Tuesday, September 7, 2010

Inflammatory Bowel Disease

Bowel flora may play a role in inflammatory bowel disease (Crohn’s disease and ulcerative colitis). An article appearing in the Scandinavian Journal of Gastroenterology (2001;36(Suppl 234):29-40) discussed the role of bowel flora and intestinal permeability in this disease. The cells lining the intestine form a barrier that protects the body from the contents of the intestines. If these cells fail to act as an effective barrier, increased intestinal permeability becomes a problem. The article states that increased intestinal permeability leads to a lack of tolerance to the bacteria that normally exist in the bowel.

There is evidence of the immune system working against the bacteria that exist in the bowel, perhaps even overreacting. Also, the makeup of the bacteria is different in these patients than in normal controls. In patients with inflammatory bowel disease, the bacteria tend to invade the mucosa. Research appearing in Gastroenterology (January 2002;122(1) :44-54) compared colonoscopic biopsies in 305 patients with 40 normal controls. Patients with inflammatory bowel disease had much higher concentrations of bacteria invading the intestinal lining than did the healthy subjects. A normal, healthy intestinal lining has the ability to act as a barrier to bowel bacteria; this ability is compromised in patients with inflammatory bowel disease.

The Scandinavian Journal of Gastroenterology article mentions that taking probiotics is sometimes helpful; patients with Crohn's disease tend to have less Bifidobacteria, and more Bactero ides, Eubacteria and Peptost reptococcus. Generally, probiotics contain lactic acid bacteria, like Lactobacilli, Bifidobacteria (the species found to be in short supply in patients with Crohn's disease), and Streptococci. These bacteria can release antibiotic-like substances, reduce the pH in the intestine, improve the absorption of nutrients and help stimulate the immune system.
by: Dr. Paul G. Varnas & WholeHealthAmerica.com present

Patients with inflammatory bowel disease are often deficient in many nutrients. They commonly have problems absorbing nutrients, have poor appetites, are often on restrictive diets, or are nutrient deficient as a result of drug therapy. According to a review of research appearing in the Annual Review of Nutri tion (1985;5:463-484), nutritional deficiencies are common in patients hospitalized with inflammatory bowel disease. Iron deficiency was found in 40% of the patients, 48% were deficient in vitamin B12, between 54 and 64% were deficient in folate, between 14 and 33% were magnesium deficient, between 6% and 14% had a potassium deficiency, 21% were deficient in vitamin A, 12% were deficient in vitamin C, between 25% and 65% were deficient in 25-hydroxyvitamin D and between 40% and 50% had a zinc deficiency. Other vitamin deficiencies included vitamin K, copper and vitamin E. A study of 114 patients with inflammatory bowel disease, appearing in the Scandinavian Journal of Gastroenterology (1979;14:1019-1024) found low serum folate in 59% of patients with chronic inflammatory bowel disease. There is an increased risk for colorectal cancer in patients with inflammatory bowel disease. Research appearing Inflammatory Bowel Diseases (2008 Feb;14(2):242-8), correlated folic acid deficiency with an increased risk of colorectal cancer.

Patients who had inflammatory bowel disease, and both a folic acid deficiency and a high homocysteine level had 17 times as many cancerous lesions as patients who were not folic acid deficient. Vitamin deficiencies may also contribute to the severity of the disease. The disease creates vitamin deficiency, which in turn makes the disease more severe. A study involving 30 male and 31 female patients with inflammatory bowel disease was published in the American Journal of Gastroenterology (2003;98(1):112-117). It found that vitamin B6 levels were significantly lower in patients with inflammatory bowel disease than they were in healthy controls. Furthermore, vitamin B6 levels were lower in patients who were experiencing a flare up in their symptoms than they were for patients in remission. Low vitamin B6 levels were also associated with higher levels of inflammatory markers (chemicals that, when present, indicate inflammation) C-reactive protein is an example of an inflammatory marker; it was increased in patients
with low B6 levels.

One of the roles vitamin C has is as an antioxidant, protecting cells from oxidative stress. According to research appearing in Free Radical Research (1995;22(2):131-143), patients with inflammatory bowel disease (Crohn's disease or ulcerative colitis) have reduced levels of vitamin C in the intestinal lining. Patients with Crohn's disease have levels that are 35% below normal while patients with ulcerative colitis have levels that are 73% below normal. The researchers state that most of the loss of vitamin C is due to oxidative stress from inflammatory cells. The loss of vitamin C makes the cells lining the intestines more vulnerable to oxidative stress.

Consumption of refined carbohydrates can aggravate symptoms.
The European Journal of Gastroenterology and Hepatology (January, 1995;7(1):47-51) conducted a prospective, epidemiological study of 104 patients and found that patients with Crohn's disease and ulcerative colitis have a high intake of starch and sugar. Other research that appeared in Epidemiology (January 1992;3(1):47-52), followed the dietary habits of 142 patients with ulcerative colitis, 152 patients with Crohn's disease and 305 healthy controls over a period of three years. The relative risk of Crohn's disease increased with sugar intake and decreased with fiber intake.

Eating fast food increased the risk for both Crohn's disease and for ulcerative colitis. These studies may support Elaine Gottschall's model of inflammatory bowel disease. In her book, Ending the Vicious Cycle , Gottschall describes a possible mechanism for inflammatory bowel disease and a dietary solution. She reasons that we eat too many complex carbohydrates (disaccharides like table sugar and lactose in milk, and starches like bread, potatoes, rice and beans).

Our own enzymes are not adequate enough to digest the large amounts of sugar and starch that we consume, so it passes into the intestine without being digested. The undigested food allows bacteria to grow, irritating the intestinal lining. The irritation of the intestine causes a further reduction in the amount of enzymes produced, resulting in more undigested food. Gottschall suggests that completely avoiding starches and sugar (the sugar that is in fresh fruit is permissible). Some patients, but not all of them, go into remission after following Gottschall's recommendations. It would seem if this is the mechanism causing a patient’s disease, giving a digestive supplement, may be helpful.

Thanks to Biotics Research for this wonderful information!

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