Mucous-ugh. Mucous Layer in the Gut- Yahhh!

When the word mucous is read or heard in some ad, a negative image immediately comes to mind. A runny nose, throat phlegm, something sticky and yucky. But there is another meaning and role of mucous that occurs within our gut throughout our entire life.

Mucous is, indeed, a sticky material. Thank goodness for that! It is secreted by certain cells that line the bowel and it covers the entire surface of the intestine. It is especially thick in the lower intestine and colon where there are huge numbers of bacteria, a few of which are bad ones and are ready to invade the colon.This mucous lining is our first line of defense against certain bad bacteria bugs that reside in our gut.

The technical name for this barrier is the biofilm, a veritable film that covers the lining of the gut. There is a lot that can be done to increase the health of the mucous layer in the gut. Eating a diet high in fruits and vegetables is key. This type of diet promotes the growth of certain bacteria that make that this biofilm healthier. Many of these foods contain prebiotics. A prebiotic is certain type of food fiber that is especially effective in promoting a healthy mucous layer in the gut. These prebiotics can also be obtained as a supplement. One such supplement is Prebiotin which can be found at http://www.prebiotin.com.

I will comment more about this mucous layer or biofilm and how it is so important in Crohns Disease and the “leaky gut”. Stay tuned for further comments.

Astrophysics of the Colon?

I just spent a great 12 hour day at a gala symposium at Arizona Sate University in Tempe on Origins. It was a scientific extravaganza extraordinaire, looking at all aspects of our planet, our own solar system, our entire cosmos and, of course, us humans ourselves. These and the archived videos of the sessions are and will all be available at asu.edu. Search out Origins Symposium.

70 of the world's leading scientists, including 6 Nobel prize winners were on the program. The world famous astrophysicist Stephen Hawkins was to attend but had to give an audio presentation instead as he became ill and could not attend. It was, perhaps, the greatest collection of such scientists ever gathered for such a symposium.

Some of the information they shared was simply beyond understanding for us mere mortals who raptly sat at the feet of these giants. However, what was totally understandable by the 3,000 of us in the audience (how about that for a conference that ran 12 hours right through the March Madness final game!) was the sheer joy of discovery that was so evident to these experts and that came across so clearly to us.

So what did it all mean to me? Well, I am a retired gastroenterologist. I haven't retired, however. I have simply shifted gears into high drive to better understand the enormous new discoveries that have occurred about the workings of our own bodies and, especially, how the bacteria within our gut have turned out to be such loving buddies and such health producing partners. Who could have predicted it? We simply take care of them and make them healthy by supplying them with the right nourishment and they, in turn, do the same for us.

There are some enormous projects being followed in this area even today. The Gastrointestinal Microbiome is one whereby the entire gene makeup of all the bacteria in the gut is to be determined and understood. There are enormous implications from this project alone. It is certain that what we know now is just the first chapter in a wonderful scientific adventure story.

So, how do I and my readers fit in? Well, my skills are in the GI field. They are also in the field of communicating the complex workings of the GI tract in health and disease to my patients. This is what is so exciting. There is simply so much to tell and it is not just of academic interest. What a cosmic physicist tells us really does not have any practical importance to us individually: Let's face it. However, how the gut works in each of us can have a very important outcome to our personal well being.

That is rather neat. I don't really understand cosmic physics, string theory or how the atom works very well, but I do understand the excitement of discovery and the thrill of telling others of practical things they can do to make their lives and health better. I look forward to continuing to share these discoveries in my own field of gastroenterology with you.

Our major international meeting of Digestive Disease Week is in Chicago this May-June. Last year there was just a breakfast meeting on Prebiotics and Probiotics. This year there is an 8 hour session with lots of other presentations. The field has come a long way in a short time. We are in an information overflow, so stay tuned.

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!)

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 you 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!

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

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