Gut Ecology

Another frequent GI disorder is called dysbiosis, an abnormality of gut ecology characterized by an imbalance in the number of good and bad bacteria in the colon. Yes, there are little critters living in your colon! In fact, there are more bacteria and viruses living in your colon than there are cells in your entire body. Overall there may be between 400 and 500 different species of organisms living in your colon. When the balance between good and bad bacteria becomes disrupted, the entire digestive process can malfunction, leading to B12 deficiency, steatorrhea (fatty bowel movements), irritable bowel disease, inflammatory bowel disease, autoimmune arthritis, colon and breast cancer, and chronic fatigue.

It appears that each of the many species of good bacteria performs a specific, necessary function. The good guys help keep the colon healthy by producing helpful products, such as N-butyrate and vitamin B12. They also hold the bad guys at bay. There is always a certain number of bad bacteria in our colon, but they're not really harmful unless they become overgrown, usually as a result of excessive antibiotic use. The small bowel usually has very few bacteria, but with reflux from the colon into the ileum, the main site of vitamin B12 absorption, these bacteria can enter the small bowel. Here, the bacteria can inhibit vitamin B12 absorption, resulting in severe deficiencies.

Good bacteria include Lactobacillus and Bifidobacillus species and E. Coli. These organisms must exist in sufficient numbers for the colon to be healthy. Several studies have shown that improving the good coloform bacteria can significantly improve symptoms in patients with Crohn's disease and inflammatory bowel diseases, such as ulcerative colitis. One study found that Lactobacillus casei greatly improved the slgA (secretory immunoglobulin A) function in the intestine of patients with Crohn's disease, which significantly improves their symptoms.437 Many times, it will significantly improve chronic constipation as well.

Some bacteria merely pass through the bowel while others take up residence. L. bulgaricus and Streptococcus thermophilus are two species that just pass through but have been shown to be very effective in cases of traveler's diarrhea. One species that actually takes up residence, Lactobacillus rhamnosus, shows much promise in controlling infantile diarrhea, especially in premature babies. Of special concern to the ulcer victim, and those with colitis, is the finding that the Lactobacillus salivarius species can prevent and treat infections by Helicobacter pylori, the causative organism in both conditions. Both the Lactobacillus and the Bifidobacterium organisms have been shown to reduce colonic inflammation in the elderly as well.

Lactobacillus ramnosus species can rapidly restore normal permeability to the intestine in cases of leaky gut syndrome, a condition in which large food components enter the blood stream. The same organism also can inhibit Candida yeast growth. Other species of good bacteria can stimulate the immune system, making it more effective in protecting you. For example, Lactobacillus casei has been shown to stimulate the activity of natural killer cells in the spleen.438

Many pathogenic bacteria, such as Klebsiella and Proteus, cannot metabolize longer-chained polysaccharides, whereas good bacteria, such as Lactobacillus and Bifidobacterium, can. This mixture of nutrients, supplied from the diet, protects us from bowel diseases, such as irritable bowel syndrome, constipation, diarrhea, colon cancer and inflammatory bowel disease.

When more virulent bacteria, such as Clostridium perfringens or difficile, become overgrown, serious disease can result, including the highly fatal pseudomembranous colitis, a condition where the lining of the colon sloughs off.439 Some of the good bacterial secrete antibiotic-like chemicals that inhibit the growth of the more pathogenic species. For instance, E. Coli secretes a chemical called colcine, which not only stops the growth of the bad bacteria but also regulates its own growth.

It should be appreciated that not all bacteria and viruses have the same ability to cause disease, a characteristic called virulence. Organisms of high virulence cause acute, severe infections. Those of low virulence may either cause no disease or produce chronic low-grade infections. This last type usually escapes your doctor's detection.

One of the more notorious of these low-virulence organisms is the Candida species. While the colon may contain a small amount of yeast, large overgrowths are harmful. We know that under such conditions, the yeast can form mycelia that can penetrate the bowel wall and enter the blood stream, where it can be carried to any organ or tissue in the body.

Yeast can also enter the small bowel, resulting in numerous microscopic perforations of the wall of the bowel. This can lead to food allergies, since large molecules of food products will be able to enter the blood stream. Interestingly, food allergies may subside when the yeast invasion is cured.

I have seen three patients with ALS, and one with Giardia infection, all of whom had serious yeast overgrowth, and all undiagnosed by their treating physicians. Each patient experienced significant improvement of bowel function following treatment, and some improved their neurological picture as well. It is also known that patients with this neurological disorder frequently have pancreatic insufficiency.

There is some evidence that low-virulence bacteria and yeast can cause diseases remote from the digestive tract, including asthma, autoimmune diseases, and eczema.440 Surgeons have been aware for many years that occasionally these bacteria and viruses can leak out of the colon into the blood stream, where they can produce infections at other sites.

Mobilization of colon bacteria into the blood stream also can occur during surgery, resulting in infections elsewhere. Colonic bacteria labeled with radioactive tracers have been followed traveling through the wall of the colon into blood vessels supplying the colon, where the bacteria then travel to distant locations. Any area of damage, such as that resulting from an operative wound, will act as a collecting point for these organisms. This is because serum, blood products, and dead tissue act as a perfect culture medium for the bacteria.

For years, hospitals and doctors have battled postoperative wound infections by meticulous hand washing with powerful antibacterial soaps, and even the use of expensive laminar flow devices and UV light; however, little headway has been made in preventing these infections. The best protection is good nutrition for the patient and correction of bladder infections and colon overgrowth before the patient arrives in the operating room.

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