The Essential Role of the Gut in Immunity

Is the Gut the Driving Force of Systematic Inflammation?

Dr Robin Martingale (2019)

Film Review

In the following video, ICU general and trauma surgeon Dr Robin Martingale explains the role of gut bacteria in protecting human beings from infection and inflammation. The key take home from his presentation is that it always seems to take the medical establishment at least 20 years to catch up with basic science research. Peer reviewed research about the role of the gut microbiome first appeared in medical journals about 20 years ago. When the mainstream media began reporting on the research around 2010, many  “alternative” health practitioners (naturopaths, homepaths, etc) began incorporating the knowledge into patient care. It’s only thanks to efforts of pioneers like Martingale, that some mainstream medical practitioners are finally incorporating it into mainstream medical practice.

The research Martingale presents shows a direct statistical link between modern humans declining diversity in gut bacteria* and the the epidemic of chronic illnesses we presently experience (eg diabetes, cardiovascular disease, autism, obesity, cancer, asthma, chronic fatigue, fibromyalgia and even mental illnesses, such as schizophrenia, depression and bipolar disorder). The mechanism here is a loss of “good bacteria” (symbiants and commensual) that protect us against endotoxin-producing pathogens (“bad bacteria”) that lead to chronic inflammation.

Martingale blames the loss of microbiome diversity to our increasing exposure to pesticides (especially Roundup), vaccines, chlorine, artificial sweeteners, emulsifiers (in processed food) and overuse of antibiotics.

He also presents numerous animal and human studies showing that obesity correlates far more closely with gut dysbiosis and systemic inflammation than lifestyle.

I found the ICU-related research he reported on the most interesting. For example, he cites one study that shows an 30% increase in ICU mortality in patients who have taken antibiotics in the past six months. And another showing a significant correlation between “leaky gut” syndrome and sepsis and multiple organ failure in ICU patients.

In the ICU at Oregan Health Sciences, where Martingale works, he has significantly increased survival rates by prescribing probiotics for all ICU patients and even fecal transplants** for patients with sepsis and multiple organ failure.

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*Human immunity is based on friendly gut bacteria that prevent pathogenic bacteria from producing endotoxin. When absorbed into the blood stream, the latter can can cause systemic inflammation.

**A fecal transplant involves the transfer of stool of a healthy patient to one with dysbiosis, an imbalance in normal gut bacteria.

The Care and Feeding of Intestinal Bacteria

My personal knowledge and understanding of intestinal bacteria stems from being diagnosed with a Clostridium difficile in 2012. C. difficile is an opportunistic intestinal infection that typically develops when excessive antibiotic exposure kills off normal gut bacteria. According to Dr Thomas Borody, the Sydney gastroenterologist I consulted, I most likely became infected with C difficile in 1993 owing to excessive use of broad spectrum antibiotics for a chronic sinus infection. For 19 years other doctors dismissed my extremely debilitating symptoms (constant watery diarrhea, pain and insomnia) as “irritable bowel syndrome” and told me I had to live with them.

Borody, founder and director of Sydney’s Center for Digestive Diseases, is world renowned for pioneering the use of fecal transplantation to treat C. difficile, ulcerative colitis and other bowel disorders triggered by an imbalance of intestinal bacteria. A growing number of doctors and holistic practitioners have come to regard intestinal bacteria, collectively known as the “microbiota” as a vital organ like the brain, liver and kidneys.

Regretfully fecal transplants didn’t work for me. My symptoms persisted until December 2013, when a chance encounter with a local chemist turned me onto the GAPS diet.

Gut and Psychology Syndrome

Dr Natasha McBride, a British neurologist with a postgraduate degree in nutrition, first developed the Gut and Psychology Syndrome (GAPS) diet for her autistic son. Like most autistic children, her son had major bowel problems in addition to the autism. Researchers have since uncovered links between endotoxin-producing intestinal bacteria, “leaky gut” syndrome and other neuropsychological conditions, such as schizophrenia, depression and ADHD.

The basic premise of the diet, which draws from the Weston A Price diet (see The Taboo Against Animal Fats) and the Specific Carbohydrate Diet (SCD), is to suppress the growth of pathogenic bacteria by eliminating the sugar and starches they feeds on, while simultaneously promoting the growth of healthy bacteria by taking probiotics and eating fermented foods.

McBride recommends that all patients begin with a strict elimination diet aimed at controlling the diarrhea. For the first six weeks, all I was allowed to eat was bone broth made from boiling stewing meat or fish heads, along with probiotics, juice from fermented vegetables, water kefir and kombucha. Once the diarrhea stopped, I was allowed to add new foods at six week intervals, starting with egg yolks (raw), then whole eggs (scrambled), then avocado, then nuts soaked in salt water overnight, cooked apple, and finally lentils, navy and lima beans soaked overnight in lemon juice or vinegar solution. Like most patients with C difficile, I have great difficulty digesting fibrous vegetables and fruits. Thus I have also been very gradually adding small amounts of cooked vegetables.

At the end of 18-20 months, I am allowed to cautiously allow starchy foods, starting with new potatoes and eventually sprouted buckwheat. After 24 months, I can cautiously add very small amounts of other grains, such as rice, oatmeal (soaked) and quinoa.

Even after the C difficile resolves, I can never return to a typical Western diet, with its heavy emphasis on carbohydrates, sugar and processed food, owing to demonstrated links with many chronic illnesses, such as cancer, diabetes, arthritis and heart disease (I discuss this in The Taboo Against Animal Fats).

My Total Life Makeover

Given the high stress fast paced lifestyle most of us lead, westerners find it extremely difficult to totally eliminate processed foods, sugar and starch from their diet. For the past six months, I have spent most of my waking hours shopping, cooking and learning to make fermented vegetables, water kefir and almond milk yoghurt (both dairy and soy products are forbidden). The first six weeks were the hardest, due to the copious amounts of fat I had to consume in my bone broth to compensate for the calories I previously derived from sugar, rice and potatoes. McBride is very explicit: patients must eat all the fat off the stewing bones they use to prepare the bone broth.*

After six months on the diet, I feel the sacrifice is definitely worth it. After 20 years of nearly constant diarrhea, pain and insomnia, it’s like a miracle to feel normal again.

Now the only major issue in my life is a social disease called monopoly capitalism.

*I admit to cheating a bit on this requirement by substituting coconut oil (which is allowed on the GAPS diet) for half of the animal fat. I am extremely concerned about the high concentration of industrial toxins found in animal fats and dairy products. Classified as endocrine disruptors, many of these toxins mimic estrogen, which is promotes the development and growth of breast cancer.

photo credit: jamesjoel via photopin cc