Archive for Gut health 101
Can calprotectin simplify the diagnosis of irritable bowel syndrome?
Calprotectin is a marker for inflammation of the GI tract and is suggested in this study as a fecal marker to differentiate IBS from inflammatory bowel disease. While this is an easy and effective way to differentiate, I have a problem with this article referring to IBS as a non-organic disease. I would much rather have researchers refer to IBS as a functional disorder. By labeling it as a non-organic disease I envision a condition that is psychogenic in origin, which I do not feel that IBS is. It may be flared by stressful situations, but that hardly constitutes a psychogenic illness.
Fish Oil Increases Acetylcholine, Eicosanoid-Induced Contractility of Ileum
This article is very timely with the FDA’s conditional approval (see next article) of alosetron. Re-release of this drug after its withdrawal after fatal side effects is a subject of hot controversy. The drug is designed to help with diarrhea-dominant IBS. Here we see a natural approach to the opposite end of the spectrum; and I’d bet I would be hard pressed to find any fatal reactions to fish oil…
Nutrition.org — Abstracts: Patten et al. 132 (9): 2506
The body digests and does everything else. In other words, digestion is absolutely critical to good health. Period. And this process hinges on stomach acid.
Without proper digestion, you open up a large Pandora’s box of problems because stomach acid has many different roles. With this in mind, you can begin to see how both emotional stress as well as medications that block acid production (like Aciphex, Nexium, Prilosec) could ruin your health.
First, though, I do need to clarify that this class of drugs has its place. If you’ve got a bleeding ulcer it’s not the time to discuss changing your diet and chewing your food better. It’s time to protect the lining of the stomach from the acid so that it does not break open and spill your blood inside your abdominal cavity. This can be fatal. For everyone else, however, blocking stomach acid is a bad thing.
Ironically, very few people make too much stomach acid. This is especially true as we age, where the region of the stomach begins to wear away with age, leaving up to 1/3 of seniors with achlorhydria (NO stomach acid production). Thus, one would think that a senior citizen would be a very unlikely candidate for any type of drug that blocks acid production.
Just so you can get a better idea of what stomach acid does, here is a short list:
- Digestion of proteins
- Turns on other digestive enxymes (they are produced in an inactive state)
- Sterilizes everything so no bacteria or funguses make it past the stomach
- Helps to absorb certain critical nutrients like vitamin B12
- Turns on certain anti-cancer compounds in foods (like indole-3-carbinol in broccoli)
- Turns the stomach contents acidic. This is critically important. The pH of the stomach contents have to be more acidic than 5 ish in order for the pancreas to release secretin to neutralize the stomach contents. If this does not happen (as with drugs) the rest of the GI tract has to deal with acid contents that are too strong for it, leading to long term damage.
This list is longer, but you get this idea. It’s important.
As I mentioned, the average senior absolutely does not make enough stomach acid. Certainly not enough to warrant medications that shut down acid production. And yet, we still write those prescriptions. Sometimes out of mere habit.
This practice is especially common when seniors end up in the hospital, and this practice has been increasing over the past few years. But, given how much stomach acid does for our health, is this a good idea?
The answer turns out to be a no.
In this particular study, researchers looked at a group of seniors discharged from the hospital to see if being given a prescription for proton pump inhibitors had an effect on his or her likelihood of dying within a year. Here’s what they found:
- Use of acid blocking drugs increased the risk of dying within a year by 51%.
- For those prescribed high-dose drugs, the risk skyrocketed to 259%.
The bottom line is that it is highly likely that shutting down acid production as you get older is a bad idea that will adversely affect your health and longevity. Instead, consider a digestive enzyme, chewing your food slowly or a tablespoonful or two of apple cider vinegar to help your body do what it is supposed to do.
How are abnormal liver function tests dealt with in primary care?
First of all, it is a shame that we still consider standard liver enzyme levels as a “liver function” test. It absolutely is NOT. With these tests, we are looking for liver damage, not function (with exception of bilirubin, which is somewhat of a functional test). True liver function tests involve what the liver DOES, such as detoxification panels. I love to see a patient come in with altered liver function, because I know there is so much that functional medicine can do for these patients.
bmj.com Abstracts: Sherwood et al. 322 (7281): 276
Protective role of probiotics and prebiotics in colon cancer
Fiber has been shown to be protective against colon cancer, but a recent study shed some doubt on this belief. However, it is commonly believed that this protective effect comes from the action of probiotics on soluble fiber, producing butyrate. I would love to see the bacterial environment of the GI tracts of the patients used in the study that showed no benefit from fiber, and re-evaluate the data.
AJCN — Abstracts: Wollowski et al. 73 (2): 451S
Protection from gastrointestinal diseases with the use of probiotics
Need I say more?? American Journal of Clinical nutrition, Feb 2001 has devoted an entire supplement to probiotics. Their value, safety and therapeutic benefit has held out in clinical trials and case controls. I use them quite frequently in my practice.
AJCN — Abstracts: Marteau et al. 73 (2): 430S
Probiotics: effects on immunity
Once we finally accept that the GI tract has a strong ability to modulate the response of the immune system throughout the entire body, then using probiotics to help boost immune function becomes an entirely rational therapeutic avenue. And remember…antibiotics will kill off these normal, protective flora. Could it be shown in the years to come that antibiotics actually lower our immune response?
AJCN — Abstracts: Isolauri et al. 73 (2): 444S
Probiotic agents to protect the urogenital tract against infection
What a wonderful article!! I have had numerous patients use probiotics for recurrent urinary tract infections as well as yeast infections. The results from a distilled water douche is almost instantaneous. Lactobacillus is a normal inhabitant of the vaginal vault, and its acidity prevents many other bacteria and yeast from growing. Such a simple therapy…
AJCN — Abstracts: Reid 73 (2): 437S
Study Suggests Environmental Factors Play a Causative Role in IBD
Now that at least a portion of mainstream medicine is beginning to recognize the role that environment plays in many diseases, we need to take a more aggressive role in managing these conditions without the use of drugs or surgery. Crohn’s disease and ulcerative colitis in this study were found to occur at higher rates in spouses of patients with the disease that would otherwise have been expected. Patient with IBD can actually respond very well to functional medicine concepts such as restoration of GI environment, avoidance of food allergens and maintenance of optimal digestive functioning.
Gastroenterology — Abstracts: LAHARIE et al. 120 (4): 816
Erythromycin as a prokinetic agent in infants and children
One of these days I may just throw up my hands in despair and give up preaching against the incoming tide. Until then… What we see here is that the pharmaceuticals may be loosing some of their business in this era of reduced antibiotic use so they are looking for another indication for their drug. Save money on R & D…just take one of the side effects of the drug and try to turn it into an indication! Truly amazing. The idea of using an antibiotic to increase motility of the GI tract goes beyond incredulous. How about using probiotics, high fiber and prebiotics (such as insulin and FOS) instead? Much safer and you are actually looking at fixing whatever is causing the decreased transit.
Synergy : Alimentary Pharmacology & Therapeutics 15 (5), 595-603