Important new information on Ulcerative Colitis

THE SHORT VERSION

The smelly flatus that most ulcerative colitis (UC) patients have is not merely an embarassment or annoyance, it is likely a real problem. 

The malodorous scent comes from hydrogen sulfide (H₂S), a gas made by certain nasty bacteria in the colon. In addition to being very pungent, hydrogen sulfide is also very toxic - as deadly as hydrogen cyanide in the same concentrations! 

Now there is evidence to show that ulcerative colitis patients don't seem to handle H2S very well. Many medical researchers now feel that H2S damages the colon's cells in those people who are genetically susceptible to UC. So, it makes sense to get rid of H2S if at all possible. 

And now, we know how this is possible:

First, reduce sulfate or sulfur in the diet. Your colon bacteria can not make hydrogen sulfide without getting lots of sulfur from the foods you eat. You can learn which foods are high in sulfur by going to my essay Dietary Therapy for Ulcerative Colitis.  Specifically, meats are very high in certain amino acids that contain sulfur. So reduce meats and other animal protein in your diet very significantly. If it were me, I would stop them entirely for a month or so. Cruciferous veggies (broccoli, cabbage, Brussel sprouts et al) are also high in sulfur. Alas, these very healthy foods may be contributing to H2S production in the colon. So, I would stop these, too, for 8 weeks.

Second: acidify your colon. I know that between heart-burn, acid-reflux and such, people have a poor perception of "acid" - but in the colon, an acidic environment is a good thing. The colon bugs that make hydrogen sulfide need a neutral environment to grow. If there is a lot of acid around, they do not grow and make H2S. Pretty simple. 

How do you do this? Not by eating acid foods such as citrus fruit. You do this by inducing beneficial bacteria in your colon - the Bifidobacter and the Lactobacillus ones - to make acid substances called short chain fatty acids (SCFA).

These SCFAs are incredibly useful substances in the colon, especially for ulcerative colitis patients. They are the very nutrients that the colon's own cells use for healthy growth. So, by stimulating the growth of these Bifido and Lacto good guys, you prevent the formation of H2S and you also nourish your own colon cells, the very ones that are damaged in ulcerative colitis. The best way to do this is to consume a good amount of prebiotic fiber. (Prebiotics are the plant fibers that these good bacteria use to grow themselves.) I recommend a daily dose of Prebiotin for this purpose.

Which brings me to oligofructose enriched inulin: Prebiotin. These special plant food fibers do the trick. 

In my experience and those of my family and friends, the maloderous smell of flatus simply disappears, indicating that H2S is no longer being produced - a nice benefit even for those of us without ulcerative colitis. But more important than this is that my friends who have ulcerative colitis have seen very significant improvement in their symptoms when they did these two things-reduce high sulfur containing foods in their diet and take Prebiotin to acidify their colon. 

So, this is what current medical research is showing us. Were I, a trained gastroenterologist, still in practice, I would start every ulcerative colitis patient on this very simple dietary program and a daily prebiotin regimen. Simply by smelling their flatus, a patient could tell if they are having a good effect. 

The fact is that most GI doctors now know that bacteria bugs in the colon are a major factor in ulcerative colitis, but till now we did not know exactly how this happened. Now, I think we do. 

So this is the "short version" of my own dietary treatment for UC patients. In the near future I will write a longer version which will address the medical evidence to support the above recommendations. Most people, I suspect,  just want to know what will work and what are the side effects. There are no side effects with prebiotics except an increase in the volume of odorless flatus if too much prebiotic is taken. Simply cut back to an acceptable level. 

I would dearly love to hear from UC patients who give this program a try. You should know that you may be on the cutting edge a very new and effective, additional way to treat this very troublesome disorder. What an amazing idea! Taking dietary control of your own medical problem!

Global (Gut) Warming

After retiring from an active career in gastroenterology several years ago, I've had the time to think through my own training and what I really knew about the gut. I knew oceans about diseases, endoscopy and the complex drugs and treatments we used. However, there just wasn't much time to think through the fine points of basic intestinal health and nutrition. 

These topics were always on our course agendas but, frankly, they were not very sexy, compared to highly technical treatments and procedures with which we dealt every day. Further, there just was not enough time to think through the very basics of the gut. It seemed pretty simple. You put decent food in one end and waste came out the other. Patients always implored me to tell them more about what they should eat and how to manage their nutrition. Aside from the obvious of recommending lots of fiber, lesser animal, saturated fats and weight control, there did not seem much more to say.

Now I am away from caring for individual patients, away from the endoscopes, away from the frantic hospital work, and, yes, away from the burden of the unending paper burden of insurance and regulators. I have remained deeply interested in quality care in medicine. I have become a medical literature mole, ferreting out  some startling new areas in our field of gastroenterology. What I have discovered and what is still not fully appreciated by my disease and procedure oriented colleagues ( I was one myself, I confess) is that the gut is a thing of beauty. The colon itself is a true health organ, providing myriad health benefits if it is just treated right. (See my article: A Wonderful Colon for more on this).

If I can borrow an analogy, I view our gut very much as we, the media and the government view the environment, climate warming and our very precious earth. We know we must clean it up and, hopefully, this is slowly happening. For too long we have treated our gut the same way, not considering the foods we put into it. If it tasted good, that was the only criteria for good nutrition for many of us. Now we know so much more about intestinal function within us in much the same way that we know about CO2 and pollutants in the air we breath. 

The colon in particular, always in the past viewed as nothing but a waste receptacle, is now known to be a health producing organ that is filled with huge numbers of healthy and some not so healthy bacteria. Feeding it correctly tilts the bacteria balance in many healthy ways. Plant prebiotics are the center piece of this new knowledge. Probiotics are likely of some benefit as well.

So, this will begin a series of blog talks and interchanges with you the public. I will speak to many gastrointestinal disorders such as diverticulosis, irritable bowel syndrome, constipation, colon and other cancers. osteoporosis (yes, there is a colon component here), Crohns Disease, Ulcerative Colitis and others. Do you have a GI topic you would like me to discuss?

I have really not retired from practice. I have simply moved away from private patient care to public gastrointestinal care. I wish to provide the best dietary advise by a trained gastroenterologist who spends time almost every day searching the medical literature and conversing with my colleagues for that which is helpful to you.

Keep tuned

Frank W Jackson MD

Overdue Intro

In reviewing my first couple posts, I realize I never really kicked off this blog - I rather just 'jumped in'. So let's rectify that:

OK, I am a trained gastroenterolgist MD, but a total amateur in the blogoshere. So I now tip my toe in the waters of the blog.

I am the founder of Jackson GI Medical (http://www.jacksongi.com). By founder I mean I wrote all the copy on the site, vouch for its accuracy and medical credibility, helped direct the creation of the web site and brought our first product, Prebiotin, to the e-commerce market. Then it got really hard and, frankly, less interesting. Running a company was just totally different from coming up with good medically sound ideas and writing for the public and patients.

Enter Kris Chronister (http://krischronister.blogspot.com). By an incredibly happy coincidence we met some time ago. Now we are a solid team. His skills and vision on running a company merged very well with mine.

The idea of bringing medically credible dietary info and products to the public and patients alike was a natural for both of us. So, he is now the CEO and I am now back in the laboratory and at my desk where I can use my own skills to the best of all our advantage-both you the public and we the company.

My plan is to get solid good dietary information to the the healthy public as well as to gastroenterology patients. For sure, I will speak in a very easily understandable manner on how the gut works and what we all can do to make it support us and keep us healthy. I can not speak to any specific person about their medical problems. That just doesn't work on the blog, professionally speaking.

But I do want to hear from the public with their own comments, opinions and general dietary questions. I promise to provide good information supported by medical facts and evidence to the extent it is available.

My next blog topics in no particular order will be:

• Peanut butter and the gut
  
• The new era of prebiotics
  
• Crohns disease and prebiotic fiber
  
• Whatever happened to natural fiber ( why has fiber become a buzz word for good health?)
  
• Ulcerative colitis and prebiotic fiber
  
• Prebiotics fibers and appetite/weight loss ( I promise no hype or lies!)
  
• Cancer (many kinds), polyps, diet and fiber.
  
• Diverticulosis- why do we get this disorder and what can we do we do about it?
  

Ok, this is a start. If you have topics you would like me to address, please let me know.

So stay tuned to my blog - and to Jacksongi.com. We have several new products in the design stage which will provide solid health benefits without the hype.

Frank W Jackson, MD
Gastroenterologist

Gut Immunity: Fact and Fiction

If you haven't noticed, many of the packaged foods and probiotic bacteria products we buy are touting "enhancement of the immune system" as a reason to buy these products. They make it sound like our own natural immune system is just not good enough and that it needs an extra kick that their products will provide. What do we make of all this? 

Everyone has an immune system. Without it the bacteria and viruses outside and inside would simply overwhelm us at an early age, like in infancy. Our immune system depends on our body's ability to make antibodies and certain other factors to fight and defeat these bugs. These are made in our lymph glands and, early in life, the thymus gland. However, a major part of the immune system resides in the intestinal tract. This is as it should be. The colon is home to a huge number of bacteria and some of these fellows are nasty. Our immune system, in the wall of the intestine and especially the large bowel or colon, protects us. 

A quite remarkable recent research finding is that some of these bacteria, when stimulated vigorously to grow, produce certain substances that, in turn, actually appear to make the bowel wall more resistant and stronger. The contents of the colon actually become more acid and this is likely the reason why. 

So, what stimulates the good colon bacteria? It is actually the foods that we eat, especially plant foods. These foods contain certain fibers, now known as prebiotic plant fibers that are the food source for these good bacteria. Vegetables, grains and fruits are loaded with these healthy fibers. 

But back to the original question. Does "enhancing" the immune system by ingesting vitamins, herbs or probiotics really do anything? And is this important? 

The answer to the first question is probably yes. Researchers who have done research on the bowel wall have found that when certain bacterial species, especially the Bifido (Bifidobacter) species, are increased in the colon, then indeed some increase in certain immune factors is seen. This has been seen when both prebiotic plant fibers and probiotic bacteria are fed to animals and in some instances to humans as well. 

The answer to the second question is uncertain at best. We simply do not know if this very small increase in immune factors in the colon in the otherwise healthy person results in fewer colds, other respiratory conditions or any other infection. In other words, if these immune factors increase by 1% or so, are we healthier for it? 

My educated guess is that the answer will be no, if an answer is ever obtained. Simply eating 25-35 grams of a mixed group of vegetables, grains and fruits each day will almost certainly give you the stimulus to your friendly Bifido colon bacteria and keep your immune system "enhanced" just fine. Taking anything beyond is likely not harmful, but it also is likely not very helpful either. 

Of course, for those who eat less than this amount, you should visit Jacksongi.com for Prebiotin prebiotic soluble fiber supplements

Our Friends, the Bacteria

Below is a link to a New England Journal of Medicine article this week. Family members Wilson and Matt are the 2 docs in the trenches who I urge to respond to my comments.

For those non-medical people, read the first and last few paragraphs of the article anyway. These give the main points. I remain a post-doc out in the pasture eating alfalfa (very good for cattle's bowels I am told). As you all know, I am now intensely interest in prebiotics and the gut microbiota, the glorious cauldron of gut microbes. But, this is a serious memo to friends and family.

If there were ever any proof needed of the power of evolution, what bacteria have shown us is the best (or worst) example. They have simply evolved to defeat whatever humans have come up with to counter them. We are possibly on the precipice of some very bad things happening.

Now that I no longer am part of the active medical community and, especially, since I am a confirmed advocate of natural responses (to the extent possible) to those things that we will not be able to change - e.g. bacterial resistance to our increasingly toxic antibiotic drugs - I pass these thoughts and recommendations on for what they are worth.

1. Most bacteria are our friends-cherish them

2. Bacteria are everywhere-air, skin, nose, mouth, every part of the gut, urinary and vaginal tract-everywhere. They are at the top of the highest mountains and the bottom of deepest seas. They were here billions of years before we arrived. They produced the oxygen in the air that we breath. They are our buddies. We want to keep the good ones very close.

3. Maintain your good skin bacteria. When bathing, use soap sparingly. Avoid "antibacterial" soaps - the A-Bomb of washing yourself. If the good skin bacteria are excessively washed away, guess who will come to dinner?

4. Maintain a flourishing collection of good gut bacteria. How?...

5. Eat 25-35 gms of veggies, fruits and whole grains each day. And make sure to take your Prebiotin with the prebiotic fibers that nourish just the probiotic good bacteria in the gut - the ones we want to keep there.

6. Absolutely avoid "detox" regimines. Your body does just fine getting rid of most of the nasty stuff we encounter. Further, you can never "cleanse" your gut nor would you want to. No regular high colonic enemas.

7. Avoid antibiotics to the extent you can. Most antibiotics kill bacteria almost everywhere in body along with bad ones we take then for. When the good ones are gone-- yep, you guessed it.

8. If you have ever had MRSA, get your nose cultured. Your pet, too. You and they may be carriers.

Bottom line - protect the good bacteria inside and outside your body, they are your friends.

Whether you call me Dr. Frank, Dad, Uncle Frank or simply friend I urge you to consider this.

----- Forwarded Message -----
From: "Frank Jackson"
Sent: Thursday, January 29, 2009 9:15:18 PM GMT -05:00 US/Canada Eastern
Subject: An article from The New England Journal of Medicine

Dr. Frank Jackson wants to notify you about thefollowing article from The New England Journal of Medicine:

Antibiotic-Resistant Bugs in the 21st Century -- A Clinical Super-Challenge: http://content.nejm.org/cgi/content/short/360/5/439??eaf