is the anal canal, which continues from the rectum and opens to the outside at the anus. The mucosa of the rectum is folded to form longitudinal anal columns. The smooth muscle layer is thick and forms the internal anal sphincter at the superior end of the anal canal. This sphincter is under involuntary control. There is an external anal sphincter at the inferior end of the anal canal. This sphincter is composed of skeletal muscle and is under voluntary control.

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The liver is a dark reddish-brown color, and is shaped a bit like a wedge. It weighs about 3 pounds. The liver has 2 lobes. Both are made up of 8 segments that have of 1,000 small lobes called lobules. These lobules are connected to small tubes (ducts) that lead to larger ducts that form the common hepatic duct. The common hepatic duct sends the bile made by the liver cells to the gallbladder and the first part of the small intestine (duodenum) through the common bile duct.

The liver holds about 1 pint (13%) of your body’s blood supply. There are 2 blood vessels that send blood to the liver. They are:

• Hepatic artery. This sends oxygen-rich blood to the liver.
• Hepatic portal vein. This sends nutrient-rich blood to the liver.

Functions of the liver

The liver has more than 500 vital functions. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood. It breaks down, balances, and creates nutrients. It also processes medicines and other chemicals. The liver:

• Makes bile, which helps carry away waste and break down fats in the small intestine during digestion
• Makes certain proteins for blood plasma
• Makes cholesterol and proteins to help carry fats through the body
• Converts excess glucose into glycogen for storage and makes glucose as needed 
• Controls blood levels of amino acids, which are the building blocks of proteins
• Processes hemoglobin for its iron and then stores the iron
• Converts ammonia to urea, which is then excreted in urine
• Clears medicines, drugs and other substances from the blood
• Controls blood clotting
• Helps prevent infections by making immune factors and removing bacteria from the blood
• Clears bilirubin from the blood 

When the liver has broken down harmful substances, this waste is excreted into the bile or blood. Waste in bile enters the intestine and leaves the body in the form of feces. Waste in blood is filtered out by the kidneys, and leaves the body in the form of urine.

Anatomical Position

The liver is predominantly located in the right hypochondrium and epigastric areas, and extends into the left hypochondrium.

When discussing the anatomical position of the liver, it is useful to consider its external surfaces, associated ligaments, and the anatomical spaces (recesses) that surround it.

Anatomical Structure

The structure of the liver can be considered both macroscopically and microscopically.

Macroscopic

The liver is covered by a fibrous layer, known as Glisson’s capsule.

It is divided into a right lobe and left lobe by the attachment of the falciform ligament. There are two further ‘accessory’ lobes that arise from the right lobe, and are located on the visceral surface of liver:

• Caudate lobe – located on the upper aspect of the visceral surface. It lies between the inferior vena cava and a fossa produced by the ligamentum venosum (a remnant of the fetal ductus venosus).
• Quadrate lobe – located on the lower aspect of the visceral surface. It lies between the gallbladder and a fossa produced by the ligamentum teres (a remnant of the fetal umbilical vein).

Separating the caudate and quadrate lobes is a deep, transverse fissure – known as the porta hepatis. It transmits all the vessels, nerves and ducts entering or leaving the liver with the exception of the hepatic veins.

Microscopic

Microscopically, the cells of the liver (known as hepatocytes) are arranged into lobules. These are the structural units of the liver.

Each anatomical lobule is hexagonal-shaped and is drained by a central vein. At the periphery of the hexagon are three structures collectively known as the portal triad:

• Arteriole – a branch of the hepatic artery entering the liver.
• Venule – a branch of the hepatic portal vein entering the liver.
• Bile duct – branch of the bile duct leaving the liver.

The portal triad also contains lymphatic vessels and vagus nerve (parasympathetic) fibres.

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It descends downward into the superior mediastinum of the thorax, positioned between the trachea and the vertebral bodies of T1 to T4. It then enters the abdomen via the oesophageal hiatus (an opening in the right crus of the diaphragm) at T10.

The abdominal portion of the oesophagus is approximately 1.25cm long – it terminates by joining the cardiac orifice of the stomach at level of T11.

Anatomical Structure

The oesophagus shares a similar structure with many of the organs in the alimentary tract:

• Adventitia – outer layer of connective tissue.
  • Note: The very distal and intraperitoneal portion of the oesophagus has an outer covering of serosa, instead of adventitia.
• Muscle layer – external layer of longitudinal muscle and inner layer of circular muscle. The external layer is composed of different muscle types in each third:
  • Superior third – voluntary striated muscle
  • Middle third – voluntary striated and smooth muscle
  • Inferior third – smooth muscle
• Submucosa
• Mucosa – non-keratinised stratified squamous epithelium (contiguous with columnar epithelium of the stomach).

Food is transported through the oesophagus by peristalsis – rhythmic contractions of the muscles which propagate down the oesophagus. Hardening of these muscular layers can interfere with peristalsis and cause difficulty in swallowing (dysphagia).

Oesophageal Sphincters

There are two sphincters present in the oesophagus, known as the upper and lower oesophageal sphincters. They act to prevent the entry of air and the reflux of gastric contents respectively.

Upper Oesophageal Sphincter

The upper sphincter is an anatomical, striated muscle sphincter at the junction between the pharynx and oesophagus. It is produced by the cricopharyngeus muscle. Normally, it is constricted to prevent the entrance of air into the oesophagus.

Lower Oesophageal Sphincter

The lower oesophageal sphincter is a physiological sphincter located in the gastro-oesophageal junction (junction between the stomach and oesophagus). The gastro-oesophageal junction is situated to the left of the T11 vertebra, and is marked by the change from oesophageal to gastric mucosa.

The sphincter is classified as a physiological (or functional) sphincter, as it does not have any specific sphincteric muscle. Instead, the sphincter is formed from four phenomena:

• The oesophagus enters the stomach at an acute angle.
• The walls of the intra-abdominal section of the oesophagus are compressed when there is a positive intra-abdominal pressure.
• The folds of mucosa present aid in occluding the lumen at the gastro-oesophageal junction.
• The right crus of the diaphragm has a “pinch-cock” effect.

During oesophageal peristalsis, the sphincter is relaxed to allow food to enter the stomach. Otherwise at rest, the function of this sphincter is to prevent the reflux of acidic gastric contents into the oesophagus.

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Location of the Pancreas

The pancreas is located behind the stomach in the upper left abdomen. It is surrounded by other organs including the small intestine, liver, and spleen. It is spongy, about six to ten inches long, and is shaped like a flat pear or a fish extended horizontally across the abdomen.

The wide part, called the head of the pancreas, is positioned toward the center of the abdomen. The head of the pancreas is located at the juncture where the stomach meets the first part of the small intestine. This is where the stomach empties partially digested food into the intestine, and the pancreas releases digestive enzymes into these contents.

The central section of the pancreas is called the neck or body. The thin end is called the tail and extends to the left side.

Several major blood vessels surround the pancreas, the superior mesenteric artery, the superior mesenteric vein, the portal vein and the celiac axis, supplying blood to the pancreas and other abdominal organs.

Almost all of the pancreas (95%) consists of exocrine tissue that produces pancreatic enzymes for digestion. The remaining tissue consists of endocrine cells called islets of Langerhans. These clusters of cells look like grapes and produce hormones that regulate blood sugar and regulate pancreatic secretions.

Functions of the Pancreas

A healthy pancreas produces the correct chemicals in the proper quantities, at the right times, to digest the foods we eat.

Exocrine Function:

The pancreas contains exocrine glands that produce enzymes important to digestion. These enzymes include trypsin and chymotrypsin to digest proteins; amylase for the digestion of carbohydrates; and lipase to break down fats. When food enters the stomach, these pancreatic juices are released into a system of ducts that culminate in the main pancreatic duct. The pancreatic duct joins the common bile duct to form the ampulla of Vater which is located at the first portion of the small intestine, called the duodenum. The common bile duct originates in the liver and the gallbladder and produces another important digestive juice called bile. The pancreatic juices and bile that are released into the duodenum, help the body to digest fats, carbohydrates, and proteins.

Endocrine Function:

The endocrine component of the pancreas consists of islet cells (islets of Langerhans) that create and release important hormones directly into the bloodstream. Two of the main pancreatic hormones are insulin, which acts to lower blood sugar, and glucagon, which acts to raise blood sugar. Maintaining proper blood sugar levels is crucial to the functioning of key organs including the brain, liver, and kidneys.

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