Chronic Fatigue and Battered Bowel Ecology

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Chronic Fatigue and Battered Bowel Ecology JoAnn Guest May 24, 2005 09:36

PDT

 

 

The bowel ecosystem is always injured in chronic states, and its

restoration is the second core thrust of my management philosophy for

chronic fatiguers — the first core thrust being a global strategy for

reducing oxidative stress.

 

THE GUT IS A MISUNDERSTOOD ORGAN

In drug medicine, when the symptoms are directly related to the gut, the

treatment strategy consists of symptom suppression with drugs.

 

When the symptoms are not directly related to the gut, any suggestion of

a possible role of a damaged bowel ecosystem in the cause of symptoms is

unceremoniously dismissed.

 

In my view, the most remarkable phenomenon in the entire field of human

biology is this: A vast number of clinical problems that are seemingly

unrelated to the bowel spontaneously resolve when the focus of clinical

management turns to all the issues in bowel ecology.

 

How often do symptoms of persistent debilitating fatigue in young men

and women clear up when an altered state of bowel ecology is restored to

normal? How often do troublesome mood swings subside when therapies

focus on the bowel?

 

How often does arthralgia (pain and stiffness in joints with or without

joint swelling) resolve when all the bowel issues are addressed?

 

How often do we successfully prevent chronic headache; anxiety;

palpitations; incapacitating PMS; recurrent attacks of vaginitis; asthma

and skin lesions by correcting the abnormalities in the internal

environment of the bowel? The answers to these questions will vary

widely among physicians.

 

Physicians who regularly neglect the bowel (and those who never

understood the issues of bowel ecology in the first place) will dismiss

these questions with scorn.

None of this has been proven with double-blind cross-over studies, they

will strenuously protest.

 

Other physicians who have learned to respect the bowel — as the

ancients did — and care for their patients with a sharp focus on bowel

issues will readily and unequivocally validate my personal (and fairly

extensive) clinical experience.

 

LIFE IN THE BOWEL ECOSYSTEM

The bowel ecosystem teems with life. Shrouded in metabolic mists, it is

as rich in biologic diversity and as broad in biochemical

interrelationships as any other ecosystem on this planet Earth.

 

The ancients seemed to have an intuitive sense about it.

 

Death begins in the bowel, they pronounced in more than one way.

Leeuwenhoek studied fecal bacteria during his invention of the

microscope in 1719, and, thus, was the first man to study life in the

bowel ecosystem with modern scientific methods.

 

Metchnikoff, the Russian biologist, who single- handedly developed the

concept of the cellular arm of the immune system, became intensely

interested in the aging process in his later years when he moved to

Paris where he served as the head of the Pasteur Institute.

 

He studied the longevity of Bulgarians and provided strong evidence

that certain bowel microbes played important roles in preserving health

and promoting longevity among them.

 

He named the microbe he thought was most prominent in this field as

Lactobacillus bulgaricus. Metchnikoff's work opened the floodgates of

basic research on the bowel " flora " .

 

WINDOWS ON THE WORLD

A cell looks at the world around it through its cell membrane. It is

this membrane that separates the cell's internal order from external

order.

 

Although molecular host defense mechanisms of both immune and nonimmune

types have progressed from simple single-cell forms to multicellular

forms to highly developed complex organisms such as humans, the

fundamental pattern of host defenses has remained the same:

 

The cell membrane or its counterparts carry the primary responsibility

for preserving the biologic integrity of the organisms.

 

For the professional reader, I discuss at length the energy and

biochemical events which occur at the cell membrane in health and

disease in my monograph, The Agony and the Death of a Cell, published in

the 1991 syllabus of the American Academy of Environmental Medicine.

 

For humans, the gut mucosa is the true counterpart of the cell membrane

of unicellular organisms. From a phylogenetic perspective, the gut

mucosa would be expected to be the primary host defense organ.

 

This indeed is the case when one looks at health and disease from a

holistic perspective.

 

In a biologic sense, man's gut lining is his window to the world around

him. What do we ever get through our skin but a little vitamin D when we

get a chance to bask in the sunshine?

 

What do we get through our lungs?

 

All our ancestors ever received through their lungs was oxygen.

 

Now we receive — unwillingly and under severe protest — a heavy load of

environmental pollutants. Everything else that enters our biologic

systems enters through the gut lining.

 

It is important to recognize that the mucosal linings of the mouth,

esophagus and stomach essentially are extensions of the gut lining.

 

The states of health and absence of health are expressions of the

dynamics of foods within the gut ecosystem —

 

the effects on foods of the digestive-absorptive processes as well as

the various life forms in the gut.

 

 

HUMAN MOLECULAR DEFENSES EXIST AS PLANTS IN THE SOIL OF THE BOWEL

CONTENTS

 

The ancients seemed to have known this intuitively. We seem to have

taken a very circuitous route to grasp this most fundamental of all

aspects of the immune system.

 

I remember that the hakim (folk-doctor) in my village always prescribed

laxatives for a headache.

 

He prescribed remedies that seemed to work on the bowel for problems of

the skin, joints, liver and other organs.

 

Of course, I, then a medical school student, found it very amusing. It

never occurred to me then why these folk-doctors would prescribe year

after year remedies that couldn't work. More important, from my present

perspective, I never wondered why people accepted those remedies year

after year if they afforded no relief.

 

I was into the science of medicine then. I wasn't into finding out what

worked and what didn't. Nor did I ever doubt the science of my

professors who doled out prescriptions for drugs by the dozens for sheer

symptom suppression. That was then. And that was poor Pakistan.

 

Now I question the science of an average American family practitioner

when he prescribes drugs for chronic bowel symptoms. How scientific is

his use of antacids for symptoms of burning or pain in the pit of the

stomach?

 

How scientific is his use of antispasmodic drugs for abdominal cramps?

 

How scientific is his use of antidiarrheal drugs for diarrhea? How

scientific is his use of steroids for inflammatory bowel disorders?

 

Steroids suppress the immune system.

 

How scientific is it to further suppress the immune system for problems

caused by an errant immune system in the first place?

 

How scientific is the use of anti-inflammatory agents, anxiolytic drugs,

antidepressants, antispastic agents, antihistamines, and, of course,

broad-spectrum antibiotics for treating various types of bowel disorders

that we — by our own admission — do not understand the causes of?

 

THE BOWEL PERPLEXES A PATHOLOGIST

How many different things can the bowel do? It cramps. It obstructs. It

turns and twists. It ulcerates. It bleeds. How does the bowel know when

to cramp and when to obstruct or bleed? And when to turn and twist?

 

For many years I have studied a host of clinical syndromes in which the

symptom- complexes can be related to events occurring in the bowel. As a

hospital pathologist, I have had the opportunity to examine more than

11,000 bowel biopsies during the last 25 years.

 

Every time I peered at a bit of bowel through a microscope and saw

inflammation — colitis in common jargon — I wondered where and how it

might have started.

 

We pathologists know quite a bit about how a damaged bowel looks, but we

know little, if anything, about the initial energetic-molecular events

that set the stage for tissue damage.

 

What is the cause of ulcerative colitis? Pathologists will tell you it

is not known.

 

What is the cause of Crohn's colitis? The answer: unknown. What is the

cause of irritable bowel syndrome and spastic colitis? Unknown.

 

What is the cause of microscopic colitis and collagenous colitis? The

answer is the same.

 

Why is it that we do not know the cause of any of these types of

colitis?

 

The reason is we search for answers in the damaged structure after the

fact rather than in the events preceding the damage. None of these

" diseases " can be understood except with ecologic thinking.

 

 

During the early 1980s, my research colleague, Dr. Madhava

Ramanarayanan, and I introduced the micro-elisa assay for

allergen-specific IgE antibodies.

 

This research interest and several subsequent studies gave me important

insights into immune and nonimmune events that inflict tissue injury. It

also raised serious questions about many of the prevailing concepts

regarding the role of food and mold allergy in the causation of numerous

bowel disorders.

 

As a clinician, I have cared for a fairly large number of patients with

autoimmune and immunodeficiency syndromes. These microscopic, immune,

molecular, and clinical observations — as disparate as they appeared in

the usual clinical setting — began to take coherent and integrated forms

before me.

 

I began to recognize that events taking place in the bowel were clearly

related to many clinical syndromes that seemed to have nothing to do

with the bowel according to the prevailing concepts of pathogenesis of

disease.

 

The single most important insight into the workings of the human immune

and nonimmune defense systems for me has been this: The integrity of

human molecular defenses cannot be preserved except through preservation

of the gut ecology. My clinical work with chronic fatigue states allowed

me to test and validate this fundamental concept with therapies founded

on my view of injured bowel ecosystems.

 

 

LAPs AND TAPs: THE GOOD AND BAD GUYS OF THE BOWEL

 

LAPs and TAPs are my abbreviations for lactic acid-producing and toxic

agents- producing microbes in the bowel. LAPs preserve the normal bowel

ecosystem, TAPs disrupt it.

 

In the chapters (from The Canary and Chronic Fatigue) , What Is Chronic

Fatigue? and Where Does It All Begin?, I discuss many elements that

increase oxidative stress on energy and detoxification enzymes. It turns

out that almost all these elements also suppress LAPs and — both

directly by inhibiting LAPs and indirectly by other mechanisms — promote

the growth of TAPs.

 

This subject is of enormous significance in the normal aging process as

well as in the accelerated aging process associated with chronic fatigue

states.

 

LAPs confer many important host defenses upon the bowel discussed later

in this section. TAPs are equally versatile in their functions and

produce a very large number of noxious substances in the bowel.

 

Among these are ammonia; phenols; tryptophan metabolites;

vaso-constrictive amines such as histamine, tyramine, agmatine and

cadaverine; certain steroid metabolites; and many toxins — most notably

mycotoxins derived from fungi (yeasts).

 

This area has received rather limited investigative attention, and it is

almost certain that future research will uncover a host of as yet

undetected bacterial and fungal toxins and metabolic villains.

 

Finally, the bowel flora both produce and potentiate some carcinogenic

substances.

 

Not unexpectedly, LAPs-TAPs dynamics are profoundly influenced by food

choices.

 

American and British individuals show overgrowth of some TAPs such as

bacteroides and some types of clostridia as compared with Japanese,

Indians and Ugandans (Lancet 1:95-100; 1971).

 

 

It appears likely that these differences are due to an abundance of

fats and beef in the former populations' diet.

 

BACTERIA: THE MASTER CHEMISTS

 

Bacteria are living beings capable of executing an enormous number of

biochemical reactions. Farmers used bacteria and fungi to turn compost

into fertilizer long before biologists understood the metabolism of

these single-celled bodies.

 

A partial list of such reactions brought about by the normal bowel

flora includes production of ammonia, conversion of amino acids into

amines and phenols,

inactivation of digestive enzymes such as trypsin and chymotrypsin and

other enzymes located on the surface of cells lining the gut,

deconjugation of hormones such as estrogen and bile acids, denaturation

of bile steroids,

breakdown of food flavonoids,

hydrogenation of polyunsaturated fatty acids in food,

utilization of certain amino acids such as B12,

conversion of some compounds into carcinogens, and many other enzymatic

reactions.

 

I list below the three genera of LAPs and several genera of TAPs that

most frequently populate the bowel ecosystem.

 

LAPS TAPS

Bifidobacterium Proteus, Pseudomonas, Salmonella, Escherichia

Lactobacillus Bacteroides, Clostridium, Peptococci, Peptostreptococcus

Streptococcus Streptococcus, Staphylococcus

 

About 30 species of LAP microbes have been identified. Some important

members of these three groups (L, Lactobacillus; B, Bifidobacterium; S,

Streptococcus) include the following:

 

L. acidophilus B. bifidum

L. bulgaricus B. adolescentis

L. lactis B. infantis

L. casei B. breve

L. helveticus B. longus

S. faecium S. thermophilous

 

 

Most byproducts of modern technology threaten LAP microbes.

 

In addition, alcohol, nicotine, various pharmacologic agents, and highly

processed and " preserved " foods have a negative impact on lactic-acid

producers.

 

Normal fecal flora in man includes the following: Bacteroidaceae

(Bacteroides and Fusobacteria), Eubacteria, Lactobacilli,

Bifidobacteria, Veillonellae, Acidaminococci, Megasphaerae,

Peptococcaceae (Ruminococci, Peptococci and Peptostreptococci),

Clostridia (C. perfrigens and other species), Enterobacteriaceae,

aerobic Lactobacilli, Streptococci, Staphylococci, and yeast and fungi

(often used interchangeably).

 

 

LAPs: THE GUARDIAN ANGELS OF HUMAN CANARIES

 

The LAPs angels look after human canaries in many ways.

 

First and foremost, LAPs keep TAPs out. It appears that this essential

role is played through different mechanisms that include simple physical

crowding out of the potential pathogens as well as production of

antimicrobial substances. L. acidophilus produces acidophilin, acidolin

and bacterlocin; L. plantartium produces lactolin; L. bulgaricus

produces bulgarican; and L. brevis secretes lactobacillin.

 

Second, they produce many life span molecules.

 

Notable among them are members of the vitamin B complex, especially

folic acid and biotin and vitamin K. Lactobacillic acid is an important

fatty acid that is produced by some lactic-acid producers and is then

converted into essential fatty acids.

 

Another notable molecule in this context is tryptophan — this is likely

to be one of the mechanisms by which organic yogurt has been reported to

be beneficial in cases of chronic anxiety and other conditions.

 

Third, they play a pivotal role in digestion.

 

Lactose intolerance is a very common clinical problem. It is often not

fully appreciated that a major portion of lactose ingested in dairy

products is actually broken down to simpler sugars by lactase enzymes

produced by lactic acid producers.

 

Lactic acid and lactase producers also play important roles in protein

digestion. This is one of the primary reasons protein intolerance is so

common among individuals with altered states of bowel ecology.

 

 

Fourth, LAPs actively break down some toxins produced during metabolism

such as ammonia, free phenols and polypeptides.

 

 

Fifth, LAPs normalize bowel transit time and are effective in

controlling infant and adult diarrhea.

 

Sixth, the antiviral and antifungal roles played by LAPs, having long

been empirically suspected by nutritionists and holistic physicians,

have recently been documented with research studies.

 

Seventh, the cholesterol-lowering effects of fermented substances have

been attributed, among other mechanisms, to orotic acid, which

facilitates fat metabolism in the liver.

 

Eighth, some LAP microbes suppress tumor cells in rats. This factor is

not of direct relevance to human canaries — at least not yet, though in

time accelerated oxidative damage is likely to increase the incidence of

cancer in chronic fatigue states.

 

http://majidali.com/Bowel%20I%20Altered%20States%20of%20Bowel%20Ecology.htm

 

_________________

JoAnn Guest

mrsjo-

DietaryTi-

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