Archive for Inflammatory bowel disease
Lymphoma, inflammatory bowel disease and immunosuppression
The idea of long term immunosupression to manage a chronic disease has always concerned me. This article reviews the concern, to include the use of the new TNF-alpha receptor blockage medications, of increase risk of lyphoma. Many, if not all, cases of inflammatory bowel disease can respond wonderfully to functional medicine concepts and lifestyle changes. The increased risk of cancer with these therapies that suppress the immune system is opposing Mother Nature, and the downstream effects of this are beyond our current knowledge.
Synergy : Alimentary Pharmacology & Therapeutics 15 (8), 1101-1108
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.
Mucosal Flora in Inflammatory Bowel Disease
This article suggests that patients with IBD have a decreased ability to keep bacteria from growing along the mucosal layer of the gut. A few things to consider here. First, this article does not suggest it, but I would consider the makeup of that flora incredibly important as to the manifestations of the disease. Second, I have seen in several Crohn’s patients that yeast infiltration plays a major role in symptoms. Maybe it is possible that IBD patients have decreased ability to fight off bacteria at the mucosal layer. Maybe in these patients it is incredibly important to maintain high levels of non-pathenogenic bacteria (probiotics) and avoiding lifestyle behaviors that alter that balance negatively…
Gastroenterology — Abstracts: SWIDSINSKI et al. 122 (1): 44
Antibiotics increase functional abdominal symptoms
Much evidence, both experimental and anecdotal, point to alterations in the physiology of the GI tract as causative factors in IBS. Impaired digestion, poor diet and abnormal/pathogenic flora are all easily modified factors. Antibiotics greatly alter the balance of the flora in the GI tract, favoring the overgrowth of yeasts. Probiotics should follow EVERY course of antibiotics. I really think that antibiotic resistance is the least of our concerns with antibiotic use–alterations in GI physiology and subsequent systemic alterations are much more common and immediate.
The buzz around overuse of antibiotics focuses on antibiotic resistance, but the danger lies in destruction of the normal, protective flora and immune balance.
For decades now, researchers have been figuratively screaming at clinicians to stop the antibiotic overuse. These voices largely seem to fall on deaf ears as antibiotics are still used routinely for things like viral infections, upper respiratory tract infections and routine dental work. Many doctors and parents are hesitant to use a watchful waiting period instead of antibiotics.
Maybe the use of antibiotics remains so pervasive before prescribing doctors do not really understand the relationship between a healthy bacterial flora in an infant and child’s gut and the delicate balance of their immune system.
We have seen studies that suggest up to 91% of kids, by the time they hit 32 months, have received antibiotics. This is frankly, appalling. My son Keegan received his only course of antibiotics at about 5 1/2 years old, which was, of course, followed up by a course of probiotics.
The relationship between the bacteria in our gut and the healthy development of the immune system has been demonstrated time and time again for over a decade. Any lack of understanding of this relationship, at this stage of the research, is unforgivable.
Some examples include:
- 2004-Lactobacillus calms inflammation in the joints.
- 2004 – using gut bacteria to prevent colitis.
- 2004 – bacteria in the gut can affect the dendritic cells, a key immune regulator.
- 2005 – healthy bacteria led to less allergies, bad bacteria led to more.
There are many more, but you can get the idea that this concept is nothing new.
One of the scariest aspects of overuse of antibiotics, though, is the potential to increase the risk of inflammatory bowel disease like Crohn’s disease or ulcerative colitis.
These are potentially devastating autoimmune conditions of the gut that lead your body’s immune system to attack itself. In bad cases, large sections of the small intestine or colon need to be removed. It can be debilitating.
And it’s happening to our kids. This is not a condition any child should have to deal with. But they are. And you can bet that rampant use of antibiotics is playing a very large role.
This particular study looks at just how strong the link between antibiotic use as a child and inflammatory bowel disease is. And it’s much stronger than anyone would’ve thought:
- The rate of developing IBD in children who had been given antibiotics was 84% higher.
- Any use of antibiotics during childhood increased the risk, but this declined as the child got older.
- Use before 1 year of age increased the risk a massive 551%.
- Use between age 1 and 5 increased the risk 262%.
- Use between 5 and 15 years increased the risk 157%.
- Each use of antibiotics increased the overall risk of developing IBD 6%.
- The more doses the worse, with >2 antibiotic courses increasing the risk 477%.
These are some VERY serious numbers. Let me reiterate again that inflammatory bowel disease like Crohn’s disease and ulcerative colitis can be devastating conditions.
Put this into perspective the next time your pediatrician recommends antibiotics for your 6 month old’s ear infection instead of avoiding dairy and adding probiotics. It’s that clear cut.
Better yet, if your child’s pediatrician is recommending antibiotics when not absolutely, positively necessary, ask what the potential long term risks are of a single course of antibiotics. If they give you a blank stare, it’s time to find a new one…
How old was your child when he or she had his or her first course of antibiotics?
Bifidogenic growth stimulator for the treatment of active ulcerative colitis
Out of all the autoimmune conditions I see in my office, inflammatory bowel disease definitely tops the list. Just last week I had a patient who had a colonoscopy done and had some mild inflammation. Her GI doc’s recommendation? Wait and watch. How’s that for proactive prevention?
A better management approach would include dietary changes to include increased soluble fiber, probiotic supplementation and EFAs. All of these have been shown to lower inflammation in the GI tract. Or, you could just wait until the inflammation builds enough to actually be classified as a disease state…
SYNBIOTIC THERAPY (BIFIDOBACTERIUM LONGUM/SYNERGY 1) INITIATES RESOLUTION OF INFLAMMATION IN PATIENTS WITH ACTIVE ULCERATIVE COLITIS
While the use of probiotics to aid in the treatment of inflammatory bowel disease is not new, sometimes it’s nice just to reaffirm the efficacy and safety of this approach with a wide range of GI disorders.
Once again, we see that the long term damaging effects of antibiotic use extend well beyond the fear of antibiotic resistance.
Probiotic Effects on Inflammatory Bowel Disease
The relationship between probiotics and IBD is definite. The problem is that we don’t have all the details worked out just yet. What is very clear is that friendly bacteria is absolutely essential for healthy immune system development in the newborn and infant. Having them there early in life helps to set up a tolerance that forever helps balance the immune system.
If the balance is destroyed early, as is the case in any infant given antibiotics and not replaced w/ probiotics (I personally have yet to see a patient come into my office that has ever been recommended probiotics by their pediatrician), the risk for IBD goes up. The problem is that later in life, if the patient develops IBD, the strength of protectiveness of probiotics is not so clear cut.
The bottom line is that we HAVE to understand what antibiotics do to the long term trajectory of our health when given to our infants. To date, it is not and our greatest concern w/ antibiotic overuse remains resistance.
Gut-associated bacterial microbiota in paediatric patients with inflammatory bowel disease
This study identified alterations in the gut bacteria of pediatric patients w/ IBD (Crohn’s, Ulcerative colitis), both increases in pathogenic bacteria and reductions in protective.
The bottom line is that destruction of normal flora through the indiscriminate use of antibiotics will have a much further reaching consequence then what most prescribing pediatricians will ever be aware of.