Interpreting the wisdom of the Donguibogam from a modern medical perspective, the concept that 'the intestines are deficient and cold' shares a very similar context with small intestinal bacterial overgrowth (SIBO). Originally, the small intestine has far fewer bacteria than the large intestine, and it performs a self-cleaning function called the migrating motor complex (MMC)—a regular intestinal peristalsis that sweeps food residues and bacteria down into the large intestine. However, when this self-cleaning function weakens, gastric acid secretion decreases, pancreatic enzymes become deficient, or structural issues arise in the small intestine, bacteria abnormally proliferate in the small intestine, resulting in SIBO.
These proliferated bacteria ferment the carbohydrates and fiber we consume, producing large amounts of hydrogen and methane gas. It is just like a small factory continuously producing gas inside your abdomen. This is the main culprit behind the severe abdominal distension, frequent flatulence, and rumbling noises we experience. These gases irritate the intestinal barrier and trigger inflammation, increasing intestinal permeability and interfering with nutrient absorption, which can even lead to anemia or vitamin deficiencies.
Chronic diarrhea is a particularly common symptom of SIBO. This occurs because bacteria deconjugate bile acids, hindering fat absorption, or cause inflammation in the intestinal barrier, diminishing its ability to absorb water. The Donguibogam's expression that 'the intestines are cold' goes beyond low temperature; it aligns with the modern medical view that normal intestinal functions—such as intestinal peristalsis, digestive enzyme secretion, and immune defense—have declined, losing overall vitality. It is also important to note that stress and irregular eating habits affect the autonomic nervous system governing gut motility, weakening the cleansing function of the small intestine.
SIBO tends to be underdiagnosed because it can be tricky to detect, but it can be diagnosed through a breath test measuring hydrogen and methane gas levels. Rather than simply suppressing symptoms, it is crucial to find the underlying cause, restore bacterial balance in the small intestine, and normalize gut function. The gut has such a profound impact on whole-body health—including the nervous system, endocrine system, and immune system—that it is called our 'second brain.' Therefore, abdominal discomfort should not be taken lightly, but actively managed. Neglecting it as simple enteritis can cause gut health to continually deteriorate.
