Nutrient Absorption, GI Interference, SIBO, Biofilm & Atrial Fibrillation

Nutrient Absorption, GI Interference, SIBO, Biofilm & Atrial Fibrillation

Introduction
• Optimal nutrition is generally recognized as fundamental to good health and longevity.
• Absorption of nutrients is critically important, is often overlooked and generally misunderstood
• Lack of nutrients in requisite amounts delivered to specific target tissue is contributory to arrhythmias and many other health problems.

Assuming there is adequate intake of nutrients from quality, whole food and supplements, frequently there are interferences that prevent nutrients from reaching their target destinations. With alarming frequency, it is common that the Interference Factor goes unrecognized as a critical diagnostic element in various ailments. Nutrients need clear access to the blood stream for absorption as well as access (assimilation) from the blood stream to the inside of all cells in the entire body where it becomes part of our tissue. As outlined in other posts, magnesium (Mg) is the key facilitator for moving nutrients into cells because Mg, itself, functions in the transport mechanism. Therefore, deficiency in magnesium affects everything downstream.

In addition to transport mechanism malfunction, several other highly influential interference mechanisms are identified. These are actual, physical impediments to nutrient flow or transfer across membranes. This report highlights prominent facts in this extensive topic that is gaining in momentum and importance at a rapid pace. This is very good news for those suffering from inadequate nutrient absorption, gastrointestinal disturbances and the downstream consequences…especially if Afib is one of those consequences. A link between various types of gastric disturbances and Atrial Fibrillation is well known.

Background
An often unrecognized or overlooked connection to many adverse health complaints is GI (gastrointestinal) or Gut related. Practitioners of Functional Medicine teaching the Advanced Learning Modules for the Institute for Functional Medicine never fail to mention that over 70% of the adverse health conditions they see every day (not just occasionally) turn out to be gut-related issues. Heal the gut; heal the patient. Unfortunately, for most patients, it’s often the last area investigated – if ever.

Assessing and managing the source of GI disturbance is typically not as easy as taking some form of an acid blocker although that’s most likely the first course of action when a patient presents in the doctor’s office with gastric complaints. Most cases of GERD are caused by lack of stomach acid which prevents complete breakdown of food which then causes stomach distress, discomfort and many other adverse effects downstream from there. This a cascade-of-events scenario commonly discussed in Integrative or Functional Medicine circles.

Although generally related, this report is not about those specific areas. Rather, the focus is specifically on various types of pathogenic GI bacterial or fungal overgrowth that interfere with nutrient absorption. Here’s what you need to keep in mind if you have GI ailments that seem to activate your afib but haven’t been addressed thus far by your current interventions.

Reminder
Even with a perfect diet, nutrient absorption is not 100% guaranteed automatic. Most of the time, digestion works properly and all is well, but it’s not at all uncommon to find individuals who can’t absorb nutrients. We often assume all we have to do is eat nutrient-dense foods or take this or that supplement and that’s does it. But with absorption interferences, it’s not a given that everything functions as intended or that nutrients reach their targets.

Review of initial pathway to digestion and nutrient metabolism
[This is a very abbreviated, over-simplified description; it’s obviously much more complicated.]
Nutrients from food sources are metabolized and made into usable nutrient molecules by various enzymes activated by chewing well and mixing with saliva as the first step in the breakdown process. Inadequate chewing either from poor dentition, not chewing long enough or lack of saliva gets us off to a poor start. Food proceeds to the stomach where it is mixed with digestive enzymes and stomach acid, picks up bile and pancreatic enzymes, and then passes to the small intestine where the “prepared nutrients” enter the blood stream via specific receptor sites in the intestinal lumen. Once in the blood there is microsomal metabolism on nutrients via cytochrome P4502E1 (CYP2E1) as blood passes through the liver, and then on to cell membrane receptor sites if all goes as it should. Metabolized food and fiber residues are called “chyme” which eventually becomes fecal matter or waste.

While about 90% of nutrients are absorbed in the alkaline environment of the small intestine, other important nutrients enter the blood stream via the large intestine (colon) where the first function is to absorb some essential vitamins and critical electrolytes from the chyme that flows to the colon from the small intestine. These include some of the B vitamins and vitamin K essential for blood clotting obviously important for overall health which just emphasizes the need for a healthy, inflammation-free colon lining that is unimpeded by bacterial or fungal overgrowth.

The stomach needs to be acidic when food arrives not only to breakdown food but also to help sterilize and protect against pathogens entering via the mouth since food isn’t sterile. When we suppress stomach acid intentionally, this permits opportunistic pathogens such as E. coli, Salmonella, C. difficile or Candida species to flourish. Achlorhydria or low stomach acid contributes to prevalence of osteoporosis, macular degeneration and increases propensity for pneumonia by a factor of four. Those with pernicious anemia are susceptible. The inability for proper methylation (low B12) is increased significantly… leading to high homocysteine, risk of clotting, etc.

Natural aging slows stomach acid production.
As we age, there is a natural decline in stomach acid production and this is the conundrum scenario… inadequate stomach acid, inability to breakdown food, food putrefies in stomach because large particles due to hasty eating and poor chewing can’t pass out of the stomach just lie there rotting --causing reflux-like symptoms, gas, bloating and discomfort. The typical remedy is a prescription for some type of stomach acid blocker-- H2 receptor antagonists, PPIs or people just use OTC antacids or remedies which might give comfort but doesn’t solve the fundamental problem. In some individuals, there will be H. pylori infection-- another factor to rule out.

In the case of nutritional supplements, which also typically break down in the stomach, some tablets or capsules have special coatings formulated to bypass stomach acid intentionally and are absorbed in the small intestine. Coatings on some (inferior) supplements are so impervious they remain unaffected by digestive secretions and pass completely intact through the stomach, small intestine and colon and can be observed as stool contents…..with absolutely no benefit.

Interference at the cell membrane
Inability for cells to take up nutrients from the blood stream occurs when receptor sites on the outer cell wall membrane (envelope) become clogged and damaged most often as a result of long-term dietary intake of hydrogenated fats (trans-fats) that form the damaging coating. This is reversible with time, abundant dosing of Omega 3 fish oils and change of dietary choices. For afibbers, magnesium absorption at these receptor sites is a key factor and as well as those with glucose handling issues.

Interference at intestinal lumen portals
Nutrient malabsorption from portals in the small intestine (intestinal lumen and villi) is an area frequently overlooked. There are two separate interference factors to be considered although they frequently are found working in tandem. One is the SIBO factor and is often accompanied by pathogenic biofilm. Dysbiosis is an imbalance in the GI tract between the naturally-occurring gut flora and pathogenic bacteria. Parasites contribute to gut ailments and need to be ruled out as well. Any and all can result in inflammation which impedes transport across the lumen in addition to the physical overgrowth impeding villi and receptor areas. Resulting inflammation from pathogenic overgrowth enters the mix and inflammation resulting from heavy metal toxicity is yet another consideration. Many factors can be present at the same time including Leaky ]Gut Syndrome which fosters other adverse symptoms.

SIBO and Biofilm – The main focus of this report]
In addition to deficiencies in the facilitators (adequate chewing and breakdown of food particles, digestive enzymes and stomach acid), absorption interference can also show up in the small intestine due to Small Intestine Bacterial Overgrowth (SIBO)(see-bow). The presence of pathogenic Biofilm is another consideration.

SIBO is not new. It was recognized at least twenty years ago but only came into the diagnostic limelight in the last five years mainly by doctors with advanced education in Integrative and Functional Medicine practices who typically test new patients first to rule out gut interferences so prescribed nutritional treatment interventions can be effective and corrective.

Small bowel overgrowth is most often thought to be associated with fistulas or post-surgical complications but it’s extremely common in everyday medical practices although still under the radar for many. Fortunately, more doctors are becoming aware because of the high correlation to Irritable Bowel Syndrome (IBS) and SIBO…although not typically recognized or considered suspect.

SIBO is the result of the translocation of various forms of bacteria and yeast found in the large intestine (colon) into the small intestine where they proliferate and block critical receptor areas and cause irritation, inflammation and other symptoms. Obviously, there isn’t a rigid partition keeping bacteria between large and small intestine separated. The ileocecal valve is just a small muscle but with valve malfunctions (which are not uncommon), more bacteria than should can migrate into the small bowel and cause multiple problems.

SIBO may be a reason why so many afibbers have trouble benefiting from magnesium even though they are using high doses or reaching bowel tolerance but not yet achieving optimal intracellular levels. In these cases, SIBO should be ruled out.

Symptoms
Gas, bloating, distension, discomfort after eating. This can be almost immediate or several hours later. When Candida (yeast) fungal overgrowth is prevalent, the yeast responds almost immediately to a carb-containing meal. Yeast thrive on starch and sugar from all sources….including fruit sugar. Accompanying constipation and/or diarrhea are commonly reported.

Restless leg syndrome, insomnia, migraines, menstrual irregularities, IBS, chronic fatigue, fibromyalgia, Crohn’s ….all commonly found in dysbiosis/SIBO patients but the correlation between is not often recognized.

Gut receptor connection
A connection to diarrhea not often mentioned is that diarrhea can be caused by gut interferences in serotonin transporters in the gut wall. Difficult to diagnose. Insomnia and feeling of well being are influenced by the neurotransmitter serotonin produced and stored in the gut. The digestive process begins when a specialized cell, an enterochromaffin, squirts serotonin into the wall of the gut, which has at least seven types of serotonin receptors. The receptors, in turn, communicate with nerve cells to start digestive enzymes flowing or to start things moving through the intestines. Since 95% of serotonin is stored in the gut, interferences have a significant impact on the patient. Too much or too little causes problems. That's why mood-altering drugs that change serotonin levels are likely to affect the digestive system even at low doses. If you are diagnosed with IBS, especially when accompanied by constipation, you may be prescribed tegaserod (Zelnorm), which boosts intestinal motility; it works by interacting with receptors for serotonin, the neurotransmitter that antidepressants affect in the brain.

IBS is found in people taking SSRIs because antidepressant medications. These meds meant to cause chemical changes in the mind often provoke GI issues as a side effect. Irritable bowel syndrome— afflicts more than two million Americans—also arises in part from too much serotonin in our entrails and has been described as a "mental illness" of the second brain.
(Michael D. Gershon MD, author of The Second Brain).

Thyroid Connection
Connecting the dots to a very interesting finding that could affect afibbers who are also hypothyroid or are undiagnosed hypothyroid….. Another casualty of SIBO is natural thyroid hormone production is dependent on healthy gut microflora.…30% of Free T-3 is produced in the gut from two inactive thyroid hormone components…T3 sulfate (T3S) and T3 acetic acid (T3AC) which must be activated by intestinal sulfatase (enzyme) …so if there is dysbiosis or SIBO, and the enzymatic activity is inhibited, you’ll lose 30% of natural thyroid hormone production. So the cascade-effect downstream for afibbers with undiagnosed hypothyroidism may rooted in this GI connection. Gastrointestinal sulfatase activity is dependent upon a healthy gut microflora

Causes of SIBO
Those speaking on the topic report a variety of causes for SIBO. Gastric emptying or transit time is suspect although there is not a 100% correlation with fast or slow gastric emptying--either way. Most often, it’s delayed gastric emptying (gastroparesis) which sets up a breeding ground for bacteria because that bacteria isn’t being cleared out in a timely fashion. So, once again, achlorhydria comes into play because it should be sterilizing at least some of the food. If chyme sits around in the small or large intestine too long, the bacteria do proliferate. It’s found that people with immune deficiency functions or deficiency in producing IgA are more susceptible to developing SIBO.

FODMAPS
A large contributor to SIBO is the consumption of specific foods that are highly fermentable and cause gas, bloating, discomfort and pain. These foods perpetuate the GI symptoms, support overgrowth and must be eliminated from the diet completely until the healthful bacterial balance is restored. In some individuals, this becomes a permanent diet and may be a clue as to why Paleo eating works so well for so many sufferers of GI distress. Paleo eating has been proven to be a key factor in reversing the Afib trend as well.

Fodmaps, (rhymes with Sod) an acronym that for stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (sugar alcohols)…includes foods such as legumes (galactans), milk sugar from dairy (lactose), fructans in wheat and rye grains, fructose in fruits, polyols (sugar alcohols) found in artificial sweeteners such as sorbitol, maltitol, mannitol, xylitol … breath mints are notorious offenders and many foods now touted to be sugar free use large amounts of sugar alcohols. Stevia is not in that category.

Avoidance of all Fodmaps for at least 8 weeks is the standard recommendation. Once a favorable bacterial balance is restored, some people can resume their normal diets…unlike Celiacs who must avoid gluten forever. However, experts note that the majority of people consume far too much fructose (fruit sugars). The body can only handle around 50 grams of fructose efficiently but many people take in 100 grams and more on a daily basis. This promotes imbalance because the body just can’t keep up.

Reminder that a healthy diet is one that does not initiate or support insulin spikes… so going by an allowable 50 grams of fructose daily is really bad advice but that’s what’s commonly recommended in many dietary protocols by the less knowledgeable practitioners.

The Fodmaps diet originated in Australia (2001) by a dietitian working with lactose-intolerant patients. Small studies in Australia and the U.K. have shown the diet reduces symptoms in about 75% of IBS sufferers—higher than other diet or medication approaches. In one study, (Journal of Human Nutrition and Dietetics – Oct. 2011), researchers at Kings College in London compared 43 IBS patients on the low-Fodmap diet with 39 given standard diet advice such as limiting caffeine and carbonated beverages. More than 80% in the low-Fodmap group reported less bloating and less abdominal pain compared with about half in the control group.

The Fodmaps diet is relatively unknown in the US, although it was presented at the American College of Gastroenterology Conference in Washington (Fall 2011)…and GI specialist Gerard Mullin detailed it in his teleconference presentation.**

Biofilm
Biofilm is a prime suspect as an Interference Factor for nutrient absorption through the intestinal wall. An intestinal biofilm matrix is a necessary, protective healthy home for beneficial or friendly bacteria. Problems surface when the pathogenic microbes overpower the friendly. Inflammatory responses in the gut lining interfere with nutrient absorption.

We’ve all heard of biofilm but probably don’t associate with gut issues. Dental plaque is an oral biofilm or matrix that accumulates naturally in the mouth as an excretory by- product of the resident oral bacteria, Streptococcus mutans. Your dental hygienist has probably mentioned the reason you need to floss daily is to disturb the plaque accumulations so they don’t become harmful to gingival tissue and tooth structure. It’s easy to recognize early problems in the mouth but not always so readily apparent in the intestine without testing. However, as this report points out… unremitting GI symptoms are a very strong clue. So if an Afibber also has GI problems, then chances are, nutrients are not being absorbed efficiently and possibly not at all.

Since 2007, Klaire Labs, a leader in probiotic research, has sponsored annual Biofilm Symposiums to present research and hypotheses on the mechanisms of action and use of probiotics, prebiotics and digestive enzymes in the management of pathogenic gastrointestinal biofilm and modulation of immune function to maintain and improve both physical and mental health.

Those knowledgeable the role of GI biofilm are gaining in numbers but for the most part, many top experts still aren’t conversant so this report segment is cutting-edge science that may prove to be extremely beneficial for those who have unsuccessfully battled GI disturbances thus far.

There is both healthy and pathogenic-supporting biofilm matrix. Think of it as a ‘slime’ that microorganisms call home that clings closely to intestinal walls. It can be a friendly home or one that supports extremely detrimental microorganisms.

From Klaire Labs’ literature
Gastrointestinal Biofilm – The Healthful and the Pathogenic.
The human gut is home to approximately 100 trillion microorganisms consisting of unattached planktonic microbes residing in the lumen and sessile biofilm organisms colonizing the mucosa and luminal particulate matter. Among the more important species involved in gastrointestinal biofilm formation are Bacteroides, Bifidobacterium, and Fusobacterium. Fusobacterium species appear to play a key role in formation and maintenance of healthy biofilm by forming coaggregation and coadhesion bridges between early and late bacterial colonizers. However, Fusobacterium, an anaerobic genus, can contribute to pathogenic biofilms because it requires association with an aerobic species in certain environments and hence promotes Streptococcus mutans biofilm in dental plaque leading to caries and Helicobacter pylori biofilm on the gastric mucosa associated with gastric ulcers.

Disrupted healthful (intestinal) biofilm permits colonization and biofilm formation by potential pathogens such as Klebsiella pneumoniae, Escherichia coli, and Candida albicans. Potential pathogens residing within biofilms rapidly express genes associated with antimicrobial resistance and are protected from both cellular and humoral immune responses. Successful eradication of pathogen-associated biofilm is critical to elimination of these harmful organisms.

Pathogenic species found in biofilms
Escherichia coli
Staphylococcus aureus
Staphylococcus aureus MRSA
Helicobacter pylori
Streptococcus pneumoniae
Klebsiella pneumoniae
Streptococcus pyogenes
Pseudomonas aeruginosa
Candida albicans
Candida paratropicalis

Candida (yeast) overgrowth
Among the most difficult opportunistic pathogens to diagnose is Candida albicans or yeast overgrowth. Tests are mostly unreliable and symptoms become the signal to treat. It’s not possible to eliminate all Candida but it is important to control populations so that nutrient absorption is functional and symptoms are eliminated.

Common symptoms
A list of common symptoms associated with the gastrointestinal and genitourinary systems, immune, endocrine and the neurological system, including mental and emotional symptoms includes… thrush, indigestion, acid reflux, abdominal gas and bloating, diarrhea, constipation, rectal itching, vaginitis, headaches, migraines, excessive fatigue, bran fog (inability to think clearly or concentrate), poor memory, hyperactivity, mood swings cravings for alcohol or sweets, anxiety, depression, irritability, dizziness, itching, acne, eczema, athlete’s foot, sinus inflammation, persistent cough, sore throat, earache, pre-menstrual syndrome, low sex drive, muscle weakness, sensitivity to fragrances and/or other chemicals and chronic pain. (Crook W 1983, 2005) This wide-ranging list is significant and indicative of the toxicity associated with Candida.
(Hanshew)****

A report specific to Candida would cover the effect of toxic chemicals and metals we accumulate through daily living and which is stored in our cells… placing us at risk for supporting Candida overgrowth. Candida can overgrow or proliferate the entire GI tract from mouth and sinus cavity to anus and beyond. There is definite nutrient absorption interference from Candidiasis and once detected, can be managed with the 4R Protocol for GI detoxification.

Testing
Testing is somewhat complicated. Many tests are inconclusive and render both false positives and negatives.

For Stomach pH…Measuring serum gastrin is one indicator. It goes up if stomach acid is low. The Heidelberg pH capsule test is thought to be reliable. A low zinc level or low B12 indicates inadequate stomach acid production.

Most endoscopic samples turn out to be inadequate and not worth doing a special procedure. If having an endoscopy anyway, aspirates can be taken for analysius but they have a low reliability rate.

The breath test for both hydrogen and methane seem to be useful.

Comprehensive Stool Analysis (Genova Diagnostics) – shows all pathogens

Organics profile will show SIBO and Candida and other pathogens.
There is a specific test for H.pylori.

The best chance for definitive testing is a practitioner of Functional Medicine and one conversant with Jeffrey Bland’s 4-R program for Gut Rehabilitation ….these people know the most reliable tests and then the methods to act on the results of the Comprehensive Diagnostic Stool Analysis (CDSA) test which identifes the GI culprits.

Intestinal Barrier Assessment test (IBA) is a reflection of the intestinal mucosal membrane and if that breaks down, there is Leaky Gut Syndrome which goes along with SIBO so the 4R protocols should be instituted.

Treatment
Once testing has identified the resident pathogenic species, typically, treatment begins with diet assessment and elimination starchy or sugary carb foods along with the Fodmaps foods that contribute to dysbiosis symptoms…the discomfort, gas, bloating, distension along with targeting the specific pathogens with herbals and antimicrobials. Some doctors prefer antibiotics; FM doctors do not typically choose antibiotics first, but use the herbals and other highly effective antimicrobials and antifungals.

Nature’s finest Antimicrobial
Top on my personal list is the nanoparticle MesoSilver from Purest Colloids because it does not kill the good bowel flora and works rapidly. If there is Candida overgrowth, there can be a Herxheimer reaction with the yeast die-off that can be fairly unpleasant. Symptoms can be flu-like with extreme fatigue and body aches. Rashes including jock itch are not uncommon. This goes away as the yeast die, providing they are not revived by eating the wrong foods.

MesoSilver, along with the powerful p73 version of the Essential Oil of Oregano and Grapefruit Seed Extract, kills and controls these common gut pathogens given time and persistence and a diet that allows the killing to be efficient. When funds are limited or knowledgeable practitioners are not available, it’s a reasonable start and avoids the adverse effects of using antibiotics.

4R Program – Gut Rehabilitation
Remove – allergens, bacteria, parasites in order to support healthy GI function
Replace - building blocks that support digestion (enzymes, stomach acid, fiber etc)
Reinoculate with friendly bacteria which proliferate and crowd out unfriendly bacteria
Repair, regenerate and/or heal the damaged intestinal mucosal lining

CDSA describes beneficial bacteria: Beneficial flora controls potentially pathogenic organisms, influences nutrient production, removes toxins from the gut and stimulates the intestinal immune system (GALT). The composition of the colonic flora is affected by diet, transit time, stool pH, age, microbial interactions, colonic availability of nutrients, bile acids, sulfate and the ability of the microbes to metabolize these substrates. Ideally, levels of lactobacilli and E. coli should be 2+ or greater. Bifidobacteria being a predominate anaerobe should be recovered at levels of 4+

Probiotics and Prebiotics
The opinions vary, but some practitioners do not use probiotics during the ‘Remove’ stage of the treatment plan. They feel that just adds the tendency to encourage more overgrowth. Others, like to use high-dose probiotics right along with the herbals and Silver. Prebiotics are thought to add too much ‘food’ and are eliminated by some practitioners.

VSL#3 is often mentioned but Dr. Mullin says in his experience, many people do not tolerate the very high populations in VSL#3 and it often makes symptoms worse. He says that it is expensive and there are many other very efficient probiotics that work very well.

He prefers not to use a prebiotic or a probiotic until the patient is completely stabilized with the herbals or antibiotics if required. Other practitioners prefer to combine the approach when following the 4R program. Dr. Mullin says it’s very important to observe the Fodmap diet to avoid stimulating activity.

Sacchromyces boulardii - star performer
This is an important, unique and exceptional probiotic that deserves space here. Note that when selecting a S. boulardii product, it’s important to choose one that is not sourced from brewer’s or bakers yeast and that is certified to be both gluten and lactose free as well as maltodextrin-free. Read labels carefully. Otherwise, it’s counterproductive.

S. boulardii is a powerful and hardy, nonpathogenic yeast that is not affected by antibiotics. It has broad antimicrobial activities against C. difficile, toxigenic E. Coli, Candida and other intestinal pathogens. It augments colon bifidobacteria populations and increases butyrate concentrations as well as enhances brush border enzyme activity and improves gut barrier function.

S. boulardii provides unparalleled probiotic support of normal gastrointestinal function in the setting of a broad array of pathogens that include anaerobic and Gram-negative aerobic bacteria, yeasts and protozoans.

Attributes:
• provides support against Clostridium difficile by secreting a protease that inhibits C. Difficile enterotoxinA and Cytotoxin B. This protease lyses enterotoxin A and inhibits binding of both toxins by disrupting their intestinal receptors.
• normalizes enterotoxin A-mediated water and electrolyte secretion and lowers intestinal permeability. It support healthy immune responses against enterotoxin A.
• used in Asia as an active ingredient in herbal teas used to treat cholera and other dysenteries.
• supports against the enteropathic Escherichia coli toxin that causes acute diarrhea. It restore intestinal barrier function during E. coli infections, inhibits enterohemorrhagic E. coli-induced cell death and greatly reduces the numbers of E. coli internalized by enterocytes.
• supports against inflammation caused by Lysteria monocytogenes, Salmonella thyphmurium, and Shigella flexneri infection.
• supports intestinal health in people with Candida overgrowth by reducing populations and helping prevent translocation to extraintestinal tisssues. It thwarts Candida adhesion and filamentation thereby preventing pathogenic biofilm formation.
• is effective against Entamoeba histolytica, Giardia cysts and Blastocystis homina.

Summary – S. Boulardii gives support:
- in healthy bowel microflora during antibiotic therapy
- in those with diarrhea or following antibiotic therapy-
- in children and adults with acute diarrhea
- against traveler’s diarrhea
- during C. difficile bowel disorders
- in AIDS-associated diarrhea
- in children with autism
- in people with inflammatory bowel disease and
- in people with Candida overgrowth.
- offers adjunctive support in Crohn’s disease
(Source: Klaire Labs technical data)

Detoxing for Heavy Metal Removal is a whole other topic worthy of its own discussion since to be effective, it involves some form of chelation and again, various opinions on those protocols. It’s highly effective, can be expensive but worth it for people who are severely contaminated because until the toxins are removed, nothing functions as it should.

Conclusion
This concludes the overview of GI influences on nutrients absorption interference. It is an extremely complex topic.

No matter how much wholesome food or supplements we ingest, if they remain unabsorbed or unassimilated, we won’t see the benefits expected.

It’s virtually impossible to prevent exposure to pathogenic microbes so the best defense is ensuring that we all have a healthy and properly functioning GI tract.

Remember, that commonly 70% of all ailments originate from gut issues and as we know from the many personal Afibber testimonials, fixing the gut can result in a calm heart.

If there is interest, we can continue this thread with treatment protocols and various product selections based on practitioner recommendations along with my own personal history. My Comprehensive Stool Analysis and Organic Acid Profile indicated I had two pathogenic intestinal species Klebsiella pneumoniae, Pseudomonas aeruginosa. Now gone. Negative for Mycology but I’ve treated for Candida successfully in the past. While I was not aware that I had a significant ‘gut’ problem…. once I had completed the 4R program, I was amazed at how much better my overall ‘innards’ felt.

Jackie


Resources

Gerard Mullin MD, MHS, CNSP, FACN
July, 2011 Teleconference on SIBO. Dr. Mullin is an internist, gastroenterologist and nutritionist who is the only physician in the USA board certified by the American Board of Internal Medicine for Gastroenterology, American Society of Enteral and Parenteral Nutrition, American College of Nutrition and the American Board of Nutrition Physician Specialist. He is presently director of Integrative Nutrition Services at the Johns Hopkins Hospital in Baltimore, Maryland. Dr. Mullin has become renowned nationally and internationally for his work on Integrative Gastroenterology and Nutrition. He has accumulated over 15 years of clinical experience in the field of Integrative Gastroenterology and has earned a master's degree in nutrition while in practice. Dr. Mullin is an associate editor for the journal, Integrative Medicine: a Clinicians Journal. He is also recently been selected by Dr. Andrew Weil to serve as a senior editor for the first book for physicians on Integrative Gastroenterology by Oxford Press.

Dr. Mullin compiled the text book collection of methods to treat GI conditions
offered by well-known leaders in the field of gastroenterology.for the
Andrew Weil Integrative Medicine Library.
Title: Integrative Gastroenterology (Weil Integrative Medicine Library) [Hardcover]

He has also written The Inside Tract: Your Good Gut Guide to Great Digestive Health (for lay public)
Gerard E. Mullin MD (Author), Kathie Madonna Swift MS RD LDN (Author),

**Fodmaps WSJ article
[online.wsj.com]


***Klaire Labs. Biofilm pdf
[www.klaire.com]

**** Hanshew, Lyn MD on Garry Gordon’s website…The Safest and Most Effective Solution for the Candidiasis and Mercury Cycle
The average person in the US has between 400-800 potentially toxic, immunosuppressive, carcinogenic, endocrine-disrupting, and gene-damaging chemicals stored his cells and is therefore at risk for Candidiasis. Mercury, lead, cadmium, arsenic, pesticides, insecticides, dioxins, furans, phthalates, VOCs, and PCBs are just some of the foreign substances that have created an excessive toxic body burden of harmful chemicals.


Michael D. Gershon, MD, Chairman of the Department of Anatomy and Cell Biology at New York–Presbyterian Hospital/Columbia University Medical Center, an expert in the nascent field of neurogastroenterology and author of the 1998 book The Second Brain (HarperCollins).

[www.scientificamerican.com]

Gershon:
[www.nytimes.com]
The occasional antacid won't hurt anyone, but purging your stomach acid is unwise over the long term. "What you eat isn't sterile, and you have more of a chance of getting an infection without acid to kill the bacteria," Gershon says. He recommends that if you do take acid-blockers, use the lowest dose you need for as short a period as possible. [findarticles.com]
Optimal Digestive Health: A Complete Guide [Paperback]
Trent W. Nichols (Author), Nancy Faass (Author
Gastroenterologist.

Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition by Elizabeth Lipski Paperback

Leaky Gut Syndrome by Elizabeth Lipski

Hey Jackie, thanks for this awesome work ( only part of which I've had time to read, but I am working my way through it. Digesting it......?). As you know, I can testify as someone who was in exactly this kind of trouble for many months, and, with your great advice, slowly worked my way back to being able to eat using all the natural remedies you point out. They do indeed work, although not overnight, one must be persistent and diligent. As you will recall, I had consulted two highly recommended GI specialists, who had ordered an array of tests , found nothing, and essentially made no recommendations except for yet another colonoscopy. And of course, no Medical specialist (internaL medicine, GI, or EP) thought to link my inability to process nutrients with my increase in Afib episodes, which, in hindsight, it clearly was.

I so appreciate your wonderful contributions to the Forum.

Louise

Thanks Jackie, this is very relevant information for me
My A-fib episodes are often triggered by digestive problems . Gas pressure in the stomach after a meal causes increasing ectopics & sometimes A-fib . The A-fib & ectopic frequency has been reduced to about once every three weeks since I started taking 50 mg Flecanide in the evening along with about 8 mg Atenolol ( 1/4 25 mg tablet). The episodes can be terminated by jogging usually within a few minutes , sometimes they are more stubborn & take a half hour or more of on/ off exercise. I have a treadmill for this purpose which I use in the winter when the weather outside is bad. I have a first appointment with an E.P. Dr SAP in Halifax at the end of March , but probably will decide to stay with the Flec for now rather than request an ablation, but am still considering as there is a long waiting list, and there is a temptation to go for a more permanent fix, and try & be done with this problem . Before starting the Flec I was getting A-fib several times a day usually an hour after eating & was ready for the ablation.

see below for a link to research on human gut Flora recently published in Nature- These scientists would seem to agree that our gut microflora have major influences on our health
[www.nytimes.com]
Bacterial Ecosystems Divide People Into 3 Groups, Scientists Say

This is great Jackie ! - I'm pretty sure my afib is linked to my digestion - it started when I got acid reflux/GERD and I was 'scoped' and diagnosed with Barretts and then put on PPI's. I don't think the PPI's did me any favours at all and have left a legacy that I am still battling through....

I'd love to see this thread continued....

rgds
Heather

Many thanks Jackie,

This information is timely for me, so I'll be studying it carefully.
==========

Heather,

A while back I was wondering if PPIs possibly inhibit the Na+/K+ATPase pumps (electricity) in the heart along with their intended inhibition of H+/K+ATPase pumps (acid) in the stomach. This randomly selected 2007 article shows that they do indeed, meaning that a PPI will lower the heart cells' voltage which will encourage arrhythmias: [jpet.aspetjournals.org]

For example, in this study omeprazole (Prilosec) inhibited the Na+/K+ pumps an astonishing 65 times more strongly than it inhibited the H+/K+ acid pumps. See TABLE 1 on p. 4 of the PDF. A GI specialist will call this a side effect for a heart specialist to sort out. Pardon my cynicism - I've been there..

Erling.

Heather - has the Barrett's resolved?

As you know, Barrett's can lead to esophageal cancer so don't neglect so don't neglect treatment.

This link offers a substitute for PPIs... DGL which we have mentioned many times previously when discussing reflux.

[www.naturalnews.com]

Jackie

DGL works instantly, another wonderful supplement!

Louise

Erling - I too am very suspicious about the PPI's not only do I think they brought on my afib but they did in fact give me terrible heartburn (bizarrely) at times.

Jackie - My Barretts hasn't got any worse, my scope year before last showed no changes - its the short stem variety (small patch) and not too severe and in fact my acid reflux/GERD issues are much better of late. I've been using Acid Ease daily and Slippery Elm lozenges and I also have Chamomile tea most nights. I keep a stash of my Lansoprazole (Prevacid) just in case it gets bad again but not had to use them for weeks n weeks. If I have to use them I'll only use for a short period of time (not constantly). I intend to keep a careful eye on my stomach !

Louise - I intend to try DGL as well will have a shop on iHerb!

Heather,

It's kinda horrifying to realize that PPI inhibition of sodium-potassium pumps means in all 70 trillion cells of the body!! Including of course the cells of the esophagus! Each and every cell is fully dependent upon full functioning of its Na.K pumps for its health. Please take a look at [www.vivo.colostate.edu] "Depending on cell type, there are between 800,000 and 30 million pumps on the surface of [each] cells".

One of the names of the game in staying healthy is not to inhibit the Na/K pumps.

Erling

The DGL that I've used in the past is from iHerb and it's the one by Natural Factors that has no artificial sweeteners.
I've recommended it to many others who find it very helpful.

Check out this DGL article written by Michael T. Murray, ND, the Director of Product Development and Education, of Natural Factors and is widely regarded as one of the world's leading authorities on natural medicine. He is a graduate, faculty member and serves on the Board of Trustees of Bastyr University in Seattle, Washington.

[www.myhealthmybody.com]

Jackie

It is all so complicated. WebMD and other sources say that Licorice has major interference on warfarin. I would try it, but now I am reluctant to do so. Comments?
Phyllis

Phyllis - for any product, if there is any hint of any interference with warfarin, you should avoid it.

According to one website: Licorice contains a chemical called glycyrrhizic acid, which is responsible for many of the reported side effects. DGL (deglycyrrhizinated licorice) has had the glycyrrhizic acid removed, and therefore is considered safer for use.

Still, I would want some absolute assurance that DGL does not interfere with warfarin.
If you are really interested in this product, why not call Natural Factors on their 800 number and ask to talk with one of their online staff medical experts.

Jackie