Wednesday, March 18, 2009

Prebiotic Comments & Questions from Friends & Family

We now get many such comments and questions from friends. Many are so worthwhile that I put them up here for every one to see.

ANTIBIOTICS, PROBIOTICS and PREBIOTICS
Q- Should I take probiotics and prebiotics when I take on oral antibiotic?

A- Yes, I think I would. A year ago I was uncertain. Now there is enough info getting into the medical literature and practice of medicine, that the potential benefit may outweigh the uncertainty. More to the specifics:
    
Probiotics

Select the ones that have the highest amounts of:
  • Bifdo logum
  • Bifido rhamnosus
  • Strepto salivarious
  • Saccharomyces boulardi
Use twice a day. (Sorry about the technical names. You can get a full essay at Probiotics)

Prebiotics

Our oligofructose enriched inulin prebiotic fiber supplement (Prebiotin) is the best. I would use2 grams twice a day

When the antibiotic course is concluded, I would use the above for at least 1 week and then continue Prebiotin indefinitely

FINGERNAILS and TOENAILS

Since I have personally been on Prebiotin, I have been quite surprised at the growth and strength of my nails. I have checked with my colleagues and they say the same thing. A person from California says "stronger fingernails". Finally, I have a long standing fungus infection in one toenail. which appears to be clearing.

I have no idea how this may occur or even if there is any effect with Prebiotin. We do know that when the bacteria factory within our colon is functioning optimally, that health benefits occur beyond the colon. Could our finger and toenails be one such benefit? It has not been proven yet, but it will be fun to wait and see.

PERIODONTAL DISEASE

A close friend of mine has been on Prebiotin for over a year. She reports that her periodontist has been amazed that the pockets around some of her teeth have been gradually closing. These pockets of of periodontal disease are caused by bad bacteria getting into these crevices. Could swallowed prebiotics in some manner stimulate "good" bacteria to grow at these sites and displace the bad ones? At this time we can only guess at this possibility since there is no reported research yet in the medical literature. However, since there is no downside to taking these naturally occuring fibers, I would say go for it! Let us know what happens.

ULCERATIVE COLITIS

An attorney friend of mine with ulcerative colitis has told me that since taking Prebiotin, he has been able to reduce his medication, he no longer has foul flatus smell and that he just feels better. How this happens is becoming clear to me. Hydrogen sulfide is the very smelly and nasty gas that is made by certain colon bacteria. Remarkably, almost all UC patients make this gas, so there is something special here. There is suspicion that this toxic gas actually promotes damage to the colon wall in some manner.

These bugs need a neutral enviornment to grow and produce this gas. The do not grow in acid conditions. Prebiotics and more specifically Prebiotin produce beneficial acid substances and so reduce the growth the growth of these bad bugs. We need further good research here, but were I still in practice I would place all my UC patients on Prebiotin along with their standard medical program. There is virtually no downside and, who knows, there may be a significant benefit.
  • From Florida: "I love how Prebiotin has helped my daughter's ulcerative colitis".
  • From Minnesota; "I was diagnosed with colitis.... my symptoms went away and have not returned"
  • From North Carolina: "It helps my ulcerative colitis symptoms"
CROHNS DISEASE

Crohns disease starts with bad colon bacteria invading the wall of the lower small intestine and/or the colon. We now know who these nasty guys are. When prebiotics such as Prebiotin are taken, certain substances called short chain fatty acids are formed by the good bacteria. In additional to these substances being very good for the nutrition of the colon wall itself, they seem to change the makeup of the bacteria next to the colon wall. The good bacteria grow and the bad ones do not. 

Will this be a benefit for the Crohns patient? We will have to wait and see, but there are researchers who are cautiously optimistic. As with ulcerative colitis were I still in practice I would advise my Crohns patients to try adding these natural plant fibers to their medical program.
  • A Prebiotin user from Pennsylvania says "not as many flare-ups of my Crohns".
We get many other positive comments, but I will save these for another day.

Frank Jackson MD

Friday, March 13, 2009

A Layman's Guide to Flatus (AKA Farting)

When I was practising gastroenterology, no subject came up for discussion more often than gas, farting and flatus. Everybody has it but no one talks about it. So here is some up to date medical information on Gas, Farting and Flatus.

The colon is home to myriad numbers of bacteria, most of which provide numerous health benefits to our colon and to our body in general. It is in our own health interest to keep this bacteria factory operating at peak efficiency. Most of the bugs rely on soluble fiber plant food for their own nourishment and growth. No problem here. This is why eating lots of veggies, whole grains and fruits is so good for us. So, it is important to know that bacteria are a normal and healthy part of our colon. 

Now our best friends in the colon are the Bifido and Lacto bacteria (Relax, you don't need to know the technical names). These guys and gals do not make gases. They only do good things for us. However, there are other bacteria in the right side of the colon that ferment these same plant fibers and do make lots of hydrogen gas. We would rather they didn't but they do and you just have to accept this fact that really can not be changed. The good news is that Hydrogen gas is completely odorless. So you may "toot" but you won't reek. So far so good. 

But stay with me here. What happens when this hydrogen gas moves around to the left side of the colon? 

Ahh, here is where 2 diabolical characters do their work. The first are the sulfide producing bugs. They take the arriving hydrogen gas and convert it into hydrogen sulfide (H2S). This is what gives flatus its foul smell. This rotten egg type gas is the source of jokes and great merriment. However, there is really nothing funny about H2S. In fact, in equal concentrations it is as deadly as hydrogen cyanide! Could this be the reason for so much talk about "deadly farts?" Humm. Well, H2S offends our nostrils, but for most of us that is the end of it, if you will excuse the pun.  

A second type of bacteria in the left colon metabolize this hydrogen gas to make odorless methane gas. Yes, methane is the gas that some of your high school jock friends light in the gym locker room. It was called lighting farts in my day. As fun as that may have been, we now know that methane, compared to H2S, is harmless from a health standpoint.

So, here are some key points. 

  1. Flatus is normal and is proof that you are feeding your good Bifido and Lacto friends adequately. 
  2. The normal number of farts per day is somewhere around 12 with females going down to 7 and beer drinking, meat eating males reaching 20 or so. 
  3. There is great variation and a lot depends on what and the amount you eat.

Can you get rid of the fart smell? Yes, you can. Certain prebiotic fibers in plant food cause the good bacteria to make certain acid substances, which in turn make the sulfide forming bacteria stop growing and so stop making these smelly gases. These prebiotic fibers are particularly present in avocados, onions, garlic, bananas, artichoke. agave, and wild jams. Americans really eat very small amounts of these plants and so get a low amount of these fibers. Of course, they are the active prebiotic fibers in our Prebiotin supplement, and as always I encourage you to visit http://www.jacksongi.com and learn more for yourself - maybe even consider adding Prebiotin to your dietary regimen

The proof-in-the-pudding is this: My friends and I as well as many customers find that their flatus no longer has any smell after taking these supplements and increasing these foods. Our CEO even 'took over' a page on the Jacksongi.com site to talk about his experience in "sinking the stink" of his flatus using Prebiotin. (He thinks I don't know, but it's definitely worth a read). 

So, the good news is there is something you can do about the ill smell of farts. 

But, can you change the volume of flatus? For certain you should increase the prebiotic fibers in the foods you eat. These and our Prebiotin supplement can be used until your flatus has no smell. They can and should be increased until the volume of flatus is within your tolerable range.  

I will close with a quote from Ben Franklin in a parody essay he wrote in 1781.

"My Prize Question therefore should be, To discover some Drug wholesome & not disagreable, to be mixed with our common Food, or Sauces, that shall render the natural discharges of Wind from our bodies, not only inoffensive, but agreable as Perfumes."

Well, prebiotic food fibers and our Prebiotin will not change the smell of flatus into a perfume, but at least we can render it odor-free. I would therefore salute my fellow Pennsylvanian Ben Franklin and tell his spirit that we have gone half way in his quest. Even now we are working on genetically inserting the smell of a lavender plant into colon bacteria to produce lavender farts. (Just kidding!)

Monday, March 2, 2009

Crohn's Disease - Important New Information

There are bugs in your colon that are your friends. There are also some bugs that you do not want there. They seem to be the ones that cause inflammation problems for Crohns patients.

We gastroenterology physicians have always known that colon bacteria play a key role in Crohns Disease. No bugs, no inflammation. We now know a lot more about Crohns and how the different types of colon bacteria may effect the disease. This new information is a bit startling in as much as it finally may allow Crohns patients to more fully participate in their own well-being by managing their diet in a more scoience based manner. You are referred to my full essay
Dietary Therapy for Crohns Disease.

The most important fact to understand is that y
ou want to enhance the growth of good colon bacteria and retard that of the bad ones, the ones that are likely the injurious ones

How do you do that? Medical research is now giving us some answers. We now know that the beneficial bugs, primarily the Bifidobacter and Lactobacillus, thrive when we eat enough of foods that are rich in prebiotic fibers. (For my detailed description, go to Prebiotics.) 

Eating enough of these foods and taking a prebiotic supplement is likely an important part of therapy along with the recommendations of your physician. 

Let me outline 5 major important points for Crohns patients, points that are new and not yet widely known by patients.

  1. Bad Bugs-Good Bugs. Crohns patients have a significant increase in the bad bacteria that adhere to the colon wall. This is where bacteria invade the intestine. Adequate prebiotic fibers can change this make up by reducing the bad actors and increasing the good ones, the ones that do not cause inflammation.

  2. A Leaky Gut. We now know that CD people have abnormal spaces between the lining cells of the colon. This almost certainly is the place where these invading bugs enter the colon and small bowel. Prebiotics act to tighten up these spaces and, hopefully, preventing inflammation from occuring.

  3. Spectacular Short Chain Fatty Acids. When the good bacteria, the Bifidos and Lactos, thrive, they generate short chain fatty acids (SCFA), a substance that helps nourish the colon's own cells. In addition it seems to act like a fire hose, significantly reducing inflammation.

  4. Impressive Immune Boost. Prebiotic food fibers also increase certain immune substances within the bowel wall. This enhanced local immunity seems to be useful in further reducing inflammation.

  5. Amazing Acidity. Increasing acidity within the colon reduces and even stops certain of the nasty bacteria in the bowel from growing, the ones we feel are part of the disease. You can not acidify the colon by eating acid foods like citrus fruit. You can do it by eating prebiotic containing foods or supplements. These, in turn, cause the production of SCFAs which are acid and seem to exert this good effect in the colon.
There is evidence in the medical literature to support the above.  Some is not as firmly established as we would wish, but most of it is going in the right direction. The fact that making major changes in the eating patterns of Crohns patients could significantly improve their disease is startling to those of us who have been reading the medical literature and who have treated so many of these patients in the past. 

Our Prebiotin product can provide a regular dose of prebiotics each day. 

In the past it seemed that diet was not particularly important and we usually recommended that patients just eat what agreed with them, whatever that was. Now we seem to be at a threshold where patients can become active participants in their own therapy. What a remarkable and welcomed fact that is!