gut health

Support Our Stressed-out Soldiers and Their Gut Health

This month’s 14th celebration of National Military Appreciation Month couldn’t have come at a better time to spotlight the problems some of our stressed soldiers experience with their gut health.

A recent study concluded that higher stress, anxiety and depression felt by 37 male army soldiers during their fourth week of intense combat training (after a resting period) were connected to a greater incidence and severity of gastrointestinal problems, including irritable bowel syndrome (IBS).

The good news: The Department of Veterans Affairs is recognizing these IBS-related health problems suffered by soldiers.

Last year, the VA began implementing an assessment rule for disability benefits, taking into account the high numbers of deployed soldiers returning from Afghanistan and Iraq suffering from IBS and other gastrointestinal setbacks.

“The effects of IBS and other digestive disorders can be debilitating and disruptive to a person’s everyday life,” says International Foundation for Functional Gastrointestinal Disorders President and Founder Nancy Norton. “It’s important that veterans are aware of symptoms of IBS and the advancements in this arena so that they can be best cared for after returning home from service.

“IBS is a long-term condition with symptoms that can change over time in a person. There isn’t an easy remedy for people with IBS, but working in partnership with a knowledgeable care provider can often go a long way toward helping to manage the symptoms.”

The Institute of Medicine released Gulf War and Health Volume 9, a recent report that found there was no “one-size-fits-all” answer for veterans experiencing chronic, multi-symptom illnesses like IBS.

Ailmentary Pharmacology and Therapeutics

Medical News Today

Probiotics May Battle IBS-Induced Stress

You may recall a recent study I posted about the possibilities of an anxiety-free future by taking probiotics. Those possibilities are looking a little more like probabilities, based on the results of a University of Michigan study on irritable bowel syndrome (IBS).

Although stressful emotions aren’t the primary cause of IBS, they can alter brain-gut interactions that trigger the intestinal inflammation that spurs diarrhea, belly pains (severe or chronic) or a loss of appetite.

In tests on mice, University of Michigan scientists discovered that stress may suppress an important element called an inflammasome, which is needed to maintain healthy gut microbes. The good news: Probiotics reversed the suppressive effect in these animals.

“This study reveals an important mechanism for explaining why IBS patients with probiotics makes sense,” said senior study author, gastroenterologist and associate professor of internal medicine at the University of Michigan John Y. Kao, M.D.

During the course of the study, researchers found inhibiting inflammosomes changed gut composition, resulting in intestinal inflammation. However, pretreating some rats with probiotics reduced inflammation in animals with stress-induced, small bowel inflammation.

Celebrate Holiday Gut Health

The holiday season is upon us and that means traveling, eating rich foods and celebrating with family and friends. With all these activities, there is no time to have an unhappy tummy. Taking a daily probiotic can help maintain the normal intestinal activity despite the changes in diet, hectic schedule and travel.

Dependent upon the vacation destination, traveler’s diarrhea can be a problem. Studies have found that probiotics can help enhance normal intestinal immunity and maintain the good bacteria to help in our digestion.  In addition, probiotics can lessen the risk of contracting traveler’s diarrhea by 30-40%; therefore, everyone should make it part of their “travel insurance.”

Traveling and visiting family and friends does increase the risk of picking up cold and flu viruses.  By taking a daily probiotic, it can lessen the risk of catching these infections, especially for children.

The bottom line is, enjoy the holidays and consider taking a daily dose of EndoMune Advanced.  If you have children, give them an EndoMune Jr. It may help to protect their GI and respiratory systems.

 

Healthy Bugs Prevent Depression and Gut Distress

This month I am discussing some new, exciting research on the effect of probiotics on the gut-brain axis(1). Before proceeding, I think it is best to explain the relationship between the intestines and the brain.

We have all experienced the effect of this axis. Most of us have been in a situation where we become very anxious about an upcoming event – making a presentation, taking an exam – and, as a result, developed a terrible gut pain or “knot.”

As quickly as the pain surfaced, it similarly eases when the stressful event resolves. When this happens, we don’t develop an ulcer or any other structural intestinal problem. So what physically happened to cause this pain?

The brain releases chemicals that travel through the blood stream (or nerves) to the gut.  The major nerves between the brain and intestines are called the vagus and the sympathetic nerves. The “knot” commonly experienced during stressful events is a result of the nerve endings releasing chemicals that cause spasms of the intestines and activation of the intestinal pain fibers.

Now, let’s get really geeky to explain how this happens in more detail. The gut-brain axis consists of:

(1) Vagus and sympathetic nerves that send messages to:

  • Stimulate or inhibit stomach and intestinal secretions
  • Increase or decrease stomach and intestinal motility
  • Enhance or decrease appetite
  • Transmit pain sensation from the gut to the brain
  • Alter our mood …positively or negatively

2) Hormones secreted by the brain and gut that stimulate or suppress the hunger and satiety centers in the brain affecting dietary intake. It is very common for people to attribute weight loss to stress. Their appetite seems to have just “disappeared.”

What really happened was that the emotional stress sent hormones and nerve signals to the intestines causing the following:

  1. Disruption of the healthy intestinal balance of the bacteria.
  2. Multiplication of the unhealthy bacteria, causing intestinal inflammation.
  3. Release of chemicals by the inflamed intestines, stimulating the satiety center in the brain – resulting in loss of appetite.
  4. Once the stress is resolved, both the healthy bacteria and appetite will return.

Be Happy…Take a Probiotic!

With this brief background, we will explore more clearly how intestinal bacteria can be impacted by stress and how probiotic bacteria can improve our mood. It is a two way street.

A research article published this month in the prestigious medical journal Proceedings of the National Academy of the Sciences discusses how probiotic bacteria may lessen anxiety and depression and help to maintain a positive attitude(3).

The point of the study was to determine how bacteria dwelling in the gut can effect the brain, and thereby influence mood and behavior. Since there are special neurotransmitters in the brain that impact mood, the researchers sought to evaluate whether these receptors could be modified by probiotics.

The researchers split their rodent subjects into two groups. One lot was fed a special broth containing Lactobacillus rhamnosus. The other group was fed an ordinary diet not fortified with microbes.

The mice were subjected to a battery of tests that measured their emotional state. The results indicated that the mice fed Lactobacillus performed more activities in a maze which indicated confidence and less anxiety. They were able swim in a container farther indicating a more positive mood.

Direct measurements of the animals’ brains supported the behavioral results. Levels of cortisone, a stress hormone, were significantly lower in the bacteria-fed mice than they were in the control group.

In addition, the number of neurotransmitter receptors was higher in the mood altering portion of the brain. Stimulation of these receptors results in sensations of relaxation and euphoria.

Finally, to prove that the vagus nerve is responsible for transmitting signals from the gut to the brain, the study was done again. But in the second study, the vagus nerve was severed in both groups of mice. The results of the repeat study revealed that the behavior in the two groups of mice was the same. The probiotic fed mice didn’t demonstrate the same activities which had been associated with confidence, less anxiety and a more positive mood. The damaged vagus nerve couldn’t transmit the benefits of the probiotics to the brain.

At this point you may say “well that is very interesting but we are not mice.  Are there studies in humans that also show similar results?”

A recent study in the British Journal of Nutrition(4) assessed whether a daily dose of a Lactobacillus and Bifidobacterium probiotic taken for 30 days could influence the psychological impact of everyday life events in normal human volunteers.

By using standardized psychological tests, the scores of the probiotic treated group had lower values for depression, anger-hostility and physical complaints.

The authors concluded that the beneficial effects of the probitotics may be explained by competitive exclusion of harmful gut bacteria and a decrease in inflammatory signals via the vagus nerve to the brain!

Take Home Message

If you are feeling a little “blue” or just want to feel positive about life, consider taking a beneficial probiotic like EndoMune. The best part of these studies is that there were no adverse effects of probiotics – no need for a black box!

References

(1) Gut-brain axis. Romijn JA, Corssmit EP, Havekes LM, Pijl H. Curr Opin Clin Nutr Metab Care. 2008 Jul;11(4):518-21.

(2) The new link between gut-brain axis and neuropsychiatric disorders. Fetissov SO, Déchelotte P.Curr Opin Clin Nutr Metab Care. 2011 Sep;14(5):477-82.

(3) Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, Bienenstock J, Cryan JF.Proc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5.

(4) Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A, Bisson JF, Rougeot C, Pichelin M, Cazaubiel M, Cazaubiel JM. Br J Nutr. 2011 Mar;105(5):755-64.

Tax Season Can Lead to Stress and IBS

April is a wonderful time of the year. Spring is nature’s way of saying, “let’s party.”(1)

Planting new flowers and watching the first blossoms of the year are very joyful and relaxing activities, especially after enduring the cold gray days of winter.

Unfortunately, despite its beauty, April can sometimes be stressful for various reasons. At the forefront of many people’s mind is the need to file taxes. Or, you may be waiting to hear where your children will be going to school next year, or if they will find a job. If you happen to be one of those millions of people experiencing stress this season, you may want to consider taking a probiotic after you read this month’s newsletter.

Stress Causes Changes in Bacteria

Two very interesting articles were published in March. These articles investigated how stress can adversely affect the healthy bacteria of intestines(2,3) .

In my practice of gastroenterology, I would see many patients who had ongoing symptoms of abdominal pain and change in stool habits. Despite comprehensive evaluations, no specific cause could be found for many of the patients. As a result, they would be labeled with the diagnosis of “Irritable Bowel Syndrome” (IBS).

At the time, it was thought that the symptoms of IBS were frequently due to stress. The common therapies included medications that combined an antispasmodic and a mild tranquilizer like Librax, Donnatal or Bentyl. These medications were treating the symptoms, but not the cause of stress. If medical researchers can determine the cause of the symptoms, then better therapy can be developed.

Immune System and Stress Regulation

The intestines contain 70% of our immune cells. It’s these cells that are responsible for monitoring the bacteria entering our system. Harmful bacteria stimulate the intestines to release inflammatory mediators (cytokines) in an effort to destroy the harmful bacteria. An increase in these mediators can result in intestinal inflammation, which in turn causes the symptoms of IBS.

One study(3)  published in March measured the level of inflammatory cytokines in 30 patients with IBS and in 30 normal controls. The level of cytokines were much higher in the IBS group – indicating there is a link between IBS and cytokines.

The other study(2)  investigated the intestinal bacteria in mice before and after they were exposed to a stressful situation. Following exposure to the stress, there was a change in the composition of the intestinal bacteria. With this change came an increase in harmful bacteria, which then induced the immune system to release inflammatory cytokines.

These research studies help to understand the cause of IBS symptoms. Now, the question is how to decrease the inflammation induced by stress. Doing this will be a giant step toward “treating” the symptoms of IBS.

Fortunately, scientific studies(4,5)  have already demonstrated that giving probiotics can reduce the immune system release of inflammatory cytokines, thereby easing IBS symptoms.

Take Home Message

If you are experiencing some stress and GI symptoms, consider taking a high quality probiotic like EndoMune so you can fully enjoy this springtime.

Eat healthy, exercise and live well!
Dr. Hoberman

References:

(1) Quote by Robin Williams

(2) Exposure to a social stressor alters the structure of the intestinal microbiota: implications for stressor-induced immunomodulation. Bailey MT, Dowd SE, Galley JD, Hufnagle AR, Allen RG, Lyte M. Brain Behav Immun. 2011 Mar;25(3):397-407

(3) Altered peripheral toll-like receptor responses in the irritable bowel syndrome. McKernan DP, Gaszner G, Quigley EM, Cryan JF, Dinan TG. Aliment Pharmacol Ther. 2011 May;33(9):1045-52.

(4) The role of microbiota and probiotics in stress-induced gastro-intestinal damage.Lutgendorff F, Akkermans LM, Söderholm JD. Curr Mol Med. 2008 Jun;8(4):282-98

(5) Therapies aimed at the gut microbiota and inflammation: antibiotics, prebiotics, probiotics, synbiotics, anti-inflammatory therapies.Quigley EM.Gastroenterol Clin North Am. 2011 Mar;40(1):207-22

 

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