Dysbiosis, Metabolic Endotoxaemia, Gallstones

Question 1

Dysbiosis

Answer 1

An imbalance in the colonies of the bowel flora, leading to a potential disruption in both local and systemic health.

Question 2

Dybiosis Aetiology

Answer 2

*Poor diet (highly processed, ↑ refined carbs, ↓ fibre, ↓ polyphenols).
*Intestinal / oral infections.
*Medications: Antibiotics / antacids / OCP.
*Chronic stress(e.g. = ↓ digestive secretions).
*Low digestive secretions (e.g. HCl, bile).
*C-section, non-breastfed.
*GI surgery and abdominal scar tissue.

Question 3

Dysbiosis and diseases:

Answer 3

• Atopic diseases
• Metabolic syndrome has been associated with less Bidifobacteria , Akkermansia spp.spp.; increased E coli and a high Firmicutes to Bacteroidetes ratio .
• Colorectal cancer (CRC)
• Neurodegenerative diseases

Question 4

Metabolic Endotoxaemia

Answer 4

A subclinical rise in bacterial LPS in the blood, resulting in chronic low-grade inflammation.

Question 5

Metabolic Endotoxaemia: Diseases

Answer 5

CVD
Diabetes mellitus
Autoimmunity
Degenerative disorders.

Question 6

Metabolic Endotoxaemia: Factors

Answer 6

• LPS are from the cell walls of gram-negative bacteria and interact with toll-like receptors (esp. TLR4) in the immune system.
• Dysbiosis, mucosal degradation and permeability of the GI tight junctions (often interlinked), increase serum LPS, which triggers the production of pro-inflammatory cytokines (e.g., TNF-α, IL-β).
• High fat diets (incl. ketogenic) ↑ LPS transport across the intestinal membrane; be cautious if a tendency to metabolic endotoxemia.

Question 7

Natural approach to metabolic
endotoxaemia

Answer 7

• Avoid alcohol (↑ LPS transport across intestinal epithelium), other dietary irritants / toxins / NSAIDs
  *↑ dietary fibre
• Avoid a Western or ketogenic diet.
• Focus on a rainbow of colour (esp. polyphenol rich foods)
• Breathing techniques and cold exposure
• Reinoculate and support the GI barrier (stage 3 and 4 of ‘5R’).
  *Support liver function, bile production

Question 8

Gallstones

Answer 8

Crystalline calculi formed within the gallbladder from a build up of bile components. 80% of gallstones contain cholesterol

Question 9

Gallstones: Causes

Answer 9

• Supersaturation of bile with cholesterol.
  –Cholesterol supersaturation can result from excessive cholesterol concentration in bile or a deficiency of substances that keep cholesterol in solution (i.e., bile salts and phospholipids).
• Bile stasis or delayed gallbladder emptying due to ↓ gallbladder motility.

Question 10

Natural approach to gallstones

Answer 10

• ↑ fibre; ↓refined sugar, trans-fats, saturated fats and alcohol.
• Consume choleretic and cholagogue-rich foods and herbs to support bile flow (e.g., ACV, bitter greens, globe artichoke).
• Weight loss may reduce gallstones in overweight individuals.
• Increase polyunsaturated fatty acids (PUFAs) as found in oily fish.
• Peppermint (its terpenes help to dissolve stones).

Question 11

Gallstones: Supplements

Answer 11

• Vitamin C (500–2000 mg / day).
• Lecithin (high phospholipid content; keeps cholesterol in solution).
• Purified bile salts (ox bile).