For thousands or millions of years – depending on your interpretation of science and scripture – mankind has had a symbiotic relationship with bacteria in the gastrointestinal tract or “gut.” In fact, a depletion or eradication of bacteria with antibiotics often causes disease. An example is “antibiotic colitis” which results from an overgrowth of an organism called clostridium difficile. This bacterium is normally held in check because it must compete with billions of other bacteria in the gut, at least until these bacteria are depleted by antibiotics and the resistant clostridia species proliferates and releases toxins which produce diarrhea and colitis (inflamed colon).
In a medical career spanning four decades I’ve attended a lot of medical conferences and lectures. However, the most memorable and entertaining medical lecture was gien by a self-described “flatologist.” This gastroenterologist’s specialty and area of research was colonic gas. Imagine a career spent collecting and analyzing gaseous emissions of the colon.
I don’t mean to be crass, but we all produce flatus, or as I was taught in grammar school, we all fart. And we’ve heard of people who are able to ignite the gas expelled from their lower regions. Methane is the principal component of natural gas which heats our homes and cooks our food more efficiently than electricity. Cows produce lots of methane from the vegetable matter they eat. The methane is then expelled in due course and is a major greenhouse gas. Some of us also expel flammable methane.
I learned from the erudite professor that about 15% of humans produce methane which can be used by those so “gifted” at fraternity parties, though with the risk of fire and explosion! In fact, one reason colon preps are ordered by your doctor is to prevent explosions which have occurred when electrocautery used to remove polyps ignites methane which remains without adequate purging. In humans methane is produced when certain strains of bacteria act on vegetable matter. It turns out that if you are among the 15% that possess the methane producing bacteria, your gut was colonized with that strain when you were a newborn infant and you received the colonizing strain from your mother – God love her!
The “Gas Expert” further enlightened me with his research demonstrating that humans on an average pass gas seven to fifteen times per twenty four hours. Women dispute this research, but men use it as a defense when “indiscretions” occur. The flatologist’s lecture concluded with a historical piece de resistance. It seems a “gifted” performer in the late 1800s at the Folies Bergere in Paris was able to control his expelled gas sufficiently to play the Marseillaise, the French National Anthem! I have not been able to corroborate this factoid, but a friend of mine maintains you should never spoil a good story with facts.
We usually get along with the bacteria in our gut unless we become “poisoned” with tainted or spoiled food. Thirty years later, I still remember the oyster that didn’t quite taste right and led to a night of misery as I struggled to decide which way to address the toilet. Scientists know that we carry billions of bacteria in our guts, but now they are asking why we are so designed or have evolved to require foreign organisms in our colon for health. A recent article in the NEJM (New England Journal of Medicine) alluding to a relationship between gut bacteria and heart attacks caught my eye and raised the issue of symbiosis and “probiotics.”
In addition to antibiotics, the gut’s bacterial ecology can be modified through dietary components known as PREbiotics which promote growth and metabolism of beneficial bacteria. You can also affect the fecal ecology by adding bacteria to the gut with agents known as PRObiotics. Lastly, as strange as it sounds, researchers have even isolated bacteria from the feces of others, and transplanted these into the colon of patients suffering from colitis to help restore a more balanced fecal flora and treat disease not responding to standard treatments!
The science of certain dietary elements known as prebiotics is described in the June 23rd New England Journal of Medicine. These nutrients (carnitine, choline and phosphatidylcholine) are processed by gut bacteria to produce TMA (trimethylamine). TMA has been shown to produce cholesterol rich cells in the walls of blood vessels which accumulate as plaque which can rupture. Oxidized TMA also makes platelets “sticky” and promotes clotting in a ruptured cholesterol plaque causing a heart attack. While these associations are intriguing, we are not ready to jump on this bandwagon and alter our diets!
Probiotics are “microorganisms [having] beneficial properties for the host,” and are increasingly being used as medicinal agents. Science has been able to demonstrate beneficial effects of probiotics in some conditions, most notably inflammatory bowel diseases like ulcerative colitis and Crohn’s Disease. There is less good data to support the use of probiotics in irritable bowel syndrome and a host of other gastrointestinal conditions. There has even been experimental models showing benefits of probiotics and immune system recognition of cancer cells. The problem is that probiotics are diverse in formulation and as dietary supplements they are not regulated by the FDA. People often ask me about yogurt to reconstitute normal bowel flora. Unfortunately, the bacteria in yogurt often don’t survive the acidic stomach and are not therapeutically useful.
Too often we take health for granted. The longer I live the more impressed I am with the majesty, intricacy and the mystery of Creation. The materialist holds that if he can’t experience something (see, touch, understand or measure) it doesn’t exist in his world view. In my experience that is hubris (arrogant pride) and foolishness. The Apostle Paul, no shoddy philosopher, spoke to our imperfect understanding and vision in I Corinthians 13:12.
How interesting that western science is increasingly embracing the concept that health is a balance (yin and yang?). We are learning that there is also balance in the gut involving bacteria, the protective lining of the intestinal tract and the underlying immune system’s destruction or tolerance of foreign agents (bacteria).
Yes, we are “fearfully and wonderfully made,” sang the Psalmist 3000 years ago. It is still true today.