Restoring Your Patients’ Health by Conquering Their Dysbiosis

by Dr. Greg Fors, DC – Board Certified Neurologist DIBCN Posted On: 06/01/2010

Most patients today have some overt signs or symptoms of gastrointestinal distress. Nearly 20 million adults are newly diagnosed with digestive disorders each year and over 100 million individuals suffer daily from digestive disorders such as: GERD, gastritis, peptic ulcer, IBS, IBD and colitis. Furthermore, research now links digestive dysfunction to disorders you see as a clinician on a daily basis, such as: chronic muscle and joint pain, arthritis, headaches, fibromyalgia, chronic fatigue, ADHD, autism, asthma, allergies, eczema and many more. How can this be?

About 80% of your patient’s immune system exists within their gastrointestinal tract. Within a healthy digestive tract there are about one hundred trillion bacteria, more than 10X the number of cells in the body, and about 99% of these bacteria come from about 30 or 40 species. The total weight of this healthy gastrointestinal bacterial flora is around 3 to 6 pounds. It is a healthy mix of beneficial bacteria in the absence of unwanted microbes that keeps your patient’s immune system in proper balance. Research is showing that alteration in this bowel flora, called Dysbiosis, is a contributing factor to many chronic and degenerative diseases. Gastrointestinal dysbiosis is best understood as ‘an over abundance of non-acute non-infectious GI microorganisms and/or a lack of beneficial bacteria, adversely affecting the human host.’

This definition is vital to understand, the imbalanced microbial growth does not have to come from an acute infectious bacterial agent to cause chronic gastrointestinal or systemic problems. Because of the high concentration of the immune system within the G.I. tract, non-acute non-infectious commensal or non-beneficial bacteria and their endotoxins in large numbers can activate your patient’s immune system. This many times leads to an enhanced inflammatory response either locally in the patient’s G.I. tract and/or systemically. There are numerous factors in our modern lifestyle that can lead to this dysbiotic flora imbalance, chief among them are overuse of antibiotics, poor diet, hypochlorhydria and maldigestion. If these factors can be eliminated or at least reduced, natural treatments aimed at ridding your patient of dysbiosis may be more successful.

When your patient suffers with pain and inflammation–that is particularly chronic and difficult to overcome–it’s vital to consider that the inflammation is being triggered or enhanced by the presence of dysbiosis. It is my experience in practice that three out of four patients with inflammatory disorders or chronic pain have dysbiosis. The presence of dysbiosis in my patients has been verified via Comprehensive Digestive Stool Analysis through a specialty laboratory. In my clinic a CDSA is completed on any patient with symptoms of inflammatory disease or complaints of chronic muscle and joint pain.

Research has verified my clinical observations. In one study about 70% of patients with chronic arthritis were carriers of asymptomatic infections potentially triggering the inflammatory response in their synovial fluid.(1) In another study a little more than half of patients with undifferentiated oligoarthritis had intestinal enteric bacteria identified as a causative agent of their inflammation and arthritis.(2) If you are not finding dysbiosis in your patients with chronic inflammation and pain it may be that you’re not looking for it. It is easy enough to find, all you need to do is call one of the specialty labs below to set up an account and start testing your patients for dysbiosis:

• Genova Diagnostics 63 Zillicoa Street Asheville, NC 28801 at 800-522-4762
• Doctor’s Data, Inc.3755 Illinois Avenue St. Charles, IL 60174 at 800.323.2784
• Metametrix Clinical Lab 3425 Corporate Way Duluth, GA 30096 at 800-221-4640

Antimicrobial treatments (“poison the microbes, not the patient”): Plant-based NO-simple carbohydrate diets have been shown to improve the quality and quantity of beneficial intestinal microflora. Sugars and simple carbohydrates have been shown to feed the growth of unwelcome bacteria and yeast. Hypoallergenic diets have also proven beneficial for the treatment of dysbiosis. There are also specific antimicrobial botanicals that can be used to directly kill or strongly inhibit unwanted intestinal microbes. The most effective and well-documented botanicals are discussed below. Botanicals for antimicrobial treatment are frequently continued for one to three months, and are co-administered with very concentrated probiotics. These products must be taken three hours away from any antimicrobial botanicals. I have found antimicrobial drugs are sometimes necessary for acute and/or severe infections. However, dietary, nutritional and botanical interventions are safer and often more effective.

Research-based effective botanical medicines are best used in combination. Generally dosage recommendations are tended for adults who are otherwise healthy; lower doses are appropriate for children, the elderly and patients with renal or hepatic insufficiency.

Berberine sulfate, the King of the antimicrobial botanicals is a very specific active alkaloid from Berberis plants. This specific Berberine sulfate alkaloid extract is more expensive, but is worth it because of its broad antimicrobial activity, showing effectiveness against Giardia, Candida, and Streptococcus.(3) It has also proven to be active against protozoa and fungi.(4) Research has shown it to be effective therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae, having direct anti-inflammatory and anti-diarrhea actions; it is also relatively nontoxic to humans.(5) An oral dose of 400 mg per day is common for adults.(6) Berberine is generally non-toxic at recommended doses, but it is not recommended for use during pregnancy.

Myrrh (Commiphora molmol) specific methanol extract has proven antibacterial activity against Staphylococcus aureus and even MRSA strains.(7) Myrrh is also remarkably effective against parasitic infections.(8) A recent clinical trial against schistosomiasis showed “The parasitological cure rate after three months was 97.4 percent and 96.2 percent for S. haematobium and S. mansoni cases, a marvelous clinical cure without any side-effects.”(9)

Artemesia annua has primarily been used for treatment of protozoan infection but is also has effective against anaerobic bacteria, due to the pro-oxidative sesquiterpene endoperoxide. One of the additional benefits of Artemesia annua is its systemic bioavailability.

Calcium Undecylenate is an extremely effective, broad-spectrum, well-tolerated anti-fungal. When treating dysbiosis it is always vital to have a very effective antifungal included in your formula. Current studies indicate this extract of castor bean oil is up to 30 times more effective in combating Candida Albicans than Caprylic Acid. When tested over a pH range from 4.5 to 6.0, the antifungal activities of calcium undecylenate are quite pronounced. However, above pH 6.0, the calcium salt is less active. Its effectiveness can be improved by utilizing a time-release form containing Betaine HCL.

 

1. Weyand CM, Goronzy JJ. Ann Rheum Dis. 1992 Feb; 51(2):253-8.
2. Fendler C, Laitko S, et.al. Ann Rheum Dis. 2001 Apr; 60(4):337-43.
3. Amin AH, Subbaiah TV. Abbasi KM. Can J Microbiol 1969;15:1067-1076.
4. Kaneda Y, et al. Annals Trop Med Parasitol 1991;85:417-425.
5. Rabbani, G. H., 1987. J. Infect. Dis. 155:979-984.
6. Berberine. Altern Med Rev. 2000 Apr;5(2):175-7.
7. Emad M. Abdallah1, Amna S. Khalid1 Scientific Research Berberine. Altern Med Rev. 2000 Apr;5(2):175-7and Essay Vol. 4 (4) pp. 351-356, April, 2009.
8. El Baz MA et al. J Egypt Soc Parasitol. 2003 Dec; 33(3):761-76.
9. Abo-Madyan AA, Morsy TA, Motawea SM. J Egypt Soc Parasitol. 2004 Aug; 34(2):423-46.