Tag Archives: IBD

New Frontier for Digestive Disorders | The Paleo Diet

Unfortunately, many adopters of the Paleo diet are personally familiar with digestive disorders.1 For those who are not, common digestive problems include heartburn/GERD, IBD, and IBS.2, 3, 4, 5 These conditions are not without their unpleasant symptoms.6 Typically, sufferers of digestive disorders report bloating, diarrhea, gas, stomach pain, and stomach cramps.7 If these symptoms persist on an ongoing basis, you can begin to understand how they become uncomfortable in life.8 Treatment is typically a combination of medication, as well as diet and lifestyle changes.9

Interestingly, a new study in Gastroenterology “Confocal Endomicroscopy Shows Food-Associated Changes in the Intestinal Mucosa of Patients With Irritable Bowel Syndrome,” was recently conducted, showing that confocal laser endomicroscopy (CLE) may help some who cannot seem to figure their digestive disorder issues.10 This technique would be a ‘next step’ when conventional testing fails to provide patients with an adequate diagnosis. This is a fairly big breakthrough, as many sufferers of digestive disorders remain undiagnosed, or are diagnosed incorrectly.11 There is also the opportunity to understand the pathophysiology of gastrointestinal symptoms directly related to food.12

However, in terms of the Paleo diet, this study is also important because it shows that milk, wheat, yeast and soy were the foods that elicited a reaction among those who were tested. This should come as no surprise to those faithful to the Paleo approach! By eliminating grains alone, we tend to see an improvement in most people suffering from digestive issues.13, 14, 15 This study is also important because it tracked the participants for one year – showing that CD3 positive lymphocytes were significantly reduced after this time period.

What does all this science mean for the average layperson? Quite simply, if you suspect or suffer from an untreated or unknown digestive ailment, CLE may be a good ‘next step.’ If you want digestive symptoms to go away, you should start consuming a Paleo diet – no procedure needed! All kidding aside, it is best to see a healthcare professional if suffering from a digestive issue – even if the end treatment is simply avoiding certain foods. But one need not understand all the science (no matter how fascinating it may be) in order to reap the benefits associated with better food choices. This is part of the appeal and ‘magic’ of the Paleo diet – it simply works!

However, if  you suspect anything irregular is happening in your digestion, it’s best to address and not ignore the symptoms. Left untreated, digestive disorders can lead to malnutrition, among other serious consequences and other health issues.16 Leaky gut, for example, is a big problem (even for many who do not realize it is occurring), but once we heal the gut, we can more easily heal the rest of the body.17 One other note here is fruit consumption may be the culprit to many digestive disorders, due to its FODMAP content.18, 19, 20 A slightly modified Paleo diet may be in order here, but again, it is best to work with a doctor or other healthcare practitioner, in order to find out what works best for you – and your digestion.

 

REFERENCES

[1] Boers I, Muskiet FA, Berkelaar E, et al. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids Health Dis. 2014;13:160.

[2] Lacy BE, Weiser K, De lee R. The treatment of irritable bowel syndrome. Therap Adv Gastroenterol. 2009;2(4):221-38.

[3] Hanauer SB. Inflammatory bowel disease: epidemiology, pathogenesis, and therapeutic opportunities. Inflamm Bowel Dis. 2006;12 Suppl 1:S3-9.

[4] Nikolaus S, Schreiber S. Diagnostics of inflammatory bowel disease. Gastroenterology. 2007;133(5):1670-89.

[5] Cho JH. The genetics and immunopathogenesis of inflammatory bowel disease. Nat Rev Immunol. 2008;8(6):458-66.

[6] Lydiard RB. Irritable bowel syndrome, anxiety, and depression: what are the links?. J Clin Psychiatry. 2001;62 Suppl 8:38-45.

[7] Baumgart DC, Sandborn WJ. Crohn’s disease. Lancet. 2012;380(9853):1590-605.

[8] Patrick L. Gastroesophageal reflux disease (GERD): a review of conventional and alternative treatments. Altern Med Rev. 2011;16(2):116-33.

[9] Tytgat GN. Review article: treatment of mild and severe cases of GERD. Aliment Pharmacol Ther. 2002;16 Suppl 4:73-8.

[10] Fritscher-Ravens A, Schuppan D, Ellrichmann M, Schoch S, Röcken C, Brasch J, Bethge J, Böttner M, Klose J, Milla PJ, Confocal Endomicroscopy Reveals Food-Associated Changes in the Intestinal Mucosa of Patients with Irritable Bowel Syndrome, Gastroenterology (2014), doi: 10.1053/j.gastro.2014.07.046.

[11] Tursi A. Gastrointestinal motility disturbances in celiac disease. J Clin Gastroenterol. 2004;38(8):642-5.

[12] Salminen S, Bouley C, Boutron-ruault MC, et al. Functional food science and gastrointestinal physiology and function. Br J Nutr. 1998;80 Suppl 1:S147-71.

[13] Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut Microbes. 2010;1(3):135-7.

[14] Ciacci C, Cirillo M, Cavallaro R, Mazzacca G. Long-term follow-up of celiac adults on gluten-free diet: prevalence and correlates of intestinal damage. Digestion. 2002;66(3):178-85.

[15] Visser J, Rozing J, Sapone A, Lammers K, Fasano A. Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009;1165:195-205.

[16] Hodges P, Gee M, Grace M, Sherbaniuk RW, Wensel RH, Thomson AB. Protein-energy intake and malnutrition in Crohn’s disease. J Am Diet Assoc. 1984;84(12):1460-4.

[17] Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71-8.

[18] Barrett JS, Gibson PR. Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and nonallergic food intolerance: FODMAPs or food chemicals?. Therap Adv Gastroenterol. 2012;5(4):261-8.

[19] Fedewa A, Rao SS. Dietary fructose intolerance, fructan intolerance and FODMAPs. Curr Gastroenterol Rep. 2014;16(1):370.

[20] Murray K, Wilkinson-smith V, Hoad C, et al. Differential effects of FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) on small and large intestinal contents in healthy subjects shown by MRI. Am J Gastroenterol. 2014;109(1):110-9.

Autoimmune Disease: Drawing the Lines of Defense

The case for the Paleo Diet continues to grow as the modern diet leads to an epidemic of modern health problems. Over the last three decades, epidemiological data provide strong evidence of a steady rise in autoimmune disease, where the body fails to recognize the difference between its own cells and foreign invaders.1

We have to wonder why more people than ever are afflicted with the following conditions: multiple sclerosis, type 1 diabetes, inflammatory bowel diseases (mainly Crohn’s disease), systemic lupus erythematosus, primary biliary cirrhosis, myasthenia gravis, autoimmune thyroiditis, hepatitis and rheumatic diseases, bullous pemphigoid, and celiac disease.2 Indicators, based on the geoepidemiological distribution of autoimmune disease, point to an environmental factor.3 Although causality has not been proven, scientists hypothesize the answer lies in the relationship between the prevalence of industrialized foods and the environmental impact they have on our guts, specifically in the intercellular tight junctions of the epithelial lining.4

THE SECRET LIES IN THE INTESTINES

The idea of “leaky gut syndrome” has circulated for decades, but many health practitioners still don’t believe it actually exists, despite over thousands of published articles relating to intestinal permeability. Historically, the functions of the gastrointestinal tract have been believed to be limited to the digestion and absorption of nutrients and electrolytes, and to regulate water homeostasis.5 An additional function has been overlooked: to regulate macromolecules through the intestinal epithelial barrier mechanism, within tight intercellular junctions, to control the equilibrium between tolerance and immunity to non-self antigens.6

It shouldn’t seem that far fetched to believe molecules can pass from inside the intestines into the bloodstream, as only a single layer of epithelial cells separates the lumen from internal milieu.7 Our bodies even make modulating proteins, such as Zonulin, in response to certain bacteria and gluten8 that has been proven to open the intercellular tight junctions responsible for maintaining the integrity of the intestinal lining. When the intercellular junctions aren’t well sealed it allows for the passage of macromolecules into the bloodstream and triggers an immune response leading to intestinal and extraintestinal autoimmune disease as well as inflammatory disorders. 9

THE SCARCITY OF REAL FOODS

We are becoming more dependent on heavily processed food sources, 10 and evolving further away from what we are genetically designed to eat.11 There are seven food additives: sugar, salt, emulsifiers, organic solvents, gluten, microbial transglutaminase, and nanoparticles, increasingly added to processed food and are finding their way in record numbers onto grocery store shelves.  These industrial food additives are believed to dissolve the epithelial barrier function, leading to increased intestinal permeability and activating the autoimmune cascade. The rate usage of the food additives has also matched the increased incidence and prevalence of autoimmune diseases during the last few decades. 12

THE GOOD NEWS

The Paleo Diet, clearly more than the meat lover’s way to keep weight off, might be the only solution to avoiding the onslaught of food additives and their effects on our health. Most of these additives can be completely avoided when following the Paleo Diet.13  Further, Paleo food provides important nutrients, often at the therapeutic levels, as well as high levels of Omega 3 fatty acids, all necessary to maintain and repair the intestinal tract.14,15

The current research has barely scratched the surface for fully understanding the effects of food additives exposure on intestinal permeability and autoimmune disease. There is enough evidence for those with autoimmune symptoms or a genetic predisposition to minimize the exposure to all processed foods. The best line of defense for those at risk for autoimmune disease may be following the Paleo diet.

Eat for gut health. Eat Paleo.

 

REFERENCES

[1] Selmi, Carlo. “The worldwide gradient of autoimmune conditions.” Autoimmunity reviews 9.5 (2010): A247-A250.

[2] Okada, H., et al. “The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update.” Clinical & Experimental Immunology 160.1 (2010): 1-9.

[3] Parks, Christine G., et al. “Expert Panel Workshop Consensus Statement on the Role of the Environment in the Development of Autoimmune Disease.”International journal of molecular sciences 15.8 (2014): 14269-14297.

[4] Hollander, Daniel. “Intestinal permeability, leaky gut, and intestinal disorders.”Current gastroenterology reports 1.5 (1999): 410-416.

[5] Diamond, Jared. “Evolutionary design of intestinal nutrient absorption: enough but not too much.” Physiology 6.2 (1991): 92-96.

[6] Fasano, Alessio. “Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer.” Physiological reviews 91.1 (2011): 151-175.

[7] Shanahan, Fergus. “V. Mechanisms of immunologic sensation of intestinal contents.” American Journal of Physiology-Gastrointestinal and Liver Physiology 278.2 (2000): G191-G196.

[8] Fasano, Alessio, et al. “Zonulin, a newly discovered modulator of intestinal permeability, and its expression in coeliac disease.” The Lancet 355.9214 (2000): 1518-1519.

[9] Fasano, Alessio. “Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer.” Physiological reviews 91.1 (2011): 151-175.

[10] Monteiro, Carlos Augusto, et al. “Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil.” Public health nutrition 14.01 (2011): 5-13.

[11] O’Keefe, James H., and Loren Cordain. “Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer.” Mayo Clinic Proceedings. Vol. 79. No. 1. Elsevier, 2004.

[12] A. Vojdani. “A potential link between environmental triggers and autoimmunity.”Autoimmune Diseases 2014.

[13] Lerner, Aaron, and Torsten Matthias. “Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease.” Autoimmunity reviews 14.6 (2015): 479-489.

[14] Li, Yousheng, et al. “Oral glutamine ameliorates chemotherapy-induced changes of intestinal permeability and does not interfere with the antitumor effect of chemotherapy in patients with breast cancer: a prospective randomized trial.” Tumori 92.5 (2006): 396.

[15] Simopoulos, Artemis P. “Omega-3 fatty acids in inflammation and autoimmune diseases.” Journal of the American College of Nutrition 21.6 (2002): 495-505.

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