"The digestive tract is an open-end muscular tube which passes through the body. Wastes excreted through it have never been "in" the body but have merely been surrounded by it. Digestion occurs outside you. The inside of your mouth, or stomach, or intestines, is really outside you. Only what passes through the walls of the tract gets inside you."' When digestion is working normally, food enters the mouth, is chewed and mixed with saliva to begin the process of digestion: changing the food into smaller, simpler components for use by the body. The muscles of the digestive tract flex and relax, pushing the food along where additional chemicals continue the process of splitting the food fragments into smaller and smaller components. Eventually, the food is absorbed through the walls of the intestinal tract where it is used by the body to rebuild tissues, fuel cellular activity or produce some of the many chemicals necessary for our survival. "Any compromise of intestinal barrier function increases the production of oxygen radicals and carcinogens by the (liver)... Compromised intestinal barrier function can cause ... hypersensitivity, inflammatory arthritides, skin conditions, chronic fatigue syndrome (and others). . .The commonest causes of damage are infectious agents. . . and non-steroidal anti-inflammatory drugs."'
In rheumatoid disease, a number of things can happen to the digestive tract which can cause further distress to patients who arc already dealing with the pain, fatigue and disabilities which accompany these diseases.
Sjogren's Syndrome - dry mouth, dry eyes constipation / diarrhea bacterial overgrowth such as candid a, E coli, salmonella gas / bloating food allergies malnutrition / weight loss leaky gut.
Saliva is the first chemical produced by the body which helps break down food. When mixed with adequate amounts of saliva, the breakdown of food begins. Sjogren's Syndrome is a condition where saliva production is severely diminished, hampering digestion. Adequate water intake keeps the balance in the gut and helps promote regularity. As food passes through the gut, water is slowly removed. Too little moisture can contribute to constipation. Diarrhea can be caused by food passing too quickly through the gut or by the action of certain unfriendly organisms. Fat absorption can become impaired, vitamins A, D, K may also be malabsorbed and B 12 can be destroyed.
A patient deficient in these vitamins may see improvement by adding them to their treatment regimen. Food moving normally through the intestinal track or gut prevents fermentation and bacterial overgrowth, but when the muscle action of the gut is impaired by disease causing food to remain too long in the dark, warm, moist environment of the gut - fermentation begins, producing gas and bloating. These bacteria can alter the chemical structure of certain compounds in bile acids (secretions of the liver) which are necessary for the body to digest fats and certain vitamins like A, D and K.
Weight loss, diarrhea, gas, bloating and vitamin deficiency arc symptoms of this bacterial overgrowth. Bacterial dysbiosis (disease induced by organisms which alter the metabolic or immunologic responses of their host) has been implicated in Chron's disease and ankylosing spondylitis. Sensitization to these bacteria can increase permeability. The use of NSAIDs can produce a chronic hypersensitivity with inflammation resulting in more permeability and so on. Some NSAIDS like ibuprofins are gentler on the gut than indomethacin which is more likely to damage the small intestine.
Changing NSAID can help as can the use of probiotics like acidophilus. Bacterial dysbiosis can be treated with antibiotics and diet. If a vegetarian diet does not bring improvement, the alered gut ecology has another cause that food. ... Consumption of vegetable oils tends to increase the free radical content of bile and to exacerbate the condition, as do low fiber diets.
In diseases like scleroderma, in addition to some of these other problems, the normal flexibility of the gut can be destroyed as the tissue thickens and hardens (sclerosis). This also impairs the movement of food and digestive juices, allows the food to stand too long in the intestine, and fosters fermentation. The stool can be light colored (high fat content), foul smelling and bulky.
When food particles squeeze through the gut walls and enter the abdomen, it can trigger an allergic reaction. After all, food is foreign substance. tolerated when it is inside the digestive tract, but not when it gets outside. Food allergies can increase gut permeability as can some medications, creating a vicious cycle. Fasting and crash diets can also increase permeability. Because toxins clear through the liver, patients with leaky gut put additional stress on their liver. In attempting
to eliminate the toxic oxidation products. the liver adds to the vicious cycle. Antibiotics of the tetracycline family, clindamycin and ampicillin
can be used to reduce bacterial overgrowth. If the overgrowth is yeast, anti-yeast medications are available. Replacing depleted vitamins is also helpful. These problems cannot be corrected by diet, however eliminating or reducing fats and sugars can help.
I The Digestive System, Family Medical
Guide, Better Homes & Gardens Books, 1973, p 45 1. 2 Leo Galland, MD, Leaky
Gut Syndromes: Breaking the Vicious Cycle, Townsend Letter for octors,
Aug/Sept 1995, p 62-68. 3 Andrew G. Plaut, MD, Bloating, Diarrhea and
Weight Loss in Scleroderma, Scleroderma Foundation. 1988. 9:2, pg 4 4
Scleroderma and the Gastro-Intestinal tract. United Scleroderma Foundation
brochure. 5 M Centofanti, Just Lookin' for a Home. Science, Jan 6, 1996,
149, p 12.