Archive for Inflammatory bowel disease
Phosphatidylcholine for Steroid-Refractory Chronic Ulcerative Colitis
Phosphatidylcholine is an important component of our cell wells; without adequate levels, the cell cannot effectively communicate messages from inside of the cell to outside. Healthier communication means healthier cells.
In this particular study, the authors use PC to see if it could more effectively help patients with UC come off of their steroids. While this was a small study, a 40% better response with the use of PC is a pretty exciting result. Couple this with other dietary changes and anti-inflammatory compounds like fish oil and it is likely to provide a very effective natural approach to inflammatory bowel disease.
Dysbiosis in inflammatory bowel disease: a role for bacteriophages?
There is very strong evidence of the contribution to altered bacterial flora in the development of inflammatory bowel disease like Crohn’s and Ulcerative Colitis. However, the role of probiotics in the treatment of IBD is not as clear cut. It basically appears that, once the alterations from improper flora are present, the physiology has a real time correcting itself. Which brings us back to what alters the flora in the GI tract in the first place. The answer begins at delivery. We know that infants born vaginally have a much different flora then C-section babies. Couple this with the 90-something percent of infants that have antibiotics by the time they’re 2 and you’ve got a recipe for physiological disaster.
At some point pediatricians have to crack open a medical journal and realize the massive level of harm we are causing by indiscriminate antibiotic use for largely self-limiting conditions. I have a 2 1/2 year old that’s never even breathed the fumes of the ink off an antibiotic prescription. It’s not that difficult to maintain healthy toddlers–you just can’t follow the status quo. Make the right decisions and you can help protect your child from adult diseases.
Back in the mid 1980′s, a doctor by the name of Barry Marshall drank a concoction of the bacteria H. pylori to prove that ulcers were caused by bacterial infection. He ended up with a Nobel Prize and forever changed medicine’s view of ulcers. Thus began the “blinders on” approach to eradication of H. pylori everytime it was found. Destroying this bacteria is a good thing, right?
Of course, we can all agree that wanton use of antibiotics (and they use 2 types of antibiotics in the treatment) is never a good thing. I have long stood by the belief that H. pylori is merely an opportunistic infection, growing in strength when the patient is not taking care of themselves.
Evidence supporting an important role for H. pylori is strong:
- H. pylori may protect against asthma and allergies
- Few patients who have H. pylori actually develop severe inflammation and ulcers
- Children without H. pylori run a greater risk of being morbidly obese later in life
- DNA damage to the stomach increases is higher after H. pylori eradication
Even if we viewed H. pylori as an infection that needs to be wiped out, evidence strongly supports the use of probiotics to keep the H. pylori at bay, which runs in direct opposition to the use of antibiotics to wipe out the bacteria.
This particular article relates problems lower down in the GI tract with H. pylori. Or rather, H. pylori is found to lower the inflammatory response lower in the GI tract, potentially lowering the risk of inflammatory bowel disease like Crohn’s and ulcerative colitis.
Antibiotic use, especially early in life, is believed to be a strong concern for the development of inflammatory bowel disease. It is believed that the destruction of bacteria that is supposed to be there causes the immune system to lose balance, attacking the tissues of the body itself.
Gestational Glucose Tolerance and Risk of Type 2 Diabetes in Young Pima Indian Offspring.
I’ve frequently mentioned how important it is for mom to be as healthy as possible prior to pregnancy, and this fact is drilled home again and again in the research. In this study, even pregnant women at the higher end but still within the normal range for glucose levels produced infants with increased risk for diabetes decades later. I can’t stress this fact enough–if we ever hope to turn around this growing trend towards obesity and heart disease, it has to start with woman prior to pregnancy to affec the NEXT generation. Read More.
Involvement of nitric oxide pathway in the acute anticonvulsant effect of melatonin in mice.
The biochemistry on this one gets a little deep, but stay with me for a second. First, this is a mouse study, so take it for what it’s worth. But this does show the incredibly complex interactions between the systems of the mammalian system. In this study, melation was given to protect against seizures. But the beneficial effect was only seen in the presence of nitric oxide (actually, the benefit was seen when a nitric oxide precurser, L-arginine, was given). So, what about insulin resistance? We know that insulin resistance lowers the effective levels of nitric oxide. So, if melationin is going to be used to help manage seizures, insulin sensitivity has to be managed as well for the most positive effects. How ’bout that for a tangled web? Read More.
Bifidogenic growth stimulator for the treatment of active ulcerative colitis.
Out of all the autoimmune conditions I see in my office, inflammatory bowel disease definately 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…Read More.
Effects of topical treatment of sodium butyrate and 5-aminosalicylic acid on expression of trefoil factor 3, interleukin 1beta, and nuclear factor kappa B in trinitrobenzene sulphonic acid induced colitis in rats.
Okay. The biochemistry in just the title of this one reminds me of how hard I tried to stay awake in biochemistry class. I’ve just included this to piggyback on the above article. Basically, healthy bacterial flora coupled with soluble fiber produces butyrate. Butyrate has consistently shown to produce anti inflammatory and anti cancer effects in the GI tract. Read More.
Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants.
While this study was done in low birth weight infants, it again supports the role of healthy digestion and stomach acid levels in acting as a sterilizing agent to all bugs making it into the stomach. While this inherently makes sense to most people, I have never once had a patient come into my office on acid suppressive therapy (and this is quite a regular occurrence) and get anything remotely akin to informed consent about the potential side effects of this class of drugs. In adults, studies have shown that acid suppressive therapy in adults contributes to small bowel bacterial overgrowth–a growth of bacteria growing in the small intestine in a location where nothing should be growing. Read More.
Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in postmenopausal women.
I have frequently voiced my unhappiness with most of the national anti-disease organizations. They take a very soft approach and seems like industry probably has a large voice in their recommendations. We have seen study after study finding stronger effects and better tolerability of a Mediterranean diet and low glycemic index diet vs the American Heart Association step 1 diet. I guess my question is, with all the research coming out over the years, why haven’t the AHA changed their recommendations? Read More.
Antipyretic Treatment in Young Children With Fever.
I just I’d use this study to illustrate a point. This study finds that alternating between acetominophen and ibuprofen has a greater effect at lower a fever then either alone. So what’s the problem? Seems pretty clear cut, right? There has never, to date, that I have ever seen or anyone’s been able to produce for me, that antipyretic therapy is safe or effective or produces a better outcome than placebo. Never. Remember that fever (within reason–we’re not talking about 104 degrees here) is a programmed response by the body so it can more efficiently fight off infections. At some point you’d think someone might actually think that shutting this normal process down may actually be a bad thing. But appearantly no one that funds any studies!! Just another example to cite when “mainstream” medicine throws the “no evidence for alternative medicine” line at you. Read More.
Calorie restriction induces mitochondrial biogenesis and bioenergetic efficiency.
We’re at another article that illustrates the incredible complexity with which our bodies operate. As background, the only thing that has consistently shown to increase lifespan in mammals is calorie restriction without nutrient restriction. But the real reasons why this occurs have been unclear. In this particular review the authors answer the “how.” Basically, calorie restriction without nutrient restriction induces greater numbers and more efficient mitochondria. Given that mitochondrial dysfunction is the root of all evil (my personal quote…) this has profound implications. It also raises another interesting question. In all the studies done in the past that used nutriceuticals to impact a condition (i.e. CoQ10 for Parkinson’s), do we need to go back and restratify for caloric intake? A Parkinson’s patient eating a higher caloric diet may have less benefit from CoQ10 as another patient taking the same amount but less calories. This also vaults calorie restriction without nutrient restriction to the top of the therapuetic list for any mitochondrial dysfunction related condition. Which, of course, in my opinion, is ALL of them…Read More.
Benefits of Niacin in Patients With Versus Without the Metabolic Syndrome and Healed Myocardial Infarction (from the Coronary Drug Project).
So you’ve had a heart attack. The cardiologist must have lots of wonderful drugs they can chose from to keep you from having another heart attack, right? How about those highly prescribed and wonderfully advertised statin drugs? They ought to work wonders. Unfortunately for the drug companies, in this moderately large study, only niacin was able to prevent second heart attacks. The catch? It was only in patients with metabolic syndrome. What a kicker, right? Few doctors recognize the importance of identification of metabolic syndrome, and yet this delineation could mean the difference between life and death if you’ve had a heart attack. And, considering that some studies put the incidence of metabolic syndrome as high as 88% in CVD patients, you odds are very high…Read More.
Predictors of worsening insulin sensitivity in postmenopausal women.
Geez. If there wasn’t the nail in the coffin of hormone replacement therapy already, this would certainly blow past that last nail and move right to cremation. Worsening insulin resistance with HRT. It’s no wonder now that we saw increased cardiovascular disease and more cognitive decline. I guess the real question is how did an intervention that was so incredibly prescribed for decades, never get a full evaluation of the potential harms before it was released? For those who think the FDA is there to protect us, this should prove this is definately not the case. Read More.