Dr Abshire on The Gut and the 4 R program

The body is a complex web. To better 'digest' this information it is easier to explain sections of the web in smaller bites. Here we are talking mostly about the gastro-immuno-neurological connections and gastro-endocrine connections to emphasize the importance of gut health.

We have more bacterial cells in our body than human cells. We can practically be called a hybrid species. There are good guys that help us. They digest for us things we cannot, and they excrete substances that nourish the cells of our gut. They make vitamins for us. Basically, we cannot live without them. There are bad guys than can take over and crowd out the good guys. Then there are bacteria that supposedly just co-exist peacefully with us and we don't really mind if they are there, and based on our current knowledge they don't help us or hurt us. Emerging science is showing us that sometimes even the good guys can cause bad things to happen if they are out of balance. It is all about balance.

A cute story I heard at a recent conference emphasizes how helpful bacteria can be. The bobtail squid that lives in Hawaii only likes one kind of bacteria and has the ability to squirt out all others. Once these bacteria get to a certain population size they communicate with each other and work together to measure the exact amount of moonlight coming in through a transparent portal in the top of the squid and glow to the exact degree of the moonlight, so that the squid will not cast a shadow and will stand a better chance of not being eaten.

The gut contains more than 60% of our immune system. The GALT, gut associated lymphoid tissue and the MALT, mucosal associated lyphoid tissue impacts the rest of the body and the brain immensely with inflammatory messengers, such as cytokines. Poor gut health can cause malfunctions of our immune, neurological and endocrine systems. This can stem from: bad bacteria, sometimes what is normally considered good bacteria that is out of balance with others, food allergies, poor health of the gut wall, i.e.leaky gut, the presence of a certain food, and types of food we eat. For example a high sugar and high fat diet can affect our community of micro-organisms.

Our micro-flora can impact obesity by not only by helping us get more calories out of our food by predigesting it, but research indicates that other informational molecules coming from balance of bacteria can change the hormonal balance of insulin, glucagon, and cortisol affecting obesity, our sugar metabolism and therefore the diseases of the metabolic syndrome. This appears to be one more key factor explaining our epidemic.

Gut Flora can also affect our mood. Certain bacteria can trigger the release of a cytokine that specifically targets an area in the brain and causes anxiety. Gastrointestinal illness can also be linked to depression and suicidal behavior.

Gut flora can cause low grade inflammation from the gut, below the level of obvious infectious disease. It is linked to coronary artery disease and cardiac health the same way that low grade inflammation from periodontal disease is accepted as being related to heart disease. This low grade inflammation is translated to other parts of the body by chemical messengers. The chemical messengers cause a domino affect across the body's immune system and these messages can also cross the blood brain barrier. The inflammatory messengers activate the glial cells in the brain which are the immune system of the brain and promote brain inflammation leading to early dementia, problems with mood, memory, the ability to think clearly, and other mental health problems. Inflammation from the gut and the messengers that cause inflammation around the body is why gut disease such as inflammatory bowel disease, Crohn's Disease and Ulerative Colitis is linked to joint pain and arthritis. Autoimmune disease is linked to gut health. Not only the classic gastrointestinal form of celiac disease, an autoimmune disease, is linked to eating gluten, but 2/3 of celiac patients do not have villous atrophy do have other neurological disease such as ataxia- loss of balance, or autoimmune diseases such as Hashimoto's thyroiditis.

Because of the profound effects gut health can have on the entire human system mind and body, fixing the gut is a pre-requisite for all other therapies to be effective.

So, What is the 4 R Program?   The 4 R's are Remove, Replace, Re-inoculate and Repair. Basically it means take the bad things out, support healing, and put the good things in. 

Many things can change the balance of bugs, also known as micro flora, in your gut including antibiotics, infections, and different diets. A high saturated fat and high sugar diet changes the flora for the worse and inflammation is the message sent all around the body. This can be part of the cause of the increase in diabetes. Gluten, even in non-allergic or apparently non-sensitive individuals can change the flora for the worse. This appears to be a part of the puzzle of why some people feel so much better off gluten, even if they test negative for an allergy.

On the positive side,  psyllium, fructo-oligo-sacharride, and inulin, which we can’t digest and therefore pass through our stomach and small bowel, are fermented in the colon by bacteria. They change the balance of flora for the better. Then friendly bacteria thrive and produce substances that help the body. There is a lot you can do over the counter to minimize toxins, and maximize nutrition for yourself and your friendly flora.