“I’m going to be sick.”
“I need a poo.”
At 4 in the morning, these are not the words I want to hear from my four year old son stood next to our bed.
And my goodness did he vomit and have diarrhoea.
The bedsheet, duvet, the sofa covers and carpet were all collateral damage from his body’s expulsions of the offending bacteria (note to Floyd, stop licking balls in the ball pit at soft play) but we are all clean again (the washing machine was busier than a one armed bricklayer in Syria).
But 24 hours later, he can fart once again in safety and a small burp doesn’t trigger my wife to dive in with the sick bowl like a TOWIE star diving for a free cartier watch at a party.
As health care professionals hopefully we know not to take drugs to stop the diarrhoea, it’s the body doing its thing.
But if we can speed up the process of removal we should.
But even more importantly, stop any bad bacteria taking up residence, because once they move in they can be hard to remove.
They often lurk after the initial infection in the gut creating a sustained inflammatory response, triggering the immune system (remember 70% of your immune system lives in the gut) on a constant low level basis with peaks and troughs of symptoms.
These might be digestive related, persistent heartburn, bloating, “IBS”, if the inflammation really gets going they might get a diagnosis of colitis/ulcerative colitis.
More subtle than that, the inflammation in the gut is often asymptomatic but the provoked immune system is attacking the joints and connective tissue. AS, RA and many other autoimmune issues are directly linked with bacterial infections (dysbiosis).
Have you ever noticed patients with autoimmune diseases going through phases of ‘flares’?
If your gut microbiome/good bacteria are a really thriving diverse population fed by diverse prebiotic fibre and polyphenols, untouched by antibiotics, NSAIDs, alcohol, glyphosate and proton pump inhibitors (omeprazole etc), you’ll be an uninviting host with a low bowel pH and stable gut lining.
But given that’s not so common (relatively), consider that your gut could be a very good host to pathogenic bacteria – you are warm and moist (hopefully), and provide a steady stream of food in the form of sugar (simple sugars and complex carbohydrates/starch broken down into sugar).
Everything a newly wed couple of pathogens need to make babies.
Trouble is the cell wall of these bad boys and girls is 80% lipopolysaccharide, or as we will now call it LPS.
And when LPS enters the bloodstream, inflammation (and havoc) ensues. This leads to peripheral and central nervous system hypersensitivity (highlights existing neuromechanical dysfunction), reduced mitochondrial output (fatigue) and altered brain chemistry (less serotonin – the “happy” brain chemical) creating altered mood and behaviour (or if your wanted to label it “depression” or “anxiety”).
This is why you often get ‘flares’ of autoimmunity.
There is often a low grade sustained inflammatory response occurring, ‘burning’ like a smouldering fire in the background, and as the bacteria population surges and then die, the cell wall breaks down and LPS is released, creating a wave of inflammation.
And this is occurring in many many of your hard to treat, chronic pain, “adjustments don’t hold” type patients. They don’t enough inflammation to return a high inflammatory marker like CRP, but it’s more than enough to stop them healing and responding to care.
The gut microbiome and gut related immunity is a key part of ACN protocols. The microbiome can be pretty complex, but I break it down into need-to-know information and use a framework to keep it simple.
Common things are common and 80% of the time, we use the same diet changes and supplements.
Anyway back to my son’s diarrhea.
One of the supplements I always keep in my (extensive) supplement cupboard is Saccharomyces boulardii.
It’s a transient yeast that inhibits the pathogens from multiplying and stimulates your own immunity.
It’s very safe, well researched to reduce the illness length of an infection and stop colonisation by the pathogens.
I routinely recommend it to patients going abroad to places notorious for getting diarrhoea (India, Egypt etc). I love that I can add value to their care with me. And they of course love less diarrhea.
Action to take today: Next time your see a patient with persistent pain, fatigue (often rationalised), and brain symptoms (mood and behaviour) consider do they have a sustained inflammatory response to a gut infection?
Ask them if they have ever caught a bug abroad or had poisoning? It’s surprising how many people will confirm an infection but dismiss it as the timing of the onset of digestive issues, pain, fatigue and mood/behaviour issues can occur months, possibly years after the infection.
And as always, don’t waste those valuable adjustments…
P.S. If you’d like to know which Saccharomyces boulardii supplement I personally use, and where I get it from, ping me an email and I’ll let you know.