Wednesday, August 20, 2014

INTESTINAL BUGS: the Good, the Bad, and the Ugly

Science is just beginning to study and understand the world of bacteria within our bodies. There are trillions of bugs inside each human, and these bugs can be “good” (beneficial) or “bad” (pathogenic, or disease-causing). Essentially, the human body is a donut, with a hole in the middle that goes from your mouth to your anus. The bacteria and food in the donut hole are not technically “in” our bodies, until they are actively absorbed by our bodies through the enterocytes (intestinal cells). With ten times more bugs than cells in our bodies, it’s almost more like they are the vehicle for humans rather than us being the vehicle for them.
Another, more harmful way that food and bacteria make it from the intestines into our blood stream is through tiny holes between the enterocytes. These tiny holes are called loose junctions, or “leaky gut”. Some researchers claim that up to 90% of people in the West have some amount of leaky gut, which is caused by a range of things like gluten (a protein found in grains like wheat), antibiotics, yeast overgrowth, eating a high-sugar diet, pharmaceutical medications, NSAIDS (ibuprofen or Advil), alcoholism, and drug use.
Two problems appear when our enterocytes are damaged and become leaky. First of all, food and bacteria from our gut leaks into the blood stream and the body responds with an immune attack. It not only attacks the invading bacteria, but also sees intact proteins (long strings of amino acids) from our food leaking into the blood stream, rather than the single amino acids that are normally absorbed through the intestinal cells. The body also “thinks” these are bacteria (especially gluten and casein from dairy) and attacks them as well. Over long periods of time, these heightened immune responses wreck havoc on the body and likely contribute or cause the development of autoimmune diseases like type I diabetes, rheumatoid arthritis, psoriasis, lupus, celiac, and multiple sclerosis.
The second way that damaged enterocytes further cause problems in the body is due to their inability to digest food properly. Instead of the food being broken up right away by enzymes (made by the enterocytes), the food sits in the gut and putrifies. This rotting food overwhelmingly feeds the pathogenic bacteria, especially the high carbohydrate, high sugar diets that are common in the West. When there is an imbalance in bacteria in the gut, it is referred to as “gut dysbiosis” and has been associated with inflammatory bowel disease, colitis, chronic fatigue syndrome, and cancer. For many people, the feeding of pathogenic bacteria also leads to bloating, belching, acid reflux, and constipation/diarrhea .
Not only are high numbers of pathogenic species thought to contribute to autoimmune disease and the diseases of gut dysbiosis, but they also cause inflammation and links are being made to chronic diseases as well like heart disease, type II diabetes, and obesity. The links to obesity are especially fascinating. A study from Washington University, published in the elite journal Science, showed that specific bacterial species are correlated with either obesity or thinness. Previous studies have found that obese people and thin people often have very different strains of intestinal bacteria. In this study, they inoculated germ-free mice (grown in a sterile environment) with bacteria from human twins, one of which was obese and one of which was thin. The mice receiving bugs from the obese twin gained statistically significant more weight than the mice given bugs from the thin twin, despite being fed the same chow. Although there is still much to be studied and learned about bacteria, studies like this show that it is a very promising topic in the field of obesity research.
Although much nutrition advice in this field has centered around adding probiotics like acidophilus to the diet, recent research has shown fermented foods (yogurt, kimchi, raw sauerkraut, and kombucha) and prebiotics to be even more effective at inoculating the digestive tract with beneficial species and healing disease. Feeding our existing beneficial bacteria with PREbiotics - like inulin, FOS (fructo-oligo saccharides), and resistant starch are thought by some to be even more effective than adding in new species. Coconut products and bone broth have also been found to be effective at healing leaky gut and helping beneficial species to thrive.
Another common gut problem that causes discomfort for many people is SIBO – small intestinal bacterial overgrowth. This is caused by an overgrowth of pathogenic species in the small intestine, rather than the beneficial bugs being concentrated in the large intestine, or colon, like they are in a healthy person. When numbers in the small intestine are closer to 104 rather than 103, which is normal, this can cause also symptoms like bloating, belching, acid reflux, stomach distention and pain.
There are a few different diets that are recommended for autoimmune diseases as well as other diseases associated with gut dysbiosis. One that has become very popular and effective for many is the SCD – specific carbohydrate diet. This diet recommends limiting carbohydrates that are made of two or more sugar molecules linked together (sucrose, maple syrup, and starches from things like potatoes and flour) based on the idea that damaged enterocytes are unable to produce the necessary enzymes to break them down and they feed the harmful bacteria. Carbohydrates made of single sugars like fruit and honey are allowed, since they don't require enzymes to be digested and so don’t feed the harmful bacteria but instead are absorbed quickly and used for energy by the body. People who suffer from bloating and gut-related discomfort like gas, belching, and constipation/diarrhea often find relief from this diet. Some believe that after a healing period, problematic foods can be added back into the diet without causing symptoms.
Another similar diet that is growing in popularity is the GAPS diet. This stands for Gut and Psychology Syndrome and was designed by Dr. Natasha Campbell-McBride. Her book by the same name details the relationship of high number of pathogenic bacteria and their relationship to issues of mental illness, including depression, anxiety, bi-polar disorder, the autism/Asperger's spectrum, and more. Her theory, which is fascinating and has shown correlation in a number of scientific studies, is that pathogenic bacteria emit neurotoxins which pass the blood-brain barrier and cause mental illness. This also explains the exponential increase in depression and mental illness we've seen in Western countries in the last century. She also discusses a phenomenon she calls "glue ear," which is the idea that reoccuring ear infections (otitis media) in children are caused by pathogenic bacteria making their way into the inner ear through the opening into the throat and causing mucus and infection in the middle ear. Her dietary advice is very similar to the SCD and excludes starch and double sugars as well as a gut-healing protocol including lots of bone broth. Many families report success treating depression and autism spectrum disorders in children using this approach.
There is variation of the SCD used in some circumstances is the low-FODMAP diet, which excludes foods containing even small amounts of short chain carbohydrates that are highly fermentable and poorly absorbed in the small intestine, including sugar alcohols, certain vegetables and fruits, grains, and some of the aforementioned prebiotics.
There are a number of supplements that are useful in removing the pathogenic bacteria and helping the beneficial bugs to take hold, as well as lowering the numbers of the harmful species present with SIBO. Often the harmful bugs include yeasts like Candida Albicans, which are able to take hold after the administration of antibiotics which kill off multiple species of good and bad bacteria and allow yeasts to take over. The yeasts and other harmful bugs create a home for themselves called a “biofilm” that makes it hard for beneficial bugs to kick them out. A commonly known biofilm is the plaque on our teeth, and one can think of biofilms as a plaque that covers the intestinal lining. There are a number of biofilm disruptors on the market that can be useful, as well as herbal versions like grapefruit seed extract and coconut oil.
Although definitely a strange concept at first, the medical treatment recently discovered that has shown the best results is the fecal transplant. Like it sounds, this involves taking the feces or isolated bacteria from the feces of a healthy person and injecting it or orally delivering it into the colon of the unhealthy person. For diseases with high mortality like Clostridium difficile, it has shown to be astonishingly effective. Although in its infancy, methods like this will likely be explored as a cure for a growing number of diseases and ailments.
Lastly, a group of researchers created the Human Food Project and are now conducting a study called American Gut, looking into the variety and specific species present in different Americans. For $99 (or less for 2 or more people’s samples) they send you a home kit to mail them a feces sample. They then send you a list of your bacteria species and their relative abundance in your gut, as well as on your skin and in your mouth, and compare this to other Americans (including famous author Michael Pollan) as well as a primitive tribe that they have been studying.
This very exciting field of science holds a lot of promise for people suffering from this long list of gut-related, auto-immune, and chronic diseases. There is much to learn but from what we already know, dietary changes and some simple supplements can be even more effective than any of the medications that western medicine now prescribes – which often only treat the symptoms and not the underlying reasons for the disease.
If you suffer from any of these digestive problems or diseases, I am a health coach and a nutritional consultant with an advanced degree in nutritional biochemistry. If you would like to schedule an appointment by Skype or in the person (in the Minneapolis area), please email me at We can tailor a diet and supplement schedule tailored to your individual symptoms and food preferences and create increased health and vitality in your body!

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