Of COPD, Steroids, Antibiotics, Prebiotics, And Probiotics.

Of COPD, Steroids, Antibiotics, Prebiotics, And Probiotics.

                              Over the years I have been admitted to a hospital on various occasions, mainly for problems with my breathing. Way back in 1995, at the age of 42, I was diagnosed with COPD which is short for Chronic Pulmonary Disorder/Disease. On the last occasion, in 2014, I was admitted to Max Hospital in South Delhi when the count of my white blood cells went haywire and caused immense shortness of breath in me. Like on previous stays in the hospitals even this time for about a week I was pumped with steroids. The count of white blood cells was restored to normal and my breathing also came back to its earlier stage, that is as it was with about after 15 years of having suffered from COPD. By then I had stopped smoking cigarettes and even ‘beedies’. 

                              At that time the doctors suspected problem/s in my gut and digestive tract. But when the gastroenterologist inserted his camera into my alimentary tract all that was visible to him was fungi caused by the overload of steroids that they had pumped into my veins. So he let me go without any treatment for my gut. I was also prescribed oral steroids in decreasing strengths to wean me off of them. But all this played havoc with my gut. For long after that, I was in like a perpetual condition of diarrhea which slowly went away, but it left me with a feeling of being bloated, occasional constipation, and irritable bowel syndrome {IBS}. 

                             Meanwhile, I changed my diet. I was eating only organic grains, fruits, and vegetables. Only extra virgin olive oil and coconut oil. Pure cow’s milk from only one cow. I reduced my food intake, and I even fasted once a week. I was also practicing the meditation that I was taught. I thought I was doing all the right things. However, none of this relieved my bloating, IBS, etc. There were days when the bloating was not severe I would think that it was just my COPD that was worsening, which it was. On other days the bloating became so acute that I would not have enough space to move my diaphragm thus making it extremely difficult for me to breathe. Very often I would think to myself that all I am doing is towing my big belly around. It was not a good feeling, to say the least.    

                          Then I believe I encountered the tipping point…after my wife expired I was shocked and depressed. She had been with me for more than 48 years. Then one day all of a sudden I got an itching sensation that started on my chest and then went to the area around my navel. It lasted for an hour or so and then subsided. It also made little bumps like mosquito bites. And even they subsided as though nothing had happened. These episodes of itching would occur about two to three hours after eating a meal. The itch would come along with the bumps and then after about half an hour or so, it would disappear.

                        At first, I thought that it was a passing phase so as a stop-gap arrangement I started to use talcum powder and then even a steroid-based cream called ‘Betnovate’. That helped but I was worried about the cause of the phenomenon. So I consulted a dermatologist. He started me on some antibiotics and anti-allergy pills. Something about the doctor did not gel with me. He seemed to be shooting in the dark. It was clear to me that he did not know the exact cause of why this was happening. 

                      After going thru the side effects of steroids, as much as 5 times in the past 25 years or so, I was hesitant about even the antibiotics. Steroids and antibiotics are good for immediate relief but they have some really drastic after effects. With long-term use, they can play havoc with the body. 

                      It is very common for people like me with chronic obstructive pulmonary disease to get stomach problems. Too much gas and bloating are like a double whammy. The medicines meant to cure my breathing problem also acted as initiators for stomach problems. That is why the stomach felt tight and stuck out, which was very uncomfortable. It became difficult to eat and get the nutrition that is needed.

                      One study found that about 85% of people with COPD had at least one digestive system problem. Bloating of the belly and feeling full very quickly after starting to eat were the most common ones that people said they had. Bloating may be caused by a number of issues, including irritable bowel syndrome and anxiety, and some people may have these conditions in addition to COPD.

                       Something in me told me that along with the COPD, it was the prolonged use of steroids that had done a number on my gut. And that was causing the bloating and other related issues with my digestion. The excessive medicines administered during my stay in the hospitals seemed to only exacerbate the already existing conditions. The shock and depression helped in triggering the latest outcome {the itch & the bumps}. But knowing just that was not enough. I had to find out and know more about the exact cause of the itch and the rash, and a suitable treatment: if possible without antibiotics or steroids.   

                       I found out that the itching and bumps are caused by an overflow of histamine. Histamine is the chemical that sends messages to the brain, signals the release of stomach acid for digestion, and is also released as part of the immune system’s response to an injury or allergic reaction. Bacteria grow when food isn’t digested properly, causing histamine overproduction.  Normal levels of DAO enzymes can’t break down the increased levels of histamine in your body, causing a reaction.

                     An intolerance to histamine happens when the body cannot break down enough of it in the intestines, causing histamine levels in the blood to rise. This typically results from having low levels of an enzyme called diamine oxidase (DAO), which is the primary agent that breaks down digested histamine.  When normal levels of DAO enzymes can’t break down the increased levels of histamine in the body, a reaction is caused leading to intolerance of histamine.

                    On the other hand, histamine intolerance also develops when there is a DOA deficiency and the DOA is unable to break down histamine. 

                    Some reasons the DAO enzyme levels could be affected include:

• medications that block DAO functions or prevent production
• gastrointestinal disorders, such as leaky gut syndrome and inflammatory bowel disease
• histamine-rich foods that cause DAO enzymes to function improperly
• foods that block DAO enzymes or trigger histamine release.

 

                   In most cases, a blocker like ‘Citerezine’ {an antiallergy medication} blocks the allergic reaction of histamine overflow. However, this can not be a long-term solution. When the gut bacteria grow due to improper digestion {for whatever reasons} a condition called SIBO-small intestine bacteria overgrowth- prevails. Bloating, abdominal pain, belching, reflux, diarrhea, constipation, IBS, headaches, migraines, skin flushing, hives, and eczema are SOME of the symptoms of SIBO and histamine overflow. 

 

So what are intestinal or gut bacteria?

                          Our body is full of trillions of bacteria, viruses, and fungi. They are collectively known as the microbiome. The microbiome consists of microbes that are both helpful and potentially harmful. Most are symbiotic {where both the human body and microbiota benefit} and some, in smaller numbers, are pathogenic {promoting disease}. In a healthy body, pathogenic and symbiotic microbiota coexist without problems. But if there is a disturbance in that balance—brought on by infectious illnesses, certain diets, or the prolonged use of antibiotics/steroids or other bacteria-destroying medications—dysbiosis occurs, stopping these normal interactions. As a result, the body may become more susceptible to disease.

                        While some bacteria are associated with disease, others are extremely important for your immune system, heart, weight, and many other aspects of health. Most of the microbes in your intestines are found in a “pocket” of our large intestine called the ‘cecum’, and they are referred to as the gut microbiome.

                          Although many different types of microbes live inside us, bacteria are the most studied. Studies have found that there are more bacterial cells in our bodies than there are human cells. There are roughly 40 trillion bacterial cells in our body and only 30 trillion human cells. That means we are more bacteria than human.  What’s more, there are up to 1,000 species of bacteria in the human gut microbiome, and each of them plays a different role in our body. Most of them are extremely important for our health, while others may cause disease 

                        Altogether, these microbes may weigh as much as 2–5 pounds {1–2 kg}, which is roughly the weight of our brain. Together, they function as an extra organ in our body and play a huge role in our health.

                       There are several different ways in which the gut microbiome can affect key bodily functions and influence our health. The gut microbiome affects the body from birth and throughout life by controlling the digestion of food, the immune system, the central nervous system, and other bodily processes. Microbiota stimulates the immune system, breaks down potentially toxic food compounds, and synthesizes certain vitamins and amino acids, including the B vitamins and vitamin K. For example, the critical enzymes needed to form vitamin B12 are only found in bacteria, not in plants and animals. 

                       The microbiome also affects gut health and plays a role in intestinal diseases like irritable bowel syndrome (IBS) and inflammatory bowel disease {IBD}. The bloating, cramps, and abdominal pain that people with IBS experience are due to gut dysbiosis {an imbalance of healthy and unhealthy microbes is called gut dysbiosis}. However, certain healthy bacteria in the microbiome can also improve gut health and probiotics can potentially restore gut health.

                       The microbiota of a healthy person will also provide protection from pathogenic organisms that enter the body such as through drinking or eating contaminated water or food.

Pre & Probiotics

 

                            The question of what exactly constitutes a healthy gut microbiome remains unanswered. Experts know that hosting a diverse set of bacteria in our digestive tract is associated with better health outcomes, and they also know that a lack of biodiversity is associated with several diseases and dysfunctions. But the scientific and medical communities have yet to identify a particular set of {or number of} microbes that is definitively the “ideal” for any individual. The “ideal” seems to be as unique as the individual.

                            If we know or suspect we’re experiencing gut dysbiosis {an imbalance between “good” and “bad” gut bacteria} or an overgrowth of bacteria in our intestines, such as SIBO {small intestinal bacterial overgrowth}, then starving out the bad bacteria (and/or excess bacteria in general) is an important step in treating this overall condition. 

                            Large families of bacteria found in the human gut include Prevotella, Ruminococcus, Bacteroides, and Firmicutes.  In the colon, in a low-oxygen environment, we find the anaerobic {organisms that can flourish in a low-oxygen environment} bacteria Peptostreptococcus, Bifidobacterium, Lactobacillus, and Clostridium.  These microbes are believed to prevent the overgrowth of harmful bacteria by competing for nutrients and attachment sites to the mucus membranes of the gut, a major location of immune activity and the production of antimicrobial proteins. 

                            It is clear that microbiota is vital to our health, and we need to ensure that we have enough of the right types. This is where probiotics come into the picture. Probiotics are either foods that naturally contain microbiota or supplement pills that contain live active bacteria. They are even advertised to promote digestive health.

                            So I was convinced that microbiota is very vital to my health. I wasn’t familiar with probiotics…I hadn’t used them earlier. I thought that since I was eating well it will all be fine. By eating well I mean I was eating food with high fiber content..these are also called prebiotics because they feed our beneficial microbiota. Although there are supplements containing prebiotic fibers, I was eating many healthful foods naturally containing prebiotics like raw: garlic, onions, asparagus,  bananas, and seaweed. In general, fruits, vegetables, beans, and whole grains like wheat, oats, and barley: are all supposedly good sources of prebiotic fibers. I was also eating probiotic foods containing beneficial live microbiota that alter one’s microbiome. These include fermented foods like yogurt with live active cultures, pickled vegetables, kimchi, miso, and sauerkraut. I was. abstaining from alcohol so I thought I must be doing fine. 

                             I was waiting for nature to take its course and improve my condition. But what convinced me to go for pro and prebiotics supplements was what Dr. Allan Walker, Professor of Nutrition at the Harvard Chan School of Public Health and Harvard Medical School, said in an article. He said and I quote: ‘Although published research is conflicting, there are specific situations where probiotic supplements may be helpful. Probiotics can be most effective at both ends of the age spectrum because that’s when your microbes aren’t as robust as they normally are,” Walker further explains. “You can influence this huge bacterial colonization process more effectively with probiotics during these periods.” He also notes situations of stress to the body where probiotics may be helpful, such as reducing the severity of diarrhea after exposure to pathogens, or replenishing normal bacteria in the intestine after a patient uses antibiotics or steroids. Walker emphasizes that “these are all circumstances where there’s a disruption of balance within the intestine.”

                          All that I had read resonated with my gut feeling {pun intended}. So without consulting any doctor or undergoing tests I imported {they are not made in India} 2 packs of the DOA enzyme pills from Spain. Till they arrived I started on pre and probiotic capsules which contained Lactobacillus Acidophilus, Lactobacillus Rhamnosus, Lactobacillus Reutri, Lactobacillus Casei, Lactobacillus Plantarum, Lactobacillus Fermentum, Bifidobacterium Bifidum. Each capsule was loaded with active bacteria in billions by count. I also started on enzymes where each capsule had Alpha galactosidase, Lipase, Alpha-amylase, Protease, and Lactase.

                         It took a while before the DOA enzyme arrived but by then I had already started to see the improvement in my condition. With the DOA enzymes added to the other enzymes and the pre and probiotics, I have now got my gut in much better shape. Although I still think it is a work in progress but near the end.

 

It eventually comes down to the age-old adage that it is not about what you eat that matters it is more about what and how you digest what you eat that matters.  

 

Sources 

•  PubMed Central The Highly respected database from the National Institutes of Health, 

• hsph.harvard.edu/nutritionsource/nutrition-and-immunity/

• The American Journal of Clinical Nutrition, and

• Harvard T H Chan School Of Public Health

• webmd.com/lung/copd/10-faqs-about-living-with-COPD

• canr.msu.edu/news/probiotics-prebiotics-foods

• foodinsight.org/nutrition-101-prebiotics-probiotics-and-the-gut-microbiome/

• cellandbioscience.biomedcentral.com/articles/10.1186/s13578-017-0183-1

• healthline.com/nutrition/probiotics-and-prebiotics

Author:- Ranjan “Jim” Chadha – a peripatetic mind, forever wandering the digital universe, in search & appreciation of peace, freedom, and happiness. So tune in, and turn on, but don’t drop out just yet!