You're only as healthy as your gut flora

Symptom Relief from GI Issues – Part Two: Foods, Drinks, and Drugs that Inflame

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Streichholz während der Entzündung / Match during inflammation

 

Today I want to continue my discussion of foods, drinks, and drugs that will aggravate an infected and inflamed gastrointestinal mucosa. Resolving inflammatory gut issues will be next to impossible without changes in diet.

Fiber

The last post covered gut bacteria’s well-known ability to produce intestinal gas by fermenting fiber. However, dietary fiber, especially insoluble fiber, has other damaging characteristics.

As I’ve mentioned before, fiber swells to four to five times its size when combined with liquid, any liquid, including acidic gastric juice. It’s the only food you eat that does so.

Now let’s try a thought experiment, shall we? Say you have an abrasion on the back of one hand. This abrasion is red and angry because of the body’s immune response to it. Would you:

A) keep it clean, covered, and free of any irritating substances or would you

B) drive to the local hardware store, buy some sandpaper, dip that sandpaper in an acidic liquid like vinegar or lemon juice, and rub that over the abrasion three or more times a day?

In you answered A, congratulations! You go to the head of the class. If you answered B, you really need to reconsider your practice of banging your head against concrete walls.

Once eaten, acidic-laden and bulked up insoluble fiber slowly scrapes its way through the many twists and turns of the narrow confines of the small intestine, irritating the mucosa along the way. In the colon, it forms dry, hardened, and bulky stool that can further irritate a mucosa in those with colon disorders.

If your intestines are already inflamed by a bacterial or yeast infection, what sense does it make to inflame them further by the equivalent of acidic sandpaper? And if the fiber irritating the intestinal wall is derived from gluten grains, well you’ve really hit the “jackpot”. The opioids in gluten (and certain types of dairy) will make sure that this acidic, gas-producing, scratchy chyme or feces will stay in extended contact with an angry gut wall.

Many “health” authorities consider this a good thing. Typical of this viewpoint is this excerpt from a book titled Digestive Wellness:

For instance, we now know how low-fiber diets lead to digestive disorders found in one out of four Americans. Improvements in bowel function can help prevent diverticulosis, appendicitis, colon polyps, colon cancer, hemorrhoids, and varicose veins. Diets high in soluble fiber are helpful to people with irritable bowel syndrome. Crohn’s disease, hiatal hernia, and peptic ulcer. Dietary fiber also helps prevent obesity by slowing down digestion and the release of glucose and insulin. Fiber has been shown to normalize serum cholesterol levels. High-fiber diets reduce the risk of heart disease, high blood pressure, and certain types of cancer.

And it also makes you young, attractive, and a millionaire too! Just kidding. Is any of this based on actual science or is it just wishful thinking?

In a recent study that examined 2,104 participants, 878 of whom had diverticulitis, researchers concluded:

In this colonoscopy-based study, a high-fiber diet did not protect against asymptomatic diverticulosis. Instead, we found that a high-fiber diet was associated with a higher prevalence of diverticula. The association was both dose-dependent and stronger when limited to cases with >3 diverticula. The risk was increased for total fiber, fiber from grains, soluble fiber, and insoluble fiber. Although constipation is conventionally thought to predispose to diverticulosis, we found that less frequent bowel movements were associated with a decreased prevalence of diverticulosis.

…In conclusion, we found that a high-fiber diet and more frequent bowel movements were associated with an increased rather than a decreased prevalence of diverticulosis. Our data demonstrated no association between fat, red meat, physical activity, and diverticulosis. Based on our results, previous hypotheses regarding diverticulosis risk factors and diet recommendations to patients should be reconsidered. (1)

So much for “Digestive Wellness”. This isn’t surprising to me. Irritating your gut wall and blowing it up like a balloon from fermenting fiber, especially insoluble fiber, isn’t likely to produce good results, as validated by this study. Why not recommend eating wood for GI health? Isn’t that also full of fiber?

And yes, recommendations for increased fiber intake for bowel health most definitely need to be reconsidered. However, if I were you, I wouldn’t hold my farts. Medical and nutritional dogmas die a very slow death in the United States because of powerful vested interests.

The U.S. is, after all, the world’s largest wheat exporter. (2) Any chance that the U.S. government will ever question this dietary dogma either through its Department of Agriculture or its various “health” agencies is slim to none. Throw in the processed food industry and the university nutrition programs they so lavishly endow, and the constituency keeping this nutritional zombie alive is quite formidable.

If you have ANY digestive issues, please put away the psyllium husks, bean casseroles, bran muffins, dried fruit, etc. and give your poor digestive tract a rest. The last thing your inflamed mucosa needs is the gastrointestinal equivalent of a dermabrasion.

Here is the USDA chart for the top 46 fiber-rich foods:

 

Fiber usda

For the full USDA list, click here.

As I mentioned in the last post, the only fiber you should be eating are small doses of soluble fiber like inulinFOS to encourage the growth of beneficial bifidobacteria. Once your gut heals, by all means increase your fiber intake by eating whole fruits and vegetables. However, always be aware of any discomfort or constipation this may cause. Your gut will usually tell you when you’ve overdone it if you just listen.

Alcohol

Alcohol’s devastating effects on the gastrointestinal tract are well documented. Binge drinkers have higher rates of cancers of the mouth, pharynx, larynx, esophagus, colon, and rectum. The more alcohol women drink, the higher the likelihood of developing breast cancer. (3) Alcohol intake has also been linked with higher rates of diverticulitis. (4)

Acetaldehyde, alcohol’s major metabolite, is a recognized carcinogen. It just loves to screw with DNA. Acetaldehyde is not only a byproduct of alcohol metabolism, it also exists in alcoholic beverages. (5)

Alcohol directly irritates and inflames the mucosa of the oral cavity, throat, stomach and small intestine. Elevated blood levels of both alcohol and acetaldehyde affect both the small and large intestine in a negative way by increasing intestinal permeability, endotoxemia and inflammation.

Alcohol also suppresses immune function. As the majority of your immune system is located in your intestinal tract, overdoing alcohol will always increase the risk of bacterial, viral, parasite, and yeast infections in your small intestine and colon. (6)

Binge drinking causes constipation by suppressing intestinal muscle contractions and dehydrating fecal matter. By causing constipation, alcohol, like opioids, guarantees that the gut wall is in extended contact with chyme and feces, irritating an infected mucosa all the more. Alcohol contributes to hemorrhoids and proliferation of rectal cells, which probably explains the high rate of rectal cancer in alcoholics. (7)

I could go on, but I think you get the message. Apart from gluten grains, lectins, and polyunsaturated vegetable oils, I can’t think of a dietary practice more harmful to gut flora and your health than binge drinking.

So to those of you suffering from small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), or inflammatory bowel diseases (IBD) like Crohn’s or ulcerative colitis, alcohol in all but small amounts is not your friend. Sorry.

Foods that Increase Intestinal Permeability

This is a short list. These foods include gluten grains (wheat, barley, rye), foods rich in dietary lectins (processed gluten grains, undercooked legumes, including peanuts), alcohol, and polyunsaturated vegetable oils (corn, safflower, sunflower, soybean, etc.), hydrogenated or not.

For gluten’s effect on the small intestine, see my post here. For plant lectins and their harmful actions on the gut wall see here. And for vegetable oil’s effect on the tight junctions of the digestive tract read this.

I would also caution all of you against consuming non-expeller pressed canola oil. This oil has been touted as “healthy” because it contains omega-3, which typically comprises 10% of its fatty acid content. It also contains 22% omega-6 fatty acids. That would be fine if this oil was never exposed to heat in manufacturing or cooking. Unfortunately, that is not the case as you can see from this YouTube video.

Appetizing isn’t it? Did you notice the steam vapors? Applying heat to polyunsaturated oils (omega-3 and omega-6) ensures that it becomes oxidized even before you buy it in a grocery store.

And what, pray tell, do most people then do with this oxidized canola oil after they buy it? Why they take it home and use it for cooking! Brilliant! This oil is also used extensively for sautéing and frying in restaurants across the country.

The other night I went out to dinner at a very nice restaurant and asked the waitress what oil the kitchen used to fry their French fries. After checking with the chef, she informed me that the cooking oil was a combination of 75% canola and 25% soybean oil. I passed.

Oh, and did you notice the “wash” that the canola oil was subjected to in the video? It’s a solvent called hexane, a chemical widely used to make gasoline and a known carcinogen. All commercial manufacturing of vegetable oils uses this solvent. This oil is “sold” to you as a healthier alternative to saturated animal fat, a fat that has been part of the human diet for hundreds of thousands of years. Sometimes I feel like I live in an alternate universe.

Iron

Pathogens need iron to grow, and that includes the gram-negative gut pathogens that are likely the causes of SIBO, IBS, Crohn’s disease, ulcerative colitis, and colon cancer:

…The acquisition of iron is possibly the major determinant as to whether a microorganism that finds itself within an animal is able to maintain itself therein. Without this ability, it will be unable to grow and will effectively be eliminated by direct attack from the host defense mechanisms or will die of nutrient starvation. The acquisition of iron is recognized as one of the key steps in the development of any pathogen in its host…

Bacteria are pathogenic because, within or on an animal, they have found an environment that provides them with warmth (usually) and nutrients (always). Warmth may not be essential but the nutrients certainly are. The pathogen can acquire all of the nutrients it needs from the host tissue except for one—and that is iron. Supplies of organic carbon are freely available in all fluids and tissues of the body as are nitrogen sources—amino acids, nucleotide bases, etc—sources of phosphate, sulfate, K+, Mg2+, Mn2+, Zn2+, etc. But iron is distinct because it is not a freely available nutrient.

Iron metabolism and pathogenic bacteria

In an infection, the body’s immune system naturally withholds iron. Feeding iron to a person fighting an infection is never recommended because it will increase the growth of bacteria, viruses, and parasites.

Bacterial species that bloom by the addition of iron include: Aeromonas sp., Clostridium sp., Corynebacterium sp., enterobacteria (Escherichia coli, Klebsiella sp., Salmonella sp.), Listeria sp., Neisseria sp., Pasteurella sp., Pseudomonas sp., Staphylococcus sp., Vibrio sp., Yersinia sp, Mycobacterium avium, and Mycobacterium tuberculosis.

Therefore, I do not recommend an iron-rich diet if you are battling or suspect a gastrointestinal infection.

When I was diagnosed with IBS and anemia, my doctor told me to start taking iron pills. Being the obedient little patient that I am, I of course complied. My IBS symptoms worsened. Luckily, I had the good sense to stop taking them.

Now most of you, no doubt, assume that red meat would be the highest source of iron in the diet, which would mostly be true in a world that did not have processed food coming out of its rears. While red meat may need to be temporarily curtailed until you get your infection under control, the number-one source of iron in the typical U.S. diet is from fortified grains:

new iron chart

So not only are Americans getting a healthy dose of gluten when they eat many of these products, but also lots of iron to feed their gut pathogens. Ain’t that convenient?

Rice is also on this top 46 list. Be sure to rinse it well before cooking to wash off the enrichment powder. For the full list of iron content in food, download here. After you resolve your gut issues, by all means feel free to reintroduce whole, non-gluten-grain foods containing iron.

Nightshades

I bring up nightshades last because many people can tolerate them with no problems at all. Nightshades or Solanaceae are part of a family of flowering plants. This family includes mandrake, belladonna, tomatillo, cape gooseberry flower, chili pepper, bell pepper, potato, tomato, eggplant, tobacco, and petunia. Edible nightshades contain alkaloids that can be very irritating to the gastrointestinal mucosa and are therefore capable of increasing intestinal permeability and endotoxemia.

My experience with edible nightshades varies. Sometimes they bother me and other times they don’t. Like all vegetables, this is probably due to the amount of irritating alkaloids they contain, how much I’ve eaten at one sitting, and how long it has been since they were harvested. I find peppers (spicy or not) and raw tomatoes to be a problem. I’m usually OK with a standard sized-baked potato, but if I eat a lot of potatoes, I’ll get a slight headache and insomnia.

If you have digestive issues, you may want to steer clear of these vegetables for the time being until you get things under control.

Drugs

The list of drugs, both legal and illegal that negatively impact gut health is long. This is not an area of expertise for me so please check with your pharmacist for any side effects for the medications you’re taking. Be aware that some pharmaceutical drugs have gluten in them so be sure to check for this as well.

Of the common drugs taken, the following are known gut irritants: aspirin, non-steroidal anti-inflammatories (NSAIDS) like ibuprofen, digitalis, steroid-based drugs, caffeine, and of course alcohol. Drugs that cause intestinal bleeding can be found here. Consult your physician or pharmacist for alternatives.

Opioids are also a big problem as they always cause constipation by impairing gastrointestinal movement. Constipation is not your friend as you don’t want to encourage prolonged contact of an inflamed gut wall with partially digested food or feces. Again, consultation with your physician or pharmacist may be necessary to explore alternatives.

If you are an illegal opiate user, well, all I can say is don’t forget Kurt Cobain of Nirvana fame. He suffered from horrible stomach and GI issues that he self medicated with heroin. While it relieved the pain, it would have made his gastrointestinal dysbiosis worse, not better. We all know how tragically that story ended.

I want to conclude by saying that these recommendations are about calming intestinal inflammation, not necessarily curing it. You’ll still need to clear up the underlying bacterial, viral, yeast, and/or parasitic infection causing your gut issues. That will require drugs (herbal or pharmaceutical) and recolonizing your intestinal tract with friendly gut flora by taking probiotics, prebiotics, and eating fermented foods rich in beneficial organisms.

 

References:

Lipski, E. (2004) Digestive Wellness. New York: McGraw-Hill.

Ratledge C. and Dovar L. G. (2000) Iron Metabolism and Pathogenic Bacteria. Annual Review of Microbiology, 54: 881-941.

8 Responses to Symptom Relief from GI Issues – Part Two: Foods, Drinks, and Drugs that Inflame

    • Ray Medina says:

      Hi Gonçalo,

      Yes, I am aware of gluten cross-reactivity. One person commented in a past post on their inability to tolerate coffee because of this. Elimination diets can be quite effective at pinpointing a problem food, far better than a test in my opinion.

  • Matt says:

    Hey chap

    Enjoying your posts thus far. In this series will you be moving onto foods/supplements that are anti inflammatory and have more of a soothing/repair action? Interested to hear your take on non nightshade spices such as turmeric that are known to have an anti-inflammatory action. And also triphala, although that might be outside your realm of knowledge.

    I’m a little like yourself with regards to night shades. Tomatoes and peppers will put me a spin whereas white potatoes, small amounts of black pepper, even chilli have less of an affect.

    • Ray Medina says:

      Hi Matt,

      Thanks for commenting.

      No, I’ve decided against doing that. There are many supplements that can temporarily soothe an inflamed GI tract like DGL, aloe vera, slippery elm, peppermint oil, etc. However, at the end of the day, these supplements, like many of the dietary changes I suggested, are just dealing with symptoms. The underlying infection needs to be identified and dealt with.

  • Steinalder says:

    Hi from Norway!
    Really interesting site! Im a woman of 49. After 11 months on a grain/dairy/sugar/fruit free diet, I am still struggling with gut problems. In Dec I took antibiotics for bacteria (Citrobakter Braakii) and some tablets for yeast overgrowth (not candida), but Im still having cramps and can’t digest a lot of foods, for instance fruits, nuts and berries are not possible. And fiber – huge problem! I have problem with bloating, cramps and constipation, especially the latter after the antibiotics. Before the antibiotics I had loose bowel for the most part. I have eaten probiotics for a long time now (not prebiotics as my stomach reacts to that immediately), digestive enzymes and now lately also HCL (because of hearturn). After two months on the new diet I could stop the medication with Levaxin for my thyroid. So low carb has been lifesaving for me, also for my thyroid. And the fibromyalgia is gone too. I still have joint pain in some of my fingers. I think the problem of leaky gut is still there, and I’ve started to react to coconut milk/fat now; I cough and sneeze and my sore throut is possibly due to this (or maybe because I lack stomach acid?). I am now going (finally) to check my gut (gastroscopy) and check for CD. (I have had problems with my stomach all my life). I was tested for food intolerances last summer and I can’t have gluten, dairy egg whites, Brazil nuts and potatoes. I don’t drink coffee aymore (gives me pain in the right leg). Do you have any ideas as what is the best approach to heal my gut other than what I have already done? I eat mostly lamb, elk and reindeer and trout. No processed food at all. I would like to be able to eat my maccadamia nuts again, but as of now I can’t digeste them either. I have reintroduced egg yolks after 6 months without eggs. My biggest concern is that I don’t have many sources of FAT and now that coconut oil is gone, I am worried that my fat intake will be too low. Thank you for a very interesting site!

    • Ray Medina says:

      Hello and thanks for sharing your experience.

      I would not overly concern myself with the fat content of your food. You are getting plenty of fat from the meat and fish you eat. Beef, but especially grass-fed beef, would be another excellent choice. However, you may need to watch your intake of iron until you get a handle on this.

      You should be fine using olive oil and butter for light sauteing. If you clarify the butter (ghee) you can use this for most of your cooking needs. Butter contains butyric acid which is what colon cells use for energy. It helps prevent intestinal permeability from that part of the intestinal tract. Beef tallow also works very well for high temperature cooking. That said, stewed, steamed, and gently cooked meats will be easiest on your digestive tract. Bone broths are also a very good choice for an inflamed gut. I personally eat Vietnamese Pho once a week with all the gelatinous bits.

      I’m concerned with your low-carb diet. I didn’t begin to heal my gut until I increased starches in my diet. I suspect part of my problem was glucose insufficiency. If your liver is under a lot of inflammatory stress from endotoxemia, it will have a very hard time producing adequate glucose from protein. You then risk a compromised gut barrier due to not having enough glucose to replenish the mucus layer of your GI tract.

      Another complication of very low carb diets is euthyroid sick syndrome. By failing to convert T4 to T3 thyroid hormone in the liver, intestinal peristalsis will slow and predispose to constipation and small intestinal bacterial overgrowth. Not all carbs are bad for you. The worst offenders are gluten grains which you appear to have banished from your life. FODMAP carbs come next followed by nightshades.

      You mentioned that potatoes are a problem which I suspect is due to the fact that they are a member of the nightshade family. You should be able to tolerate sweet potatoes, yams, taro and other non-potato starchy tubers. These should be the major part of your carb calories with butter mixed in for flavor and to prevent insulin spikes.

      I’m a big fan of white rice as long as it comes from a country that has no known arsenic issues with their rice. In Norway I would imagine you can easily find rice grown in Asia. Stay away from rice grown in the United States unless from California. Rice grown in the American South has elevated levels of arsenic due to past use of pesticides to grow cotton on land that now grows rice.

      Increasing your glucose intake from safe carb sources should be a priority for you. Your thyroid issues were caused by gluten proteins, not carbs. I recommend reading The Perfect Health Diet for more info on safe starches. There is a Kindle edition of the book available through Amazon.com. A link to this book is available in the sidebar.

      You need to continue taking probiotics. Unfortunately, most on the market are crap, pure and simple. The first problem is that most rely on enteric-coated capsules to survive stomach acid. Sorry to say, this is not a very effective way to deliver viable organisms to the intestines.

      Second issue is refrigeration. Try to find a probiotic that is temperature stable or you know was kept refrigerated the entire time after production. This latter recommendation can be difficult to meet. If you rely on refrigerated probiotics, try to find one that is sold by the manufacturer directly to the customer. Once you introduce the middle men of wholesale and retail distribution, chances are high that the refrigerated probiotics you buy are dead by the time you take them.

      Another option is to make kefir from the freshest milk you can find. There is plenty of information on the web on how to do this. However, you may not be able to tolerate it because of the ongoing inflammation in your gut. While fermenting milk does help predigest casein, in my experience it wasn’t broken down enough to prevent me from having issues with it.

      Some claim that kefir made from coconut water works for them, but I have my doubts. Milk proteins seem to have a unique capacity to ensure survival of beneficial strains through the environment of the stomach unlike coconut water.

      I recognize that prebiotics can cause discomfort, but I would reconsider that decision if I were you. Prebiotics will help encourage the growth of beneficial bifidobacteria in your colon. My advice is to use a prebiotic powder, but start with a quarter of the dosage mixed in water. You’ll find that after a while, you can tolerate the full dose.

      Good luck!

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