By Dr. Scott OlsonBacteria are small. Our red blood cells are ten times larger than the typical bacteria (and our red blood cells are not all that big). Who would have thought that the lowly bacteria could have such an impact on Irritable Bowel Syndrome (IBS)?
Of all the organisms on the earth, the bacteria are some of the simplest, but being simple is not the same as being unimportant. Even though we dont like to think about it, bacteria are everywhere in our environment. In fact, our bodies are a sort of bacterial zoo. Somewhere between 500 and 1000 different species of bacteria call your body home. Our skin, our mouths, even our eyelashes are home to bacteria.
The most important bacterial population, at least for the sake of Irritable Bowel Syndrome (IBS), is the bacteria that live in your digestive tract. These bacteria are collectively called the gut flora. Recently, scientists have begun to recognize the huge role that these bacteria play in our health and the creation of disease.
This gut flora is so important that it might well be considered an organ unto themselves as they help us digest food, provide us with nutrition, and help us fend off diseases. But these gut bacteria can also have a dark side.
Bacteria and Gut HealthWhile the reason why people get IBS is still under investigation, it is clear that there is a strong connection to the health of the gut bacteria and the disease.
The IBS connection to gut health comes about because of the close relationship between the gut flora and the lining of the gut.
Bacteria, like much of life on earth, know how to do a few things really well. Bacteria generally do three things: grow, multiply, and produce waste. Some of these waste byproducts that bacteria produce are good for us and some are not. For example, lactobacillus acidophilus has a waste byproduct called hydrogen peroxide, which can actually reduce harmful bacteria. Others help release vitamins that we absorb.
However, other bacteria produce harmful waste byproducts that can hurt the gut wall. And what is worse is that some of these byproducts from harmful bacteria actually turn on the immune system, causing a generalized inflammatory state in the gut. These harmful bacteria thrive in a high sugar environment, or when people are under stress. They also tend to be the bacteria that survive when antibiotics are taken.
The Mucosal BarrierThere is a barrier between the food that is ingested and the rest of the body. This barrier is called the mucosal barrier and is made up from the cells of the gut, a mucous layer, and the bacteria in the gut.
When this mucosal barrier becomes irritated it becomes inflamed. It can also be inflamed when irritants or allergens cross the barrier of the gut and turn on the immune system of the body.
Either way, an inflamed gut has a way to deal with this inflammation. The gut determines that the problem is coming from the contents of the gut and decides to get it out of the body, as quickly as possible. The result is diarrhea.
This sets up the endless cycle of IBS, where the gut becomes irritated and causes diarrhea and then the gut calms down, sometimes leading to constipation and then the cycle starts all over again.
What seems to be irritating this mucosal layer is an increase in bacteria that are harmful to the gut wall . Probiotics have been shown to actually decrease inflammation . They do this by directly competing with the bad bacteria and by producing chemicals that help the gut and reduce the inflammation.
Are you Getting Enough?Choosing the right probiotic is difficult. In order for bacteria to become established in the gut when taking them by mouth, you need to take a lot. After all, the place that you want the bacteria to be is in the colon and this is some 23 or 24 feet (the length of the small intestines) or so past the stomach. That is a long way to go, and it means passing through the stomach with its hydrochloric acid and digestive enzymes in order to end up in the colon.
1 billion live bacteria is the absolute minimum that you need in order to have probiotics establish themselves. Taking supplements with a lot more than 1 billion live bacteria is your best bet.
You should also avoid probiotics with Fructooligosaccharides (FOS). FOS is a food for bacteria, but it will feed the bad bacteria as well as the good bacteria, and it has been known to cause problems for people with IBS.
Bacteria are small, but they are powerful. Having the right balance of them in your gut can calm your IBS. Seek out a good probiotic supplement, and your gut will thank you.
- Quigley EM: Bacterial flora in irritable bowel syndrome: role in pathophysiology, implications for management. J Dig Dis. 2007 Feb;8(1):2-7.
- Menard S, Candalh C, et al: Lactic acid bacteria secrete metabolites retaining anti-inflammatory properties after intestinal transport. Gut. 2004 Jun;53(6):821-8.