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What is the association between obesity and microbiota (or lack thereof)

-H. pylori affects gastric hormones that have a role in energy homeostasis, such as leptin and ghreline; a link between its disappearance and the increasing prevalence of metabolic syndrome, type II diabetes and obesity has also been postulated

-profound changes in the composition and metabolic function of the gut microbiota in obese individuals which appear to enable the "obese microbiota" to extract more energy from the diet....the gut microbiota interacts with host epithelial cells to indirectly control energy expenditure and storage

-obese individuals found to have elevated levels of Enterobacter


Know H. Pylori – beneficial vs. adverse effects on digestive health

beneficial: H. pylori assoc. with reduced risk of adenocarcinoma in the lower esophagus, modulates gastric hormones

adverse effects: gastric adenocarcinoma, lymphoma, ulcers


Homeopathic approaches (and remedies) for dysbiosis

General approach for candida: Candida nosode, Nystatin nosode, Syphilinum
-Use one dose of 30C weekly


What prerequisites are needed to define a probiotic?

prebiotics are cofactors for probiotics


What is a prebiotic? How does it work?

a non-digestible food that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon
ex: Inulin, FOS (support the growth of beneficial bacteria)


Synbiotic? The advantages of its use?

mixtures of probiotics and prebiotics that beneficially affect the host

Improved survival of live bacteria in food products, prolonged shelf life
Increased number of ingested bacteria reaching the colon in a viable form
Stimulation in the colon of the growth and implantation of both exogenous and endogenous bacteria
Activation of metabolism of beneficial bacteria, antagonistic toward pathogenic bacteria
Production of antimicrobial substances (bacteriocins, hydrogen peroxide, organic acids etc)
Anti-inflammatory, Anti-mutagenic, Anti-carcinogenic, and production of bioactive compounds (enzymes, vaccines, peptides etc)


Know the triggering events of dysbiosis

overgrowth of normal species (usually present in small amounts) when population of other normal species are decreased
normal species spreads to areas not normally found (e.g. colon to SI -> SIBO)
Pathogen establishes itself in gut, usually resulting in some clinical disease state
Uncommon overgrowth of normal flora leading to secondary displacement


What are the effects of antibiotics on intestinal flora?

-Both human and animal studies have shown that even a one-time antibiotic treatment can lead to decreases in bacteria usually considered beneficial, such as Bifidobacteria and Lactobacilli, as well as increases in potential pathogens such as Clostridium difficile and the yeast Candida albicans.
-In the short term, such shifts in microbiota can cause yeast infections and GI symptoms including bloating, abdominal pain, and diarrhea.
-Recent work suggests the consequences may be much longer-lasting and more serious (from 4 weeks to 2 years)


How does a high carbohydrate diet influence dysbiosis?

slows bowel transit time - increases bacterial fermentation, increases exposure to potentially toxic bowel contents, promotes fungal overgrowth

high carb diet (esp gluten and casein)- incr. disaccharide load to colon (can feed microbiota, esp yeast), results in abnormal bacterial overgrowth and fermentation


What are the non-GI symptoms and conditions associated with dysbiosis/intestinal permeability?

behavioral problems in children
environmental allergies
recurrent infxn


Anti-candida botanicals?

Allium sativum
Calendula officinalis
Commiphora myrrha
Grindelia spp.
Mentha piperita
Pau d'Arco


Anti-microbial/anti-bacterial botanicals?

Allium sativum
Calendula officinalis
Hydrastis canadensis
Juglans nigra
Thymus vulgaris (essential oil)
Usnea spp. (Collins)


What diets are most appropriate for dysbiosis? why?

Anti-candida (initially avoiding all carbs)
Elimination (avoiding allergens/food sensitivities is an essential part of treatment)


what are the most important quality control considerations in selection a probiotic?

-a minimum of 2.5 billion organisms for mild conditions, upwards of 20-30 billion often needed
-choose your probiotics carefully- ask for assays from the companies
-refrigerated strains seem to have improved therapeutic efficacy
-take with meals/after meals


what are the applications of the probioitics? - esp their effectiveness against pathogenic microbs

-reduce plasma levels of bacterial endoxtoxin concentrations, by inhibiting translocation of bacteria across the GI lumen into the bloodstream (may be due to ability of probiotics to tighten the mucosal barrier)
-There are several ways probiotic microflora can prevent pathogenic bacteria from adhering and colonizing gut mucosa:
-Disallow colonization by disease-provoking bacteria through competition for nutrients, immune system up-regulation, production of antitoxins, and up-regulation of intestinal mucin genes.
- Lower colon luminal pH and foster growth of non-pathogenic commensal bacteria by SCFA (Short Chain Fatty Acid) production. (SCFA, acetic acid, has antimicrobial activity against molds, yeasts, and bacteria)
-Exert protective effects through production of hydrogen peroxide and benzoic acid, which inhibit many pathogenic, acid-sensitive bacteria