Constipation

Could Constipation Shut Down Your Kidneys?

As our understanding of the human gut grows, modern medicine has come to realize that constipation is a much more prevalent and serious health problem and far less benign that we ever realized.

In fact, constipation may be a symptom of greater health problems, from hormonal issues to diabetes, colon cancer and multiple sclerosis.

Add chronic kidney disease to that list of serious diseases, based on a recent study appearing in the Journal of the American Society of Nephrology.

Researchers at the University of Tennessee’s Health Science Center and Memphis Veterans Affairs Medical Center discovered the link as they studied and monitored the health of some 3.5 million veterans for nearly a decade.

Compared to healthy patients, those suffering from constipation were 13 percent more susceptible to chronic kidney disease, and 9 percent were more likely to develop kidney failure, necessitating dialysis treatments or a kidney transplant.

The link between constipation and chronic kidney disease may be an uncomfortable blessing in disguise, because there are few signs or symptoms in the early stages.

What’s more, a cluster of health problems ranging from diabetes and high blood pressure to obesity and heart disease can increase your risks of chronic kidney disease too, blurring that simple connection to constipation.

“Our results suggest the need for careful observation of kidney function trajectory in patients with constipation, particularly among those with more severe constipation,” says Dr. Csaba Kovesdy, chief of nephrology at the Memphis Veterans Affairs Medical Center, according to a press release.

Right now, constipation is nothing more than a warning sign of chronic kidney disease. However, if constipation is found to play a more active role in this disease based on future research, Dr. Kovesky believes simple lifestyle adjustments and taking a probiotic may be enough to protect a patient’s kidney health.

Taking a probiotic with multiple species of beneficial bacteria like EndoMune Advanced Probiotic is a safe, proven way to boost the healthy diversity of your gut microbiome to treat constipation safely, effectively and without a drug.

Your Gut Health Connection to Parkinson’s

Now that modern science has finally embraced the gut-brain axis, it was only a matter of time before researchers began to find other pathways that connect the two.

Recent studies have linked both to Parkinson’s disease, one of the most common neurological brain disorders Americans face. Parkinson’s is a neurodegenerative disorder related to the brain’s shrinking production of dopamine, which leads to problems with tremors, stiffness and balance.

Interestingly, your gut health connection to Parkinson’s disease may be tied to some common problems, like constipation and imbalances in gut bacteria.

Does Parkinson’s start in the gut?

One study, appearing in Neurology, examined the health of patients receiving resection surgery or a vagotomy, a procedure that removes the main portion or branches of the vagus nerve, the longest cranial nerve in the human body extending from the neck to the abdomen, to treat ulcers.

Researchers discovered the gut health connection to Parkinson’s when comparing two types of vagotomy surgeries that fully or selectively (partially) resected the vagus nerve.

Over the scope of the 40-year study, three times as many patients who had a selective vagotomy eventually developed Parkinson’s versus a full resection. Plus, patients who had a full resection were 40 percent less likely to experience Parkinson’s.

The “bread crumbs” left behind by a partial resection led researchers to conclude that Parkinson’s origins may start in the gut, says study author Dr. Bojing Liu, MSc, of the Karolinska Instituet in Stockholm, Sweden, according to a press release.

In fact, gut health problems like constipation that manifest decades sooner may be a sign that Parkinson’s could emerge later on in a patient’s life, says Dr. Liu.

Can a gut bacteria imbalance lead to Parkinson’s?

A lot closer to home, researchers at the University of Alabama at Birmingham (UAB) may have found another telltale sign of Parkinson’s disease via the composition of bacteria that inhabit the human gut.

Scientists discovered the connection while comparing the health of some 200 patients from three distinct regions of America (Northwest, Northeast and Southeast) with Parkinson’s to 130 healthy controls, according to the study appearing in Movement Disorders.

Unfortunately, health experts couldn’t figure out what came first:

  • Are changes in a patient’s gut bacteria balance a red flag that Parkinson’s is a possibility?
  • Does this disease play an active part in the disruption of gut health?
  • Could a Parkinson’s drug be causing problems?

One clue that may determine which way this gut bacteria imbalance goes is the method in which the microbiome helps the body get rid of environmental pollutants not typically found in the human body.

The balance of bacteria tasked with eliminating these chemicals was different in Parkinson’s patients, a critical finding since exposure to herbicides and pesticides in farm settings increases one’s risk of this debilitating disease.

These discoveries may lead to new treatments for Parkinson’s disease, says Dr. Haydeh Payami, a professor in the Department of Neurology at the UAB School of Medicine, according to UAB News.

Therapies that regulate the imbalance in the microbiome may prove to be helpful in treating or preventing the disease before it affects neurologic function.”

Could taking a multi-species probiotic like EndoMune Advanced Probiotic be a possible solution?

While scientists were quick to discourage any quick fixes, taking a probiotic does boost the body’s natural immunities and is a healthy and effective way to treat constipation without a drug.

Multi-species probiotics conquer constipation

All by itself, constipation is a serious health problem accounting for some 2.5 million visits to American doctors, not to mention a growing number of trips to the ER. Constipation is also one of the telltale symptoms of irritable bowel syndrome (IBS), a chronic condition that affects the colon.

In the past, people have attempted to treat their IBS symptoms with drugs like mesalazine and mexiletine with only mixed results and a lot of unwanted side effects.

The real problem with taking these kinds of drugs is that they don’t get to the root cause of the problem: Rebuilding the healthy balance of beneficial bacteria in the gut.

Taking a multi-species probiotic can do a great deal of good, not only in restoring that gut healthy balance, but treating IBS symptoms associated with constipation too, according to a recent Italian study appearing in BioMed Research International.

For their randomized, double-blind study, scientists divided 150 IBS patients (all adults between age 18-65) with constipation issues into three groups, including one who received a placebo, for 60 days.

Interestingly, three of the five strains of beneficial bacteria in the multi-species probiotic given to patients — blends of Lactobacillus rhamnosus, Lactobacillus plantarum and Lactobacillus acidophilus — are contained in EndoMune Advanced Probiotic.

Compared to the placebo group, the major symptoms of IBS patients taking a multi-species probiotic improved from 74-82 percent compared to just 40 percent for the placebo group.

Even better, patients in both probiotic groups enjoyed relief from symptoms 30 days after the end of supplementation. In fact, signs of some beneficial bacteria were present in stool samples taken from patients too.

This study provides more evidence that taking a probiotic can be a much safer, healthier solution for treating constipation, especially the variety connected with IBS and a lot of other gut-related problems.

Again, the real trick is taking a probiotic made with multiple strains of bacteria from three key “families” (plus a prebiotic) like EndoMune Advanced Probiotic that supports the diversity of bacteria that inhabit your gut.

How to get rid of constipation

How to get rid of constipation?

Have you ever experienced such a bad case of constipation that you considered going to the ER? Don’t be embarrassed. A growing number of Americans have made that trip, according to a recent report in The American Journal of Gastroenterology.

After collecting data from more than 950 U.S. hospitals, researchers found the number of emergency room visits related to constipation rose from nearly 500,000 in 2006 to more than 700,000 in 2011, an increase of 41 percent.

In addition to the growing number of constipation-related ER visits, patient costs rose by more than 50 percent.

Of all age groups, younger and senior patients suffered the most. A 2006 study shows that infants under age 1 visited the ER most frequently, followed by geriatric patients above age 84.

Alarmingly, the number of children ages 1-17 in need of ER treatment increased over 50 percent from 2006-11. This group also represented the second largest age group making ER-related visits due to constipation.

These recent numbers certainly add to the 2.5 million visits patients making visits to their doctors or gastroenterologists for constipation, as cited by the American College of Gastroenterology.

What You Can Do About It

As mentioned before in this space, the lack of a hard-and-fast definition for constipation can be a problem. Although it’s often described as the inability to have regular bowel movements, your regularity may vary depending on your diet, exercise levels and age.

According to the Mayo Clinic, other signs that you or a loved one may be suffering from constipation could be:

  • Straining to complete a bowel movement.
  • Feeling a blockage that prevents a bowel movement.
  • Producing lumpy or hard stools.
  • Needing help (pressing on your abdomen) to finish a bowel movement.

Medical experts say the underlying causes of constipation could range from medication side effects to hormonal issues and serious diseases such as multiple sclerosis, colon cancer and diabetes.

Fortunately, many cases of constipation are easily treatable by following these common steps:

  • Keep your body hydrated by drinking plenty of water.
  • Be sure to incorporate more fiber-rich foods into your daily diet.
  • Stop sedentary living and get moving with a little exercise every day.
  • Schedule plenty of time in the bathroom to complete a bowel movement.
  • Take a probiotic with multiple strains of beneficial bacteria, like EndoMune Advanced Probiotic or EndoMune Junior (for kids).

If these simple steps do not relieve your constipation problems, please make an appointment with your primary care physician. Doing so could prevent a painful trip to the ER.

Going or Not Going: Relieve Constipation Safely

Constipation is an uncomfortable health problem that can make for painfully awkward conversations. This is why Americans often turn to family physicians or gastroenterologists when constipation becomes a concern.

Constipation is responsible for some 2.5 million visits to a doctor or specialist annually in America, according to the American College of Gastroenterology.

There is no hard-and-fast definition for constipation, but it’s often described as the inability to have more than three bowel movements per week. However, some people who experience only three bowel movements weekly are still healthy, depending on their age, diet and daily physical activity.

Telltale signals you may want to see your doctor about a constipation problem include straining, hard stools and incomplete evacuation occurring in more than 25 percent of bowel movements, according to WebMD.

Common, less serious causes of constipation:

  • Living a sedentary lifestyle.
  • Forgetting to drink enough water.
  • Not eating enough fiber-rich foods.
  • Postponing a necessary trip to the bathroom.
  • Failing to deal with life’s stressors.

A more serious problem

Constipation can be a more costly and serious health problem than you assume, according to a 2009 report published in Clinical Gastroenterology and Hepatology.

Some 63 million people living in America suffer from constipation every year, according to the National Digestive Diseases Information Clearinghouse, and spend $235 million annually to treat it. Researchers also found links between constipation and a number of painful health problems:

Hemorrhoids: Straining during a bowel movement may cause veins in lower rectum to swell or become inflamed.

Anal fissure: These small tears in thin, moist tissue may happen when you pass large or hard stools during a bowel movement.

Fecal incontinence: Constipation, along with diarrhea and muscle or nerve damage, may cause an inability to control bowel movements.

Colon cancer risks increase with chronic constipation

The health outcomes become even more serious if you experience chronic constipation, according to a 2012 study that compared the health of nearly 29,000 patients suffering from persistent constipation to some 87,000 healthy patients. The risk of colon cancer nearly doubled among patients with chronic constipation while the incidence of benign tumors (neoplasms) increased nearly threefold.

Colon cancer is nothing to ignore, as it’s the third most common cancer and the second leading cause of death among all cancer types in the U.S.

“Although chronic constipation is considered a relatively benign disease, practitioners should be aware of this potential association to monitor and treat accordingly,” said Dr. Nicholas Talley of the University of Newcastle and co-investigator of this study. “We encourage anyone with questions related to their condition to talk to their health care professional so that the specific health needs of each patient can be balanced with the risks and benefits of medications.”

Relieve constipation

One of the popular medications people use to treat constipation — sodium phosphate laxatives — was the subject of a recent FDA warning, based on patients exceeding the recommended daily dosage of this over-the-counter remedy.

The FDA’s Adverse Event Reporting System showed a single dose of sodium phosphate per day was associated with rare, but serious damage to a person’s lungs and heart.

Children under age 5, baby boomers over age 55 and people diagnosed with or taking medications for kidney disease are among the patient groups who are at the greatest risk of serious complications when laxative dosage is exceeded. (Children under age 2 should not be given the rectal form of sodium phosphate.)

Taking a probiotic with multiple strains of beneficial bacteria, like EndoMune, is a safer treatment for constipation that has the added advantage of boosting your immune system, reducing your risks of colon cancer and maintaining normal intestinal motility.

10 Reasons Everyone Should Take a Probiotic

With 100 trillion bacteria and many different species of microflora floating around in our intestinal tract, a balance of good and bad bacteria is necessary to maintain the normal functioning of our immune system and intestines, as well as to promote optimal health.

Considering the recent attention being paid to probiotics—many positive medical studies have been reported in the mainstream media—more people are asking why they need to take a probiotic to protect and improve their overall health.

Here are 10 reasons to take a probiotic for your good health:

1. Your body is under constant attack externally (from exposure to bad bacteria) and internally (our go-go lifestyles hinder our eating habits). Taking a good probiotic, ideally with multiple strains of good bacteria, is the safest, easiest and most effective way to maintain a healthy balance of good bacteria in your body.

2. The human body cannot replenish the various strains of live and beneficial bacteria your body needs every day to stay healthy just by eating foods like yogurt, miso soup, pickles and sauerkraut that usually contain limited amounts of a single strain of bacteria. This is especially true if you’re using probiotics to treat a specific health problem.

3. Probiotics containing multiple strains of beneficial bacteria are more effective in treating a range of health-based problems, including irritable bowel syndrome (IBS), diarrhea, immune function and respiratory tract infections, according to a 2011 analysis of studies.

4. A growing number of studies are showing how taking a probiotic can be beneficial for patients when they are prescribed a broad spectrum antibiotic. Antibiotics can often disrupt the balance of good and bad bacteria in patients’ bodies, causing unwelcome side effects like diarrhea.

5. Taking a good probiotic boosts patients’ natural defenses, protecting them from traveler’s diarrhea, too.

6. New moms can sidestep the prolonged crying and discomfort from their babies suffering infantile colic by giving them a high-quality probiotic.

7. Recent studies have been linked with taking a high-quality probiotic to beneficial effects on the gut-brain axis that may positively affect your emotions and help you beat depression.

8. The healthy bacteria contained in a good probiotic help maintain normal intestinal motility and lessen the problems of constipation.

9. Reducing your risks of colon cancer is as simple as taking a good probiotic.

10. Probiotics are a newfound weapon that may assist in lowering elevated blood pressure and cholesterol levels that contribute to cardiovascular disease.

To Go or Not To Go… that is the problem

Dear EndoMune subscribers,

Now that we are enjoying the beauty of the spring days, we really don’t want to be slowed down by any GI issues. The following real case report describes how EndoMune can make a positive difference in your health this season:

Case Study: Constrained By Constipation

Karen, a 34-year old corporate executive, saw her primary care physician due to a problem of constipation. Karen had a longstanding history of difficulty with normal stool habits. She had tried a variety of diets and laxatives with no real improvement.

A comprehensive gastroenterological evaluation did not reveal any abnormality. She was told that her problem was due to “irritable bowel syndrome.”

The physician recommended a high fiber diet, stool softeners and exercise.

Karen continued to have problems with bloating, distention and constipation. Her GI issues made it hard for her to function at work. Enjoying outdoor activities like hiking and biking with her family were difficult.

Karen read about probiotics and decided to try EndoMune.

After one week of therapy, Karen’s constipation markedly improved. She was so delighted with the results that she emailed to let me know how EndoMune had made such a difference in her life.

The Discomfort of Constipation

After reading the case report, it is apparent that this month’s newsletter is about how probiotics can ease the problem of constipation.

Constipation is a common condition affecting children and adults. In the vast majority of cases, no underlying organic cause is found and functional constipation or “irritable bowel syndrome” is diagnosed.

Did you know that:

Constipation is medically defined as less than 3 stools per week and associated with straining1

Constipation is one of the most common GI disorders in clinical practice

Approximately 20% of the general population suffers from chronic constipation during their lifetime

Childhood constipation accounts for 3-5% of all visits to pediatricians2

Approximately 70-80% of nursing home residents have constipation3

Finding Relief

In the last 5-6 years, there have been a number of medical studies evaluating whether probiotics can improve constipation and associated symptoms. Not all of them have shown benefit.

I have listed the results of some of the most well done studies:

In 2011, Guerra et al4 reported the results of a study involving 59 children suffering with constipation. Over a 10-week period, the group receiving probiotics had significant improvement in stool frequency, consistency and less abdominal pain.

In 2011, Waller et al5 published a study done on 100 adults with chronic constipation. The group receiving probiotics for 14 days had significantly improved stool frequency and decreased abdominal symptoms compared to the control group.

In 2010, Hyang et al6 reported the results of a clinical study using probiotics in a group of nursing home patients. After 2 weeks of therapy, there was a significant improvement in frequency and consistency of the stools.

In addition to improving GI function, there were no adverse side effects associated with the use of probiotics in these medical studies. This is a very important and unique benefit of probiotic use when compared to other constipation therapies.

How probiotics improve intestinal function is being actively researched by medical experts. Studies7 have found that the bacterial flora in constipated individuals is different than in individuals with regular bowel movements in that they lack the ability to produce beneficial fermented products that enhance intestinal function. Adding probiotics reestablishes a healthy intestinal flora resulting in improved intestinal activity.

Take Home Message

If you struggle with GI issues, consider adding EndoMune to your daily regimen and enjoy these beautiful spring days comfortably!

Eat healthy, exercise and take EndoMune!

Best Wishes,

Lawrence Hoberman MD

1) Epidemiology of constipation in North America: a systematic review.Higgins PD, Johanson JF.Am J Gastroenterol. 2004 Apr;99(4):750-9. Review

2) Epidemiology of childhood constipation: a systematic review.van den Berg MM, Benninga MA, Di Lorenzo C.Am J Gastroenterol. 2006 Oct;101(10):2401-9. Review.

3) Chronic Constipation in the Elderly free Juan F Gallegos-Orozco, Amy E Foxx-Orenstein, Susan M Sterler & Jean M StoaThe American Journal of Gastroenterology 107, 18-25
doi:10.1038/ajg.2011.349

4) Pediatric functional constipation treatment with Bifidobacterium-containing yogurt: a crossover, double-blind,controlled trial.Guerra PV, Lima LN, Souza TC, Mazochi V, Penna FJ, Silva AM, Nicoli JR, Guimarães EV.World J Gastroenterol. 2011 Sep 14;17(34):3916-21.

5) Dose-response effect of Bifidobacterium lactis HN019 on whole gut transit time and functional gastrointestinal symptoms in adults.Waller PA, Gopal PK, Leyer GJ, Ouwehand AC, Reifer C, Stewart ME, Miller LE.Scand J Gastroenterol. 2011 Sep;46(9):1057-64. Epub 2011 Jun 13.

6) Efficacy of Lactic Acid Bacteria (LAB) supplement in management of constipation among nursing home residents.An HM, Baek EH, Jang S, Lee do K, Kim MJ, Kim JR, Lee KO, Park JG, Ha NJ.Nutr J. 2010 Feb 5;9:5.

7) Functional dysbiosis within the gut microbiota of patients with constipated-irritable bowel syndrome (pages 828–838) C. Chassard, M. Dapoigny, K. P. Scott, L. Crouzet, C. Del’homme, P. Marquet, J. C. Martin, G. Pickering, D. Ardid, A. Eschalier, C. Dubray, H. J. Flint and A. Bernalier-DonadilleAlimentary Pharmacology and Therapeutics, 03/19/2012

Probiotics Recommended for Nursing Home Residents

Over the years, I have written a number of newsletters that discuss the benefits of probiotics for children and adults. This month will focus on the older generation, an important topic since there are currently 11.4 million people living in nursing homes in the United States (1). This figure includes 14% of the population older than 84.

For anyone who has loved ones in nursing homes and is concerned for their well-being, there are numerous reasons I recommend all nursing home patients take probiotics.

Scenario One: Hospitalization

A recurring story is that of a functioning senior citizen living at home who fractures a hip due to a fall or experiences a stroke. The following series of events is likely to happen:

  1. Upon injury, 9-1-1 is called.
  2. The individual becomes a hospitalized patient.
  3. The patient is required to take medications, including antibiotics.
  4. The antibiotics adversely affect the gastrointestinal tract.
  5. The individual is now at risk of developing hospital-acquired infections like Clostridia difficile and methicillin-resistant staph infections.
  6. Eventually, the patient improves and is transferred to a rehab unit or nursing home.

The seniors may have had normal intestinal function prior to hospitalization, but with all the medications and change in activity level, constipation and diarrhea become real problems. These disorders can severely affect quality life and health of the people within the nursing homes.

For instance, other healthy nursing home residents are now at risk of being exposed to surface areas that have become contaminated by the arrival of the recently hospitalized patients.

This scenario is one reason to consider giving probiotics to healthy nursing home residents. Should a resident be exposed, the probiotics can prevent harmful bacteria from colonizing the intestines and causing damage.

Scenario Two: General Aging Process

Another main reason to give probiotics has to do with the changes that occur in the normal intestines as they age. Due to reduction in acid production, enzyme secretions, reduced intestinal immunity and slowed motility, the healthy intestinal bacteria population is reduced. This change in the intestinal microflora contributes to the risk of diarrhea and constipation.

According to the Administration of Aging (2), among healthy adults 65 years of age and older, 26% of men and 34% of women experience constipation. These numbers increase drastically for elderly people living in nursing homes – more than 80% suffer from constipation.  Medications, immobility, and dementia are all contributing factors for this increase.

Residents of nursing homes have a much higher risk of developing infectious diarrhea. In the United States, nursing home residents are four times more likely to die from gastroenteritis than those living outside nursing homes. Additionally, of all deaths occuring from diarrheal disease, nursing home residents account for 17.5% (3,4).

The physicians and nursing staff are very aware of the health risks associated with severe constipation and diarrhea. Unfortunately, nursing home patients often require medications that can slow intestinal motility, damage the lining cells, and disrupt the healthy balance of the intestinal bacteria. As a result, severe intestinal disorders can occur despite good medical care.

Probiotics Improve Constipation and Diarrhea

During the last three years, there have been several reports published that found that probiotics improved constipation and diarrhea in nursing home residents (5,6,7).  The research protocols were similar; One group of residents received probiotics containing Lactobacillus and/or Bifidobacteria, and the other group received a placebo. The research findings revealed that the frequency and consistency of the stools improved in the groups treated with probiotics, as compared to the control groups (5,6,7).

After considerable review of the literature, I have come to the conclusion that giving nursing home residents daily probiotics can help to improve intestinal function, quality of life, and lessen the risk of serious health issues.

The real concern in medicine is that we “do no harm.” Probiotics, fortunately, have an excellent safety profile. It is worth noting, though, that there have been rare reports of infections due to probiotics in seriously immune-compromised patients (9).

Take Home Message

If you have a loved one in a nursing home, ask the health care provider to consider giving them a probiotic. The daily dosage should be at least 10 billion and contain multiple strains of Lactobacillus and Bifidobacteria, like EndoMune Advanced.

Eat healthy, exercise and live well!
Dr. Hoberman

References:

(1) National Center for Health Statistics. Health, United States, 2009: with special feature on
medical technology. Hyattsville, MD, 2010.

(2) Sources: Data releases from the web sites of the National Center for Health Statistics; and from the Bureau of Labor Statistics web site

(3) Mortality due to gastroenteritis of unknown etiology in the United States. Frenzen PD.J Infect Dis. 2003 Feb 1;187(3):441-52. Epub 2003 Jan 24

(4) Clin Infect Dis. 2010 Oct 15;51(8):907-14.Surveillance for outbreaks of gastroenteritis in long-term care facilities, Australia, 2002-2008. Kirk MDFullerton KEHall GVGregory JStafford RVeitch MGBecker N

(5) Efficacy of Lactic Acid Bacteria (LAB) supplement in management of constipation among nursing home residents. 1)Sources: Data releases from the web sites of the National Center for Health Statistics; and from the Bureau of Labor Statistics web site

(6) Fermented cereal with specific bifidobacteria normalizes bowel movements in elderly nursing home residents. A randomized, controlled trial.Pitkala KH, Strandberg TE, Finne Soveri UH, Ouwehand AC, Poussa T, Salminen S.J Nutr Health Aging. 2007 Jul-Aug;11(4):305-11

(7) Clostridium difficile in the long-term care setting. Makris AT, Gelone S.J Am Med Dir Assoc. 2007 Jun;8(5):290-9. Review

(8) Probiotics and the nursing home: should we give bacteria for breakfast?Morley JE.J Am Med Dir Assoc. 2009 Jul;10(6):365-7.

(9) Safety assessment of probiotics for human use.Sanders ME, Akkermans LM, Haller D, Hammerman C, Heimbach J, Hörmannsperger G, Huys G, Levy DD, Lutgendorff F, Mack D, Phothirath P, Solano-Aguilar G, Vaughan E.Gut Microbes. 2010 May;1(3):164-185. Epub 2010 Mar 4.

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