Gut Flora and Introduction to Dysbiosis - Week 11

Question 1

What is the association between obesity and microbiota (or lack thereof)?

Answer 1

• Obesity may be caused by infections
• Studies have seen changes in composition and metabolic function of the gut microbiota that appear to enable the “obese microbiota” to extract more energy from the diet
• Gut microbiota interacts with host epithelial cells to indirectly control energy expenditure and storage
• Study showed obese person had extremely high levels of Enterobacter (35% of bacteria in colon), and then lost 51 kg after it was eradicated

Question 2

What are the benefits vs. adverse health effects of H. pylori on digestive health?

Answer 2

• Historically part of our natural micro-flora

Benefits

• Now thought to modulate immunologic, endocrine, and physiologic functions in the stomach
• Decline in infection incidence may be contributing to increasing incidence of esophageal adenocarcinoma
• Affects gastric hormones (leptin and ghrelin)
• Decline in infection incidence may be contributing to increasing incidence of metabolic syndrome, DM2, and obesity

Adverse Effects
- Been shown to contribute to gastric adenocarcinoma, lymphoma, and ulcers

Question 3

What are the homeopathic approaches and remedies for dysbiosis?

Answer 3

Candida

• Candida nosode
• Nystatin nosode
• Syphilinum (one dose of 30c weekly)

Question 4

What prerequisites are needed to define a probiotic?

Answer 4

• Non-pathogenic, non-toxic, non-allergic
• Capable of surviving and metabolizing in upper GI tract secretion in gut environment
  > Resistant to low pH, organic acids, bile juice, saliva, and gastric acid
• Human in origin, genetically stable and capable of remaining viable for long periods in field condition
• Able to modulate immune response and provide resistance to disease
• Antagonistic against carcinogenic/pathogenic organism
• Clinically proven health benefit
• Have technologic properties for commercial viability

Question 5

What is a prebiotic? How does it work?

Answer 5

• Non-digestible food (food component)
• Selectively stimulates the growth and/or activity of one or a limited number of bacteria in the colon
  > Ex: Fructo oligosaccharides
• Act as cofactors for probiotics
• Should not be hydrolyzed or absorbed in the upper GI
• Helps in increasing the absorption of certain minerals (calcium and magnesium)
• Provide improved resistance against infection

Question 6

What is a synbiotic? What are the advantages of its use?

Answer 6

• Mixtures of probiotics and prebiotics
• Improves the survival and implantation of live microbial dietary supplements in the GI tract
• Increases number of ingested bacteria reaching the colon in a viable form
• Activates metabolism of beneficial bacteria, antagonistic toward pathogenic bacteria
• Produces antimicrobial substances
• Immuno-stiumlation
• Anti-inflammatory, anti-mutagenic, anti-carcinogenic

Question 7

What are the triggering events of dysbiosis?

Answer 7

• Overgrowth of normal species usually only present in small amounts
  > Ex: candida
• Displacement of normal species to areas they aren’t normally found in
  > Colon bacteria to SI = SIBO
• Pathogenic establishment in gut and causes clinical disease state
• Quantitative (uncommon overgrowth of normal flora leading to secondary displacement)

Question 8

What are the effects of antibiotics on intestinal flora?

Answer 8

• Short-term can cause yeast infections and GI symptoms (bloating, abdominal pain, diarrhea)
• Leaves intestinal flora altered for 1 month up to 2 years after one short course of antibiotics
• The reduction in beneficial flora leaves room for pathogenic/opportunistic bacteria to infect

Question 9

How does a high carbohydrate diet influence dysbiosis?

Answer 9

• Slows bowel transit time
  > Increases bacterial fermentation
  > Increases exposure to potentially toxic bowel contents
  > Promotion of fungal overgrowth
• Increases disaccharide load to colon
• Results in abnormal bacterial overgrowth and fermentation
• Especially problematic when eating gluten and casein

Question 10

What are the non-GI symptoms and conditions associated with dysbiosis/intestinal permeability?

Answer 10

• Bad breath
• Body odor
• Cystic fibrosis
• Dermatitis
• Fatigue
• Migraines
• Poor complexion
• Rheumatoid arthritis
• Vaginits
• ADHD
• Asthma
• Behavioral problems in children
• Depression
• Eczema
• Environmental allergies
• Multiple sclerosis
• Otitis media
• Recurrent infections
• Sjogren’s syndrom
• SLE

Question 11

What are anti-candida botanicals?

Answer 11

• Gymnema sylvestre 2 caps BID, 30 minutes before meal
• Allium sativum
• Calendula officinalis
• Commiphora myrrha
• Grindelia spp.
• Mentha piperita
• Pau d’Arco

Question 12

What are anti-microbial/anti-bacterial botanicals?

Answer 12

• Allium sativum
• Calendula officinalis
• Hydrastis canadensis
• Juglans nigra
• Thymus vulgaris (essential oil)
• Usnea spp.

Question 13

What diets are most appropriate for dysbiosis? Why?

Answer 13

• SCD
• Low FODMAPs
• Anti-candida
• Elimination diet
• Food allergy/sensitivity testing
• Increase dietary fiber
  > Stabilize blood sugar

Question 14

What are the most important quality control considerations in selecting a probiotic?

Answer 14

• A minimum of 2.5 billion organisms for mild conditions, upwards of 20-30 billion often needed
• Ask for assays from the companies
• Refrigerated strains seem to have improved therapeutic efficacy (even if label says it’s not necessary)
• Take with meals/after meals

Question 15

What are the applications of the probiotics? What are their effectivenesses against pathogenic microbes?

Answer 15

Effects on pathogenic bacteria

• Reduce plasma levels of bacterial endotoxin concentrations
• Decreases in translocation of bacteria d/t tightening of mucosal barrier
• Prevention of adherence and colonization of gut mucosa