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

Inflammation risk and leaky gut: Crohn's disease model

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Inflammation and oxidative stress have been implicated in the causation of many chronic disorders ranging from autism, PANDAS, fibromyalgia, chronic fatigue syndrome, TMJD, chronic headaches to heart disease, diabetes, obesity and Alzheimers. 

 

Dysbiosis and leaky gut have been implicated as unifying factors in disease process.

 

Crohn’s disease involves inflammation of the gastrointestinal tract anywhere in the gut from mouth to anus. The rising incidence and differences in different parts of the world point to involvement of environment. 

Is It Leaky Gut or Leaky Gut Syndrome?

 Thus the impact of environmental factors on Crohn’s disease may provide clues on how to control inflammation in the gut in general.

 

Breast feeding

• Although the studies show conflicting results, the preponderance of evidence indicates a beneficial effect of breast feeding against subsequent development of Crohn’s disease in the child.
• Breast feeding reduces risk by almost 50 percent. 

Smoking

• Smoking increases risk for Crohn’s disease.
• Patients suffer more complications and require more surgeries. It impairs healing and increases risk of relapse.

Diet

• High fat, high carbohydrate, and low fiber diet  increase the risk
• High vegetable and high fruit diet are protective.
• High protein consumption especially high meat increases risk.
• Multiple studies have documented harmful effect of refined sugar although it still remains embroiled in controversy.
• Vitamin D deficiency is a risk factor. Of note, vitamin D deficiency is very common in the West.

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Obesity

Obesity has deleterious effects since increased body fat is associated with increased inflammation.

 

Stress and psychological factors

• High stress and poor coping mechanisms increase risk for relapse
• Depression and anxiety are common and have negative effects on Crohn’s
• Inadequate sleep can increase risk for relapse. 

Seasonal variation

While cold climates and winter sesons have been implicated, the effect of climate and seasons has not been fully established.

 

Nonsteroidal anti-inflammatory (NSAID) drugs

NSAIDs increase the risk of development of Crohn’s disease as well as risk of relapses.

 

Is It Leaky Gut or Leaky Gut Syndrome?

Antibiotics 

• Antibiotic use in early childhood increase risk of development of Crohn’s disease.
• Antibiotics are helpful during active disease especially for treatment of fistulae.

 

Childhood infections

• Respiratory and GI infections in early childhood are associated with increased risk.
• Consistent with hygiene hypothesis, gastric colonization with Helicobacter pylori as well as early exposure to worm infections alter the immune balance reduce the risk of Crohn’s. 

Vaccinations

Studies have come to variable conclusions. There are passionate but conflicting opinions.  

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Can Acupuncture Treat Chronic Fatigue Syndrome or CFS

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Treatment of chronic fatigue syndrome or CFS continues to be controversial as is its cause. Most treatments are suboptimal and an ideal treatment remains to be identified.

 

Given the paucity of high quality studies on this topic, a research team led by Drs. Ng and Yiu from the University of Hong Kong examined the effect of acupuncture in CFS. Their findings were published in the Alternative Therapies in Health and Medicine. 

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Acupuncture-CFS study

• Single-blind, randomized controlled trial
• Tertiary care hospital
• 127 subjects received acupuncture or sham acupuncture
• 2 sessions per week for 4 consecutive weeks

Outcome measures of acupuncture-CFS study

• Chalder's Fatigue Scale
• SF-12 for health-related quality of life
• GH Q-12 for general mental health

Results of acupuncture-CFS study

Ninety-nine participants completed the study

Acupuncture group demonstrated significant improvements:

• Physical and mental fatigue
• Physical component score of SF-12

Some Improvements were also seen in the sham group for the three scores. The improvement in experimental group was significantly greater than the controls for all three measures examined.

 

Dr. Minocha’s comments on acupuncture-CFS study

Is It Leaky Gut or Leaky Gut Syndrome?

The sham acupuncture group also showed some benefit which is consistent with the literature. This therapeutic effect in the control group may be due the pressure of sham needles at the acupuncture points in addition to the some placebo effect especially since the study was done at a major referral center.  

 

Overall, the results indicate that the net positive effects of acupuncture seen in this study may be a conservative estimate of total benefit from acupuncture.

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Is It Leaky Gut or Leaky Gut Syndrome?

Marijuana Smoking Heals Inflammation in Crohn's Disease

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Medicinal use of marijuana use has been legalized in a few states in the U.S..Marijuana  is derived from the plant Cannabis sativa. Its extracts are called cannabinoids and have been used for medicinal purposes since ancient times.

The most active compounds are tetrahydrocannabinol (THC) and cannabidiol (CBD). One of the mechanisms of action might be the potent effects in streamlining inflammation. 

Is It Leaky Gut or Leaky Gut Syndrome?

Traditional digestive uses of cannabis

• Poor appetite
• Abdominal pain
• Diarrhea
• Gastroparesis or slow stomach.

The anti-inflammatory properties of cannabis raise the obvious question about its effects in inflammatory bowel disease. Animal studies reveal that cannabis has beneficial effects against colitis.

Dr. Naftali and colleagues from the Meir Medical Center, Tel Aviv University in Israel examined the effect of cannabis in patients with active Crohn’s disease.

Design of cannabis-Crohn’s study

• Randomized placebo-controlled
• 21 subjects non-responsive to usual medical therapy
• Intervention group received cigarettes containing 115 mg of THC or placebo twice a day for 8 weeks

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Results of cannabis-Crohn’s study

• 5 of the 11 patients in cannabis group and 1 of 10 patients in placebo group achieved remission.
• A clinical response in the form of decrease in Crohn’s disease activity index was in 10 of the 11 patients in cannabis group as compared to only 4 of 10 in the placebo group.
• Patients in cannabis group also had improvements in their appetite and sleep.
• No significant adverse effects were noted.
• None of the patients suffered withdrawal symptoms on cessation of treatment.

Conclusions of cannabis-Crohn’s study

Is It Leaky Gut or Leaky Gut Syndrome?

Cannabis produces a clinically significant response without any significant side-effects in patients with Crohn’s disease.

Dr. Minocha’s comments

While long-term use of marijuana has side-effects, these need to be considered in the context of significant adverse effects of current medical therapies for Crohn’s disease.

Subject to confirmation by large trials, potential benefits of cannabis in suppressing inflammation and use in devastating life-long illness like Crohn’s disease should not be summarily rejected based on possible side effects alone.  

This post is meant to be informational in scientific context. It should by no means be considered Dr. Minocha's endorsement or rejection of marijuana use. Consult your physician and your lawyer for advice. 

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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health