Sept/Oct 2004 Newsletter

The Colon's Role in Digestion
The Perils of Dysbiosis (too much bad bacteria)
Probiotics for Diarrhea
Probioitics for IBS and IBD
What Probiotics Do

September & October

Colon Health and Probiotics
(From the booklet User's Guide to Probiotics by Earl Mindell, R.PH., PH. D.)

The colon plays a complex role in the processing of nutrients and hormones. It provides a home for between 100 million and 100 billion friendly microrganisms, including Bacteroides spp., Fusobacterium spp., Lactobacilli, and Bifidobacteria. Less friendly inhabitants such as Clostridium and Salmonella are sometimes found in the colon, but when this organ is in its healthy state, they don't survive long.

Probiotic bacteria have a number of tactics for inhibiting the growth of pathogens throughout the GI tract. They produce at least three substances that wipe out bad bacteria: acidophilin, a natural antibiotic that kills off dangerous strains of E. coli, streptocossus, and staphylococcus bacteria; lactic acid, which creates an inhospitable acidic environment for pathogens; and hydrogen peroxide, a free radical used by the immune system to do battle with unwanted invaders. Probiotics also directly boost immune function.

When the balance of good and bad microorganisms in the colon is chronically out of whack--a state of affairs known as dysbiosis--unfriendly bacteria can grow unfettered. Overgrowth of pathogenic bacteria and yeasts leads to the production of toxic byproducts that pass through the colon wall and into the bloodstream.

The Colon's Role in Digestion

Probiotics in the colon complete the digestive process by breaking down complex molecules that can't be dismantled anywhere else in the GI tract. Electrolytes and water are reabsorbed through the walls of the colon. The cells that line the colon are replaced completely every week, and this process requires a lot of energy; they don't receive nutrients from the bloodstream as most tissues do, however. Vitamins, minerals, and accessory nutrients needed by this organ are all made by the probiotics that live along its walls. Arginine, cysteiene, glutamine, B vitamins (thiamine, riboflavin, panothenic acid, and pyridoxine), antioxidants, and vitamin K are produced by gut bacteria in the colon. Electrolytes and water are also absorbed through the colon walls. 

The colon is about 5 feet long and two and a half inches in diameter. Once a meal has passed through the small intestines, most of the nutrients have been absorbed through the intestinal wall. Your body isn't content to let the rest of your meal go, however, until probiotics have a chance to eke a bit more nutritional value from what's left. Probiotics break some kinds of fiber into short-chain fatty acids such as butyrate, which is then directly utilized as fuel by the cells that line the colon wall.

Cholesterol that ends up in the colon is used to make steroid hormones, which can then pass through the walls of the colon back into the circulation. This can have the effect of lowering circulating levels of cholesterol--a good thing, considering that more than 13 million Americans are on cholesterol-lowering statin drugs!

Estrogen levels in the body are also affected by the type and number of colon bacteria. When probiotic enzyme activity decreases, blood levels of estrogen also decrease--possibly indicating a relationship between colon dysbiosis and diseases that involve estrogen, including osteoporosis and breast cancer. 

The Perils of Dysbiosis

When your diet is rich in fiber and fluids and your gastrointestinal physiology is otherwise in balance, the resulting stools are soft (but not too soft) and are easily passed. If internal ecology is not in equilibrium, the result can be constipation--where stools stay too long in the colon, making them hard and difficult to pass--or diarrhea, where unfriendly bacteria stimulate the colon to get rid of its contents before enough water or electrolytes can be reabsorbed. Insufficient probiotic populations in the colon contribute to gas, flatulence, and bloating.

All of these symptoms are typical to irritable bowel syndrome (IBS), a disorder that mainstream has not been able to explain or treat effectively with drugs. Alternative practitioners, on the other hand, have successfully treated IBS with natural protocols that include probiotic supplements. Now that the majority of research into IBS and probiotics supports this approach, the medical mainstream is beginning to change its tune and employ good bacteria in the fight against this unpleasant malady.

Probiotics for Diarrhea

Diarrhea is undeniably an uncomfortable problem, but it almost always strikes for good reason. It is your body's way of quickly moving harmful substances--including foods that don't agree with you, or pathogenic bacteria--out of your body. When the immune cells that line the intestinal tract perceive a threat in something you've eaten or has passed into your intestines through a leaky gut wall, the muscles that line the small and large intestines shift into overdrive, contracting powerfully to move the threatening substance out before it can adhere to the intestinal wall or be absorbed. This happens so quickly that there's no time for the reabsorption of water and electrolytes in the colon, and so the bowel movements that result are watery.

Drugs for diarrhea typically work by slowing intestinal contractions or by solidifying stools. These approaches may deal with the immediate problem, but they set you up for more long-term problems by retaining pathogens or other toxic substances inside your body. A better approach  is to improve the body's ability to deal with those substances, and probiotics are a good way to accomplish this end.

Diarrhea is one of the more troublesome symptoms of inflammatory bowel disease (including Crohn's disease and ulcerative colitis) and irritable bowel syndrome (IBS). Many sufferers of these often painful maladies, for which mainstream medicine has no lasting solutions, turn to drugs (anti-inflammatory) that can do more harm than good: steroids such as Prednisone are sometimes effective, but don't cure these diseases.

Crohn's and ulcerative colitis sufferers are believed to have twenty times the likelihood of developing colon cancer compared to those without these inflammatory gastrointestinal conditions.

Probiotics for IBS and IBD

IBS--also known as "spastic colon"--consists of a poorly understood group of symptoms, including abdominal pain, flatulence, bloating, and irregular bowel movements. Ten to 20 percent of adults in the United States have at least some of these symptoms on a regular basis; 25 to 50 percent of those who visit a gastroenterologist's office do so because of symptoms suggestive of IBS. Some people with IBS are chronically constipated; others have chronic diarrhea; still others have episodes of both. Several studies have shown that IBS sufferers have abnormal gut bacteria. In one such study, researchers found that subjects with IBS had lower numbers of lactobacilli and bifidobacteria compared to healthy controls.

Probiotics have been shown to benefit IBS patients. For example, in one Swedish study, published in the American Journal of Gastroenterology, sixty IBS patients were given the probiotic L. plantarum for four weeks. Their gas and pain were significantly reduced and their overall gastrointestinal function improved. In another study, researchers showed that probiotic supplementation gave IBS sufferers pronounced relief within two weeks of the beginning of the study. Another research team showed that the gut bacteria of twenty IBS patients were of similar composition, with decreased lactobacilli and bifidobacteria compared to healthy controls.

University of Alberta professor Richard N. Fedorak, M.D. is an expert Inflammatory Bowel Disease (IBD). According to his research, IBD is caused by the passage of pathogenic bacteria, or a toxin produced by those bacteria, into the intestines. They may adhere to the intestinal lining. In most people, this elicits an immune response in the intestines that handles the problem. Those who suffer from IBD, however, have genetic traits that cause the immune cells that line the intestines to overreact to the pathogen, creating inflammation that ends up injuring the intestinal lining and causing IBD symptoms.

Probiotics protect against IBD by adhering to the intestinal lining and preventing the adhesion or crossing-over of harmful bacteria. Friendly bacteria can actually move through already adhered layers of harmful bugs to offer this protection. Additional studies from Dr Fedroak's laboratory have shown reduced counts of bifidobacteria in fecal and tissue samples of Crohn's disease and reduced counts of Lactobacillus in ulcerative colitis; the worse the symptoms, the lower the numbers of these good bugs. Researchers at UNC Chapel Hill found that therapy with Lactobacillus rhamnosus prevented the relapse of colitis in rats, and that L. plantarum prevents and treats colitis in mice.

Probiotic supplementation also benefits viral diarrhea. It has been found to decrease viral shedding and secretory lgA, an antibody associated with improved healing from viral infection.

What Probiotics Do

Probiotics have been found to aid in the prevention or treatment of bacterial infections and viral and fungal infections. They support digestive health in several ways. Growing scientific evidence supports their value in the prevention of certain types of cancer. Maintaining the proper balance of probiotic bacteria has a cleansing effect on the body, which in turn helps prevent diseases that can spring from toxic overload, including autoimmune disease, allergy, and cancer. Efforts to make micro-flora feel at home in your body will improve your health in many other ways as well. 

Probiotics........