Digestion; The Microflora, Dysbiosis and Intestinal Permeability

Question 1

Large Intestine:
Microflora

Answer 1

The large intestine hosts a vast community of around 100 trillion microbes. It often contains over 1000 bacterial species. The microflora performs the following crucial functions:
* The final stages of nutrient extraction through microbial fermentation. This includes the fermentation of remaining carbohydrates to create the odorous waste by-products methane and hydrogen, as well as the fermentation of amino acids to create hydrogen sulphide (fermentation of carbohydrates = production of methane and hydrogen (SIBO = overproduce methane OR hydrogen = requires carbohydrate (fibre) specific diet); Fermentation of amino acids = excess/smelly flatulence = digestions impaired)
* Therefore, XS flatulence with a strong odour can indicate poor digestions as a result of the bacterial action on the remaining food

Question 2

Large Intestine: Microflora functions

Answer 2

• Synthesises vitamins: Synthesisers vitamins such as biotin and K2
• Supports intestinal barrier: Bacteria produce short-chain fatty acids from fibre (cellulose) they ingest, that is then used by enterocytes. This supports the intestinal barrier and is hence protective against leaky gut
• Pathogen protection: Out-completes for attachment to the intestinal epithelium and nutrients (e.g. against Candida)
• Gut Associated Lymphoid Tissue (GALT): crucial for effective functioning of the immune system
• Regulates appetite/satiety: bacteria produce appetite – regulating proteins
• Mood regulation: as indicated by Edward Bach (Bach therapy). The microflora can synthesise neurotransmitters (e.g. E. coli help synthesise serotonin, Lactobacillus and Bifidobacterium produce GABA)

Question 3

Intestinal barrier

Answer 3

The GI Mucosal membrane surface is the largest interface between our internal body and the external world, covering more than 400 m²
* It plays an important role in protecting against ingested toxins, pathogens and undigested food
* When damaged, the tight junctions become leaky. This allows large molecules including undigested proteins to enter circulation before being broken down into their simplest forms (amino acids)
* Furthermore, the cell membranes of some gut bacteria can also abnormally enter the blood, leading to excessive immune responses, potentially including allergies and autoimmunity

Question 4

Intestinal permeability
(‘Leaky Gut’)

Answer 4

The intestinal barrier can be damaged by:
* Poor nutrition: Hydrogenated and trans-fats, refined sugars, processed foods / junk foods
* Heavy metal (e.g. mercury, lead, aluminium), pesticides, herbicides and cleaning toxins etc
* Drugs: corticosteroids, NSAIDs, antibiotics, vaccinations
* Excessive stress
* Dysbiosis and candida overgrowth
* Alcohol and smoking
* Radiation and chemotherapy
* Early weaning (<6 months)

Question 5

Leaky Gut test

Answer 5

Comprehensive digestive stool analysis (GDSA)
* A marker called Zonulin (Protein) Is associated with increased permeability – it dissembles transmembrane proteins between cells.
* Raised Zonulin indicates impaired intestinal permeability / leaky gut

Question 6

Large intestine:
Microflora – Dietary and other negative factors

Answer 6

Dietary composition strongly influences the diversity and dominant species in microflora.
* By feeding bacteria with a typical western diet (refined sugars, damaged fats, concentrated proteins, including animal proteins and processed soy, low in fibre), the strains become pathogenic
* The diversity of the microflora helps to support the immune system. It helps leukocytes to learn from the microbes, making them more effective at combating pathogenic organisms
* As well as poor nutrition, the colonies of bacteria can also be altered negatively by:
o Chronic stress and diabetes (higher levels of circulating glucose)
o Medication such as antibiotics and antacids
o Lack of digestive secretions, e.g. stomach acid
Pathogenic = disease-causing

Question 7

Dysbiosis: meaning and associations

Answer 7

‘Dysbiosis’ describes an imbalance in the colonies of the bowel flora, leading to a disruption in health.
* Bacterial toxins (lipopolysaccharides -LPS) can cross the intestinal wall if the barrier has been impaired. This can create a systemic inflammatory response.
* Dysbiosis can be associated with the following:
o Vitamin, mineral, amino acid insufficiencies
o Malabsorption of carbohydrates and fats
o Inflammatory bowel disease (e.g. Crohn’s)
o Colorectal cancer
o Alzheimer’s and Parkinson’s
o Autoimmune fatigue, allergies and tolerances (via increased intestinal permeability and an exaggerated immune response)
o Obesity and mood disorders
Dysbiosis = imbalance of gut microflora. Dys = bad, difficult (Greek), Bio = life, sis = indicating condition

Question 8

Effects of eating junk food

Answer 8

Junk food has no nutritional value but is high in calories, refined sugars, salt, damaged fats and synthetic additives. It causes:
* Gut Dusbiosis, leading to inflammation, reduced immune function and ‘leaky gut’
* ‘spikes’ in blood glucose, resulting in excessive insulin production, increasing the risk of Type II diabetes, obesity, polycystic ovarian syndrome (PCOS) and acne (insulin is a big hormonal drive for the production of sebum in skin, therefore highlevels of insulin = increased sebum production = acne)
* Increased blood pressure and cardiovascular disease (atherosclerosis)
* Deficiencies in vital vitamins and minerals
* Addictive eating behaviour, mood swings

Question 9

Natural agents to balance Microflora

Answer 9

Natural agents to balance Microflora:
* Garlic (Prebiotic)
* Berberine (In Barberry bark, goldenseal)
* Thyme – anti microbial
* Serrapeptase (protein digesting enzyme) – to break down biofilms

Question 10

Germ theory versus terrain theory

Answer 10

Louis Pasteur (1822 to 1895) developed the germ theory of disease which holds microbes such as bacteria responsible for disease.
* Pasteur said ‘germs cause disease’. He proposed that disease occurs from outside of the body
* Antoine Bechamp (1816 to 1908) challenged this and develop the Terrain theory, which holds that it is not the microbes, but the internal environment that is responsible for disease
* Bechamp said that ‘germs were ‘opportunistic’ in nature and lived with us symbiotically”.
* To prevent illness, he advocated not to ‘kill’ germs but to promote health (i.e. through diet, exercise etc.)