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Worm infection counters inflammatory bowel disease by drastically changing gut microbiome

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original article on Science Daily

Infection with worms counters inflammatory bowel diseases (IBD) by triggering immune responses that change the mix of bacteria, or microbiome, in the gut. This is according to a study published online April 14 in the journal Science.

The study results support the hygiene hypothesis which, in the case of IBD, argues that the absence of exposure to worms in too-clean modern living spaces has left some with oversensitive, gut-based immune systems vulnerable to inflammatory diseases. Gut worms have helped to train and balance immune systems throughout human evolution, but are now missing in developed nations, which, in turn, have the highest rates of Crohn’s disease and ulcerative colitis.

In the newly published study, a team led by researchers from NYU Langone Medical Center found that mice infected with intestinal worms experienced as much as a thousand-fold decrease in Bacteroides — a group of bacterial species linked by past studies to higher risk for IBD. At the same time, the number of Clostridia, a bacterial species known to counter inflammation, increased tenfold. The investigators argue that the immune response to the worms triggers the growth in Clostridia, which then either outcompete Bacteroides for nutrients or release toxins harmful to Bacteroides.

“Our findings are among the first to link parasites and bacteria to the origin of IBD, supporting the hygiene hypothesis,” says study co-senior investigator and parasitologist P’ng Loke, PhD, an associate professor at NYU Langone. Loke says this model may also be applicable to other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and type 1 diabetes, in which processes meant to attack foreign invaders instead become oversensitive and react to the body’s own cells.

Also among the study’s key findings was that people in rural parts of Malaysia, a region known to have low rates of IBD but a high incidence of worm infections, had significantly more Clostridia and fewer Bacteriodes in their microbiomes than people comprising a nearby urban population. In addition, the researchers found that people treated and dewormed had less Clostridia and more Bacteriodes.

“Our study could change how scientists and physicians think about treating IBD,” says study co-senior investigator and microbiologist Ken Cadwell, PhD, an assistant professor at NYU Langone and its Skirball Institute of Biomolecular Medicine. “Patient testimonials and anecdotes lead many to think that worms directly cure IBD, while in reality, they act on the gut bacteria thought to cause the disease.”

Loke also led a study, published in the journal PLOS Pathogens in 2012, which found that giving worm eggs to monkeys protected them from the simian version of IBD. Worm eggs may be able to trick the immune system into thinking it has a worm infection, and to trigger a specific kind of worm-related response that counters gut inflammation. Along the same lines, future treatments might include giving patients some form of the immune chemicals produced by immune cells in the presence of worm infection, like interleukin 13, Cadwell says. Such treatments may be acceptable to patients as long as they know they cannot possibly get worms in the process.

As part of the new study, the NYU Langone team fed between 10 and 15 parasitic whipworm eggs to mice lacking a gene called NOD2, which is tied to several immune disorders, including IBD. After the worms matured, the investigators measured the amount of Bacteroides and Clostridia in the mice’s intestines and stool and noted the presence or absence of IBD. They found that many of the symptoms of IBD, such as intestinal bleeding and ulceration, went away along with almost all Bacteroides, while the Clostridia levels increased.

For another part of the study, the researchers compared the bacteria found in 75 members of the Orang Asli indigenous people in rural Malaysia to those of 20 people living in urban Kuala Lumpur. Researchers found that rural people had much fewer Bacteroides than city dwellers.

Cadwell says he and Loke plan to investigate how Clostridia outcompete Bacteroides, and search for harmless Clostridia species that can still induce this effect. In addition, they intend to explore alterations to gut bacteria by worm infections as the foundation of treatments for several inflammatory diseases.

Funding support for the study was provided by National Institute of Health grants DK103788, DK093668, and AL093811, and by grants from the Burroughs Wellcome Fund and Dr. Bernard Levine.

In addition to Cadwell and Loke, other NYU Langone researchers included Deepshika Ramanan, BS; Rowann Bowcutt, PhD; Zachary Kurtz, BS; Martin Blaser, MD; and Mei San Tang, MD. Further research support was provided by Soo Ching Lee, PhD, and Yvonne Al Lim, PhD, at the University of Malaya in Malaysia; Kenya Honda, PhD, at the Center for Integrative Medical Sciences in Yokohama, Japan; Richard Bonneau at the Simons Foundation in New York; and William C. Cause, PhD, at the Center for Immunity and Inflammation at New Jersey Medical School.

Cytokine plays dual role in regulating IBD

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February 16, 2016
Original article on Science Today
Source:
Georgia State University
Summary:
Small proteins that affect communication between cells play an important role in regulating inflammation that occurs during inflammatory bowel disease, according to researchers.
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FULL STORY

Small proteins that affect communication between cells play an important role in regulating inflammation that occurs during inflammatory bowel disease, according to researchers at Georgia State University, Emory University, the University of Michigan and Amgen, a biotechnology company.

The researchers compared immune cells in mice with and without intestinal inflammation and identified a new factor, a cytokine called IL-36, that is expressed in the inflamed intestine of mice. They explored the role of this cytokine to determine if it’s promoting disease, helping to protect against disease or simply associated with the disease. The findings are published inThe Journal of Immunology.

“What we found was quite striking,” said Tim Denning, lead author of the study and associate professor in the Institute for Biomedical Sciences at Georgia State. “If we block the effects of this cytokine, IL-36, in a mouse model of intestinal inflammation, the mice were better and had less disease early on, which suggested that this was a pro-inflammatory cytokine. However, when we assessed the ability of mice deficient in the receptor for IL-36 to heal, which is a vital part of resolving intestinal inflammation, they were completely unable to do so. The study highlights the important role of IL-36, not only in driving some of the inflammatory process, but also in helping to resolve the inflammation.”

Inflammatory bowel disease (IBD), chronic inflammation of all or part of the digestive tract, affects about 1.5 million Americans. The two main types, Crohn’s disease and ulcerative colitis, develop from uncontrolled inflammation in the intestine, which leads to severe diarrhea, pain, fatigue, weight loss and even death.

There are trillions of helpful bacteria inside human intestines, and the immune system is trained not to react aggressively. However, in people with IBD, the immune system doesn’t tolerate these bacteria and instead fights against them.

In this study, the researchers investigated the factors that may be regulating the immune system’s balance between tolerating these bacteria and reacting aggressively against them. They discovered the dual role of IL-36 in both promoting intestinal inflammation and resolving or healing that inflammation. The findings highlight the significance of understanding the timing and phase of disease, Denning said.

“Treatments that block certain factors, regardless of knowing the role it may be playing at a certain stage of disease, could lead to a poor outcome and may be the reason some clinical trials fail,” Denning said. “It is key to understand what phase of disease patients are in, what cytokines are expressed and the appropriate therapeutic targets during these distinct phases. Oftentimes, blocking a factor is not universally beneficial. Immune responses and inflammation, which are often viewed as deleterious, can be both good and bad depending on the context.”

For instance, blocking IL-36 may be beneficial in certain phases of the disease, but eliminating this factor could also make the body unable to recruit and activate cells necessary for healing and resolution of the disease. Therefore, it’s important to understand the pathways IL-36 affects because this cytokine could be valuable in other stages of the disease, he said.

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The above post is reprinted from materials provided by Georgia State University. Note: Materials may be edited for content and length.

A diet of worms to help IBD?

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Original article on The Gaurdian

For hundreds of thousands of years, worms have been infecting humans, burrowing into our bodies, setting up shop in our organs and generally making themselves at home. Until about 150 years ago, nearly everyone who ever lived was probably infected with some parasitic worm or other. Worms can cause intestinal problems, anaemia and, depending on the species, more severe problems, including seizures and paralysis. But, with modern sanitation, we have eradicated them from many parts of the world – a great public health success.

However, growing numbers of scientists have begun to argue that the loss of these parasites, known as helminths, has led to a spike in a range of illnesses, including autoimmune diseases, allergies and asthma, and even depression and other mental health problems. They say that worms, or drugs developed from them, could be potent treatments for these ailments, superior to current approaches, and with fewer side-effects.

“Our bodies, especially our immune systems, have evolved to expect input from these creatures,” says University of Iowa immunologist David Elliott, who has studied helminths for more than a decade. “Without this feedback, the immune system can get badly off track.”

Some immunologists claim our immune systems have evolved to expect input from parasites.

The first study of helminths as a treatment was 40 years ago, when JA Turton, a parasitologist in Surrey, dosed himself with hookworm and found that his chronic hay fever disappeared. In the past decade, helminth research has expanded significantly; so far, it has largely involved animal studies, which have mostly found positive results. “I can give a mouse multiple sclerosis, rheumatoid arthritis or colitis, and when I give it worms, the disease goes away,” says Elliott. “Can we do that in humans too? I don’t see why not.”

There have been just a handful of human studies: perhaps the most well-known is by Joel Weinstock, a gastroenterologist at Tufts University in Massachusetts, which examined the effect of worms on patients with inflammatory bowel disease. Almost 75% of those who ingested the worms were cured, especially noteworthy given that they had not been helped by more traditional treatments. But research with human subjects is difficult, largely because of regulatory obstacles; many worms are considered hazardous pathogens.

 

It is not clear exactly how helminths help their human hosts. They appear to have developed molecular strategies to hack into our immune system, reining in its response to alien cells. In allergy, asthma, autoimmune diseases, and probably many other illnesses as well, this inflammatory response is excessive, and ends up damaging the body. It makes sense that helminths would have found ways to calibrate our immunity; as long-term parasites, their survival depends on neutralising the host’s defences. “They can live in our bodies, and we can stay healthy and they can stay healthy,”’ says Weinstock.

He is among a group of researchers who are focusing on finding the particular molecules that allow worms to manipulate us. The aim is to develop these molecules – or analogues of them – into medicines. “By understanding what the worms do, we may be able to develop magic bullets,” he says. This approach has advantages over using the worms themselves: dosing would be more controlled, and patients wouldn’t be disgusted.

Others are sceptical, arguing that helminths are extremely complex and probably use multiple mechanisms to nullify our defences. “It’s hard to recreate complex biological interactions,” says William Parker, an immunologist at Duke University in North Carolina. “These organisms are their own living drug-delivery systems. They have so many effects on their hosts.”

The arrival of worms-in-a-pill, if it happens at all, is probably years away. But a handful of companies already offer live worms to consumers. Judy Chinitz and Marc Dellerba started their helminth supply company, Biome Restoration, in the UK three years ago, and have more than 1,200 regular customers. They ship microscopic larvae – which grow into worms after being swallowed – all over the world. Dellerba, who has a PhD in chemistry, oversees a rigorous manufacturing process.

Biome Restoration worked with the Medicines and Healthcare Products Regulatory Agency, which permits the company to sell the organism as a non-pharmaceutical product. But much of this commerce exists in a legal grey area, because many health regulatory agencies, including those in the UK and the US, deem most helminths to be pathogens that cannot be transported.

Some people are now taking the DIY route, raising helminths themselves. Parker estimates that 7,000 or so people worldwide have used worms as medicine in the past few years. There are several vibrant online communities where devotees discuss the best worm-raising regimens and the most effective dosing strategies.

One key question: which worm works best, for which ailment? Researchers, suppliers and consumers have identified a few promising species that fit the key conditions: they don’t cause serious health problems, don’t reproduce in humans, can’t spread from person to person, don’t migrate within the body, and can be eradicated with anti-worm medicines. Almost all of those who use worms ingest one of four different species: rat tapeworm, pig whipworm, human whipworm, or human hookworm.

Parker and his researchers have gathered data from hundreds of users and growers. “I’m convinced,” he says. “Based on the evidence I’ve seen, it is very effective,” he says. “It has a really good benefit-to-risk ratio, especially for serious autoimmune diseases such as multiple sclerosis and inflammatory bowel disorder.”

Not surprisingly, though, some scientists are suspicious of the current use of helminths, calling it unscientific, premature and possibly risky. Parker, too, recognises that more research is necessary: “It’s a slow process, but I think it’s inevitable that it will significantly change how we treat these diseases.”

Bovine Colostrum

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This is an interesting article I stumbled across, I’m going to try it!

Original article on Well-belly

I am in an all-out UFC cage fight with my autoimmune disease and I’m winning!  For the past 15 months, my ulcerative colitis (UC) and I have been in an intense battle and for the majority of that time, I was losing.  I began following the Paleo lifestyle right away and got in a few good punches, but after awhile, it fought right back.  I went stricter and eliminated even more foods to follow the Autoimmune Protocol (AIP) and really started to get some great strikes in to this persistent disease.  But then, I got pinned.  I had eliminated some of my favorite foods, taken away my ability to eat out at great restaurants, and given up my social life in order to keep my symptoms from flaring.  But, I wasn’t getting any better.  I was just maintaining a  level of health…not good enough for this girl!  I was stumped and frustrated, not ready to give in to the battle.

My rock bottom came 6 weeks ago.  I was hungry for a midday snack and grabbed a beautifully ripe, locally grown peach.  I don’t eat much fruit and hadn’t enjoyed peach season yet, so I was excited for the treat.  Instead, I got sick.  Minutes after eating the peach, I looked like I was 6 months pregnant.  Intense pain and bloating from one tiny little piece of fruit led me to the most frustrated mental state I had been in since starting my healing a year before.

Something had to change and now.  I went to my trusty friend, Google, for advice.  Just a bit of research and I had my ‘Aha!’ moment.  It was something I knew all along but hadn’t taken the time or effort to actually do.

I NEEDED TO HEAL MY LEAKY GUT

not just try to get rid of my UC symptoms.  Autoimmune diseases WILL NOT go into remission if gut health is not restored.  All this time I had been focusing on healing the wrong thing.  I had been taking out any foods and factors that caused my UC to flare, instead of spending my time working on HEALING.  It may not sound different, but it is. I think this is where so many of those suffering from autoimmune diseases go wrong.  Research shows that leaky gut is one of three factors that makes someone susceptible to autoimmunity, along with genetic predisposition and environmental factors.  Even though I already knew all of this (thanks to The Paleo Mom) which is why I was on AIP in the first place, once I was deep in the diet trenches, I began focusing on the wrong issue and not getting anywhere.  

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Back to my story…

I am a huge believer in fate, so when I ran across a post on Instagram from Alexandra at High On Fat entitled “How I Healed My Leaky Gut” the exact same day as my ‘peach incident,’ I knew I needed to take her advice.  I was desperate for help and wanted those words to be in my vocabulary too!  The post was all about a new supplement she had been taking that had healed her gut and changed her life — bovine colostrum.

Another Google-fest ensued to learn about this supplement and my heart began to beat faster with the excitement of health:

What is it?

You may already be familiar with colostrum: the ‘pre-milk’ fluid produced by mammary glands during the first few days after giving birth.  This is the first food given to a baby to provide them with essential growth factors to build the gut wall, antibodies to build immunity, and vital nutrients to give them strength in their first days of life.  Bovine colostrum does the same thing, just in cows.  Human consumption is not new.  It has been prominent in Ayurvedic healing for thousands of years and was once the treatment for infections before pharmaceutical companies took hold and antibiotics became popular.

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What does it do?

The more research I did, the more benefits I found.  The list is seemingly endless.  But don’t take my word for it.  Here are excerpts taken from reputable sources surrounding the human consumption of bovine colostrum:

Crohns.net

“Colostrum has the greatest components of ingredients directed toward the digestive tract. Its growth factors help cells of the digestive tract redevelop themselves and it also has immune factors that reestablish the immunity of the gastrointestinal tract and kill off bad bacteria that is overgrown.  Colostrum decreases intestinal permeability and enhances the assimilation of nutrients.”

“Colostrum contains powerful immune factors (immunoglobulin, lactoferrin, cytokines, etc.) that work to restore optimal immune functioning. Colostrum also contains PRP, shown in clinical studies to both enhance an under active immune system and balance an overactive tendency.”

Web MD

“Bovine colostrum is also used for boosting the immune system, healing injuries, repairing nervous system damage, improving mood and sense of well being, slowing and reversing aging, and as an agent for killing bacteria and fungus.”

Memorial Sloan Kettering Cancer Center

“Bovine colostrum has been used as a dietary supplement to treat diarrhea, infections, colitis, and to improve athletic performance. In vitro studies suggest that bovine colostrum has anti-inflammatory and chemopreventive properties.”

“There is also some evidence that bovine colostrum prevents NSAID-associated gastrointestinal damage and is effective in treating distal colitis.” 

So, I gave it a shot!  I was skeptical but I also didn’t think I could make things any worse just by trying it.

The Results?

Within a week, I felt like a whole new person!  So much so, that I didn’t actually believe it could be true.  I kept doubting that it was working.  But everyday, I kept getting better and better until I was feeling like my ‘pre-colitis’ self.  Not only did my UC symptoms vanish, but ALL of my digestive issues were gone, my energy was through the roof all day, and I was just happy… because I finally felt free.  Even though autoimmune diseases stick around for life, mine is no longer reminding me everyday.

After a few weeks, I began reintroducing foods I had given up months ago for AIP.  First up were eggs.  After my first breakfast with eggs, I wanted to get up and dance on the table.  Not only did I not have the reaction I had in the past when trying to reintroduce, but I felt nourished and energized!  I’ve kept the eggs and have also been able to add almond butter and coffee so far!

Now, let me be clear.  I’m not going out eating donuts, pizza and nachos.  I’m still following the Autoimmune Protocol with the addition of eggs and almond butter, and plan to slowly continue to add REAL FOOD in a controlled manner.

Which one should I take?

Here’s what to look for:

  • Sourced from pasture-raised, organic cows
  • No antibiotics, GMO’s, hormones
  • Provided only after the newborn calf has been given its share
  • Harvested within 8 hours after birth
  • Low pasteurization temperatures (flash pasteurization below 115 degrees)
  • Pure Colostrum (not colostrum-whey)

A Few Warnings 

This product may contain a trace amount of lactose and casein and could have a slight effect on those with severe lactose intolerance.  If you have severe intolerance, Surthrival recommends taking a lactose digestive aid along with your colostrum dose for several days while initiating it into your system.  I have a dairy sensitivity and had no problem without the need for an aid.  Alexandra was diagnosed with lactose intolerance and was fine with it also.
Your first few days may be a little rocky!  Some people may experience a “die-off effect” as the body releases toxins in the form of digestive problems, skin eruptions, rashes or flu-like symptoms. This is a sign that it’s working.  These symptoms usually disappear in a couple of days.  Start with a small dose and work up into the full dose to avoid these symptoms.  I started with 1/4 tablespoon twice a day and worked my way up.  The first two days I experienced flu-like symptoms and just didn’t feel well.  By the third day, I was beginning to feel amazing and it’s only gotten better since!

I’m so hopeful that this amazing supplement works for others the way it has me!  Please let me know if you have questions, concerns, or are going to give it a shot and I will support you along the way!  Leave a comment below or email me at shawnmynar@gmail.com.

If you’re a ‘Google-er’ like me and would like to do more research, here are a few more great links that I referenced for this post:

www.naturalnews.com 
http://www.icnr.org/articles/lgs.html
http://www.surthrival.com/customer_support

 

And this comment is taken from Crohn’s forum suggesting you mix Bovine colostrum with L-glutamine

I can tell you that for us, we may have discovered our “Magic Bullet”!!! My husband has suffered for years with SIBO, with virtually no help from gastroenterologists ( we have seen all 7 in a group associated with the hopistal). As a nurse, I have researched the literature, trying many treatments for the nausea, cramping, bloating, abdominal pain, orange oil excretion….
Tried antibiotics, fecal transplants, VSL #3 DS ( prescription strength probiotic with 900 Billion bacteria per packet)

My husband’s latest regimen until two weeks ago was Regimint, 4 caps/ in divided doses, chamomile tea with Peppermint( 3 bags) 3 times a day, Hydrocodone for pain, antidiarrheals am and PM, Meclizine for nausea 3 times a day( this worked very well), digestive enzymes ( Zen Pep). And self Reiki to abdomen every night.

NEW….NOW…ONLY FEW SYMPTOMS of occasional bloating and occasional orange oil related inability to digest fat.

NOW…No Nausea, NO Cramping, No Pain, No Diarrhea!!! Two weeks ago I started him on L-Glutamine with the recommended dose of 30 gm/ day..powder form….6 teaspoons in water on empty stomach.( each tsp is 5gms.). Sips this during day to continually bathe small intestine….AND Bovine Colostrum……gradually increasing to 8 caps a day, then to 4 caps a day. I open the caps and mix in water….on an empty stomach.

Nausea is completely gone, pain is completely gone. No need for Meclizine , regiment, Hydrocodone, antidiarrheals,. HE FEELS NORMAL!!!!!!! His quality of life is 100% improved, he is able to go out without fear of having an accident, and it is just amazing!!!!!

YOU MUST try L-Glutamine and Bovine Colostrum…also can be added together.
Let me know how you do on this. We get our Bovine Colostrum from ImmuneCare in NZ….antibiotic free…..

No more

Study Links Common Food Additives to Crohn’s Disease, Colitis

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By Dr. Mercola

If given a choice, virtually everyone would choose to be healthier or, if you’re already healthy, to maintain that disease-free state. Yet when you go about it in practice it might seem overwhelming. Where do you begin to “get healthy”?

An excellent starting point is this: cut back, with the goal of eliminating,processed foods in your diet. If you’re at all health-conscious you’re probably already aware of many of their downfalls… excess sugar, often high fructose corn syrup, refined grains, genetically engineered ingredients, soybean oil, and more.

Yet, these are not the only problems. Most processed foods also contain any number of additives, like artificial flavors, colors, and preservatives. They also contain another less talked-about additive called emulsifiers.

Each of these has the potential to disrupt your health and in many cases researchers are only beginning to understand how and why.

In the case of emulsifiers, for instance, which are ubiquitous in processed foods like margarine, mayonnaise, baked goods, and ice cream, they’ve been linked to serious inflammatory diseases in your gut along with metabolic syndrome.

Emulsifiers Might Promote Inflammatory Bowel Disease (IBD)

More than 1.5 million Americans suffer from inflammatory bowel disease (IBD), which is an autoimmune condition that involves inflammation in your digestive tract and includes both Crohn’s disease and ulcerative colitis.

IBD sufferers have severely disrupted gut biota with different dominant species than healthy people, and those with Crohn’s and ulcerative colitis suffer from a breakdown in the mucosal lining of their gut. As reported in the journal Nature:1

“The intestinal tract is inhabited by a large and diverse community of microbes collectively referred to as the gut microbiota.

While the gut microbiota provides important benefits to its host, especially in metabolism and immune development, disturbance of the microbiota-host relationship is associated with numerous chronic inflammatory diseases, including inflammatory bowel disease and the group of obesity-associated diseases collectively referred to as metabolic syndrome.

A primary means by which the intestine is protected from its microbiota is via multi-layered mucus structures that cover the intestinal surface, thereby allowing the vast majority of gut bacteria to be kept at a safe distance from epithelial cells that line the intestine.

Thus, agents that disrupt mucus-bacterial interactions might have the potential to promote diseases associated with gut inflammation.”

Indeed, a new animal study revealed that emulsifiers, which are “detergent-like molecules,” impact mouse gut microbiota, induce low-grade inflammation and metabolic syndrome and promote “robust” colitis in mice predisposed to the disorder.

The researchers concluded:2 “… the broad use of emulsifying agents might be contributing to an increased societal incidence of obesity/metabolic syndrome and other chronic inflammatory diseases.”

Food Additives Might Be Impacting Your Health…

The emulsifiers used in the study were carboxymethylcellulose and polysorbate-80. Similar emulsifiers include lecithin, carrageenan, polyglycerols, and xanthan gum.

These additives keep oils and fats from separating, helping to improve the texture and shelf-life of salad dressing, non-dairy milk, and even foods like veggie burgers and hamburger patties.3

The emulsifiers caused chronic colitis in mice with already abnormal immune systems. In mice with healthy immune function, they resulted in mild intestinal inflammation and subsequent metabolic dysfunction that led to obesity, hyperglycemia, and insulin resistance.

Most notably, the emulsifiers were fed at levels that an average person would be exposed to if eating a lot of processed foods, suggesting these additives may indeed affect the health of many Americans.

Food additives such as these are all approved by the US Food and Drug Administration (FDA), again highlighting the severe limitation of our current regulatory system.

A 2013 study published in the journal Reproductive Toxicology found that nearly 80 percent of the food additives approved by the FDA lack testing information that would help the agency estimate the amount people can safely consume before suffering health consequences…4

Nourishing Your Microbiome Is Crucial for Preventing Disease

It’s becoming clear that the microbes in your body may very well make or break your health. In the case of Crohn’s disease and ulcerative colitis, for instance, there is evidence that there may be a breakdown in your body’s “phage-based” defense system.5

Bacteriophages, or phages, are a group of viruses that help you stay healthy by destroying harmful bacteria and encouraging beneficial bacteria to flourish in and on your body.

Scientists found that mucus-dwelling phages (which coat the inside of your mouth, nose, eyelids, lungs, and your digestive tract) have symbiotic relationships with their host (you) and help control the delicate microbial balance in your body, giving you “smart mucus.”

However, as mentioned, in people with Crohn’s and ulcerative colitis there is a breakdown in the mucosal lining of their gut. It’s now known that food additives may be one culprit in this breakdown, but there are others as well, like air pollution. As reported in Scientific American:6

“Many of the 160 gene regions implicated in the development of bowel diseases also regulate how the immune system recognizes and interacts with the trillions of bacteria that exist in the human gut.

‘In the gut, you have a barrier between the immune system and the bacteria that live there. It’s important that barrier gets maintained,’ [Karen] Madsen [a gastroenterological scientist from the University of Alberta in Edmonton] said.

Air pollution particles may disrupt the barrier by making the gut more permeable to bacteria and possibly altering the composition of the bacteria. Studies with mice show that pollution particles make the gut more permeable.

‘Those changes can lead to inflammation and may set up someone who is genetically predisposed to inflammatory bowel diseases,’ [Dr. Gilaad] Kaplan [a gastroenterologist at the University of Calgary in Alberta], said.”

The Road to Healing IBD May Be Through Bacteria…

If you have IBD, tending to your gut health is crucial, and a key way to do this is by getting plenty of beneficial bacteria. You can do this by regularly consuming traditionally fermented foods that are not pasteurized or taking a high-quality probiotic supplement, along with limited added sugars and fructose (another reason processed foods should be avoided).

Research presented at the American College of Gastroenterology annual meeting by researchers at the University College Cork in Ireland showed that people with inflammatory conditions such as ulcerative colitis who took the probiotic bacteria Bifidobacterium infantis for eight weeks had lower levels of inflammation than those taking a placebo.7

Fermented foods are ideal for this, however, because if properly fermented can contain 100 times more probiotics than a supplement. Another option to improve the makeup of bacteria in your gut,the fecal transplant, is also proving to be quite effective. A fecal microbiota transplant (FMT) involves taking donor feces (the donor is typically a spouse or relative) and basically transferring it to the patient during a colonoscopy.

The benefit? The patient receives a transplanted population of healthy flora that can go to work correcting any number of gastrointestinal and other health problems. Research has found the transplants showed promise in the treatment of ulcerative colitis and Crohn’s disease, with symptoms improving in days to weeks.

Natural Solutions for Inflammatory Bowel Disease

IBD can cause cramps, bloody diarrhea, weight loss, and other potentially serious complications in your intestines, along with increasing your risk of colon cancer. Because IBD can be extremely painful, debilitating, and even life threatening, many IBD patients wind up having extensive sections of their colon removed to address the problem when conventional therapies fail — and this can result in devastating and life-threatening complications.

The goal of most IBD treatment, whether conventional or holistic, is to suppress the inflammation that is leading to the damaging symptoms, and exposure to environmental pollutants is only one contributing factor. Some of the greatest contributors to chronic inflammation are lifestyle factors like smoking, a diet high in sugar, fried foods, and synthetic trans fats, inadequate exercise, stress, and vitamin D deficiency. So, if you have IBD the first place to start getting the disease under control lies in addressing these underlying factors. If you have IBD, I urge you to:

  1. Take a high-quality, animal-based omega-3 fat supplement like krill oil for the anti-inflammatory benefits. If you’re already taking a plant-based omega-3 such as flax, know that it will not work as well, as your body needs the preformed omega-3 fat DHA to have a serious impact on this disease — not the omega-3 ALA found in flax.
  2. Avoid all types of sugars and processed foods, particularly fructose, as these will increase inflammation by increasing your insulin levels.
  3. Also avoid grains until your symptoms are under control. Many with inflammatory bowel disease have gluten sensitivities. Additionally, the grains tend to increase insulin levels, promoting inflammation.
  4. Avoid artificial sweeteners. Inflammatory bowel disease may be caused or exacerbated by the regular consumption of the popular artificial sweetener Splenda, as it inactivates digestive enzymes and alters gut barrier function.
  5. Optimize your vitamin D levels. Vitamin D appears to be nearly as effective as animal-based omega-3 fats in countering IBD. One of the reasons that vitamin D may work is that it helps your body produce over 200 antimicrobial peptides that help fight all sorts of infections, and there are many experts who believe inflammatory bowel disease has an infectious component.
  6. Get plenty of beneficial bacteria either through fermented foods or probiotics in your diet, as this will help to heal your intestinal tract.
  7. Consider using an herbal anti-inflammatory. A solid body of clinical research indicates that the spice turmeric, and its primary golden-hued polyphenol known as curcumin, as well as the Ayurvedic herb boswellia, may provide far superior therapeutic outcomes and safety profiles, as compared to conventional drugs, in the treatment of IBD.8

Are You Having Trouble Ditching Processed Foods?

Getting back to my original suggestion of ditching processed foods to get healthier, this becomes all the more important if you’re struggling with a serious condition like IBD. I have long stated that if you want to be optimally healthy, you should spend 90 percent of your food budget on whole foods, and only 10 percent on processed foods. Unfortunately, most Americans currently do the opposite, and their health suffers as a result.

Ditching processed foods requires that you plan your meals in advance, but if you take it step-by-step as described in mynutrition plan, it’s quite possible, and manageable, to painlessly remove processed foods from your diet. You can try scouting out your local farmer’s markets for in-season produce that is priced to sell, and planning your meals accordingly, but you can also use this same premise with supermarket sales.

You can generally plan a week of meals at a time, making sure you have all ingredients necessary on hand, and then do any prep work you can ahead of time so that dinner is easy to prepare if you’re short on time in the evenings (and you can use leftovers for lunches the next day). As you remove processed foods from your diet, it’s important to replace these foods withhealthy fats, not protein or grain carbs—a fact that’s often not addressed. I believe most people may need between 50 and 70 percent of their daily calories in the form of healthy fats, so as you remove processed foods from your meals be sure you’re eating more of the following:

Olives and olive oil Coconuts and coconut oil Butter made from raw grass-fed organic milk
Organic raw nuts, especially macadamia nuts, which are low in protein and omega-6 fat Organic pastured egg yolks and pastured meats Avocados

Apple Cider Vinegar

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Original article on The Detox Diva

Raw apple cider, unfiltered and with “the mother”  which is made up of strand-like enzymes of connected protein molecules with living nutrients and bacteria, is the good stuff.  The mother is the “stuff” that, along with the unfiltered sediment from the apple juice, settles at the bottom of the bottle and, if you put it in water, you will see “bits” floating around.  You also want the sediment of the apple juice which has all the pectin, malic acid, vitamins and minerals.  In other words, it will be cloudy with bits settling to the bottom that you will shake up before you use it.  My favorite is Bragg’s Raw Unfiltered Apple Cider Vinegar which you can buy at any Whole Foods or order online.  I buy the 32 oz. because I don’t like the really big ones with the plastic jugs.

So to recap, buy the cloudy, gunky good stuff full of life and leave the clear, pretty brown stuff for cleaning.  (Or better yet, leave it on the shelves!)

 The many health benefits of raw apple cider vinegar::

*Rich in potassium, a mineral that very difficult to find in the Standard American Diet (SAD). This mineral is necessary for building proteins and metabolizing carbohydrates; also imperative for transmission of nerve impulses and regulating electrical impulses of the heart; has been shown to prevent bone loss; decreases high blood pressure; also prevent kidney stones.

*Loaded with acetic acid which has been shown to slow the digestion of starch helping to slow down and lower the rise in glucose that commonly occurs after meals. This is important for those with blood sugar issues such as diabetes or insulin resistance and is helpful for balancing hormones in those with estrogen dominance and PCOS.

*Although it tastes acidic it is rich in ash which gives ACV its alkaline property. This is important for your body in maintaining proper pH levels for a healthy alkaline state. (This is particularly important if you drink coffee, alcohol, eat a lot of grains, meat, or sugar.)

*High in malic acid which gives ACV its anti-viral, anti-bacterial and anti-fungal properties. Other acids in apple cider vinegar are stellar for helping with detoxification by boosting circulation and the liver’s ability to purge toxins.   The acids also help to eliminate impurities by binding to free radicals and other toxins that are stored in the blood, fat cells and organs, thus chelating or  ‘pulling them out’ of the body. In addition, apple cider vinegar supplies the body with a large amount of vitamins, minerals and enzymes, which helps the body recover after detox.

*May help improve bowel irregularity and helps to remove toxins from the body at a faster rate. It can help clear up skin conditions and blemishes.

* Studies have shown ACV helps with weight loss by breaking down fats so that your body can use them rather than store them.  Although scientists say the jury is still out on whether ACV is key in losing weight, because of its many health benefits, helping slow the digesting of starch and slow down and lower the rise in glucose, couple with the fact that it helps maintain the pH levels for healthy alkalinity, the side effect would naturally be balancing weight to normal levels making ACV a superstar in reducing obesity rates.

*Its mineral salts and enzymes help reduce C-reactive proteins helping reduce inflammation.  This is important for those suffering from chronic inflammation (pretty much everyone today), and especially those with inflammatory based illnesses such as those with autoimmune disorders like rheumatoid arthritis, polymyositis, lupus,  fibromyalgia, and even IBS and Chrohn’s.

*It can help combat candida by restoring the gut’s natural bacteria balance.

*Several studies have found that ACV has a marked effect on killing cancer cells or slowing their growth.

How do I use apple cider vinegar?

Some people swear by adding two tablespoons into a glass of water and drinking it before meals.  If I know I am going to be eating out or at someone’s house where I don’t have control over what I am served, I will do this.  I also swear by drinking a glass before every heavy or starchy meal. It is often a better remedy than commercial indigestion medicines for cases of gastric upset.  A few tablespoons in tepid water and bye bye bubble guts.   I tend to not love chugging water though so I add a few teaspoons at a time to either my water in the summer or the Turkish Apple Tea I sip through the winter.  I don’t recommend you drink it in the morning on an empty stomach unless you are going to eat breakfast very soon after.  It’s too much of a shock to my system and it might be to yours.  If you want to drink it in the morning with water, drink your Ginger Lemon Tea first, make breakfast and while you are making breakfast drink a glass slowly. If the taste is off putting in the morning, add a little honey or stevia to it.   If you are making a smoothie or green juice you can add a few teaspoons to your smoothie but I think that’s overkill.  If you are an oatmeal lover you might want to consider drinking a tablespoon or two in water before you eat as it will slow the insulin spike that always accompanies digesting grains. Again, after your ginger lemon tea.  It is a great way to get hydrated!

My favorite way to use raw apple cider vinegar is in marinades and salad dressings.  My Banish The Bottle Raw Detox Salad Dressing is a fantastic way to use raw apple cider vinegar.  The nice thing about the dressing is you can use it liberally, not counting tablespoons as with bottled salad dressings.

It can be used, diluted in water, for a shine boosting rinse.  Diluted in a spray bottle with either plain or some rose or orange flower water as a nourishing tonic.  It will help heal eczema, psoriasis, and dermatitis both with external (diluted of course 1 part vinegar to 10 parts water is a good rule of thumb for skin use) and internal use.

What can apple cider not do?

It will not, on its own, heal you of cardiovascular disease, diabetes, PCOS, insulin resistance or any number of other illnesses and disorders, if you refuse to change your diet from refined flours, sugars, conventional meats, and little plant based foods.  It will not, on its own, heal you, even if you are eating a plant based healthy diet.  It is a PART of the healing process.  It will not make you a supermodel or even supermodel thin if you don’t eat right and move your body.  It may not even do that if you do.  It will help along the process of digesting carbohydrates and metabolizing fats so they can be used as energy but even fat metabolized, if it isn’t used, goes right back….you guessed it….to fat.  It is not to be used in lieu of treatment for cancer.  I know some of the websites say it will cure it unequivocally. This is so very irresponsible to even imply.   Again, it can help heal. It is fantastic as a part of a detox for cancer patients both during and after treatment.  It is a great addition to any alternative healing path as well, in fact, is integral to one. (Notice I say addition, not the whole thing. ) It is really a miraculous compound.  But it is not meant to be singled out as a miracle drug.  It is meant to be a part of a healthy lifestyle.  Use it.  Use it liberally but use it as part of a healthy lifestyle right alongside of coconut oil and other superfoods and a plant based healthy nutrition plan and watch your energy levels soar, your complexion radiate, your hair shine, and your overall health skyrocket abundantly!

Mutaflor Probiotic

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Mutaflor: Probiotic Containing Escherichia Coli Nissle 1917

Mutaflor: Probiotic Containing Escherichia coli Nissle 1917Original article on http://www.probiotics-help.com/mutaflor.html

 

Mutaflor is the only probiotic supplement on the market containing the friendly bacterium Escherichia coli Nissle 1917. This is a non-pathogenic helpful bacterium, which is NOT to be confused with the disease-causing Escherichia Coli 0157.

The strain contained in this product, Escherichia coli Nissle 1917, is named after the German doctor Professor Alfred Nissle, who first isolated the bacterium in 1917 during the First World War.

Ingredients

  • E. coli strain Nissle 1917 (2.5–25 x 109 viable cells (CFU))
  • Talc
  • Methacrylic acid-methyl methacrylate copolymer (1:1)
  • Macrogol
  • Dibuytl phthalate
  • Glycerol
  • Titanium dioxide
  • Iron (III) hydroxide oxide monohydrate
  • Gelatin
  • Beeswax (yellow)
  • Carnauba wax
  • Shellac
  • Purified water

The capsules are free from gluten, milk proteins and lactose so are suitable for those with allergies or intolerances to these substances. The product does contain gelatin though so is not suitable for vegetarians.

It is also available as a high strength capsule and as a suspension for children in Germany.

Clinical Evidence Supporting Mutaflor

Since it was first isolated, the bacterium contained in Mutaflor has been studied extensively and has been shown in scientific research to help numerous conditions

As well as being able to colonize the gut, biologically fit and active against disease-causing agents known as pathogens1, Escherichia coli Nissle 1917 has been shown in scientific studies to be of benefit for both inflammatory bowel as well as functional bowel disease:

Inflammatory Bowel Disease

  • Pouchitis: Induction and maintenance of remission2.
  • Ulcerative Colitis: Studies concluded that the use of Mutaflor with mezalasine was effective as a treatment for ulcerative colitis in maintaining remission3,4,5.
  • Crohn’s Disease: Fewer relapses in Crohn’s Disease patients taking Mutaflor versus control group (33.3% versus 63.6%)6.
  • Pseudomembranous colitis (also known as antibiotic-associated diarrhea and often caused by the bacterium Clostridium Difficile or C. Diff): Helpful when combined with intestinal lavage, otherwise known as colonic hydrotherapy or colonic irrigation7.

Functional Bowel Disorders

  • Diverticular Disease: Pilot study concluded that treatment with Mutaflor was helpful in reducing symptoms in diverticulitis8.
  • Diarrhea: Mutaflor normalized acute diarrhea more quickly than a placebo9.
  • Chronic Constipation: Research concluded Mutaflor was as effective as the laxative lactulose10 and it also increased the number of bowel movements in chronic idiopathic constipation11.
  • Irritable Bowel Syndrome: Significant improvement in stool frequency was observed as well as a marked improvement in other symptoms such as abnormal urge, flatulence and abdominal fullness12.

Advantages

Scientific studies suggest that this probiotic bacterium may be beneficial for a good number of conditions. The capsules are covered in a hard enteric coating to ensure that the friendly bacteria contained inside survive the stomach acid unharmed and are alive and viable when they reach the bowel, where they set to work.

The product can also be taken with or without food and is suitable for use as a long term therapy. According to the manufacturer of the product, Ardeypharm, the product can be taken with certain antibiotics WITHOUT loss of effectiveness. These antibiotics are those that are directed against gram-positive bacteria and include:

  • Clindamycin
  • Erythromycin
  • Metronidazole
  • Penicillin G
  • Quinupristin/Dalfopristin
  • Rifampin
  • Teicoplanin
  • Vancomycin
  • Cefsulodin

Antibiotics that are directed against gram-negative bacteria will, however, render the product less effective.

Whilst the product should be kept cool by means of refrigeration, it can be kept at room temperature for short periods of up to 72 hours without any loss of potency. This makes it suitable for taking on short trips away.

Disadvantages

Mutaflor is a Probiotic Containing Escherichia coli Nissle 1917Compared to many other probiotic products, Mutaflor has a short shelf life of between three and six months when kept under refrigeration. Please don’t buy in bulk – you will waste your money.

The product also contains a good many additional ingredients such as fillers and preservatives, which may make it difficult to tolerate for the more sensitive patients. The hard enteric capsule also makes it almost impossible to open up the capsule to try just a small amount of the product to begin with. Very sensitive individuals may thus find that the dose of beneficial bacteria contained in a whole capsule may provoke side effects such as gas, changes in stool frequency and nausea in the initial stages of therapy.

Meditation may relieve IBD

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Original article on Harvard Gazzette

A pilot study has found that participating in a nine-week training program including elicitation of the relaxation response had a significant impact on clinical symptoms of the gastrointestinal disorders irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and on the expression of genes related to inflammation and the body’s response to stress.

The report from investigators at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital (MGH) and at Beth Israel Deaconess Medical Center (BIDMC), both Harvard affiliates, is the first to study the use of the relaxation response in these disorders and the first to investigate the genomic effects of the relaxation response in individuals with any disorder. The report was published in the open-access journal PLOS ONE.

“Our results suggest exciting possibilities for further developing and implementing this treatment in a wider group of patients with gastrointestinal illness,” said Braden Kuo of the gastrointestinal unit in the MGH Department of Medicine, co-lead author of the report.

“Several studies have found that stress management techniques and other psychological interventions can help patients with IBS, at least in the short term; and while the evidence for IBD is less apparent, some studies have suggested potential benefits. What is novel about our study is demonstration of the impact of a mind/body intervention on the genes controlling inflammatory factors that are known to play a major role in IBD and possibly in IBS,” said Kuo, who is also a Harvard Medical School assistant professor of medicine.

Both IBS and IBD are chronic conditions that produce related symptoms, including abdominal pain and changes in bowel function such as diarrhea. But while IBD — which includes Crohn’s disease and ulcerative colitis — is characterized by severe inflammation in all or part of the gastrointestinal tract, no inflammation or visible abnormality is present in IBS. Stress appears to exacerbate both conditions, and since the symptoms themselves can increase stress in patients, finding ways to break that vicious cycle could have significant clinical benefits.

The relaxation response — a physiologic state of deep rest induced by practices such as meditation, yoga, and prayer — was first described more than 40 years ago by Herbert Benson, director emeritus of the Benson-Henry Institute and a co-author of the current paper. Many studies have shown that regular practice of the relaxation response not only alleviates stress and anxiety but also directly affects physiologic factors such as blood pressure, heart rate, and oxygen consumption. In reports published in 2008 and 2013, Benson, along with Towia Libermann and Manoj Bhasin — both of the BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center — described how elicitation of the relaxation response in healthy individuals affected the expression of genes in pathways involved with the body’s response to stress, inflammation, and energy metabolism. Libermann is co-senior author and Bhasin is co-lead author of the current study.

The current study was designed to investigate whether a relaxation-response-based intervention could improve the quality of life in patients with IBS or IBD and to analyze the intervention’s effects on inflammatory markers and gene expression. The study enrolled 48 adult participants — 19 of whom had been diagnosed with IBS and 29 with IBD — who participated in a nine-week group program focused on stress reduction, cognitive skills, and health-enhancing behaviors. Each of the weekly sessions included relaxation response training, and participants were asked to practice relaxation response elicitation at home for 15 to 20 minutes each day. Along with aspects featured in other group programs offered at the Benson-Henry Institute, this program included a session specifically focused on gastrointestinal health.

Study participants were assessed at the outset, midway through, and at the end of the program, and then three weeks later. The assessments used standardized tools for measuring symptoms common to both disorders, assessing anxiety and pain, and determining the effects of the disorders on participants’ quality of life. Blood samples were taken at baseline and a week after the study period’s conclusion for purposes of profiling gene expression and measuring known inflammatory factors.

Both in patients with IBS and those with IBD, participation in the mind/body program appeared to have significantly improved disease-related symptoms, anxiety, and overall quality of life, not only at the end of the study period but also three weeks later. While there were no significant changes in inflammatory markers for either group of participants, changes in expression were observed in almost 200 genes among participants with IBS and more than 1,000 genes in those with IBD. Many of the genes with altered expression are known to contribute to pathways involved with stress response and inflammation.

“In both IBS and IBD, the pathway controlled by a protein called NF-κB emerged as one of those most significantly affected by the relaxation response, which confirms the findings of our previous genomic studies,” said Libermann. “Indeed the relaxation response reduced the expression of a number of genes directly linked to the key inflammatory processes of IBD. While the mechanisms behind IBS are less well-defined, they most likely involve stress response, which also could be improved by relaxation response practice.”

Co-senior author John Denninger of the Benson-Henry Institute at MGH noted, “One interesting clinical impact was a decrease in both IBS and IBD patients in what is called pain catastrophizing — a negative cognitive and emotional response to pain or the anticipation of pain. In other words, participants became more resilient in the face of the pain they were experiencing. But before we can offer a program like this to patients with these disorders, we’ll need to conduct a longer, randomized trial with a control group and enough participants for statistically significant results.”

Vitamin D & IBD

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Original article on Vitamin D Council

Summary

Inflammatory bowel disease is a chronic disease that causes inflammation in all or part of the digestive tract. The two main types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis, which affect different parts of the digestive tract.

The cause of inflammatory bowel disease is not fully understood, but scientists think it is a combination of genetics, the environment, and your immune system.

Many studies have shown that there is a link between vitamin D and inflammatory bowel disease. People with inflammatory bowel disease are more likely to have low levels of vitamin D. In inflammatory bowel disease, vitamin D may help the immune system to reduce levels of inflammatory proteins that get overproduced.

Although inflammatory bowel disease is not curable, there are ways to manage the symptoms and keep the disease in remission. Having high vitamin D levels may be a way to help manage inflammatory bowel disease, as well as to reduce complications related to the disease, such as hospitalizations, surgeries, infections, and colon cancer.

More experiments need to be done to determine just how effective vitamin D might be for inflammatory bowel disease, if at all.  Research hasn’t been able to show yet that low vitamin D levels cause inflammatory bowel disease. Doctors don’t know yet whether taking a vitamin D supplement, or getting more sun exposure, can help to prevent inflammatory bowel disease.

If you have inflammatory bowel disease and want to take vitamin D, it is unlikely to make your IBD worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help to treat your inflammatory bowel disease.

If you have inflammatory bowel disease, you shouldn’t take vitamin D in place of your treatment medications. Talk to your physician for more advice about taking supplements.

What is inflammatory bowel disease?

Inflammatory bowel disease, or IBD, is a chronic or recurring disease that causes inflammation in all or part of the digestive tract. There are different types of IBD. The main types are Crohn’s disease and ulcerative colitis.

Ulcerative colitis only causes inflammation in your colon (large intestine) or rectum, while Crohn’s disease can happen anywhere along your digestive tract. Crohn’s disease can also spread deep into the tissues of your digestive tract. Crohn’s disease is usually more severe and causes symptoms more frequently than ulcerative colitis.

It is common for people with IBD to have periods of flares, which is when you have worse symptoms, and periods of remission, when the symptoms are better or not there at all. When IBD symptoms are flaring up, the disease is called “active”1.

What are the symptoms of inflammatory bowel disease?

The symptoms for IBD vary by person, depending on where their inflammation is and how severe it is.  In general, symptoms for both Crohn’s disease and ulcerative colitis include1,2:

  • Diarrhea
  • Cramps and abdominal pain
  • Rectal bleeding or bloody stool
  • Fatigue
  • Bloating
  • Skin, joint, or eye inflammation

Some people who have severe cases also experience a loss of appetite, weight loss, and malnutrition from not getting enough nutrients. Ulcerative colitis symptoms usually come on gradually, whereas Crohn’s disease symptoms may come on suddenly.

People with Crohn’s disease are also more likely to get small sores or ulcers on the surface of their digestive tract. Sometimes these ulcers can become large and can occur inside the walls of the intestine.

How common is inflammatory bowel disease?

It is estimated that 1.4 million people in the United States have some form of IBD. Most people develop it between the age of 15 and 30, but it can occur at any age. There are some things that can increase your chances for developing IBD, including1,2:

  • Gender. Ulcerative colitis is more common in men, while Crohn’s disease is more common in women.
  • Ethnicity. IBD is more common in Caucasian and Ashkenazi Jewish people.
  • Family history. You have a higher risk of developing IBD if your parent or sibling has it.
  • Smoking.

What causes inflammatory bowel disease?

It is not fully understood what causes IBD or how it develops. Researchers think that IBD is caused by a combination of genetics, the environment, and your immune system.

It is not fully understood what causes IBD or how it develops. Researchers think that IBD is caused by a combination of genetics, the environment, and your immune system.

It is not fully understood what causes IBD or how it develops. Researchers think that IBD is caused by a combination of genetics, the environment, and your immune system.  Some researchers think that an invading germ in your digestive tract causes your body to become overly inflamed when your immune system is trying to fight it off.

There are things in the environment that might affect the chance of developing IBD, such as where you live, if you smoke, and your diet. People who live in urban areas, industrialized countries, or northern latitudes are more likely to have IBD3,4.

Other researchers think that it is an autoimmune disease, which means that your immune system has a hard time telling the difference between your own healthy cells and foreign things like germs, bacteria, or viruses. This causes your body to attack your healthy tissue, which can cause inflammation and pain.

Overall, there is some combination of genetics, the environment, and your immune system that causes IBD to develop1,2,5.

What is the link between vitamin D and inflammatory bowel disease?

Many studies have shown that there is a link between vitamin D and IBD. People with IBD are more likely to have low levels of vitamin D. Some researchers think that low vitamin D levels may be a consequence of having IBD because the symptoms may cause you to stay indoors more and eat less.

However, studies have found that even people who are newly diagnosed with IBD tend to have low vitamin D levels. This means that low vitamin D levels may be a risk factor for developing IBD3.

Vitamin D receptors are found on the surface of a cell where they receive chemical signals. By attaching themselves to a receptor, these chemical signals direct a cell to do something, for example, to act in a certain way, or to divide or die. There are vitamin D receptors found on cells in the digestive tract and the immune system, and vitamin D can bind to these receptors.

In IBD, vitamin D works in the immune system by reducing levels of inflammatory proteins that get overproduced. One of the proteins that vitamin D can lower is called tumor-necrosis factor, or TNF.  One of the medications to manage IBD involves blocking TNF production. Therefore, researchers think that vitamin D may be a natural way to block TNF and help reduce inflammation in the digestive tract4,6.

While it is thought that there is a link between low vitamin D levels and IBD, more experiments need to be done to figure out whether or not taking vitamin D supplements can help to prevent or manage IBD.

What does the research say in general about vitamin D and inflammatory bowel disease?

Preventing inflammatory bowel disease

Not many studies have been done about preventing IBD. However, it has been shown that there is a difference in the risk of developing IBD based on where you live and the amount of sun exposure you get.

People who live in northern latitudes with less sunlight have an increased chance of developing IBD. Vitamin D is made in the skin from sunlight, so researchers think that low vitamin D levels may be a factor that increases IBD risk in these populations7.

Managing inflammatory bowel disease

Having high vitamin D levels may be a way to help manage IBD, as well as reduce complications related to IBD, such as hospitalizations, surgeries, infections, and colon cancer.

Having high vitamin D levels may be a way to help manage IBD, as well as reduce complications related to IBD, such as hospitalizations, surgeries, infections, and colon cancer.

Although IBD is not curable, there are ways to manage the symptoms and keep the disease in remission. Having high vitamin D levels may be a way to help manage IBD, as well as reduce complications related to IBD, such as hospitalizations, surgeries, infections, and colon cancer8. However, it is not known for sure yet that vitamin D can help to prevent these outcomes.

Some studies have found that people with IBD who have higher vitamin D levels tend to have lower disease activity, meaning their symptoms are less severe or they are in remission more9,10.

People with IBD are more likely to have low bone density, which increases the risk for osteoporosis and fractures. People with IBD tend to have lower bone density for different reasons, including long-term use of steroid medications, low nutrient intakes, and changes in bone formation from too much inflammation. Since vitamin D helps to strengthen bones, researchers think that low vitamin D levels may be one of the reasons why people with IBD tend to have low bone density11.

Although many studies have shown a link between low vitamin D levels and increased IBD severity and complications, most of the research has been observational, meaning that we can’t say for sure whether or not vitamin D can help to manage IBD.

What does the recent research say about vitamin D and inflammatory bowel disease?

An experiment published in 2013 looked at a small group of 18 adults in the United States with mild or moderate Crohn’s disease. All of the patients started with taking 1,000 IU of vitamin D every day for 2 weeks, and then they increased the dose every 2 weeks until it reached 5,000 IU per day. The total treatment time was 24 weeks. The researchers looked at their vitamin D levels, quality of life, and disease activity score throughout the study. They found that12:

  • Vitamin D levels increased greatly after 24 weeks. The people who started with the lowest vitamin D levels saw the biggest improvement.
  • All but 1 person had lower disease activity scores and higher quality of life after treatment.
  • Sixty-seven percent of the people went into remission.

The researchers conclude that 5,000 IU per day of vitamin D may help to lower disease activity and improve quality of life in people with Crohn’s disease, but more experiments need to be done to say for sure.

A 2010 experiment from Denmark looked at adults who were in remission from Crohn’s disease. The researchers gave them either 1,200 IU of vitamin D plus 1,200 mg calcium every day or a dummy pill and calcium. After one year, the researchers found that13:

  • People in the vitamin D group had fewer relapses into active Crohn’s disease compared to people in the dummy pill group.

The researchers conclude that vitamin D might help to keep people in remission from Crohn’s disease.

A study published in 2013 in the United States recruited a large group of people with IBD and looked at their vitamin D levels and various outcomes related to IBD. The researchers found that8,14:

  • People who had low levels of vitamin D were more likely to be hospitalized or have surgery related to IBD, compared to people with high levels of vitamin D.
  • People who had low levels of vitamin D were more likely to get cancer than people with higher levels.
  • For every 1 ng/mL increase in vitamin D levels, there was a 6% decrease in risk of colorectal cancer.

Negative outcomes like surgeries, hospitalization, and colon cancer are common for people with IBD. The researchers conclude that having higher levels of vitamin D may help to protect against these outcomes.

A study in 2013 in the United States looked at people with IBD who were on a specific treatment medication. The researchers wanted to know if vitamin D levels before treatment started would have an effect on how the treatment went. They found that15:

  • People who had low vitamin D levels before treatment started were 3 times more likely to stop treatment early compared to people with high vitamin D levels.
  • The people who stopped treatment early did so because they weren’t getting better or seeing a response.

The vitamin D status of people with IBD before starting treatment may affect how well someone responds to treatment. Having a high vitamin D level could make it more likely to see an improvement in symptoms once treatment is started.

Key points from the research

  • People who have IBD tend to have low levels of vitamin D.
  • In IBD, vitamin D may help the immune system in reducing levels of inflammatory proteins that get overproduced.
  • Having high vitamin D levels may be a way to help to manage IBD symptoms.
  • Vitamin D may help to reduce complications related to IBD, such as hospitalizations, surgeries, infections, and colon cancer.
  • Overall, more experiments need to be done to determine if taking vitamin D supplements can help to prevent or manage IBD.

What does this mean for me?

Research has shown that there is a link between vitamin D and IBD. People with IBD are more likely to have low levels of vitamin D and are more likely to experience worse outcomes, like hospitalizations, surgeries, more severe symptoms, and colon cancer.

Research shows that there is a link between vitamin D and IBD, but it is not known yet whether taking a vitamin D supplement, or getting more sun exposure, can help in prevention or management.

There is a link between vitamin D and IBD, but it is not known yet whether taking a vitamin D supplement, or getting more sun exposure, can help in prevention or management.

Some studies have shown that having high levels of vitamin D can help to lower the risk of these outcomes. However, more experiments need to be done to determine just how effective vitamin D might be for IBD, if at all.  Research hasn’t been able to show yet that low vitamin D levels cause IBD. Doctors don’t know yet whether taking a vitamin D supplement, or getting more sun exposure, can help to prevent IBD.

If you have IBD and want to take vitamin D, it is unlikely to make your IBD worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help to treat your IBD.

If you have IBD, you shouldn’t take vitamin D in place of your treatment medications. Talk to your physician for more advice about taking supplements.

References

  1. Mayo Clinic. Inflammatory Bowel Disease (IBD). 2012. Web. Accessed at < http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/causes/con-20034908>.
  2. CDC. Inflammatory Bowel Disease (IBD). 2014. Web. Accessed at < http://www.cdc.gov/ibd/>.
  3. Ananthakrishnan AN. Environmental triggers for inflammatory bowel disease. Curr Gastroenterol Rep 2013;15(1):1-11.
  4. Cantorna  MT, McDaniel K, Bora S, et al. Vitamin D, immune regulation, the microbiota, and inflammatory bowel disease. Experimental Biology and Medicine 2014;0:1-7.
  5. WebMD. Inflammatory Bowel Disease. 2014. Web. Accessed at < http://www.webmd.com/ibd-crohns-disease/crohns-disease/inflammatory-bowel-syndrome>.
  6. Reich KM, Fedorak RN, Madsen K, et al. Vitamin D improves inflammatory bowel disease outcomes: basic science and clinical review. World Journal of Gastroenterology 2014;20(17):4934-47.
  7. Butcher RO & Limdi JK. Vitamin D status in inflammatory bowel disease: are clinicians seeing the light? Journal of Crohn’s and Colitis 2012;6:1039-1040.
  8. Ananthakrishnan AN, Cagan A, Gainer VS, et al. Normalization of plasma 25-hydroxy vitamin D is associated with reduced risk of surgery in Crohn’s disease. Inflamm Bowel Dis 2013;19:1921-27.
  9. Fu YN, Chatur N, Cheong-Lee C, et al. Hypovitaminosis D in adults with inflammatory bowel disease: potential role of ethnicity. Dig Dis Sci 2012;57:2144-48.
  10. Ham M, Longhi MS, Lahiff C, et al. Vitamin D levels in adults with Crohn’s disease are responsive to disease activity and treatment. Inflamm Bowel Dis 2014;20:856-860.
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Mindfulness & IBD

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Original article on Science Daily

Training in meditation and other mindfulness-based techniques brings lasting improvements in mental health and quality of life for patients with inflammatory bowel diseases (IBD), according to a study in Inflammatory Bowel Diseases, official journal of the Crohn’s & Colitis Foundation of America (CCFA). The journal is published by Wolters Kluwer.

“Our study provides support for the feasibility, acceptability, and effectiveness of a tailored mindfulness-based group intervention for patients with IBD,” concludes the research report by Dr. David Castle, a psychiatrist at St. Vincent’s Hospital, Melbourne, Australia, and colleagues. More research is needed to demonstrate the clinical benefits of mindfulness techniques–including whether they can help to reduce IBD symptoms and relapses.

Mindfulness Reduces Anxiety and Depression in IBD Patients

The researchers evaluated a mindfulness-based stress reduction (MBSR) program tailored for patients with IBD. The study included 60 adults with IBD: Crohn’s disease or ulcerative colitis. The patients’ average age was 36 years, and average duration of IBD 11 years. Twenty-four patients had active disease at the time of the study.

The MBSR intervention consisted of eight weekly group sessions plus a daylong intensive session, led by an experienced instructor. The program included guided meditations, exercises designed to enhance mindfulness in daily life, and group discussions of challenges and experiences. Participants were also encouraged to perform daily “mindfulness meditation” at home.

Thirty-three patients agreed to participate in the MBSR intervention, 27 of whom completed the program. Ratings of mental health, quality of life, and mindfulness were compared to those of the 27 patients who chose not to participate (mainly because of travel time).

The MBSR participants had greater reductions in anxiety and depression scores, as well as improvement in physical and psychological quality of life. They also had higher scores on a questionnaire measuring various aspects of mindfulness–for example, awareness of inner and outer experiences.

Six months later, MBSR participants still had significant reduction in depression and improvement in quality of life, with a trend toward reduced anxiety. The patients were highly satisfied with the mindfulness intervention.

Anxiety, depression, and decreased quality of life are common in patients with IBD. Psychological distress may lead to increased IBD symptoms and play a role in triggering disease flare-ups. Previous studies have shown benefits of MBSR for patients with a wide range of physical illnesses, but there is limited evidence on mindfulness-based interventions for patients with IBD.

The new results show that the MBSR approach is feasible and well-accepted by patients with IBD. The study also suggests that training patients in mindfulness practices to follow in daily life can lead to significant and lasting benefits, including reduced psychological distress and improved quality of life. Dr. Castle comments, “This work reinforces the interaction between physical and mental aspects of functioning, and underscores the importance of addressing both aspects in all our patients.”

The researchers point out some important limitations of their study–including the fact that patients weren’t randomly assigned to MBSR and control groups. They also note that the study didn’t assess the impact on measures of disease activity, including IBD flares. Dr. Castle and colleagues conclude, “A larger adequately powered, randomised study with an active control arm is warranted to evaluate the effectiveness of a mindfulness group program for patients with IBD in a definitive manner.”