Gut-Brain Connections

[RobinN]

Gastric bacterial overgrowth increases the risk of systemic infection. Gastric bacteria convert dietary nitrates to nitrites and nitrosamines; hence, the increased risk of gastric cancer in individuals with hypochlorhydria( 15) . Some bacterial infections of the small bowel increase passive intestinal permeability.

Carbohydrate intolerance may be the only symptom of bacterial overgrowth, making it indistinguishable from intestinal candidosis; in either case dietary sugars can be fermented to produce endogenous ethanol. Chronic exposure of the small bowel to ethanol may itself impair intestinal permeability. Another product of bacterial fermentation of sugar is D-lactic acid. Although D-lactic acidosis is usually a complication of short-bowel syndrome or of jejunoileal by-pass surgery (colonic bacteria being the source of acidosis), elevated levels of D-lactate were found in blood samples of 1.12% of randomly selected hospitalized patients with no history of gastrointestinal surgery or disease. Small bowel fermentation is a likely cause of D-lactic acidosis in these patients. British physicians working with the gut-fermentation syndrome as described by Hunisett et al have tentatively concluded, based on treatment results, that the majority of cases are due to yeast overgrowth and about 20% are bacterial in origin. The symptoms include abdominal distension, carbohydrate intolerance, fatigue and impaired cognitive function.

Deficiency
Exposure to antibiotics or a diet depleted of soluble fiber may create an absolute deficiency of normal fecal flora, including Bifidobacteria, Lactobacillus and E. Coli. Direct evidence of this condition is seen on stool culture when concentrations of Lactobacillus or E. Coli are reduced. Low fecal short chain fatty acids provide presumptive evidence. This condition has been described in patients with irritable bowel syndrome and food intolerance (see below). Deficiency and putrefaction dysbiosis are complementary conditions which often occur together and have the same treatment.

Sensitization
Aggravation of abnormal immune responses to components of the normal indigenous intestinal microflora may contribute to the patho- genesis of inflammatory bowel disease, spondyloarthropathies, other connective tissue disease and skin disorders like psoriasis or acne. The responsible bacterial components include endotoxins, which can activate the alternative complement pathway and antigens, some of which may cross react with mammalian antigens. Treatment studies in ankylosing spondylitis and inflammatory bowel disease suggest that sensitization may complement fermentation excess and that similar treatments may benefit both conditions.

Clinical research has implicated bacterial dysbiosis in a number of diseases of inflammation within the bowel or involving skin or connective tissue. The published associations are reviewed below:

Atopic Eczema
Ionescu and his colleagues have studied fecal and duodenal flora in patients with atopic eczema and found evidence of small bowel dysbiosis and subtle malabsorption phenomena in the majority. Treatment with antibiotics or with a natural antibiotic derived from grapefruit seeds, produced major improvement in the gastrointestinal symptoms of eczema patients and moderate improvement in severity of eczema. One advantage in the use of grapefruit seed extract over conventional antibiotics lies in its anti-fungal activity. This agent adds a second therapeutic dimension and eliminates the possibility of secondary candidosis. The minimum effective dose of grape- fruit seed extract for bacterial dysbiosis is 600 mg a day.

http://www.healthy.net/scr/Article.asp?Id=423&xcntr=4

[RobinN]

Findings indicate that infrequent bowel movements are associated with an elevated risk of future Parkinsons Disease. Further study is needed to determine whether constipation is part of early PD processes or is a marker of susceptibility or environmental factors that may cause PD.

http://www.neurology.org/cgi/content...urcetype=HWCIT

[RobinN]

Conclusions: Neurologic disorders associated with Inflammatory Bowel Disease (IBD) are more common than appreciated and follow a different pattern of involvement in Ulcerative Colitis (UC) and Chrons Disease (CD). A prospective study is required to define the nature of this association.

http://www.neurology.org/cgi/content...urcetype=HWCIT

[RobinN]

UWO researchers investigated the "gut-brain" connection after many parents of autistic children reported significant improvements in the behaviour of their autistic children when they modified their diet, eliminating dairy and wheat products, Dr. Derrick MacFabe, the director of a research group at UWO in London, Ont., told CBC News Thursday.

Researchers were particularly interested in one dietary characteristic the autistic children seemed to exhibit, he said.

"Certainly, a lot of these children had peculiar cravings for high-carbohydrate foods that caused their behaviours," he said.

"We were interested in finding a link between certain compounds that are produced by bacteria in the digestive system — particularly those occurring with early childhood infections."

The bacteria produce propionic acid, a short chain fatty acid, which in addition to existing in the gut, is commonly found in bread and dairy products, MacFabe said.

Autism Study

[RobinN]

SPECT brain imaging of the majority of the few celiac disease patients studied reveals abnormalities that are usually most severe in the frontal areas of the brain. Improvement of these abnormalities are seen on a gluten-free diet. The frontal area of the brain is important in brain function that controls attention, impulse control, organization, and problem solving. Problems in this area of the brain result in short attention span, disorganization, procrastination, short-term memory problems, anxiety and depression.

Not surprisingly these are common symptoms reported by Sprue patients and in non-celiac gluten sensitivity that improve with a GFD. ADD, schizophrenia, alcohol and drug addiction problems and depression, all associated with gluten in some studies, are also associated with functional disturbances in the frontal area of the brain seen on SPECT scans. Though the reports of SPECT imaging in celiac disease are limited there have been some very interesting findings that make sense to those of us familiar with the effect of gluten on the brain.

Gut brain connection seen on SPECT scan

[RobinN]

Did you know that studies show that an irritable bowel (which affects nearly 60 million Americans) can cause an irritable brain? It isn’t being anxious and irritable that messes up your stomach, it is your stomach that makes you anxious and irritable.

We call it the ENS, or enteric (or gut) nervous system, as opposed to the CNS, or central nervous system. This gut-brain actually comes from the same embryonic tissue as the brain-brain. And it is still connected via the autonomic nervous system—the sympathetic and parasympathetic nerves.

Literally everything that happens in your gut is communicated to your brain via the ENS. If your gut is stressed out, if it is inflamed, if it has too few probiotics, or if the protective barrier that lets food in and keeps toxins out has been breached, your gut tells your brain about it.

That makes your brain unhappy.

Dr. David Relman from Stanford is studying the DNA of the ecosystem of bugs in the gut. He has found the bugs who live with you in your gut may be more important in determining your health than your own DNA fingerprint. A healthy gut is a healthy brain!

Dr Mark Hyman's Blog

[LuvMyTwins]

I had epilepsy that was controlled until recently. I had nausea on a daily basis and after several tests they found h.pylori and gastritis. What a nightmare!! The doctors did not know what to do with me. They gave me the antibiotics and then---all hello broke loose. My medicine level climbed, they (not gradually) took me off the meds---you can only imagine what happened next. It caused 2.5 months of suffering! Only now am I finally getting to the point that I feel stable again. Yet, that is only b/c I took my body into my own hands.

[RobinN]

In “sensitive” people who are genetically predisposed to this celiac disease, malabsorption of significant nutrients including B vitamins, essential fatty acids, some minerals (calcium and zinc, for instance) compound the mental and emotional component. Malabsorption can stunt the stature of children, slow the maturation rate, create an over-sensitive or irritable brain tissue, and perhaps alter the learning styles (sensory perception issues) of these children. Because gluten enteropathy is, in part, an immune system disorder originating in the wall of the small intestine, any amount of gluten from wheat, rye, barley, and oats keeps the immune system activated, which in turn may result in “spreading” of symptoms. It is hypothesized that organ systems not apparently involved during childhood become involved as the child ages. What began in the gut seems to move through the body, affecting lung function, the skin, and even the brain. Again, evidence to support such a theory is based on the effect of gluten avoidance – less mucus and bronchial symptoms, clearer skin, improved cognition, stabilization of mood, etc.



In addition to the biochemical and immune effect of gluten, the loss of nutrients would result in loss of some of the supportive tissue (glial cells) which would lead to larger cerebral ventricles (they would expand by default into areas where the glia have been lost), deeper sulci (the crevices apparent in the cortical surface of the brain), narrower gyri (the humps on the cortical surfaces), and perhaps the disarrangement of neurons positioned in infancy and early childhood.



Since the fats and oils we eat become both structural and functional components of the “barrier” membranes in our bodies, such as the cell membranes, gut wall and the blood-brain barrier, another result of lipid malabsorption could be a less-reliable blood-brain barrier. In those parts of the brain where the blood-barrier is purposely “thin,” such as areas close to the middle of the brain (parts of the hypothalamus and the pituitary gland - the paraventricular regions) the insufficient or imbalanced lipid components certainly would be expected to affect many functions. These areas of the brain have much to do with basic motives and behaviors dealing with food intake, thirst, sexuality, sleep regulation, etc.

From an informal survey of about 20 people with gluten related sensitivity, >90% reported improvement from a gluten-free diet. All spoke of delayed learning prior to a gluten free diet either in themselves or their children. Some of the physiological, cognitive, and emotional symptoms they reported with dietary avoidance of gluten included:

* Improved ability to learn
* Improved interest in school
* Improved concentration
* No more meds for depression problems
* No more avoidance of meeting people
* Expected full recovery of ataxia problems (inability to coordinate muscle movements)
* Improved gross motor skills (was delayed in some cases)
* Improved physical growth (was smaller than expected)
* Went from bottom of class to the top of his class after 3 months on diet
* Found a "hunger" for learning after avoiding gluten
* Improved mood with less “crossness” and “crankiness”
* Improved development to catch up with peers
* Improved intellect with definite increases in intelligence
* Grade point average went from 2.5 to 3.9
* Many have acquired college degrees with high gpa after going gluten-free
* Came alive academically
* Improved ability to meet daily challenges
* Improved speed of learning ("quicker" in her studies)
* Absenteeism no longer a problem
* Lots of stories about coming out of withdrawn state socially to an outgoing one -- running for student council, more motivated in doing well and meeting people
* Increased well-being and better brain chemistry
* No more "brain fog"
* Improved in reading (“noticeable”)
* Improved temperaments in children

Celiac disease of mental illness

[RobinN]

H. pylori Infection May Aggravate GI Injury in Patients Taking Low-dose Aspirin

Doctors commonly prescribe low-dose aspirin for the prevention of heart disease, but it may also be responsible for some potentially serious side effects when taken frequently. Among the most common of these are gastrointestinal erosions and ulcers.

A recent study in The American Journal of Gastroenterology sought to determine whether certain people taking low-dose aspirin — specifically, people infected with Helicobacter pylori, a common bacterium that can cause ulcers — are more susceptible to gastrointestinal erosions and ulcers than people who are not infected with H. pylori.

Researchers from the University of Texas Southwestern Medical School and Baylor College of Medicine recruited 61 healthy volunteers between the ages of 18 and 61. Of these, 29 volunteers were infected with H. pylori. Forty-six of the volunteers were then randomly selected to receive low-dose aspirin (either 81 mg daily or 325 mg every three days), while 15 received a placebo.

After 46 days of treatment, an upper GI endoscopy was performed on each subject to determine the extent of gastrointestinal injury. The researchers did not detect any injury in the stomach or duodenum (upper intestine) of the patients taking placebo. In the subjects taking aspirin, those patients who were infected with H. pylori were significantly more likely to have gastrointestinal injury than those who were not infected (50% vs. 16%).

However, there was no difference between the groups in complaints of pain, nausea, vomiting, indigestion, or heartburn. In addition, the difference in outcomes between patients taking 81 mg of aspirin daily and 325 mg every three days was not statistically significant.

The researchers caution that the results of this study may not hold for older people or those with gastrointestinal diseases such as peptic ulcer disease, because the volunteers were healthy and aged 61 or younger. However, this study does suggest eradicating H. pylori infection may help prevent gastrointestinal erosions and ulcers in patients taking low-dose aspirin on a long-term basis.
October 2001 Update

https://www.health.harvard.edu/fhg/fhgupdate/M/M6.shtml

[Bernard]

Don't forget to add Paolo's research to this index:

neuropeptide Y (NPY)

[RanMan]

Robin

As I've said in the past, I have Ulcerative Colitis and Epilepsy.
My Neurologist always said that the two go hand in hand, both brought on by stress and unhealthy eating.

When I told ppl that, nobody believed me as there was no documentation to prove it.

Thanx Robin for posting this info.

Randy

[RobinN]

I believe it is what is happening to my daughter as well Randy. Though she is much younger, and if we didn't have a symptom of a seizure, we might never have learned as much as we have in how an unhealthy but can cause other illnesses / disorders.

People can go years without digestive symptoms. They might only have skin rashes and never understand how that actually begins in the gut.

So I hope that with time and diligence on your part you might be able to improve your situation with care in your eating habits. Good nutrition can also help with the ability to manage stress.

[RobinN]

I somehow missed that thread Bernard. Thanks for bringing it here. Lots of great info and much to send on to the medical team involved.

[paradise survivor]

Hey Robin! Any chance there is any info/research on E and ischemic colitus? Wouldn't ask except....

[RobinN]

Sorry PS I just saw this post.
Putting in a Google search, I came up with a few interesting articles.

http://www.everydayhealth.com/coliti...lcerative.aspx

A number of factors can contribute to reduced blood flow to the colon, including congestive heart failure, dehydration, recent surgery, infections and even long distance running. Most often with this condition, normal blood flow already has returned by the time symptoms appear. When a doctor is looking for the cause, it's common that none can be found.

Usually there's no reason to directly treat ischemic colitis because it resolves on its own. Still, people can feel very ill. Patients often require one to two days in the hospital to receive antibiotics to help stop bacteria from spreading and fluids to prevent dehydration. If the underlying cause is found, the condition may need to be treated.

Colon damage from an initial episode typically heals completely within two weeks. Most people never have another episode.

Mayo Clinic

From my research it appears that if there is gut inflammation, seizures can be a symptom. If someone that prove that information wrong, Please let me know.

[paradise survivor]

Aloha and thanks Robin! My situation really has my docs baffled. It starts with a rising pain in my lower belly that continues for quite a while. I have vomiting and 'the other' which has caused some moderate bleeding. Then if that isn't enough the pain keeps going till I pass out. After I am completely drained and exhausted. It has happened in the am as well as the pm. Two colonoscopies back to back and emergency cat scans all say ischemic colitous but it is not supposed to re-occur so often...guess it's one of those things

[RobinN]

I am interested because my son has bleeding as well. He has had two colonoscopies and is told it must just be a tear. However, he is thin and has a bit of a belly. When he stays away from certain food items the bleeding does not occur. So it is my belief that this might be a thread that runs through my family.

[RanMan]

Robin, Thanx for providing the documentation.
Nobody ever believes me when I tell them that there is a connection between Gut/Bowel and Epilepsy. (In my case Ulcerative Colitis)

Randy

[RobinN]

I believe you Randy. I am trying to learn whether or not it can be healed?

[RobinN]

REFRACTORY CELIAC -- NEW SOLUTIONS

Did you know that some people with celiac disease (the condition that makes people unable to digest the gluten found naturally in wheat, rye and barley) are unable to control their symptoms even with faithful adherence to a gluten-free diet?

The reason why that’s so is a puzzle doctors and researchers are working to solve. While they’re not ruling out the possibility that some or even all of these patients are unknowingly consuming gluten, even though they think they are adhering to a strict gluten-free diet, many doctors believe that another factor is at work as well. (For more on the topic of gluten contamination in supposedly "safe" foods, see Daily Health News October 5, 2010, "Gluten-Tainted Foods".) It appears that the damage done to the digestive systems of these patients doesn’t heal when they stop consuming gluten -- unlike most people with celiac disease, these unlucky folks continue to experience symptoms, and ultimately a higher risk for other serious illnesses, including cancer.

This condition is called refractory celiac disease. The good news is that this problem is rare, affecting only about 1% of people with celiac disease. Not only that, but inroads are being made in treating this unusual condition. Specifically, researchers have identified a new class of drugs to treat refractory celiac disease that is showing great promise -- I will tell you all about it in a minute, but let’s first talk about how this happens, because few people are aware that this problem even exists.

BLAME THE PATIENT?

When patients with celiac disease continue to suffer their miserable symptoms (including frequent bouts of diarrhea and flatulence) even after changing their diets, doctors tend to assume that they are still ingesting gluten from somewhere. As Daniel Leffler, MD, MS, founding member of the Celiac Center at Beth Israel Deaconess Medical Center, Boston, and coauthor of the book Real Life with Celiac Disease, told me, sticking to the diet can be "really, really hard." That’s not to say that these folks are giving in to temptation and eating pastries, pasta and bread, but rather because gluten lurks in many surprising foods including, as I mentioned above, some foods that are labeled to be free from gluten.

It’s a serious issue that goes far beyond the discomfort and inconvenience of the symptoms -- refractory celiac disease is associated with lymphoma and any number of other potentially deadly illnesses. Since the condition remains unusual, there’s still much to be learned about diagnosing and treating this problem, Dr. Leffler told me.

Treatment options focus on controlling inflammation:
Corticosteroids, which suppress the inflammatory response, have been the first-line treatment, but they have numerous troubling side effects, including dependency, immune suppression and bone thinning.
A small study of refractory celiac patients at the University of Virginia in Charlottesville reports that thiopurines (immunosupressants) may be effective. Dr. Leffler told me that he agrees that thiopurines are useful and that they let patients avoid some of the problems associated with steroids, but they too have potential side effects including the risks to the rest of your health when your immune system is suppressed, as well as liver and pancreatic damage, so patients taking them require close monitoring.
Now there’s yet another possibility -- a drug called mesalamine (similar to aspirin), which controls inflammation and was developed for inflammatory bowel disease and Crohn’s disease. This seems to be safe for refractory celiac, but the medication takes longer to work than the others and Dr. Leffler says there is still much to be learned about mesalamine for refractory treatment.
NATURAL TREATMENTS

I asked Daily Health News contributing medical editor Andrew L. Rubman, ND, about this problem, and he told me that some physicians have had success treating patients with refractory celiac disease with willow bark extract, which contains salicin, the compound upon which aspirin and mesalamine are based.

Individuals who have, or suspect that they have, refractory celiac disease should seek out an experienced celiac team whenever possible, according to Dr. Leffler. A list of celiac centers can be found at www.bidmc.org/celiaccenter. And meanwhile, you can be sure that I’ll continue to follow this story -- it’s an important one.

Source(s):

Daniel Leffler, MD, MS, founding member of the Celiac Center at Beth Israel Deaconess Medical Center, Boston, coauthor of Real Life with Celiac Disease (AGA).