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Belly Aches

March 1, 2001
Functional medicine explores the relationship between antibiotics and gastrointestinal woes.
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Antibiotics that are prescribed indiscriminately are a topic of controversy because of the mutant strains of bacteria that become resistant to antibiotics. While such medication patterns pose a serious, acute threat to public health, is this the only consequence of indiscriminate antibiotic use? Recent studies reveal a more chronic side effect of antibiotics that can be countered with advances in nutrition.

Functional medicine, which is still in its infancy as a branch of traditional medicine, employs noninvasive lab tests to determine suboptimal levels of organ function in apparently healthy people. This determination allows the practitioner to restore optimum function through nutritional intervention. This intervention of functional medicine occurs before organ dysfunction leads to a diagnosed disease that requires costly and sometimes heroic medical intervention.

An understanding of the relationship between the digestive system, immune system, and the liver reveals the chronic effects of antibiotics usage. Although antibiotics provide a valuable contribution to the medical community, they do have a negative side effect associated with each episode of use.

One side effect of antibiotics surfaces in the form of a yeast infection. When antibiotics destroy competitive bacteria, candidiasis is provided an opportunity to proliferate, resulting in an unpleasant yeast infection. Once these symptoms appear, antifungal medications can be administered to correct the imbalance of yeast and bacteria.

A similar situation of microbial imbalance occurs in the intestinal tract, often unbeknownst to the patient in the early stages. This imbalance over a lifetime can eventually manifest as symptoms of unwellness unrelated to the GI tract. When this happens, the patient isn't likely to obtain satisfactory results from traditional medicine. These symptoms can easily be diagnosed as idiopathic or attributed to the aging process, with little or no effective treatment.

Examining the portal of entry

One aspect of functional medicine examines first the functional state of the intestines and then the effect intestinal dysfunction has on overall wellness. Our digestive tract is involved in more than just the digestion and absorption of nutrients and elimination of wastes. In the course of a lifetime, our digestive tract will process more than 100 tons of food. Everything consumed orally must be broken down and identified to determine if passage into the body will be allowed.

The intestines must be able to discriminate between friends and foes, allowing the friends to be absorbed through active transport and the foes to be eliminated. The intestines provide a physical barrier with the active transport mechanism allowing nutrients access to the body. Since the intestinal tract is a portal of entry into the body, it is a major aspect of the immune system. Roughly two thirds of our immune function is contained in the gut-associated lymphoid tissues (GALT). Intestinal toxins stimulate the gut to produce antibody proteins, which enter the blood circulation to defend against infectious agents.

The human intestinal tract is inhabited by many different species of microflora. The number of bacterial cells in our intestinal tract outnumbers the human cells of the body. A healthy intestinal tract contains three groups of microflora - symbiotic, commensals, and toxic or parasitic.

The largest group lives symbiotically within us. These bacteria contribute to our well-being, and we provide an environment for them. Bacteria in this classification include Bifidobacteria and Lactobacillus. They assist our bodies in the digestion process, aid in the absorption of nutrients, produce vitamins, and stimulate the body's immune system to function better. A large population of symbiotic bacteria crowd out the toxic bacteria.

Neutral bacteria, or commensals, are the second largest group. Normal species of E. coli and streptococcus fall into this category. These bacteria simply take up space, and they mainly function to crowd out the undesirable bacteria without any harmful effect to the human host.

Ideally, the undesirables are minimal in number. This group include parasites and pathogenic bacteria. They secrete toxic substances that cause intestinal irritations. These toxins can be absorbed and circulated systemically. These toxins are known to hinder the liver-detoxification process at the same time that they increase the toxic load.

'Death in the colon'

As an individual ages, the balance of beneficial and toxic bacteria reverses naturally and health declines. The effects of a high-sugar diet, prescription drugs, over-the-counter medications, NSAID, drugs and alcohol use, and drinking chlorinated water - combined with the effects of a suboptimal diet - contribute to the intestinal imbalance. Antibiotics have a very direct, lethal impact on intestinal microflora because they target any susceptible bacteria indiscriminately.

The effects of antibiotics on the normal aging process accelerate the imbalance by providing an opportunity for pathogenic bacteria and candidiasis to proliferate. When the symbiotic bacteria is diminished, the positive health benefits they provide diminish, adding to the dysfunction of the intestinal cells.

Absorption is also affected, creating the intestinal inflammation that can cause the "leaky gut" syndrome. Leaky gut syndrome occurs when the gut lumen becomes damaged to the point of perforation. Perforation creates a major defect in the barrier functions of the gut, allowing substances destined for excretion access to the body.

Intestinal inflammation and perforation lead to the uptake and systemic distribution of toxic substances. Intestinal toxins are known to inhibit the liver-detoxification mechanism while they increase the toxic load. Additionally, the immune system and other parts of the body are affected by circulating endotoxins at a time when nutrient absorption and liver detoxification are impaired.

Unless the medical practitioner is trained in functional medicine, it is likely the symptoms of unwellness produced by these endotoxins won't be recognized. Left untreated, the damage progresses to manifest itself in a disease state often far removed from the GI system. Understanding the relationship of our intestinal tract to overall health and wellness clearly makes the phrase "death begins in the colon" mean something other than dying from constipation.

Nutrients to the rescue

With this understanding in mind, what can be done to protect ourselves and our patients? The answer is found in nutritional advances and functional testing that are used by functional medicine. Specific nutrients are known to aid healing of the gastrointestinal system. These nutrients include the amino acids Glutamate and L-arginine, vitamin E, beta-carotene, vitamin C, zinc, selenium, and probiotics of symbiotic bacterial to reinoculate the gut.

Of particular importance is the addition of fructooligosaccarides (FOS). FOS, a phytonutrient derived from soybeans, preferentially feeds and supports symbiotic bacteria at the expense of the harmful bacteria, enhancing the reinoculation process. Natural foods don't contain enough FOS to be effective and must be concentrated in supplemental form.

People who experience recurrent yeast infections or gastrointestinal distress after antibiotic usage may be advised to have a complete intestinal evaluation. The assessment can be performed under the guidance of a practitioner trained in functional medicine in an effort to restore intestinal health. The Great Smokies Diagnostic Laboratory in Asheville, N.C., provides lab tests to assess physiological function and diagnose intestinal function. A specific nutrient regimen can then be tailored to the individual needs of the patient.

Preventively, intestinal imbalance can be slowed by reducing the contributing factors and countering each antibiotic episode with probiotics that contain FOS. Such probiotics are readily available at health food stores. I offer this information to my pre-med patients, reminding them to re-inoculate the gut along with my inquiry about pre-med compliance.

In these times of chemical assault from many sources, the importance of maintaining a healthy intestinal tract is vital to wellness and the liver's ability to detoxify. When traditional medicine dictates the necessary use of antibiotics, it is nicely complemented with functional medicine and nutrition to counterbalance the chronic effects of intestinal imbalance and premature aging.

Cindy Powell, RDH, has been practicing dental hygiene with a blend of holistic and traditional methodologies since 1986. She can be reached by fax at (561) 793-8405 or by e-mail at [email protected].

The author's road to intestinal health

While attending a nutritional seminar hosted by Dr. Jeff Bland, I was introduced to the concept of functional medicine. After his statement about liver-detoxification malfunctions in people who were becoming increasingly sensitive to their environment, I initiated testing on myself. Each year, my environmental allergies had been getting worse. I wanted my liver function to be tested and hoped to correct this situation.

It was also at a time when I suffered a near-debilitating fatigue and was going nowhere with advice from traditional medicine. All tests were inconclusive, and the only suggestion numerous physicians could offer was to increase my exercise activities. They assumed that - because I was eating a well-balanced diet - lack of exercise was the missing link. My attempts to follow the doctors' orders met with increased fatigue, as well as a lack of empathy from the doctors when I expressed my concerns. I resisted their suggestions of depression and the use of mood-altering drugs, simply because I did not feel depressed.

Functional testing revealed that my liver-detoxification pathways were not functioning properly, and my intestinal absorption was minimal. Finally, the source of my fatigue was identified as malnutrition. Trying to follow the doctors' orders was making a bad situation worse. I was struggling to maintain minimum activity, and dramatically increasing activity was pushing me over the edge. It's no wonder that increased activity caused me to be ravenous and weak.

I was among the first generation of people to be raised with the wonder drugs - "antibiotics" - which were the cure for every known ailment. My intestinal function was totally messed up and that translated to fatigue and liver dysfunction.

When I completed a course of treatment implementing nutritional food supplements tailored to my specific needs, retesting showed that improved intestinal health led to an automatic improvement in my liver function. My problem wasn't a lack of exercise or depression; it was malnutrition and slowly being poisoned by endotoxins, caused largely by overuse of antibiotics.

I found it very interesting that I could experience such a dramatic improvement in the matter of a few weeks following this program. It was also intriguing to hear Dr. Bland speak of a patient who was referred to him for nutritional support while she waited for a liver donor. His role was to help the patient maintain the current level of health, in the hopes of slowing the progression of disease until a donor could be located. He reviewed her test results and, with her physician's permission, initiated the intestinal phase of this program. By the time a donor was found, the patient no longer required a transplant! Improving her intestinal function enabled her liver functions to improve as well.