Tuesday, May 18, 2010

Grow the Garden

Gut flora sounds so much nicer than intestinal bacteria, don't you think? So many people think of the intestine as a sewer system when in fact it is an amazing garden of diverse micro-organisms and the center of a healthy life.

Like growing a garden, cultivating healthy gut flora can be a slow process. And, yet, bad diet, illness or medicines of mass destruction can destroy it as quickly as the aerial spraying of Agent Orange can wipe out an ancient forest.

Most depictions of the small intestine and the large instestine look like coiled sausages and support the misconception that it is just a bunch of yucky looking plumbing full of waste. Let's take a look inside this much misunderstood miracle.

The lining of the intestine is carpeted in a growth of finger-like protusions called villi. Think a luxuriant and diverse habitat as rich as an Amazonian rain forest ... or, if you want to dive deeper into a metaphor, maybe a vibrant tropical coral reef teaming with life. This is the prime residential real estate in the gut ... garden view ... and where all the bacteria prefer to live. When the bad bacteria or thug bugs take over the neighborhood, things get out of balance and often a confused immune system will destroy the delicate villi in a failed effort to attack the source of the problem. Autoimmune inflammatory bowel diseases are a case of the forest being slashed and burned in a failed action to bring balance to a serious messed up gut environment.

Let's back up and look at what's in the gut besides the villi. People who think the intestine is just full of ... well, you know ... probably are full of it. In a person cultivating good gut health, maybe 75% of the contents of the gut are diverse micro-organisms. In an unhealthy person, maybe only 25%. The human gut contains 10-100 trillion micro-organisms which is a lot more than the total number of human cells in the body. In the words of microbiologist Dr. Jeffrey Gordon, "We are more microbe than man." Hundreds of species, thousands of sub-species, far weightier than the human mind ... we have only just begun to understand the microbial complexity of the human gut.

So, when the doctor prescribes broad spectrum antibiotics to kill the bad bugs and suggests you eat yogurt to minimize the effect of Antibiotic Associated Diarrhea (AAD), here's a good question to ask -- Doesn't most yogurt just have two kinds of bacteria? What about the other 998 species of bacteria we will be killing?

Let's speak in generalities -- good and bad bugs. Your state of health is clearly reflected in the microbial composition of your gut, your gut ecology. Obese people have very different bugs than thin people, and people who suffer chronic disease with the associated chronic inflammation have very different gut flora than healthy people. Allow me to tell a simple tale of good and bad.

Probiotics (the good bugs) are sticky. They love living in the luxuriant villi that line the wall of the intestine and literally stick around this area of the gut. When they establish residence here, there is little available space in the neighborhood for bad bugs like E. coli, Salmonella, Clostridium, Candida yeast, etc. Probiotic organisms also produce substances that create an unfavorable environment for bad bugs and encourage the growth of more good bugs. Finally, the good bugs ferment soluble fiber into the short chain fatty acid (SCFA) butyrate which has many beneficial effects in the gut. It signals the immune system that peace and harmony reigns in the gut and prevents any autoimmune attacks that may lead to chronic inflammation.

The prebiotic fibers that I previously wrote of are like fine dining in the gut environment that only encourage the best of bugs to take up residence. Think of fructose and other simple carbohydrates as the equivalent of crystal meth being distributed in the neighborhood. An evil substance that supports the thug bugs and makes things quickly deteriorate. Probiotics are the outstanding bacteria that you want to daily invite into your body knowing they will bring out the best in your gut's microbial community.

Obviously, the above is a gross simplification, but I hope it gets you thinking about what you need to be doing to grow your garden and be healthy.

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