Probiotics . . .

There is a whole world of “bugs” living in our intestinal tract. These “bugs” consist of bacteria, mold, and fungi. Medical science is just beginning to understand their importance for our health. More than just breaking down unabsorbable food into waste, their active growth leaves no room for foreign bacteria to take up residence, such as C. diff. Like any tight-knit community they do not like foreigners invading their turf. It is also estimated that our immune system, most of which is in our GI tract, develops and is maintained because of a constant contact with the intestinal bacteria which have their own genetic and immune system. This “communication” between these immune systems is important and its breakdown has been linked to such diseases as Crohn’s disease. Bacteria also produce a wide variety of organic substances which helps maintain the health of our GI tract. Many of the nutrients we absorb are byproducts of this bacterial growth.

The word probiotic refers to a wide variety of these bugs such as lactobacillus which live in a mutually beneficial relationship with us.

What makes one brand of probiotics better than another?

• 1. Proper balance of the many different varieties of bacteria.
• 2. Bacteria that are harvested when they are young adolescents and not “senior citizens”.

When to take probiotics?

• 1. Traveling to a country where dysentery or traveler’s diarrhea is likely.
• 2. After extensive course of antibiotics.
• 3. Anybody suffering from inflammatory bowel disease.
• 4. After surgery on the GI tract.
• 5. With the excessive use of antibiotics in all animal feed, it is probably best that we include a good probiotic in our daily supplements.

IBS (Irritable Bowel Syndrome)

IBS is the most common GI condition diagnosed in this country. Unfortunately, it is used when no specific illness such as ulcerative colitis, etcetera can be found. It is frustrating for the doctors who have no specific treatment and especially for the patient who cannot find any explanation for the condition nor any reliable treatment. Cramps, bloating, constipation, and/or diarrhea are blamed on emotional-psychological factors. Who would not have increased stress and upset when faced with symptoms that disrupt a normal life and social enjoyment.

The truth is there are many underlying and often missed diagnosed factors leading to IBS:

• 1. Food allergy and sensitivity - includes lactose intolerance and gluten sensitivity. Blood tests are not very reliable and the patient may be sensitive to food thickeners and additives whose presence they are not aware of.
• 2. Pancreatic insufficiency - the pancreatic gland hidden at the back of the abdomen makes many vital digestive enzymes. Measuring its function is difficult and is usually not done.
• 3. Achlorhydria – big word meaning stomach does not make enough acid for proper digestion. Measuring the stomach acid production is a very important and easy test which is not commonly done.
• 4. Bacterial overgrowth - beneficial bacteria in the lower intestine are vital for our health and well being. For various reasons, bacteria can sometimes migrate to the upper intestinal tract where they grow rapidly creating gas, inflammation, and cramps. This is a new concept and will prove very beneficial in the treatment of IBS.
• 5. Autonomic nervous system - this is the silent part of our nervous system that controls our internal organs. It controls the peristalsis (muscular contractions) and enzyme production along this disassembly line as food is broken down. If it is not functioning in a coordinated fashion, yes you guess it, cramps, bloating, gas, and diarrhea can result. This nervous system in turn is very sensitive to the adequate levels of various vitamins and minerals, and again there are tests to determine how effective it is performing.

These five areas give you an idea of how much can be done for IBD in the right hands.

Malabsorption . . .

The old expression that you are what you eat is not true. You are what you absorb, a big difference. As a GI specialist, I was trained that malabsorption (a condition in which the body absorbs only a small portion of the ingested food) was a rare condition causing severe symptoms. In recent years I have observed this not to be true. Malabsorption or decreased absorption is quite common. It affects all ages but especially those over 65. There are often no specific GI symptoms, but the patient suffers from fatigue, muscle pain, headache, dizziness, and many other symptoms as a result of the nutritional deficiencies. Vitamin D is a great example of this. Originally thought to be important only in childhood bone growth, my office recognized its role in myalgia (muscle pain) and bone health over five years ago.

This year vitamin D deficiency is a hot popular medical topic especially in relation to cancer and heart disease. Older folks also suffer decreased absorption of many nutrients due to the ageing of gut, but also (1) the increased use of NSAIDS, causing stomach inflammation and (2) increased use of acid blockers which decrease the stomach acid production which in turn decreases the effectiveness of the digestive enzymes. This type of decreased absorption can occur even in those on a healthy diet and taking supplements. The increased incidence of Alzheimer has been clearly linked to nutritional deficiencies in the elderly and certainly relates to the malabsorption, in this age group.

Eating healthily is important. It does not, however, guarantee that the person is getting all of the optimum nutrition their body requires. Only specific nutritional testing can determine this.