Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Eating disorders spirituality

Spirituality for eating disorders? Believers and non-believers, read on the importance of spirituality in eating disorders. Eating disorders include anorexia nervosa, bulemia nervosa etc.

A randomized, controlled trial compared the effectiveness of a spirituality group with Cognitive and Emotional Support groups in subjects receiving inpatient eating disorder treatment [Richards 2006]. Authors compared the effectiveness of a Spirituality group with Cognitive and Emotional Support groups. Patients in the spirituality group scored higher on spiritual well-being and lower on psychological disturbance and eating disorder symptoms at the conclusion of treatment compared to patients in the other groups. Thus spiritual therapy  during inpatient treatment may help reduce depression and anxiety, relationship distress, social role conflict, and eating disorder symptoms.

Do you or someone you know suffer from eating disorders like anorexia nervosa, bulemia etc? Have you used spirituality for treatment in your life for any reason? please share your thoughts.

Prebiotics health benefits

Prebiotics, Probiotics, FOS & GOS - Health Benefits

Prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gut bacteria leading to benefits for the host well being and health. Synbiotic is a combination of prebiotic and probiotic.

Bifidobacteria and lactobacilli have been shown to have potent antipathogenic properties for potentially providing health benefits.

A successful prebiotic has the following properties:

1. Is not destroyed or absorbed in the gut on its journey from mouth to the colon.
2. Undergoes bacterial fermentation in the gut.
3. Selectively promotes the number and/or activity of the indigenous beneficial bacteria like bifidobacteria and lactobacilli

While dietary fiber may act as prebiotic, the most promising however are fructo-oligosaccharides (FOS) because of their selective fermentation towards the more healthy gut bacteria.Galacto- oligosaccharides (GOS) are used in infant formula foods. Both FOS and GOS meet the criteria for prebiotics as outlined above. Inulin type fructans have positive prebiotic effects. Other products with possible prebiotic potential include soybean oligosaccharides from soybean whey. Isomalto- oligosaccharides may be regarded as a quasi-prebiotic since it is partially metabolized in human gut.

Possible health benefits of prebiotics include:

1. Improved lactose tolerance
2. Improved resistance to pathogens resulting in decrease in gastrointestinal infections and respiratory infections
3. Decrease in cholesterol
4. Increased bacterial synthesis of vitamins
5. Protection against allergies by reducing gut inflammation
6. Improved absorption of calcium and magnesium

Dose of prebiotic: 5-8 g per day

Products on the market that may be fortified with prebiotics include diary products, health drinks, infant formula, cereal, dried instant as well as canned foods, and pet foods etc.

Do you or someone you know takes probiotics or prebiotics? If yes, in what form do you take and do you think it makes a difference? Please share your thoughts.

Turmeric, curcumin in ulcerative colitis

Curcumin is a biologically active phytochemical component in turmeric or yellow curry powder and has been found to be effective in numerous diseases including cancer. Ulcerative colitis (one form of inflammatory bowel disease) may be one of those conditions with poven benefit.

The study below was discussed at one of the sessions at the annual Digestive Diseases week (2008) which is the largest gathering of the gastroenterologists in the world. The two panelists (Dr. Koratz from UCLA and Dr. Mullen from Johns Hopkins) gave two thumbs up to this study of turmeric and endorsed its used in ulcerative colitis.

Hanai and colleagues studied the effect of turmeric (curcumin) as a maintenance therapy for ulcerative colitis in a randomized controlled fashion. They reported their findings in the journal Clinical Gastroenterology & Hepatology (2006) in a study titled, "Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial."89 with ulcerative colitis in remisssion participated in the study. Patients received curcumin (1g twice a day) or placebo in addition to the standard treatment (sulfasalazine or mesalamine) for 6 months.Of the patients receiving curcumin, 5% relapsed as compared to 21% in the placebo group.

The investigators concluded that curcumin seems to be a promising and safe medication for maintaining remission in ulcerative colitis.

What are your thoughts on the above study and the action of a "natural remedy" being endorsed at a prominent medical scientific meeting? Please share your thoughts.

Probiotics and prebiotics

Pasteur made the prophetic statement that life sans microbes would be impossible. It was Metchnikoff who in 1907 came up with idea of positive role of some bacteria. Lilly & Stillwell coined term probiotic in1965. A 2001 FAO/WHO report defines probiotic as live microorganisms when given in adequate amounts confer benefit to the host.

The intestinal bacteria participate in normal functioning of gut:

• Structure and function e.g gut transit is delayed in germ-free animals.
• Biochemical interactions
• Immunology
• Maturation of blood vessels
• Gene expression
• Maintaining body weight

Potentially helpful actions of gut bacteria

• Reduce or eliminate pathogens
• Reduce/eliminate toxins/carcinogens
• Release nutrients/antioxidants, growth factors
• Impact on immune function
• Synthesize vitamins (K, FA, B group)

Prebiotics

As mentioned in the book Natural Stomach Care, these are the substances that provide substrate for fermentation by the intestinal bacteria. They are usually undigested food, mostly plant food. They are also known as colonic foods. They involved in the following functions in the intestines.

• Maintain mucosal growth
• Water electrolyte balance
• Provide Energy/nutrients for host/bacteria
• Stimulate growth of flora

Clinical studies

Probiotics, prebiotics as well as combined probiotics and prebiotics have been studied in many digestive illnesses like infantile colic, infectious diarrhea, travelers diarrhea, inflammatory bowel disease, antibiotic induced diarrhea, recurrent C. difficile colitis and irritable bowel syndrome.

Studies have also examined the impact of probiotics in non-digestive illnesses like atopic dermatitis, dental caries, gingivitis, postoperative infections, infections in liver transplant patients, preventing colds and sickness-related absenteism, baby growth etc.

Many of these studies have been very positive leading to introduction of multiple commercial products into the market. However, each product is different with respect to the type, number of strains and bacterial count. Just like antibiotics, some antibiotics may work in certain situations and not the others.

Properties of an ideal probiotic

• Ability to survive through gut
• Able to proliferate and colonize gut
• Safe and effective
• Maintain potency for the shelf-life

Myths about probiotics

• Alters the composition
• Permanent homeliness
• Impact on bowel ecosystem

Bacteria for your infant's colic?

Infantile colic is a difficult problem, vexing both to parents and physicians. The cause is thought to be excess intestinal gas. On the lines of irritable bowel syndrome or IBS, new research indicates that probiotic bacteria help in kids with colic.

Probiotics or "good bacteria" that tend to maintain a healthy balance of good versus bad bacteria in the gut. They are being increasingly have been found to be useful for treatment of various illnesses, both gut and non-gut related.

Dr. Savino and colleagues from the University of Turin in Italy conducted a randomized placebo controlled trial to study the effect of Lactobacillus reuteri. Their findings were published in the journal Pediatrics (January 2007).

The study cohort consisted of 90 breast fed babies who were administered either the probiotic or the common over the counter anti-gas medication known as simethicone for 28 days. Mothers refrained from ingesting cow's milk in their diet. Baby crying times were assessed.

The daily median crying time at day 28 was 145 minutes/day in placebo group as compared to only 51 minutes/day in the probiotic group. 95% babies were termed as responders among the probiotic group in contrast to only 7% in the placebo group.

The mechanism of action of the probiotic in such conditions remains to be established. Possible mechanisms include immune-modulation and enhanced peristalsis thus affecting the balance of the gut flora and reduced triggers for abdominal pain.

Do you or someone close to have kids? Do any of them have colicky problems? What remedies have you tried for such episodes?