Tag Archives: slow transit constipation

Butyrate Series, Part 8

Hello! I have not stopped working on and constructing butyrate posts (or other posts, like recipes and homeschooling posts), but I haven’t been able to complete them in a very timely manner. Whew! Homeschooling is hard work! However, I’m ready to start posting the next installment of my Butyrate Series. Let’s look at another way to potentially increase butyrate production in the body. . .

Warning: Writing up what I’ve learned about certain topics is simply a hobby of mine. It’s my entertainment and way to unwind from motherhood, homeschooling, and housework. When you read my writing, I’d like you to enter into an agreement with me: you read it to see what I think I’ve learned, but you do not read it with the thought that I am some expert or that I can possibly help you. I can’t help you. Supplements and treatments discussed enthusiastically on the internet can be dangerous. You, however, armed with knowledge and curiosity, can take the initiative to safely and non-ignorantly make a difference for yourself. This site is not medical advice.

Probiotics to (directly) increase butyrate

The Japanese have used a strain of Clostridium butyricum, a direct butyrate-producing bacteria, as a probiotic since about the 1970s. Savvy health professionals know butyrate best for its gut benefits (healing leaky gut, improving the mucous barrier, and improving motility), but it also has positive effects on the kidneys, brain, and metabolism–not to mention colon cancer prevention. Despite its structural simplicity, the little short chain fatty acid called butyrate truly makes a powerful, all-encompassing health difference.

Personally, my favorite way to increase butyrate in the body is NOT to take supplements– but to eat green bananas, leftover boiled cassava root, and/or leftover potatoes. Aiming to eat whole, real food is always best, but it may not be enough for select problems.  I get that. So I’m curious about all the other ways to increase butyrate.

If you have read any of my butyrate posts, you may remember that I outlined and explored four potential ways to increase the body’s butyrate levels:

  1. Eat butyrate-rich foods, like butter from grass-fed cows.
  2. Eat foods that butyrate-producing bacteria like to metabolize, particularly green bananas, green plantains, refrigerated and then reheated potatoes, beans, lentils, cassava root, and/or rice.
  3. Take butyrate supplements directly.
  4. Take probiotics which contain bacteria known to make butyrate.

Since last writing, I’ve expanded my list of potential butyrate-producing methods that I’d maybe eventually like to write about:

5. Take probiotics which support butyrate-producing bacteria in the GI tract.
6.  Consume prebiotic fibers which enhance butyrate production by GI tract bacteria.
7. Maybe we could somehow upregulate our colonic butyrate importers, such as MCT1 and SMCT1. (1, 2)

My other butyrate posts have waded through points one through three. After quite a gap in my writing due to my work raising four wonderful people in the early stages of life, let’s talk about point number four: probiotics which contain bacteria known to directly make butyrate.

Commercially available butyrate-producing probiotics

The only direct butyrate-producing bacteria (that I found) that we have available as a probiotic for human consumption is Clostridium butyricum. Quite a bit of searching turned up only two different probiotic brands to buy with Clostridium butyricum. (Have you seen any others I’ve missed?) Although both probiotics contain spores of the same species, Clostridium butyricum, they are different strains of the species.

When ingested, the bacterial spores germinate and grow in the intestinal tract, making the short chain fatty acids butyrate and acetate (6). Both strains and brands have studies behind them for various health conditions which I’ll try to discuss in this thread of posts (but not in this post today). Both probiotics can be found on Amazon.

  1. MIYAIRI 588 (CBM 588) Miyarisan Tablets
  • A one-strain probiotic of Clostridium butyricum
  • Manufactured in Japan and distributed there as an over-the-counter medicine
  • Commonly available and used in Asia
  • Available in two strengths: standard and strong. If you look at my citation number 4, you’ll find the recommended dose and much, much more about this probiotic.
  • Other listed ingredients are lactose, corn starch, talc, microcrystalline cellulose, and magnesium stearate
  • History: First isolated from feces by Dr. Chikaji Miyairi in Japan in 1933. CBM 588 is the 588th MIYAIRI strain, isolated from a soil sample in Nagano, Japan in 1963.
  • As mentioned, the probiotic is composed of spores of C. butyricum (rather than “live,” active bacteria), which are then activated in the gastrointestinal tract, making the probiotic quite shelf stable with no refrigeration required. (3, 4)

2. Advanced Orthomolecular Research Probiotic-3

  • A three-strain probiotic which includes Clostridium butyricum TO-A, Enterococcus faecium (same as Streptococcus faecalis) T-110, and Bacillus subtilis TO-A (some places I see the label with Bacillus mesentericus)
  • Only the Clostridium butyricum is the direct butyrate-producing bacteria
  • Also contains lactose, potato starch, polyvinyl alcohol, providone, and sodium stearyl fumarate
  • If I understand correctly, it contains Bio-Three probiotic formula. I believe the “TO-A” implies that the strain was produced by the TOA Pharmaceutical company in Japan (inferred from Bio-Three website). The Bio-Three formulation is used in Japan, and has studies behind it.
  • No refrigeration necessary. As with the Miyairi probiotic, the Clostridium butyricum is in the shelf-stable spore form. (5)

About Clostridia and the bacterial species Clostridium butyricum in general

When we are about one month old, different commensal species of Clostridia start to colonize our gastrointestinal (GI) tracts. They are supposed to be there and provide specific and essential benefits to us without causing harm. Since we only typically hear of the toxic Clostridial diseases like botulism, tetanus, and “C. diff.,”  it may sound strange to some of you to know you healthfully have an abundance of clostridium residing in your GI tract! If you think of Clostridia as a “bad” class of bacteria, you might find it even more disturbing and confusing to know that a known pathogen like Clostridium difficile (the culprit in C. diff pseudomembranous colitis) can be part of a normal human gut biome or can actually prevent infection. (6-9)

[Opinionated aside: The fascinating idea that a strain of C. difficile, a bacteria we think of as toxic, can be normal flora supports why I would argue with people that we have to stop oversimplifying health, stop trying to peg things, and start convincing people to do complete overhauls to their modern lifestyles and mindsets to bring the body into rhythm with itself. Don’t just take butyrate supplements and butyrate-enhancing probioitics—investigate your life, eating, habits and make impact changes. Being honest with and scrutinizing oneself often hurts for several months, but if done properly, you move past the pain, and healing and change can begin. Perfection will never be reached in this realm, but progress feels so good to a mind and body.]

Clostridium butyricum is one species of Clostridia bacteria. It is Gram-positive, rod-shaped, and anaerobic. It lives in soil and in the GI tracts of birds and mammals and can be found on the skins of potatoes, Swedes, and even in cream and yoghurt. It ferments starches to produce butyrate. When C. butyricum is exposed to a stressful environment, it can form endospores, an alternative form which allows it to survive the stressful conditions, to later reactivate when exposed to desirable conditions. It is the spores which are used in the probiotic formulation, allowing them to be shelf-stable without refrigeration for several years. (3, 4)

Some of you may have read about the clusters of clostridia and wondered about that. The Clostridia microbiological class (to which C. butyricum belongs) is exceptionally diverse, and even the commonly accepted shared characteristics, such as being rod-shaped (bacillus), anaerobic, and spore forming, have variations and exceptions to the rules. In the attempt to break down, stratify, and classify the types of Clostridia, the species C. butyricum is categorized into what is called “Cluster I Clostridia.” Cluster I Clostridia aren’t common inhabitants of the human gut. Human guts seem to mostly contain butyrate-producing bacteria from Clostridium clusters IV and XIVa rather than cluster I, but some human GI tracts do contain Clostridium butyricum, so clearly it does naturally happen. Fecal studies have found Clostridium butyricum in about 10-20% of its surveys. (6-9)

For all practical purposes, C. butyricum is a non-toxic clostridium species, but there have been reports that it can acquire some of the toxic genes from other clostridia, leading to production of poisonous toxins which may contribute to infant botulism or infant necrotizing enterocolitis. Regarding adults, one case of sepsis from Clostridium butyricum has been reported in an intravenous drug user and one case of antibiotic associated diarrhea has been reported. The complexities of toxin acquisition/production depend on the strain, the host, and interactions with other strains. Some strains of Clostridium butyricum are probiotic and beneficial and other strains show virulence. The probiotic strains mentioned are tested for non-virulence.  (6, 7)

Closing

I’ll cut off this post for today and try to clean up my next writing segment regarding specific uses of the probiotic Clostridium butyricum. I do not have it “polished up” yet, but posting this half will force my hand to get the rest of it tidied up and posted for those interested. I’d like it if you’d point out typos or mis-information to me so I can make corrections. Thanks in advance.

Please keep in mind: I don’t really care about probiotics or bacteria or food. What I really care about is that you grasp your life, your whole life, and tenaciously latch on to the things that are good and real– and that you weed out the things that are bad for you and noxious. I love life. I’ve had my share of challenges, smaller than many, bigger than some. But no matter what, I try to choose to face life HEAD ON with as much transparency as I can. And each new day, each new week, each new stress, shows me how to become more true and real.

The best to you,

Terri F

Citations:

  1. Pedro Gancalves, Fa’tima Martel. Butyrate and Colorectal Cancer: The Role of Butyrate Transport. Current Drug Metabolism. Volume 14, Issue 9, 2013.
  2. Pedro Gonçalves, Fátima Martel. Regulation of colonic epithelial butyrate transport: Focus on colorectal cancer. Biomedical Journal. Volume 1, Issue 3, July–August 2016, Pages 83-91.
  3. Wikipedia site regarding Clostridium butyricumhttps://en.wikipedia.org/wiki/Clostridium_butyricum
  4. Clostridium butyricum Miyairi 588 Novel Food Application, public version: C. butyricum MIYAIRI 588 as a novel food supplement.  Probiotic food supplement. Miyarisan pharmaceutical company, LTD. https://acnfp.food.gov.uk/sites/default/files/mnt/drupal_data/sources/files/multimedia/pdfs/clostridiumbutyricumdossier.pdf
  5. Bio-Three website: http://www.bio-three.com/
  6. N.Cassir, S.Benamar, B.La Scola. Clostridium butyricum: from beneficial to a new emerging pathogen. Clinical Microbiology and Infection. Volume 22, Issue 1, January 2016, Pages 37-45. Review. 
  7. Rousseau, Clotilde & Poilane, Isabelle & De Pontual, Loic & Maherault, Anne-Claire & Le Monnier, Alban & Collignon, Anne. Clostridium difficile Carriage in Healthy Infants in the Community: A Potential Reservoir for Pathogenic Strains. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2012. 55. 1209-15.
  8. CS Cummins and JL Johnson. Taxonomy of the Clostridia : Wall Composition and DNA Homologies in Clostridium butyricum and Other Butyric Acid-producing Clostridia. Journal of General Microbiology.   (197 I), 67,33-46
  9. Lopetuso LR, Scaldaferri F, Petito V, Gasbarrini A. Commensal Clostridia: leading players in the maintenance of gut homeostasis. Gut Pathogens. 2013;5:23. doi:10.1186/1757-4749-5-23.

 

Slow Guts Need Tenacity

256px-Pieter_Lastman_-_Jonah_and_the_Whale_-_Google_Art_ProjectTenacity.  Word for the day.  Word for a season.  Word for life.  I can hear mom’s voice even now, “Oh, Terrrr-rrrri.  You have a one-track mind.”  She said it like it was a bad thing!  Pshaw.  But, tenacity got her to buy me some black parachute pants; I think it’s restoring my gut too.  I’ve worked very hard to get this gut moving.  Very.  I’ll be laying out all that I can think of that I tried and how I think it affected my gut and me.  There is no ONE thing that worked for my colon regularity and stool consistency.  Geesh.  What would I have to write about if it was that easy?  I’ve turned down more cookies, cakes, and cheese platters than you can even imagine.  I’ve made myself go to bed early more than I’ve ever made my kids go to bed early.  I’ve attacked my gut on all fronts that I can.  Tenacity.

I’m starting out by writing about the supplements I’ve tried.  That does NOT mean that the supplements are the most important.  Just that I’m postponing talking about acupuncture and gargling and chakras.  I’ve already mentioned vitamin K2 in the last post.  These posts will just keep rolling.  So let’s continue.  Don’t use this as medical advice.  It’s my story.  If it gives you ideas to try, talk about them with your doctor.  Be SAFE.

Iodine

I’ve taken iodine for about two years now. I don’t have much in the way of a reliable iodine source in my diet, so I supplement. Iodine comes to a conventional diet via egg yolks, dairy, seafood, and iodized salt.   Iodine didn’t seem to have any particular impact on MY constipation, although other people have reported to me that when they started taking iodine it did seem to improve their constipation; I experienced other positive benefits from taking iodine. I was able to have my thyroid labs followed to make sure I was safely supplementing. Hypothyroidism (low thyroid) causes constipation. I was never categorized as hypothyroid. However, iodine supplementation did slowly drive my TSH down over time, which was medically interesting to watch.

Bottom line for me: Iodine did not seem to make my constipation better, but it helped other things for me. I think that a TSH needs periodically checked and symptoms need closely monitored if a person is going to take iodine.  In case you’re counting, this is the second supplement I take routinely.

Probiotics and Probiotic Foods

I’ve tried dozens of probiotics. Not A DOZEN—but DOZENS. There is no probiotic that makes my motility improve directly. I’ve tried soil based. I’ve tried VSL. I’ve now tried the Japanese kind. I’ve tried Klaire Labs. I’ve tried pickles, pickle juice, sauerkraut, sauerkraut juice and kimchi. I’ve made my own fermented pickles, sauerkraut, and beets. I’ve tried 24 hour homemade yogurt. I’ve tried homemade coconut yogurt. Tenacity.  There is one probiotic source I haven’t tried, but I’d like to try: Mutaflor. It has studies showing it helps constipation. However, it’s only available in certain countries, and the USA isn’t one of them.

Probiotics aren’t the “cure” for my STC.  I’ve tried many kinds, and I’ve tried driving up the doses.  Tenacity.  In fact, for a couple of months this summer, I even stopped probiotics completely!!!!  I suffered no ill GI effects and my gut still moved! Why did I stop them? I think that I have a mild case of small intestinal bowel overgrowth (SIBO).  (Why not test?  1) I already eat a tailored diet.  2) Things are improving.  3)  I’ve tried antibiotics before for it, and it came right back.  And now, I won’t take antibiotics because I’m nursing.  4)  My case isn’t that bad.)  I now waffle between probiotics and no probiotics.

What is SIBO?  This is where the bacteria from the colon track up into the small intestine in larger numbers and/or with different species than those that should be there. It leads to significant bloating, distention, bowel movement changes, fatigue, and other symptoms. There is a dispute in the SIBO arena about whether one should take probiotics with this disorder. Having no vested interest and an open mind, I could see both sides. So since I’d tried probiotics like crazy for years, I thought I’d try without. (Another aside: I have not always had SIBO symptoms. They started at about age 35. I think it was a result of chronic non-movement of my gut.  I think to effectively treat SIBO, a person HAS to address the underlying issues.)

Bottom-line for me: I tried coming off my probiotic. My gut still moved off the probiotic! However, my gut also moved normally for a couple of months before I got pregnant a couple of years ago and I was ON a probiotic. So for my body, I’m not yet sure whether it prefers a probiotic or not.  LOTS of people swear by probiotics for constipation.  I have been trying to utilize normal portions of Bubbie’s pickles, Bubbie’s sauerkraut, and eating my home-grown produce.

Butyrate

Butyrate has kick-started my gut twice in my life now. In 2013, I started taking it after a big dose of magnesium and immediately I had normal bowel movements daily. I then titrated up resistant starch using potato starch (which leads to natural butyrate production) and came off of the butyrate pills. I then titrated up food sources of resistant starch (green bananas, plantains, cooked and cooled potatoes and rice, raw potato and sweet potato sparingly) and stopped the powder forms of resistant starch.

BINGO. I thought I was a diet-controlled constipetic and the story was over! (I always told God I was going to stop blogging when my constipation was cured.  Never tell God what to do or what you think YOU’RE going to do.  Instead, when you hear “Jump.” from the Big Man, you say, “How high?”  Got it?) But I got pregnant in 2013 and I’ve been chasing GI rainbows ever since. Finally, late this summer of 2015, I decided to get back on butyrate. I took a good dose of magnesium to try to propel that butyrate deep into my intestines (just in case that would help, you know).  BAM.  My gut has been doing pretty well since then. Knock on wood. And I’m working on building back up my food sources of resistant starch again and working on other areas I’ll elaborate on through these posts (like stress management, core strength, etc). THIS IS NOT A SIMPLE QUICK-FIX JOURNEY. You want that? Go somewhere else.  Tenacity.

I KNOW butyrate does NOT work for all people. They’ve told me. More people have told me that butyrate did NOT help them than people have told me that butyrate DOES help them. I’d like to also point out that during pregnancy and post-partum, my gut kind of stopped working and I was on high dose magnesium. Butyrate did not work at this time—even though this summer I tried again and it did! This leads me to suspect that hormones play a huge role in constipation—which I already suspected and this simply pounded into my heat that I need to make sure and learn about this (and hopefully write it up too—although I must say the other day in my research, I saw a new review article that was downplaying hormones…).

Many people write to ask what butyrate I take. I simply tell this as part of my story. Listen. I do not support this brand, other than it has worked best for me out of all the ones I’ve tried. I don’t pretend to think this brand or even butyrate will help you. Heck, it may even set YOU back, while it sets me forward.  I use Body Bio Mag-Cal Butyrate 600 mg (two three times daily, usually, but not always with a meal). If you decide to try this, flash it to your doctor so he/she can make sure it’s going to be fine for you. A commenter, Vicki, has noted that Body Bio has received some reprimands. You may read about this by scrolling down to the comments and looking for an interchange between Vicki and me.  Sometimes, I have a strange feeling that some bottles work better than others.  I don’t know, though.  I have NO proof of that.

Bottom-line: Butyrate has some good evidence supporting its role in promoting gut motility.  I have many posts on that in my butyrate series.  Some people have tried it and found that it helped their food intolerances and gut motility. Others have tried it without success—and with a loss of hard earned cash.  If your’e counting, this is the third, and final, supplement that I currently take routinely.

Magnesium (Natural Calm)

What did I take during pregnancy and post-partum when hormones gripped my gut so tightly? I took three tablespoons of Natural Calm magnesium citrate in a tall glass of water nightly–every night. This is WAY too much magnesium. I am well aware that most of us are magnesium deficient, but this is a lot much! One electrolyte at a high dose is not good for the other electrolytes and their balances.  So even though this got things moving (diarrhea), this is not a good place to live for the rest of my life if I can help it.  Tenacity.

I tried some different forms of magnesium because the taste of this, although the unflavored is really okay, is becoming repulsive after four years or so of using it. The other forms, both topical and oral types of magnesium, just don’t work. And Epsom salts bath, although relaxing, don’t do anything at all for my GI.  This is the only brand of magnesium that has worked for me.  Again, I’ve no vested interest in this supplement, and I’m not saying it will work for you.

At my best right before pregnancy and also the last two months now, I was able to get off of the magnesium.  I still had/have to use it about once a week, and usually at a much lower dose– a heaping tablespoon.  But I only use it when I skip a day or things are too hard.

Bottom-line: Calm magnesium citrate now can keep my gut going (although with diarrhea) through thick and thin. Before I changed my eating and lifestyle four years ago, high dose magnesium did not work. So the fact that it works is great! But I still want off of it entirely! I am currently down to about once a week.  So I guess, if you are a nickel and dime counter, we would call this 3 and 1/2 regular supplements—since I only have to take it as needed and this only about once a week now.

Closing

I am going to stop now.  I have LOTS more to say.  You will be so bored by the time I finish.  You’ll think I talk and think about nothing but moving GI tracts. But, finish I will.  Tenacity.  Get those parachute pants.

Terri

Click here for Slow Guts Need Care, the first post in this series.

 

Slow Guts Need Care

“Colectomy rates for constipation are rising, are associated with significant morbidity and do not decrease resource utilisation, raising questions about the true benefit of surgery for slow transit constipation… (1)”

Whew!  From second chakras to acupuncture to triphala, I have been taking this alternative medicine front by storm to cure my slow gastrointestinal (GI) transit.  If all conventional medicine has to offer is a colectomy, then there is no shame in yoga and Squatty Potties.  Where do I stand?  Pretty good.  Pretty good.  Not yet cured.  Definitely have some ups and downs, but overall, my gut has totally reversed itself.  Knock on stinking wood.  Or incense sticks–or something–just so my gut doesn’t fall back again.  (Which those with this problem know is quite easily possible.)

Constipation isn’t talked about.  But it should be.  Colons are cut out because of it (seriously–see opening quote).  And people go to the ER for it (quite embarrassing, quite).  Not to mention hemorrhoids and anal fissures and horrible cramping (ouch).  Sometimes all it takes is simple diet maneuvers to get things back on track.  Other times, like in my case, it takes exploring your sanity and motivation.  (For the record, I am completely sane.  I ask my husband and friends every day.  Although I question some of my friends–so maybe you ought to wonder about me…Which brings me to the necessary disclaimer that this is only my story.  It is not medical advice.  You should absolutely discuss anything you try for your health with your doctor.  I am not your doctor.  I quit that jazz for Oz and its Munchkins.)

My History

I’m going to take a few posts to lay out what I do or have tried for my slow transit.  Let me briefly get you up to speed on my gut history.  I’ve had constipation all of my life.  As long as I can remember.  It worsened, just like the medical texts said it would, every decade of my life.  Until I was pooping once a month WITH Miralax, fiber, and a probiotic.  (Magnesium simply did not work at all.)  This was about age 35, and I had to start cranking on the stimulant medicines (which until this point I had only used as needed for the most part).  Not only was this ineffective, the high doses led to ouchy cramping.  I knew something else had to be done, so I turned to the halls of the internet clinic (because my doctors didn’t have any good answers for me–I mean, how could they?  I didn’t have any for myself!) after I quit working to homeschool my kids and I had “time.”

Now I must say, there have been three times, each lasting a mere few months, in my life where I have had what I feel are completely normal people bowel movements with little to no use of supplemental pills or powders. Once in my twenties after being treated for ulcer type symptoms with a PrevPac (involves amoxicillin and clarithromycin). Second time was two years ago just before getting pregnant.  Pregnancy and lactation proceeded to undo the hard-earned success I had achieved using diet, lifestyle changes, and focused supplementation. Finally, the third time I feel my gut has been reliable has been the last few months.  So, here I am with about daily Bristol 4 stools.  I’ll admit, I’m nervous going to bed each night, wondering, “Will I go tomorrow?”  Thinking the next day will be the beginning of the end of my GI success.  Unless you have a very bad problem with constipation, you may simply just not get this.   But I’m hoping if that’s you, I lost you at the first paragraph.

Getting to the Details

I have tried A LOT of stuff.  Since pregnancy and nursing, it has been focused on things that are safe to my baby.  I am still nursing, so I am still careful about what I try.  Let’s get started with more of my story.  There is a lot to write, and I will break it up.  If you have severe constipation and you expect a quick-fix, you may need to reset your expectations.

I am going to start with the supplements I take or have taken.  Some I don’t even take for the constipation, but I have to wonder about the role they play in my gut progress.  I only have room to cover vitamin K2 in this post.  MUCH more to come.  And, please, supplements really need to pass the approval of your doctor.

Vitamin K2

Briefly about:  Vitamin K2 is a relatively recent health-related discovery. It helps shuttle calcium where it’s supposed to go, whether we’re talking about shuttling it TO the bones or shuttling OUT of the heart blood vessels where it doesn’t belong. Getting enough vitamin K2 in our modern diet is tough for anyone because our meat, egg and dairy sources are not eating what they would eat if turned out of the pen. Vitamin K2 is present in the egg yolks of birds who eat worms, seeds, and other things they peck at in nature; the fat of grass-grazing animals; liver; and the milk-fat products of grass-grazing animals (butter and full-fat milk). It is also formed by bacterial action on milk-fat when cheese is being made or by bacterial action when natto (from soybeans) is being made. One last rich source is fish eggs. Vitamin K2 is a fat-soluble vitamin, and therefore likes to be in fat and is best absorbed when eaten with fat.

My story:  I started taking vitamin K2 because I realized with my dairy and egg intolerance, I was not getting any K2 to support my bones, blood vessels, and gums/teeth. (Vitamin K2 plays a large role in the structure and health of the oral region.) (Aside:  Vitamin K2 is supplemented in conventional chickens and so it is a source of vitamin K2; I strangely can’t eat chicken either.) I don’t know if vitamin K2 has helped my STC or not as an individual agent. However, it is a supplement I have taken daily for the last four months or so.

Is there research that may lend itself to the idea that vitamin K2 may be helping my gut move forward? I found an abstract in which bone morphogenetic protein 2 (BMP2) helped improve slow transit constipation. Vitamin K2 does impact BMP 2:

Mol Med Rep. 2015 Nov;12(5):6547-54. doi: 10.3892/mmr.2015.4297. Epub 2015 Sep 7. Bone morphogenetic protein 2 regulates the differentiation of nitrergic enteric neurons by modulating Smad1 signaling in slow transit constipation. Liu X1, Liu S2, Xu Y3, Liu X4, Sun D1.

 

And then here is a connection linking vitamin K2’s effect on BMP 2, a vitamin K dependent protein:

Oman Med J. 2014 May; 29(3): 172–177. doi: 10.5001/omj.2014.44PMCID: PMC4052396. Vitamin K Dependent Proteins and the Role of Vitamin K2 in the Modulation of Vascular Calcification: A Review. Margueritta S. El Asmar,1 Joseph J. Naoum,2 and Elias J. Arbid2,*

Bottom line for me: Vitamin K2 modulates BMP2. BMP2 may help slow transit constipation. MAYBE my vitamin K2 supplement is helping my slow transit. (Big question mark.)

Closing

Next post will have lots more.  It’s a long, long story.  Eat right.  Sleep right.  Look up the second chakra.  Love your gut.  Question your sanity.  Keep going.  🙂

Terri

 

 

  1.  Aliment Pharmacol Ther. 2015 Dec;42(11-12):1281-93. doi: 10.1111/apt.13415. Epub 2015 Oct 1. Colectomy for constipation: time trends and impact based on the US Nationwide Inpatient Sample, 1998-2011. Dudekula A1, Huftless S2, Bielefeldt K1,3.

Digestive Link Sharing

Fall leavesThere are so many helpful, fascinating topics I really want to get a chance to read on and summarize for my blog posts.  Writing and explaining helps solidify the information in my mind and hopefully the summarized information helps some readers too.  Sadly, I just can’t keep up with all that I want to do in a timely fashion.  So today I’m going to share three links which have been shared with me that some readers may be interested in.  Eventually, I’d like to read and summarize on the methanogens and progesterone links.  But, honestly, I can see it may take me a year to do it.

Link ONE is about how certain microorganisms in the gut make methane which then slows the intestinal transit leading to chronic constipation.  This may lead to the idea that a breath test could be diagnostic and certain antibiotics helpful.

Methanogens in Human Health and Disease
http://www.nature.com/ajgsup/journal/v1/n1/full/ajgsup20126a.html

Link TWO is about the effect of progesterone and prostaglandins on women’s colons.  Women with chronic constipation and slow transit have been found to have abnormal levels of prostaglandins and cyclooxygenases in their colons.  When researchers applied progesterone to colon cells from women without constipation, they were able to bring about the abnormal levels seen in cells from constipated colons.  So there is clearly a role between progesterone, prostaglandins, and chronic constipation. 

Chronic constipation in women linked to prostaglandins
http://www.modernmedicine.com/modern-medicine/news/modernmedicine/welcome-modernmedicine/chronic-constipation-women-linked-prostag?page=full

Link THREE is about an online, digestive conference coming up.  It is free.  There are some good speakers involved who are on the cutting edge, or at least reading up on the cutting edge, of digestive health.  The speakers are from a wide variety of backgrounds, some MDs and some not.  Usually something like this is a good place to listen, generate ideas, and then verify ideas with research or run them by your doctor.

The Digestion Sessions
http://digestionsessions.com/

Closing

Information is key.  Help your doctor help you by learning the new information out there.  Your doctor is like a good coach.  They have strong knowledge and experiences, but they’re trying to orchestrate many, many players all day long.  There is no way on God’s great earth doctors can ever keep up on all of the new information.  Print off credible articles, highlight important information in it which you think applies to you, and then say, “Hey, Doc.  I found this article about my problem.  Could we try it for me or do you think it’s a bad idea?”

Thank you Ashwin, Nishka, and Toni for the links.  I can’t wait to delve into them more.

 

Terri

Butyrate and Constipation

I have been excited about butyrate because rat studies showed that it increased the motility of the colon (please let’s not dwell much too long on the fact I’m reduced to rat status and writing about constipation).  I am going to summarize and explain an abstract to a study, from which the following quote is taken:

“Little is known about the environmental and nutritional regulation of the enteric nervous system (ENS), which controls gastrointestinal motility. Short-chain fatty acids (SCFAs) such as butyrate regulate colonic mucosa homeostasis and can modulate neuronal excitability. We investigated their effects on the ENS and colonic motility.” 

~  from Gastroenterology,  2010, “Short-chain fatty acids regulate the enteric neurons and control gastrointestinal motility in rats.”  Emphasis was mine.

Aside:  Please note that I am probably a fool and excited about nothing, but it is a path worth exploring for my slow transit constipation.  Also note, I do my best to simplify studies and concepts, some of which are difficult for my basic molecular biology background.  My husband, being an exceptionally logical and fact oriented doctor, hates it when I do this.  Big time scowls.  He is right, sometimes the explanations become kind of inaccurate.  So I will do the best I can.  If you have any questions or note any errors, I would like to know.  Gaps in my understanding will be bridged this way.  And one last note, don’t use my blog stuff to cause any harm to yourself.  Please.  See your doctor.

What did these researchers do? 

  1. Fed rats a resistant starch diet.  (I will write a resistant starch post soon.  Soon is always relative.)
  2. Inserted short chain fatty acids (i.e. butyrate) into rats’ cecums (a part of their colons).  (I only have an abstract so we are left to our imaginations for this lovely process.)
  3. Applied butyrate to some “free-standing” cultures of enteric nervous system cells in a “test tube.”
  4. In the “test tube” cells, they examined how the cell “looked”–its “phenotype.”  What kind of receptors did the nervous system cells have on their outer membranes?  What kind of proteins are expressed?  Knowing this kind of information helps us to know what the cell is capable of responding to and what substances the cell makes.  Special antibodies that will seek out these known proteins and receptors on the cells are used.   Researchers also used polymerase chain reaction (PCR), a way to amplify and increase certain material.  Specifically, these researchers looked for antibodies to Hu, choline acetyltransferase (ChAT), and nitric oxide synthase (NOS).  If you refer back to “Changes in Severe, Chronic Constipation,”  you will see a couple of these discussed:  Less neurons immunoreactive for ChAT and more neurons immunoreactive for NOS.  They also proceeded to analyze signaling pathways using various tests.
  5. Observed the motility of the colon both in the rat and outside the rat.

What were the results?

  1. Resistant starch diet (which increases butyrate) and butyrate (but NOT acetate and propionate, other short chain fatty acids made from resistant starch by the colon’s bacteria) both:
      A.  Increased the ChAT neurons, these are the ones partly responsible for increasing peristalsis.  Neurons with ChAT should make more acetylcholine, the neurotransmitter that encourages the bowel to move forward and empty.
      B.  Did not alter the NOS neurons’ proportion and number.  NOS would bring about nitric oxide, which slows down the bowel’s movements.  It makes the bowel relax rather than move.
  2. Bowel neurons have a transporter called monocarboxylate transporter 2 (MCT2), which helps bring butyrate into the colon cell after the bacteria graciously make it.  Well, the researchers were able to “stop” these transporters so butyrate wouldn’t move into the cell so much.  By stopping the MCT2 transporters, the increase in ChAT neurons–and therefore neurons that would increase colon motility–was halted.
  3.  Butyrate increased histone H3 acetylation in enteric neurons.  When DNA is acetylated, it allows the DNA to be transcribed.  So butyrate alters the actual genetic expression of cells.
  4. Resistant starch diet increased colonic transit.
  5. Ex vivo it was noted that butyrate increased the circular muscles contraction when exposed to acetylcholine.

Their Conclusion

“Butyrate or histone deacetylase inhibitors might be used, along with nutritional approaches, to treat various gastrointestinal motility disorders associated with inhibition of colonic transit.”  And that’s as far as I’ve seen it up to this post.  I’ll keep looking.

My Conclusion

I’m not trying to live forever.  I don’t have cancer yet.  I’m eons away from a stroke.  But my gut has a mind of its own.  In addition to more information on butyrate (and resistant starch), I need to explore the outcomes of slow transit constipation in 80 year-old women.  Do they have a study on that?  Right now, things are tolerable with all the changes I’ve made the last 18 months or so of my life, but what happens later?  Or when the magnesium stops working again?  Anyhow, here are my closing thoughts:

  1. Butyrate is made in the gut and absorbed by the gut.  The gut has been my constant, lifelong problem.
  2. Butyrate may affect the immune system and decrease inflammation.  We have studies supporting food intolerances causing severe, chronic constipation and these studies document subtle inflammatory changes in the mucosa.
  3. Butyrate may affect the nervous system through modulation of gene expression.  We know the enteric nervous system is messed up in slow transit constipation.
  4. Butyrate may stimulate the contractile activity of the colon and accelerate GI transit.  We know slow transit constipation has a reduction in high amplitude propagating contractions and a disruption of the coordinated peristaltic activity.
  5. Butyrate is increased by eating resistant starch, a type of “fiber.”  (This is a bit confusing, but I will clarify later.  Resistant starch would be high in diets rich in lentils, beans, tubers, etc.  Please see Butyrate Series, Part 6 for a better, more thorough explanation)  Fiber has long been recommended for constipation.  Perhaps it’s not the fiber.  It could be the fiber.  Or it could be a rich bacterial population capable of making more butyrate for an individual.
  6. Butyrate has been shown to possibly decrease colon cancer.  Colon cancer is higher in patients with chronic constipation (Chronic Constipation Linked To Increased Risk of Colorectal Cancer–summary article from Science Daily).

And finally, I’ll leave you with this quote:

If the promising results by Soret et al [the paper whose abstract I summarized and explained above] can be confirmed and expanded by controlled therapeutic trials, then butyrate-generating foods might become an effective and simple option to prevent or treat functional gut disorders via modulation of enteric neuroplasticity.” (2–a very good little commentary to read!)

Terri

Butyrate Series Page

Sources:

1.  Soret R, Chevalier J, De Coppet P, Poupeau G, Derkinderen P, Segain JP, Neunlist M.  Short-chain fatty acids regulate the enteric neurons and control gastrointestinal motility in rats.  Gastroenterology. 2010 May;138(5):1772-82.  Sadly, abstract only:  http://www.ncbi.nlm.nih.gov/pubmed/20152836

2.  de Giorio R, Blandizzi C.  Targeting Enteric Neuroplasticity:  Diet and Bugs as New Key Factors.  Gastroenterology.  2010 May; 138(5):1663-1666.

Also, if you will please see “Why Does My Gut Defy Gravity:  Changes in Severe, Chronic Constipation” and But What Causes All of Those Changes Found in Chronic, Severe Constipation?and “Cow’s Milk and Refractory Constipation”   then you can find further information plus sources for that information and information mentioned above.

Thanks,

Terri

I also have run a whole series on butyrate.  I need to come back and link eventually; the WordPress blogging platform used to have a feature to do that but not now.  If you look under GI Tracts Defies Gravity page, there are links there to the series pieces.

Why Does My GI Tract Defy Gravity: Changes in Severe, Chronic Constipation

What is the problem?  There definitely is a problem, even if knowing what we know of the problem won’t help you move your bowels any more frequently yet.  And of all these “problems,” we don’t know which is the primary problem, if any of them!  I guess what I’m saying is, it’s good to know, but I’m sorry it won’t help you.  Advances in science occur in spurts, and then it takes time to shape these advances into hypotheses and then theories.  Even then, we may arrive at an incomplete understanding–as we may have in leading you to believe “fat is bad for you.”

I will describe in a later post how I use this and other information to try to gain any edge I can on my bowel function.

Please let me know if any of these links don’t work, please.  It is fascinating information, and if it may help you with your disease process, I’d like to make sure you can read it!

  • Less Interstitial Cells of Cajal (ICC).  Normal movement of the GI tract requires interstitial cells of Cajal.  These cells act as pacemakers and signallers between autonomic nerves and smooth muscle, causing the colon’s neurons to fire and bring about peristalsis, and alterations in their number and function are thought to bring about drastic functional changes.  Decreased ICC numbers and abnormal integrity are considered a hallmark in the gut disorders of diabetic gastropathy and slow transit constipation. (1, 2, 4)
  • Increased number of mast cells.  Mast cells are immune cells which are often found in connective tissue, particularly in sites where there is close interaction with the “outside world”—the external environment—like in the GI tract.  They are often associated with allergic responses, including food allergies.  In the GI tract, mast cells are preferentially located next to nerve terminals in the region known as the lamina propria and play an important role in the regulation of gastrointestinal visceral sensitivity, vascular permeability, and motor function.  Interestingly, they have also have been found to be elevated in many cases of irritable bowel syndrome.  (1,3)
  • Abnormal neurotransmitters and response to these neurotransmitters , including but not limited to– serotonin, vasoactive intestinal peptide, and substance P.  (1, 3, 4, 9)
  • Too many progesterone receptors.  Progesterone slows the GI tract down.   It does this, in part, by decreasing the effect of acetylcholine (the neurotransmitter that, in the bowel, leads to increased peristalsis) and serotonin.  This may explain why constipation may worsen during pregnancy and at certain times in female cycles.  Check. (1, 5)
  • Reduced Substance P Fibers.  Substance P brings about an increased GI motility effect. (1)
  • Less neurons immunoreactive for ChAT.  Basically saying there are less neurons sensitive to acetylcholine, which is necessary for peristalsis.  (6)
  • More neurons immunoreactive for NOS.  Basically saying that there are more neurons sensitive to nitric oxide (NO), a substance that allows the distal gut to relax as peristalsis occurs.  Having more NO sensitive neurons will make the gut more likely to be “relaxed” rather than peristalsing.  (6)
  • Less neuron density  (50% less), decreased neuron numbers, reduced number of ganglia, reduced number of cells per ganglion, and reduced enteric glial cells.  (6, 9)
  • Reduction in high amplitude propagating contractions and a disruption of the coordinated peristaltic activity.  Basically saying that there are less of the sweeping contractions that bring about defecation and that the whole system just is not coordinated at all like in normal person.  (6)
  • Weaker contraction to acetylcholine in the colon. (7)
  • Relaxation to adrenalin stronger than a normal colon. (7)
  • Possible antibodies to GnRH with decreased GnRH and its receptor in enteric neurons.  GnRH is gonadotropin releasing hormone.  (8)
  • Excitatory nerve fibers present in the circular muscle are deficient in tachykinins and encephalin.  (9)
  • Expression of c-kit mRNA and c-kit protein was also found to be significantly decreased, which may lead to reduced interstitial cells of Cajal. (9)

In summary, your gut (and mine) doesn’t move, and we aren’t sure exactly why.  However, there are MANY identifiable differences in a gut with slow transit constipation and a normal gut.  The unique nervous system of the gut is disordered, in both the neurons, hormone production, hormone processing, and the supporting cells for the neurons.

More posts to follow along this topic:  What could cause this problem?  What I personally do about it.  The role of butyrate and short chain fatty acids (SCFA) on the gut/my Metametrix result for SCFA.

Take care,

Terri

Citations:

(1)  This requires a log-in.  So you may not be able to pull this little review article up:   http://www.medscape.org/viewarticle/770638_3

(2)  http://cdn.intechopen.com/pdfs/31218/InTech-The_role_of_interstitial_cells_of_cajal_icc_in_gastrointestinal_motility_disorders_what_the_gastroenterologist_has_to_know.pdf

(3)  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033552/

(4) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710411/#!po=11.363

(5) http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2011.01705.x/full

(6)  http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2008.01165.x/full

(7)  http://www.ncbi.nlm.nih.gov/pubmed/12397730

(8) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2885307/#!po=63.0435

(9) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710411/#!po=11.3636  (I really liked this article for pulling things together and giving me leads to follow.)

Is It Autoimmune?

Zugspitze von der Alpspitze aus gesehen. Links...

Zugspitze von der Alpspitze aus gesehen. Links der Jubiläumsgrat (Photo credit: Wikipedia)

A friend asked the other day, “What would you recommend diet-wise for an autoimmune disorder, such as lupus?”

Good question.  However, allow me to change the question a little bit, yet not really.  Because this blog is about my story.  And I don’t have lupus.

“What would you recommend diet-wise for an autoimmune disorder, such as CONSTIPATION or IRRITABLE BOWEL SYNDROME?”

Now we’re talkin’. Could I have an autoimmune disorder?

Does Irritable Bowel Syndrome and Dysmotility Have an Autoimmune

Origin? (Neurogastroenterol Motil 2011;23:1000-1006, e459)

Jeong Eun Shincorresponding author

Do you have an autoimmune disorder?  I personally have been playing around with an autoimmune diet (while continuing on this thing called GAPS diet).  I definitely notice a difference in how I feel, but I find the autoimmune protocol very challenging.  I am no expert on any of this.  I’m just a medical doctor who has the opportunity to explore nutrition as it applies to her own issues and the issues in her immediate family.  I don’t know how this all fits together scientifically.  I can’t wait to find out.  Seriously.  I have to forge my own path.  Maybe you do, too.  But still make sure and get real medical advice and guidance.  But don’t sit around waiting.  Move.  For today, let’s say I had to pick two sources to send my sister to regarding addressing an autoimmune disorder, any autoimmune disorder, and nutrition.  I’d send her here:
  • Terry Wahls’, MD “You Tube” video regarding her “curing” her multiple sclerosis:  This video is A MUST WATCH.  Just totally told me what I knew deep inside about food–it’s for the function of my body–not whatever else I or society tries to make it! Terry Wahl’s is a medical doctor who reversed her severe, debilitating MS.  Basically, her nutrition was very similar to diets called GAPS/Paleo/SCD/Whole30, with a few tweaks here and there. Amazing story.  She now has her own book, website, etc.  I have heard the book is a bit outdated and she has made some changes.  I am on the list for when the new edition rolls out.  Can’t wait to read it and compare it to all I am learning.
and here:
  • Paleo Mom:  She has a PhD in medical biophysics and has deeply explored an autoimmune diet for her health.  She tries to base her posts on science as much as possible, yet she does so in a completely understandable manner for lay people.  She had to take her diet down to autoimmune paleo to achieve results she needed.  Her recipes all look awesome, but be careful signing up for her Facebook page.  She rolls out all the sweet dessert recipes there.  Kills me.  Kills me.
Good luck in all you do!  Eat right!  You keep healthy so you can get down on the floor with your grandkids.  Hike in a Costa Rican forest with them.  Or just climb the bleachers to their ballgames.  My grandma made one ballgame of mine that I can remember.  One.  She was an awesome smart woman, but diabetes, vascular disease, and obesity made it exceptionally difficult to navigate the likes of a high school sports event.  I want to climb mountains with my grandkids.  See you at the top!
Terri