IMaking Sense of IBS, IBD, and Leaky Gut
BY BARRY W. RITZ, BS
By now, we've all heard that intestinal health is the foundation of overall well being. That fact is clear. The intestinal lining is responsible for absorbing nutrients from the foods that we eat and serves as our most important immune barrier, protecting us from potential allergens in undigested foods, as well as microbiological and chemical threats. But sorting through the terminology and the countless catalog pages and store aisles of intestinal health products and digestive aids can be confusing and overwhelming. We're not all gastroenterologists (gut doctors), but it seems a discussion is in order on irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), as well as the concept of leaky gut and how to best support intestinal health in these conditions or in a preventive manner.
Irritable Bowel Syndrome
Irritable bowel syndrome is a disorder of intestinal function that affects 1 in 5—or 55 million— Americans during their lifetimes. Of the estimated 18.5 million current sufferers, 67 percent are women. The condition occurs in the small intestine, colon, or both. It can be characterized by abdominal discomfort, pain, bloating, mucus in the stool, and irregular bowel habits. IBS is typically a gut motility problem, resulting in constipation, diarrhea, or an alteration between these two extremes. It may also involve low-grade inflammation that is not detected in evaluations, but plagues the patient (termed sub-clinical inflammation). The cause of IBS is not well understood, and IBS is something of a catch-all term. While not considered the cause, stress may exacerbate existing irritable bowel symptoms. Traditional GI tests are necessary to rule out diseases such as cancer, ulcerative colitis, or Crohn's, but diagnosis of IBS is based entirely on symptoms. Lotronex®, a serotonin receptor medication and the first FDA-approved drug for the treatment of multiple symptoms of IBS, was released in February, 2000. While many people with diarrhea-predominant IBS found relief with the product, severe complications led to its withdrawal by November, 2000. As of mid-2002, 84 cases of ischemic colitis, 113 cases of severe constipation, 89 hospitalizations, 45 surgeries, and four deaths had been tied to the use of the drug. However, due in part to pressure from IBS sufferers who benefited from the drug, it was re-released in June, 2002, with strong restrictions on use. Another medication, Zelnorm™, was approved by the FDA in July, 2002, for the treatment of multiple symptoms of IBS, but only for short-term use in women whose primary complaint is constipation.
Inflammatory Bowel Disease
Inflammatory bowel disease is a chronic inflammatory condition divided into two types depending on the location of the inflammation. Ulcerative colitis affects the colon, but just the lining. Crohn's disease can affect all layers of the intestine and even the entire length of the GI tract from mouth to anus. Again, the cause of IBD is not entirely understood, but autoimmune conditions and allergies, lack of blood supply to the area, abnormal bacterial overgrowth (often related to the overuse of antibiotics), and heredity all seem to play a role. Current medical therapy consists of anti-inflammatory drugs such as corticosteroids (Prednisone), Azulfidine, or mesalamine, and immunosuppressives like 6-mercaptopurine, Imuran, methotrexate, or cyclosporine. All of these medications have been shown to be effective, but long-term use is often complicated by serious side effects.
Leaky gut syndrome is a surprisingly common problem with widespread effects and is not limited to a diagnosis of IBS or IBD. An understanding of leaky gut helps clarify how intestinal integrity relates to overall health. Food allergens and toxins that leak through an inflamed or damaged intestinal lining are carried by the blood to the liver and eventually affect systems throughout the body by aggravating inflammation in the joints, expressing toxins in skin disorders, triggering food sensitivities, and causing "brain fog" or hyperactivity. Managing leaky gut is preventive medicine at its finest. Reducing the toxic load on the liver and body can prevent illness or improve its outcome. Leaky gut can be caused by any number of different conditions that cause inflammation or damage to the intestinal lining, including infection, trauma (burns or surgery), and the use or overuse of many medications, like NSAIDs (ibuprofen). Chemotherapy or radiation therapy patients and those with HIV also cope with the effects leaky gut. Leaky gut is associated with a wide range of general symptoms, such as fatigue, fevers of unknown origin, abdominal pain, bloating, diarrhea, feelings of toxicity, memory problems, difficulty concentrating, and poor tolerance to exercise, and can cause:
LEAKY GUT MAY CAUSE....
Attention Deficit Disorder
Symptoms Resembling Autism
Chronic and Rheumatoid Arthritis
Chronic Fatigue Syndrome
Food Allergies and Intolerances
Irritable Bowel Syndrome (IBS)
Inflammatory Bowel Diseaase (IBD)
Multiple Chemical Sensitivities
While both IBS and IBD are associated with leaky gut syndrome, the relation between leaky gut and Crohn's disease is better established than between leaky gut and either ulcerative colitis or IBS.
NUTRIENTS THAT HEAL THE GUT
In addition to removing food and chemical allergens from our diets and environment, as well as reducing stress that might trigger intestinal distress (there are a variety of mind-body techniques), there are a number of nutrients and supplements that can help heal the irritable, inflamed, or leaky gut:
SEACURE® hydrolyzed protein from white fish provides healing peptides that promote intestinal health. The product is manufactured by Proper Nutrition, Inc., and is available through NEEDS. In addition to providing high quality protein, the bioactive peptides from hydrolyzed fish act locally on the gut lining as growth or healing factors to repair a damaged intestine. Clinical studies conducted with Seacure® demonstrate success with the symptoms of irritable bowel syndrome and HIV-related intestinal dysfunction, as well as IBD and leaky gut. Results with food intolerances and chemotherapy or radiation-induced intestinal injury also appear promising.
Another source of peptides that promote intestinal healing is BOVINE COLOSTRUM, which also supplies valuable immune factors. Colostrum reinforces the intestinal lining's role as an immune barrier. If you suffer from food sensitivities or allergies, consider a form that is specially prepared to remove the casein and lactose.
THE AMINO ACID L-GLUTAMINE is considered the primary energy source of the healing intestinal cell. Glutamine is available as a component of Seacure® or by itself, if higher levels of intake are required.
ZINC is essential for growth and wound healing, particularly in cells that turn over rapidly, like those of the intestinal lining.
VITAMIN A is necessary for the maintenance of GI tract integrity, as well as the production of secretory IgA, an antibody that protects the gut lining.
ANTIOXIDANTS, like NAC (N-acetyl cysteine) for example, are necessary to reduce oxidative stress to the gut lining. NAC is a synthetic amino acid that helps to replenish glutathione, a very important cellular antioxidant.
SHORT-CHAIN FATTY ACIDS, the butyrates, are important for the lower portion of the GI tract, particularly the colon.
SOOTHING HERBS, like DGL (deglycyrrhizinated licorice), and herbs with anti-inflammatory properties, like boswellia and peppermint, can promote healing. There are many useful herbs.
PROBIOTICS provide the "good bacteria," like those found in yogurt, to aid in digestion, while also crowding out unwanted, harmful bacteria and yeasts.
DIGESTIVE ENZYMES, mostly available from plant sources, can also aid in the digestion of food, thus improving nutrient absorption and preventing damage to the intestinal lining from undigested food particles.
Optimal Digestion, Edited by Trent W. Nichols, MD, and Nancy Faass, MSW, MPH
Proper Nutrition, Inc.