Leaky Gut Alternative Treatment Ebooks Catalog

Leaky Gut Cure

Leaky Gut Cure by Karen Brimeyer teaches sufferers all around the world that healthy foods can be harmful for people who already developed leaking gut. This 10-week system points out that your gut is responsible for protecting you against pathogens containing harmful parasites, viruses, bacteria, yeast and fungi. Additionally, the e-guide contains guidelines for food choices and recipe guides that help them remove all symptoms of leaky gut naturally and permanently. You are going to discover everything related to inflammation and the ways to remove it, methods to repair the intestinal lining, some tips for health maintenance that you can use for continuance after program, and the right mindset for the absolute healing. Read more here...

Leaky Gut Cure Summary


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Author: Karen Brimeyer
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Of all books related to the topic, I love reading this e-book because of its well-planned flow of content. Even a beginner like me can easily gain huge amount of knowledge in a short period.

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Gastrointestinal Conditions

Oral Aloe vera Is a popular treatment for a variety of gastrointestinal disorders. It has been shown to Improve different parameters of gastrointestinal function In normal subjects, such as colonic bacterial activity, gastrointestinal pH, stool specific gravity and gastrointestinal motility (Bland 1986). Due to Its anthraqulnone content, It Is used as a stimulant laxative.

Role Of The Gastrointestinal Microbiota In Humans

Traditionally, the colon has been considered to largely be the human sewage system which, as well as storing and removing waste material from the GI tract, was capable of recycling water (i.e., absorption). However, we now recognize that the GI tract is one of the most metabolically and immunologically active organs of the human body. Indeed, the primary function of the microbiota is generally considered to be salvage of energy via fermentation of carbohydrates, such as indigestible dietary residues (plant cell walls, non-digestible fibers and oligosaccharides), mucin side-chains and sloughed-off epithelial cells (5,6,8,13,17). It has been estimated that between 20 and 60 grams of carbohydrate are available in the colon of healthy human adults per day, as well as 5-20 grams of protein. In addition to salvaging energy, principally through production of short-chain fatty acids (SCFAs) and their subsequent absorption and use by the host, microbial fermentation produces gases (principally...

The Metabolism of Polyphenols by the Human Gut Microbiota

Polyphenols are considered to be key active constituents of fruits and vegetables and responsible for many of the health protective effects of diets rich in these foods. While their structure varies considerably, following ingestion, most ( 95 ) persist to the colon where they encounter the human gut microbiota. Here they may undergo considerable structural alteration to compounds that may have enhanced biological properties or possibly degraded into inert metabolites and excreted. As such, the human gut microbiota may have a significant influence on the final outcomes of polyphenol ingestion. Moreover, interindividual variation in the composition of the microbiota means that certain compounds are metabolized in different ways, and this is reflected in the considerable variability seen in excreted polyphenol metabolites. Consequently, polyphenols as active ingredients in functional foods may turn out to be beneficial for only a certain proportion of the population. Clearly, this may...

Gut Bacterial Involvement in Colorectal Cancer

In animals, the presence of the intestinal microbiota has a major impact on colonic tumor formation (37,38). In a study conducted by Reddy and coworkers (38) the rate of tumor formation was much more rapid in conventional than in germ-free rats treated with the tumor initiator 1,2-dimethylhydrazine (DMH). After 20 weeks, 17 of conventional rats had colon carcinomas, whereas there were no tumors (adenomas or carcinomas) in the germ-free animals. At 40 weeks, two out of 18 germ-free rats had developed benign adenomas (although still none had carcinomas), compared to six out of 24 conventional rats with tumors (4 cancers, 2 adenomas) thus the gut microbiota had a tumor-promoting effect when DHM was the tumor initiator. A high incidence of spontaneous CRC has been demonstrated in the T-cell receptor (TCR) b chain and p53 double-knockout mice. In one study, 70 of the animals with a conventional microbiota developed adenocarcinomas, whereas adenocarcinoma of the colon did not occur in...

Effects of Gut Microbiota on Gene Expression

To date, there are only a few molecular descriptions of how bacteria in the normal microbiota regulate gene products with presumed positive functions in the intestine or systemically. Dramatic changes in gene expression were noted when germ-free mice were mono-colonized with Bacteroides thetaiotaomicron, a component of the normal microbiota of adult mice and humans (64). A number of genes involved in general mechanisms like nutrient uptake, fortification of the intestinal epithelial barrier, postnatal development, and angiogenesis are regulated in response to this commensal microbe. In addition, it is becoming clear that metabolic products, produced by the gut microbiota, can alter gene expression in the colonocyte e.g., butyrate, produced by bacterial fermentation of dietary fiber, induces p21 Cip1 WAF1 mRNA (important in cell cycle control) and secondary bile acids, produced from primary bile acids by the gut microbiota, alter AP-1-dependent and COX-2 gene transcription) (65,66).

Use of Probiotics to Combat Gastrointestinal Infections

Probiotics have been shown to be useful in the treatment of a variety of gastrointestinal disorders, and the details are presented in Table 4. A number of these disorders have a significant inflammatory component in the small and or large intestine and there is a growing body of research to suggest that probiotic bacteria may be useful particularly in many of these pediatric gastrointestinal conditions. Specific strains of Lactobacillus rhamnosus, Lb. reuteri, Lb. plantarum, Bifidobacterium lactis, and Saccharomyces cerevisiae (boulardii) have all been extensively studied. Probiotics can reduce the duration and severity of rotaviral enteritis, as well as decrease the risk of antibiotic-associated diarrhea in children and Clostridium difficile diarrhea in adults. Prevention of viral diarrhea in day-care centers as well as traveler's diarrhea has been demonstrated with some probiotics, although not all are equally effective (67). Small bowel bacterial overgrowth conditions may respond...

Manipulation of the Gastrointestinal Microbiota by Diet

Dietetic methods can also be used to influence the microecosystem of the intestinal tract in piglets during weaning. At this period important morphological and functional changes occur in the digestive tract of piglets that are also accompanied by changes in the composition of the gut microbiota (17,61). In the first days after weaning Lactobacillus populations decrease considerably whereas the numbers of coliforms increase. In piglets the brush border of the intestinal epithelium can be damaged by feed components (62) or viruses (63) such damage enables enterotoxigenic E. coli to colonize the injured epithelium. Important factors that the piglets had been receiving by maternal milk and that prevented E. coli from colonizing the gut (64) are no more at the animals' disposal. All these changes support the tendency to low weight gain and predispose to the occurrence of the diarrheic syndrome. Several researchers tried to influence the morphological and functional development of pigs...

Age Altered Aspects of the Intestinal Microbiota

Normal aging is associated with significant changes in the function of most organs and tissues, such as decreased taste thresholds, hypochlorhydria due to atrophic gastritis, and decreased liver blood flow and size (11). The GI tract is no exception, and there is increased evidence of impaired gastrointestinal function with aging (3,11-13). In the GI tract of the elderly, the age-related changes include decreased acid secretion by the gastric mucosa, and greater permeability of mucosal membranes which have been linked to increase in circulating antibodies to components of the intestinal microbiota in elderly subjects. Therefore, certain microbes which can take advantage of new ecological niches are assumed to become predominant inhabitants, leading to a dramatic shift in the composition of the gut microbiota upon age. Although the knowledge about the age-related alteration of the human intestinal microbiota is still limited, the structure of the intestinal microbiota in the healthy...

Development Of Intestinal Microbiota In Dogs And Cats

Although there is paucity of research data concerning the development of intestinal microbiota of dogs and cats, it can be considered to follow a similar pattern as known for other mammals. Intestinal colonization is a gradual process starting immediately after birth. In newborn puppies and kittens the alimentary canal is sterile but is quickly inhabited by bacteria from birth canal and environment. The dam usually licks the newborn thoroughly thus transferring its own indigenous bacteria to her offspring. Within 24 hours the numbers of bacteria in various parts of the gastrointestinal tract of a newborn puppy are similar to those of an adult dog (2). The indigenous intestinal microbiota is considered an integral part of the host defense mechanisms. It forms a barrier against pathogen colonization and also influences the host's immunological, biochemical, and physiological features (6). Once the microbiota has become established, it is relatively stable. Oral antibiotics may have a...

The Prebiotic Strategy To Modifying The Intestinal Microbiota

For a variety of reasons, the two bacterial genera most often advocated as beneficial organisms with which to augment the intestinal microbiota are lactobacilli and bifidobacteria, both of which are common members of the human intestinal microbiota (11,12). These bacteria are numerically common, non-pathogenic, non-putrefactive, non-toxigenic, saccharolytic organisms that appear from available knowledge to provide little opportunity for deleterious activity in the intestinal tract. As such, they are reasonable candidates to target in terms of restoring a favorable balance of intestinal species. While the probiotic strategy aims to supplement the intestinal microbiota via the ingestion of live bacteria, the prebiotic strategy aims to stimulate the proliferation and or activity of beneficial microbial populations already resident in the intestine. The characteristics shared by all successful prebiotics is that they remain largely undigested during passage through the stomach and small...

Manipulation of the Gastrointestinal Microbiota by Application of Probiotic Microorganisms

It is of great importance to influence the intestinal microbiota of calves, piglets and poultry at an early age since this is the period when the danger of diarrhea-accompanied diseases of the digestive tract reaches its maximum. Due to their high morbidity and mortality rates such diseases present an extraordinarily serious health and economic issue. Preventive application of probiotics at an early age helps to optimize the composition of the gut microbiota and has an inhibitory effect upon the pathogens of the digestive tract in the young of farm animals. Preventive application of Lactobacillus casei at a dose of 1.108 germs decreased the counts of enterotoxigenic E. coli O101 K99 adhering to the small intestinal mucosa of gnotobiotic lambs by 99.1 and 76.0 on day 2 and 4 after inoculation, respectively (74). Perdigon and coworkers (75) found the preventive effect of L. casei and yoghurt against Salmonella typhimurium infections in mice to depend on the duration of administration....

Gut Bacterial Metabolism and CRC Risk

The enormous numbers and diversity of the human gut microbiota is reflected in a large and varied metabolic capacity, particularly in relation to xenobiotic biotransformation, carcinogen synthesis and activation. The metabolic activities of the gut microbiota can have wide-ranging implications for the health of the host (42). To date the vast majority of mechanisms whereby bacteria are involved in carcinogenesis involve toxic or protective products of bacterial metabolism. Such metabolic activities include numerous enzymatic reactions and degradation of undigested dietary residues. Diet can substantially modulate these activities by providing a vast array of substrates. A wide range of enzyme activities capable of generating potentially carcinogenic metabolites in the colon are associated with the gut microbiota, including b-glucuronidase, b-glucosidase, nitrate reductase and nitro-reductase. These are usually assayed in fecal suspensions and appear to be present in many bacterial...

Modifying The Intestinal Microbiota Pre And Probiotics

First documented studies of dietary manipulation of canine and feline intestinal microbiota date back to the beginning of the twentieth century (71). Today, there is growing interest in modifying their gut microbiota towards what is considered a healthy composition, i.e., increase in LAB and bifidobacteria, and decrease in potential pathogenic bacteria (72). Many commercial pet foods now contain prebiotics (e.g., fructo-oligosaccharides, FOS). In addition, probiotics are also marketed for dogs and cats.

Composition Of The Adult Fecal Microbiota Assessed By Molecular Techniques

The development and application of PCR-based methods and probing strategies, which have circumvented cultivation, highlighted the tip-of-the-iceberg scenario that our knowledge of the GI tract microbiota amounted to. The coverage that cultivation studies afforded has been calculated to be as low as 10 , although others suggest it may be as high as 40-58 (15,54-56). Modern cultivation media and incubation conditions enable greater diversity, and therefore coverage, to be recognized. However, many components of the human gut microbiota remain elusive to cultivation in vitro. Molecular strategies also have their limitations, including detection limits and inherent biasing. As such, the overall objective of the study generally determines which assay is most appropriate. In the case of investigations to elucidate the diversity and dynamics of the human gut microbiota, a polyphasic approach is best, allowing thorough analysis at multiple taxonomic levels.

The Role Of The Enteric Microbiota In The Normal

Underpinning the probiotic concept is the importance of the normal intestinal microbiota in health and disease (12). Establishment of gut microbiota begins within minutes of delivery of the newborn (13,14). During delivery the infant is exposed to bacteria in the birth canal, the environment, maternal fecal microbiota, and other sources (15). The gut is initially colonized by facultative anaerobes such as Escherichia coli and Enterococcus species, possibly due to the absence of anaerobic conditions in the intestine (16). Colonization with bifidobacteria follows, particularly in breast-fed infants, and as the environment becomes more anaerobic, Bacteroides and Clostridia. The importance of the intestinal microbiota is suggested by the fact that the healthy adult gastrointestinal tract is home to a gut microbiota comprising over 400 different species with more bacterial cells in the gut than eucaryotic cells in the human body and with the average mass of bacteria being 1-2 kg. Commensal...

Efficacy Of Probiotics In Inflammatory Bowel Disease Probiotics in Animal Models of IBD

The model of IL-10 knockout mice develop colitis when colonized with normal enteric microbiota but remain disease-free if kept in germ-free conditions. In a study of IL-10k k mice colonization with Lactobacillus plantarum 299v was performed 2 weeks before transferring from a germ-free environment to a specific pathogen-free environment (84). This treatment led to a reduction in disease activity and a significant decrease in mesenteric lymph node IL-12 and IFN-g production. A role for Lactobacillus reuteri in prevention of colitis in IL-10k k mice was also demonstrated (81). In this study, the oral administration of the prebiotic lactulose (shown to increase the levels of Lactobacillus species) and rectal swabbing with L. reuteri restored Lactobacillus levels to normal in neonatal mice, originally found to have low levels of lactobacilli species. This effect was associated with the attenuation of colitis. In a placebo controlled trial, orally administered Lactobacillus salivarius...

Surrogate Markers For Dietrelated Colon Cancer Studies

As discussed above, the gut microbiota has been implicated in the etiology of CRC by a number of studies and these observations form the theoretical basis for the use of several gut microbiota biomarkers (fecal biomarkers) in studies on diet and colon cancer. They are composed of two main categories those examining the activity of bacterial enzymes or bacterial metabolites and those based on bioassays on fecal water. For a more thorough review of this subject, the reader is referred to Rafter and coworkers (67).

Increasing Numbers of Beneficial Microbes

One of the properties thought to be important for the health benefits of consumed probiotic organisms is their ability to adhere to the intestinal mucosa. As such they can resist peristalsis and occupy a habitat at the expense of potentially harmful organisms. The probiotic applications to the human gut are already widespread, and evidence is mounting that these organisms have a beneficial effect on the host. It is now well established that the probiotic organisms can transiently establish themselves in the GIT and inhibit the adhesion and growth of enteropathogens. Table 5 delineates the effect of feeding selected probiotic preparations on the human gut microbiota.

Suppressing Numbers of Potentially Harmful Microbes

The artificial manipulation of the human intestinal microbiota by consumption of large numbers of probiotic microorganisms may lead to the presence of large numbers of lactic acid-producing microorganisms in the small intestine. Any available sugars will be quickly fermented to various organic acids and or ethanol. This leads to a change in the environment where the production of various low-molecular toxic metabolites and antigenic macromolecules by various intestinal, potentially pathogenic microbes and the effects of endotoxins may be strongly reduced (Table 5). The intestinal growth of all other types of nonintestinal pathogens is strongly inhibited by abundant probiotic fermentation in the small intestine. Reduction of viral infectivity was attributed to ethanol or acid-mediated denaturation of viral envelope proteins. In addition to organic acids, bacteriocins, such as e.g., Lactacin F (88), and some unidentified compounds synthesized by probiotic organisms Table 5 Effect of...

Reflection of Environmental Factors

Amongst the best examples of factors which have been clearly shown to influence the development of the gut microbiota and have also been implicated in allergic diseases include the mode of delivery and breast-feeding (116-123). Indeed, it is plausible that the characteristics of fecal microbiota associated with atopic eczema and allergic sensitization may partly reflect dietary factors. It is well known that changes in diet may dramatically affect the microbial composition of the gut. Then again, in allergic infants the diet can reflect the child's health status due to food restrictions. In 39-63 of all infants and young children, atopic eczema is triggered by one or more challenge-confirmed food allergies (124-126). Moreover, the development of manifestations of allergic diseases in children correlates with differences in the composition and immunological characteristics of breast-milk, which on the other hand are affected by maternal gut microbiota and atopy (127-133). For example,...

Reflection of Atopic Genotype

Incomplete knowledge of the genetic characteristics of allergic diseases restricts the full understanding of their possible influence on the development of gut microbiota (58). Theoretically, microbial colonization could be directly affected for example if the atopic genotype was associated with receptor expression on epithelial cells or production of intestinal mucus. There is some indication that the atopic genotype is associated with Figure 2 Mechanisms by which specific components of intestinal microbiota may protect from allergic sensitization and or alleviate symptoms. Adequate microbial composition may reduce allergen uptake by providing maturational stimulus for gut barrier function, enhancing allergen degradation by production of digestive enzymes (this may also reduce allergen allergenicity), improving mucosal integrity by direct exclusion of pathogens that may cause epithelial damage or by enhancing secretory IgA (sIgA) production (possibly via inducing TGF-b secretion) and...

In Situ Profiling Of Transcription In The Gi Tract

Fucose and coordinates the decision to generate a signal for production of host fucosylated glycans when environmental fucose is limited or to induce expression of the bacteria's fucose utilization operon when fucose is abundant (68). Additional studies have evaluated the global intestinal response to colonization of gnotobiotic mice with B. thetaiotaomicron. This colonization dramatically affected the host's gene expression, including several important intestinal functions such as nutrient absorption, mucosal barrier fortification, and postnatal intestinal maturation (9). From the in situ global transcription profiles mentioned above and follow-up experiments it could be established that the production of a previously uncharacterized angiogenin is induced when gnotobiotic mice are colonized with B. thetaiotaomicron, revealing a mechanism whereby intestinal commensal bacteria influence GI-tract bacterial ecology and shape innate immunity (69). In addition, the cellular origin of the...

Investigations At The Subspecies Level

Taken together, the above-mentioned work clearly demonstrates the value of investigations at the subspecies level, as such studies afford more detailed analysis of the diversity and dynamics of the gut microbiota. Furthermore, such strategies allow the detection of microbial perturbations which are often not evident at the bacterial group, genus or species levels (79).

Directed PCR Analysis

Wang and coworkers (66) developed 12 species-specific PCR primer sets to monitor the predominant gut microbiota of humans (Bact. distasonis, Bacteroides thetaiotaomicron, Bact. vulgatus, Bifidobacterium adolescentis, Bifidobacterium longum, Clostridium clostridioforme, E. coli, Eubacterium biforme, Eubacterium limosum, Fuso. prausnitzii, Lactobacillus acidophilus and Pep. productus). During validation of the species-specific PCR assays, the sensitivity of each primer set was examined with DNA extracts from pure cultures. Interestingly, such work demonstrated that PCR sensitivities varied markedly. Following validation of the PCR assays, Wang and coworkers (66) examined the presence of the bacterial species in fecal samples from humans (seven adults and two infants), two BALB c mice, two Fischer rats, two cats, one dog, one rhesus monkey and one rabbit. High titers of Clos. clostridioforme, Fuso. prausnitzii and Pep. productus were detected in all samples examined. High titers of Bact....


The normal microbiota of the human GI tract is a complex microbial community whose composition is defined by a number of factors (including host genomics, diet, age, bacterial succession, immune function and health status). In general, the predominant bacterial groups are relatively stable in healthy human adults. However, inter-individual variations are evident, reflecting the unique equilibrium of each person's GI ecosystem. In addition, examination of the microbial populations in more detail (i.e., investigations at the subspecies level) further demonstrates the complexity and dynamics of this bacterial community, and most probably reflects its adaptive nature. Interactions between the host and the gut microbiota have led some researchers to acknowledge that the human intestine is, indeed, intelligent based on Alfred Binet's definition of intelligence intelligence is the range of processes involved in adapting to the environment (13).


Anthocyanidins and anthocyanins have been reported previously as having several positive effects on health (35,65-72). Much of this evidence has been derived in vitro and very little is known about their bioavailability in vivo. Previous human and rat studies have reported very low recoveries of intact anthocyanins in urine (73). Very little is known of the specific fate of the balance of these compounds. Given their structure, it is likely that they will undergo substantial metabolism by the human gut microbiota in much the same way as any other flavonoid structure. And yet, studies performed in the 1970s indicated that degradation of anthocyanins by the microbiota occurs to a much more limited extent than with other flavonoid structures (61). However recent studies investigated in vitro whether the anthocyanin glycosides, cyanidin-3-glucoside, and cyanidin-3-rutinoside were deglycosylated and whether the resulting aglycones were degraded further to smaller phenolic compounds by...


This review highlights the extent to which certain polyphenol classes undergo metabolism and structural alteration in the colon, and suggests that much of the prescribed in vivo health benefits of polyphenols may be due to secondary metabolites of polyphenols rather than the original compounds. Only a limited amount of research has been targeted at specifically trying to identify actual species of the human gut microbiota that are responsible or capable of metabolizing polyphenols. This is perhaps a reflection of the difficulties encountered in undertaking such an effort. Simply isolating single strains of bacteria anaerobically and carrying out suitable fermentation assays when presented with such a complex mixed culture of bacteria is an extreme challenge in terms of the laboratory time required. Furthermore much of the microbial mass in the colon remains to be described or cultured (85,86). In terms of the metabolic pathways that polyphenols follow during...

The Large Intestine

It is becoming increasingly evident that the large and complex bacterial population of the large intestine and their metabolism has an important role in toxicity of ingested chemicals and in cancer (28-31). A number of potential mechanisms have been proposed whereby gut bacteria may impact carcinogenesis. They may have a direct effect through the binding of potential mutagens and thus reduce exposure to the host (32). The normal microbiota present in the gut is known to produce and release toxins, which can bind specific cell surface receptors and affect intracellular signal transduction (33). Bacterial involvement in CRC has been widely studied with most information being derived from animal work and some human studies. Evidence from a wide range of sources supports the view that the colonic microbiota is involved in the etiology of cancer (Table 1).

Bacterial Enzymes

A wide range of enzyme activities capable of generating potentially carcinogenic metabolites in the colon are associated with the gut microbiota, including b-glucuronidase b-glucosidase, nitrate- and nitro-reductase. These are usually assayed in fecal suspensions and appear to be present in many bacterial types. Of these enzymes, b-glucuronidase has been the most extensively investigated as a biomarker of CRC risk. It should be noted that


Nitrate, ingested via diet and drinking water, is reduced by gut bacterial nitrate reductase to its more reactive and toxic reduction product, nitrite. Nitrite reacts with nitrogenous compounds in the body to produce NOC. The reaction can occur chemically in the acidic conditions prevalent in the human stomach and can also be catalyzed at neutral pH by gut bacteria in the colon. The primary bile acids, chenodeoxycholic acid and cholic acid, are subject to extensive metabolism, predominantly 7-a-dehydroxylation, by the intestinal microbiota, which converts cholic to DCA and chenodeoxycholic to LCA. These are termed secondary bile acids. Gut bacterial enzymes and fecal metabolites are relatively simple to measure routinely and in general may be of use in assessing effects of diet on modulating exposure of the colon to potential carcinogens, rather than reflecting cancer risk.

Germ Free Animals

Considerable achievements have been made since the 1970s in investigating the role of the gut microbiota using germ-free animals. Germ-free animals have enabled investigation of animal gut physiology in the absence of the gut microbiota. Studies using germfree animals have revealed that the gut microbiota is indeed of tremendous importance for the biochemical properties of the GIT, by metabolizing compounds in ingested feed and host factors of mucosal and pancreatic origin. Data from these studies revealed that many physiological and biochemical features of the GIT are indeed the result of microbial gut activity (79,80). The gut of germ-free animals have different physiological and biochemical properties to that of CV animals. The biochemical properties of germ-free and CV animals are often regarded as either germ-free associated characteristics (GAC) or microbiota associated characteristics (MAC). The characteristics of MAC and GAC are described in the chapter by Norin and Midtvedt.

Nonradical Surgical Treatments

Endoscopic mucosal resection has been developed for early cancers in Japan, and is now well established there. A well-established set of prognostic criteria are used to select suitable patients. Essentially tumors need to be protuberant or flat, without ulceration or deep penetration into the submucosa (54). Most authorities set a diameter limit of about 2 cm (55-58). These criteria are based on large prospective cohorts, but not on randomized trials comparing endoscopic mucosal (EMR) with open surgery (evidence level 2b). For relatively early tumors in the distal stomach, techniques have been described preserving the vagus nerves and pylorus, to improve gastric emptying and function (59-61). Series have also been reported where small T2 tumors are resected locally with only a cuff of surrounding stomach tissue, together with appropriate lymph node dissection in well-defined areas of maximum risk (62). For disease in the proximal half of the stomach, one attractive solution for...

Syndromic Surveillance Case Studies

Factors, including over-the-counter remedy sales, topical Internet searches, and emergency department cases, can often be early warning signs or diagnostic precursors of an outbreak. The New York City DOH and Mental Hygiene currently operate a syndromic surveillance network in New York City (Heffernan et al., 2004). New York City has established a Water-borne Disease Risk Assessment Program to determine Giardia and Cryptosporidium species levels. This program monitors information on cases presumably linked to tap water consumption, so as to ensure rapid detection of any outbreaks. The database maintains information on gastrointestinal disease, particularly emergency department and nursing home statistics, over-the-counter sales for related medicines, and collections of relevant clinical laboratory tests performed. Detailed monitoring of these factors is expected to accelerate the public health response to a biological agent exposure. Additional examples of syndromic surveillance...

Apicomplexans and their plastids

The clade Apicomplexa is comprised of unicellular eukaryotic protists characterized by an apical complex (Perkins et al. 2000). All of the estimated 5000 species of Apicomplexa are parasitic. The most notable members of the group include Plasmodium falciparum, the causative agent of human malaria, a disease that causes 2 to 3 million deaths annually Cryptosporidium parvum, a significant AIDS-related pathogen that was responsible for more than 400 000 cases of gastrointestinal disease in Milwaukee 1993 (MacKenzie et al. 1995) Toxoplasma gondii a significant agent of morbidity and mortality, particularly among immunosuppressed individuals

Background And Relevant Pharmacokinetics

The generally accepted definition of a probiotic is 'a live microbial food supplement which beneficially affects the host animal by improving its intestinal microbial balance'. This definition is, however, rather limited as some probiotics are transient and do not take up residence in the intestinal tract. A better definition may be ' a microbial dietary supplement that beneficially affect the host physiology by modulating mucosal and systemic immunity, as well as improving nutritional and microbial balance of the intestinal tract' (Salminen et al 1998). The gastrointestinal tract is sterile at birth. Normal gut flora develops gradually over time and is influenced by factors such as composition of the maternal gut microflora, diet, degree of hygiene, use of antibiotics or other medication, the environment and possibly genetic aspects. Once established, a person's individual gut flora remains surprisingly constant throughout life. This is likely to be due to the fact that the gut...

Detection of Outbreaks

Yih et al. (2005) used the detection algorithm method to study retrospectively 110 gastrointestinal disease outbreaks in Minnesota. They studied daily counts of the CDC DoD Gastrointestinal, All code set. The detection algorithm they used was a space-time scan statistic algorithm

Three ecological postulates that underlie conservation biology

Coevolution involves a series of reciprocal adaptive steps during which two or more interacting species respond to one another evolutionarily. A study of mammalian grazing ecology offers many classic examples of coevolution. Ruminant artiodactyls have evolved fermentation chambers that shelter legions of microscopic flora and fauna. These microbial sym-biants extract the energy and nutrients they need from the vegetation consumed by the host-ruminant. In return, the gut-flora ferment cellulose, providing energy and repackaging nitrogen for their hosts. Grazing mammals, in turn, structure the vegetative communities of their grassland habitats. Higher-order coevolution has been demonstrated among species of grazing ungulates, particularly in Africa. Thomson's gazelles, or tommies (Gazella thomsonii), for example, are so small that they cannot effectively exploit the tall grass that grows rapidly after the first rains of the wet season. So, just as other grazers depart the depleted...

Anticoagulation During Cardiopulmonary Bypass

Vitamin K is a fat-soluble vitamin that is generated in the gut by the bacterial flora. It is also present in the normal diet (in dark green vegetables like spinach and broccoli and in oils, particularly soyabean oil). It is absorbed with the help ofbile salts in the liver to form clotting factors II, VII, IX, and X and proteins C, S, Z, and M. Activated protein C functions as an anti-coagulant by degrading the activated forms of factors V and VIII. Protein S is the co-factor for the activation of protein C. Neonates, where the gut flora is not yet developed and patients suffering from malnutrition or hepatic dysfunction are prone to vitamin K deficiency. Neonates can be given 1 mg of vitamin K before the operation. Adult patients falling in the above-mentioned category should receive 1 to 10 mg of vitamin K. The action of warfarin is reversed with the transfusion of fresh frozen plasma in the acute setting and with vitamin K in the elective setting if the prothrombin time persists...

Irritable Bowel Syndrome

People suffering from IBS sometimes experience symptoms of abdominal cramping and either diarrhoea or constipation or a combination of both. Although the aetiology of IBS is still unknown, there is growing suspicion that there is a persistent, mild inflammatory state with changes in mucosal function or structure and an associated imbalance of intestinal flora (Camilleri 2006). This imbalance can lead to inefficient metabolism of nutrients and the formation of gas and short-chain fatty acids, both of which induce propulsive contractions and accelerate colonic transit or enhance fluid and sodium absorption in the colon. As such, clinical trials have been conducted to clarify the role of probiotics in this condition, so far producing promising results. In a 4-week, double-blind placebo-controlled trial, 60 people with IBS were treated with L. plantarum or placebo. The patients recorded their own gastrointestinal function, starting 2 weeks before the study and continuing throughout the...

Summary of Research on Information Value

Table 22.1 summarizes the results of the above studies. The categories of OTC healthcare products that show the most promise for the early detection of disease outbreaks include pediatric electrolytes for large outbreaks of respiratory and gastrointestinal disease in children (including disease caused by influenza virus, rotavirus, and respiratory syncytial virus) flu remedies, chest rubs, and cold, cough, sinus, and allergy medications'' for large outbreaks of respiratory disease diarrhea remedies for waterborne outbreaks of cryptosporidiosis and other gastrointestinal pathogens and thermometers, pediatric cough syrups, and pediatric antifever medications for outbreaks of influenza.

Solid organ transplant recipients

Clinical sequelae of HHV-6 may result from symptoms directly attributable to the virus or from its immunomodulatory effects. Table 1 shows a summary over the clinical syndromes that has been suggested being associated with HHV-6. Symptomatic infections seem to be more common in SCT than in SOT patients although published reports vary from very limited clinical effects of HHV-6 to a contributing effect on overall mortality. A fever of unknown origin with or without a skin rash bone marrow suppression, and encephalitis are the most frequently observed clinical features of HHV-6 (Carrigan et al., 1991 Drobyski et al., 1993 Carrigan and Knox, 1995 Wang et al., 1999 Ljungman et al., 2000 Zerr et al., 2001). Less commonly, interstitial pneumonitis, gastrointestinal disease, and hepatitis have been reported (Cone et al., 1993 Singh et al., 1997 Rossi et al., 2001 Hentrich et al., 2005).

Principles and Practicality

Starting treatment is never an urgent requirement and clinical benefit is seen only after several weeks. It is important to optimise the chance of adequate absorption and tolerance of these drugs. It is usually wrong to initiate treatment in a very ill child with a life threatening illness where gastrointestinal function may be compromised and the child is receiving many other concomitant medications. One should also consider the duration of other treatments (e.g., for tuberculosis) and delay the initiation of HIV therapy until the number of other medications can be reduced whenever possible. It is equally important to optimise the chance of good adherence to the regimen once it is commenced.

Basic Formulation A Low Dose Linearity

The hypothesis driving risk predictions for genotoxic carcinogens since the mid-1970s is that at low doses, the dose-response relationship is linear. Crump et al (3) observed that, in environments containing significant amounts of carcinogenic processes, the carcinogenic effect will increase proportionately to the amounts of carcinogen added. They noted that, if individual cancers arise from a single transformed cell and the agent in question acts additively with any ongoing process, then under almost any model the response will be low-dose linear. Figure 1 illustrates this concept. It applies primarily to carcinogenic processes in which the agent acts at the cellular level to produce heritable genetic or epige-netic change, but may not apply to indirect influences (e.g., pH changes or dietary modifications that lead to modifications of gut flora) (3).

Environmental factors

Macrophage bactericidal properties, intestinal permeability to macromolecules, contractile activity and microcirculation. Finally, cigarette smoking may modulate the IBD phenotype, increasing the risk of CD in smokers and the risk of UC in non-smokers (Bridger etal., 2002). The resemblance between CD and infectious disorders such as intestinal tuberculosis or yersi-niosis suggested that CD may be an infectious condition. The effect of bacterial colonization on the digestive tract in genetically engineered animal models and the clinical effect of some antibiotics and intestinal flux manipulation in the human disease reinforced the idea that IBD may be related to certain bacterial species. However, the main argument in favour of infectious agents in CD came from genetic studies showing an association between CD and CARD15 NOD2 (see below). The gut flora as a whole is usually proposed to be an etiological factor for IBD and these diseases are considered to be an abnormal response to the...

Nonneoplastic Conditions

Infective oesophagitis may be seen in otherwise healthy individuals but is more commonly encountered where there is alteration of either local or systemic immunity (e.g., AIDS). Underlying ulceration, broad-spectrum antibiotics, diabetes, corticosteroid therapy and immunosuppressive drugs can all alter the local gut flora resulting in superimposed infection. Causative agents are candidal fungus, herpes simplex virus (HSV 1 and 2), cytomegalovirus (CMV), and atypical mycobacteria.

Spices as Antimicrobials

Aldehydes, sulfur, terpenes and their derivatives, phenols, and alcohols, exhibit strong antimicrobial activity. Spices have strong, moderate, or slight inhibitory activity against specific bacteria (Table 8). Cornell University studies have reported that garlic, oregano, onion, and allspice kill all bacteria thyme, cinnamon, tarragon, and cumin kill up to 80 of bacteria chilies up to 75 of bacteria and black and white peppers, ginger, anise, and celery seed up to 25 . Kansas State University studies have reported that clove, cinnamon, oregano, and sage suppress growth of Escherichia coli O157 H7 in uncooked meats, which causes gastrointestinal disease. Other recent studies have shown that dodecenal in coriander leaf and seed kills Salmonella in meats.


Many studies investigated the effect of age on gastrointestinal tract functioning. After multiple conflicting findings, and some drastic paradigm shifts, it is now believed that, in general, many essential aspects of GI function are preserved in old age 1 , 25 . Many of the clinically relevant alterations in esophageal function are more likely due to chronic diseases, medications, and lifestyle exposures, than to purely age-related deficits. Comorbid conditions that may influence gastrointestinal function in older adults include coronary disease, diabetes, chronic obstructive pulmonary disease, and neurological conditions such as stroke and Parkinson's disease 1 , 3 . For example, a hemispheric stroke will affect the components of swallowing under voluntary control, as well as the pharyngeal and esophageal components such as LES relaxation and pharyngeal peristalsis 26 . The elderly also undergo lifestyle changes that exacerbate reflux, including reduced mobility, increased sedentary...

RNO20 rnh2

Formation of p -aminobenzoate from p -nitrobenzoate is observed in conventional rats, but is, relatively, very low in germ-free animals. Studies with microorganisms have found reduction by the gut flora Lactobacillus plantarum, Bacteroides fragilis, Peptostreptococcus productus, Clostridium, Proteus mirabilis, S. faecalis and E. coli A124 . The reduction rate in rat gut wall and contents is reduced by treatment with oral antibiotics, whereas liver activity is unaffected A3480 . p -Nitrobenzoate is reduced in the nematode Ascaris lumbricoides. Activity is found in the intestinal brush border but not in other tissues. The enzyme is cytosolic, it has a stability range of pH 4-7 (it rapidly loses activity at 0 outside this range), and has a sharp optimum at pH 6.5. It Many studies have detected the removal of the para hydroxyl group in catechols, usually by gut flora. Little information is available about the enzymes involved. Dehydroxylation of dihydrocaffeate occurs, for instance, in...


Gilberts Potoroo Birth

The bettongs and potoroos are mainly fungivores, eating a large proportion of the fruiting bodies of underground (hy-pogeous) fungi. In order to accomplish this, it is necessary that they have a well-developed sense of olfaction a large proportion of their cortex is devoted to this. Animals dig with their forefeet to access their diet. The well-developed fore-stomach of potoroids allows them to have sufficient time to digest the fungi and the gut flora fauna assist in providing essential amino acids that may be absent from the diet. Animals can exist almost exclusively on fungi, which provide a nourishing diet high in both protein and lipid. The fungi grow on the roots of eucalyptus and other native trees and their spores are activated during passage through the bettong's gut, thereby allowing germination at the site of defecation.

Digestive Processes

The gut bacteria carry out a number of biochemical functions, including deconjugation and dehydroylation of bile acids, the conversion of bilirubin to urobilinogen, the metabolism of cholesterol to coprostanol, production of vitamins K, B1, B2, B6, B12 and generation of short-chain fatty acids. Probiotics are involved in balancing colonic microbiota and aid in the treatment of diarrhoea associated with travel and antibiotic therapy, and control of rotavirus and Clostridium difficile-induced colitis.


Ad infections occur worldwide as epidemic, endemic, and sporadic infections. Of the 51 human Ad serotypes currently known, the most common in clinical materials are the respiratory types of subgenus C (Ad1, Ad2, Ad5) and subgenus B (Ad3 and Ad7) (102,103). Along with being an important cause of respiratory tract infections, Ad can also cause conjunctivitis and gastrointestinal disease. Ads have been implicated in aseptic meningitis, encephalitis, hepatitis, and hemorrhagic cystitis and may cause severe disseminated infections in immunocompromised patients of all ages (104). In humans, the majority of Ad infections in immunocompetent hosts are subclinical, meaning that no apparent symptoms are present. This feature has made Ad an attractive platform for numerous gene therapy applications, including cancer. However, like most human virus pathogens, Ads possess a substantial genetic armamentarium to interfere with the immune system of the host to ensure their evolutionary survival...

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