Experimenting Probiotics and Prebiotics on Myself #1

From all the previous entries, one can detect how I did my homework. Reason for that is, I got a bowel bug that impaired my life for sixteen days, delaying my dental surgery and creating a lot of malnutrition (and consequent muscular pain and edema).

I presently am on:

FOSs: 7 grams/day (prebiotic - have used it for a week)
VSL#3: 1 envelope a day (probiotic - have used it for 4 days). VSL#3 is composed of:
Streptococcus thermophilus
Bifidobacterium breve
Bifidobacterium longum
Bifidobacterium infantis
Lactobacillus acidophilus
Lactobacillus plantarum
Lactobacillus casei
Lactobacillus bulgaricus

I have tried fructose (diabetic sugar) for 4 days but would get me bloated, so I discontinued it yesterday (and am already improving).

Just today I added a functional yogurt having Bifidobacterium lactis BB12. The rationale behind that is, I seem to do great on FOSs, which feeds bifidobacteria. So, I gathered I lack bifidobacteria more than lactobacilli and Bifidobacterium lactis BB12 is not encompassed in the VSL#3 mix, thus I added it.

I might be adding Lactobacillus johnsoni La1 and Lactobacillus casei immunitas later on. I also plan to add Saccharomyces boulardi and see how it goes.

I keep my diet religious about:
1. drinking at least one cup of skim milk a day (lactose feeds bifidobacteria and lactobacilli! If we don't drink milk, or drink lactose-free one, chances are we aren't helping them help us!);
2. eat a little salad twice a day (I empirically noticed that some kind of greens are better for me than others.. radicchio and lettuce are dangerous to some degrees, but rocket, baby spinach, baby mix, spring mix are not);
3. try not to have "carb meals" alternated with "protein meals". On the contrary, I try to always eat balanced: some bread/focaccia, together with some proteins (fish, eggs, or cheese) and some greens at every meal.

Prebiotics and IL

If probiotic comes from the ancient Greek and means "in favour of life", prebiotic still comes from Greek and means "before life".

Prebiotics are substances (not microorganisms!) that pass un-modified through the bowel. This means that our body does not modify them, while bacteria in the bowel do .

Basically, prebiotics are substances that our bodies don't eat but that our bacteria do eat. Plus, intestinal bacteria get their energy from sugars that are “leftover” because we can not digest them and from our own mucus.

Prebiotics selectively feed the growth of healthy intestinal bacteria (such as bifidobacteria and lactobacilli) at the expense of the less friendly putrefactive bacteria (such as bacteroides, clostridia, and other coliforms).

If we don't feed probiotics with prebiotics, even if we supplement our diet with probiotics, it will not be enough. This is the basic reason for functional food industry is going toward the commercialization of synbiotic food, having both pre- and probiotics.

Prebiotics are oligosaccharides, that is sugars "bigger" than normal sugar but "smaller" than starch.

The main prebiotics are:

*fructooligosaccharides (FOS), normally found in Jerusalem artichoke tubers, dandelion root, burdock root, onions, leeks, some grains, garlic, wheat, bananas, asparagus, tomatoes, yacon, raisins, prunes and honey;
*galattooligosaccharides (GOS), normally found in human milk (and some humanized baby formula, especially in the EU);
*inulin, normally found in dahlia tubers, burdock roots, chicory roots and greens.

Interestingly, bacterial species differ in the types of sugars required for growth. Bifidobacteria grew well on FOSs and inulin, while lactobacilli grow poorly on these sugars.

The by-products of the metabolism of these sugars are primarily short-chain fatty acids, which are considered to be "food" for the bowel cells in the colon.

Coming to IL, why is it all so interesting?

Because among the several aspects affecting the gut microflora, high levels of fat in the stool as well as high level of proteins can negatively affect the level of Bifidobacteria.

Intestinal Lymphangiectasia Damange Control

What to do when the sh*ts hit? There are many things that I found helpful and I'm going to list them here so that every surfer stumbling on this site can benefit from them.

When the whole thing starts and you get nauseated, you can lay down on your left side: that will prevent vomit and ease your nausea. Because of its anatomy, the Gubaroff valve will keep your stomach closed.

When the pain hits, put a hot water bottle on your tummy: heat relieves the cramps you undergo due to diarrhoea.

After loosing all those liters of fluids, rember to rehydrate your body! In order to do it correctly, you have to weight how much you loose.

If you don't have oedema, you can drink isotonic solution (1 liter, 9 grams of salt, 30 gr of sugar) and use the equation for burnt people to establish at which pace to rehydrate (half of the total losses in 8 hours and the other half in the next 16 hours). If you do have oedema, add a protein mix (such as Meritene) to the whole solution.

Stop eating for a while. Your diarrhoea is of the osmotic type, which means it will go on as long as there is food in your bowel. Therefore, fast for some number of hours, usually 12, meanwhile living on isotonic solution and solution of water and sugar.

Re-start getting eating those foods that block your bowel. It's pretty personal, but mine are canned tuna, french bread and cous cous, together with unheated skim milk/dairies.

Eat foods with a very low fat content for a couple of days before restarting pushing toward a higher percentage. My personal threshold is 3%, and I eat food below 1% for a day or two after an "episode".

If you are eating a fattier meal, take some simethicone (Mylicon): that will prevent unabsorbed fats from being used as food by bacteria, with consequent production of gas that will overstretch your bowel's wall (which is already full of oedema by itself!) and accelerate your bowel movement speed.

Taking 1 teaspoon of lecithin per meal helps emulsifying the fats, thereby enhancing absorption and diminishing the symptoms. A food that can help you hugely, because of its content in phospholipids (emulsifiers) is egg.

The way you eat is also very important.

1. try to eat MAINLY polyunsaturated fatty acids: they are absorbed via a protein, not through the "fat" part of cell membranes the way saturated fats are and create far less pain for you because they put less pressure on your lymphatics;
2. avoid transfats COMPLETELY: they enhance diarrhoea even in healthy individuals, so.. bake your own tarts, cakes, muffins, etc.
3. don't give up on making tasty food, there are zillions of ways you can substitute, for example, butter in bakery or use spices. Just learn, learn, learn

There's More To It Than Low-Fat

Despite a low-fat diet, some fat free foods still made me sick, and I couldn't understand why for the life of mine. Once, I had eaten a 2.4% fat chocolate sorbet with fat free whipped cream and I still got sick!! Patterns seemed herratic... I couldn't understand the meaning of it all.

I started - surprise surprise - reading the food labels and... I made some important discoveries!!!!!

Aside from the illness per se and the low tolerance to high amounts of fats, there are some substances that make me sick no matter what. I found it out by journaling the food I was eating and the symptoms I was having (that's a technique that is used for bipolar, in which one charts his/her moods AND what happens in their life).

These substances are used as food preservatives, emulsifiers, and substitutes of fats.

First big thing I discovered:

Foods advertised as fat-free might not be fat free, for three reasons:
1. the FDA regulation allows manufacturers to claim a food is fat-free when the fat concentration is less than 0.5 grams per serving. When the serving is below 0.5 gram (like for PAM spray), it can be labelled as fat-free even if the whole serving is composed of fats (that's what happened to me with the "I can't believe it's not butter" JUST before Thanksgiving!);
2. up to January 2006, trans fats were NOT included in the count of fats you find on the label (!!!) and the FDA allows manufacturers to still sell food with old labels provided the food was labelled before Jan 1st 2006;
3. mono and diglycerides (which basically are fats, but broken down in their components) are NOT counted as fats in the label.

Trans fats are also called partially hydrogenated fats and are artificial fats that aren't absorbed or digested by our bowel (thereby creating diarrhea!!). Even bacteria can't eat them, which is why they are used as preservatives (the food spoils later because even bacteria can NOT eat them!!!!). Interestingly, the "average" American eats up to 6 grams of trans fats a day, and diarrhea starts at 10 grams (some 30 grams "fat-free" chips, or cookies, are enough to go way above this limit).

Mono and dyglycerides are byproducts of fats (called triglycerides). When you eat them you eat exactly the same amount of calories you get from fats. They too can give diarrhea, especially in allergic people and especially in people allergic/intolerant to aspirin.


Second big thing I discovered:

Later, when I got back to Italy, some OTHER artificial food addictives, preservatives, emulsifiers, leviting agents and dyes can ALSO give problems. I have a whole list of all these substances, which ones are ok and which ones are bad, I will post them later.

Now, back to when I was in the States. I wanted to cook some Italian dishes but I couldn't find swiss chard. I got pointed to Whole Foods and I started buying organic food. Note: I had never bought organic stuff and thought that it was pure quackery. But I improved so much in my condition that now I eat organic only (OR industrial food without those nasty preservatives, trans fats and mono/diglycerides).


Third big thing I discovered:
The reason for organic food is healthier are two folds:

1. it's without nasty substances (preservatives, dyes, etc etc), and
2. it has loads of omega3 essential fatty acids, which are mood stabilizers, anti-inflammatory and natural pain killers. Omega3s are found in WILD oily fish (salmon, herring, tuna, yellofin, mackerel ONLY if wild, the farmed version contains too much fat and too much saturated, that is, animal fats), game (deer, wild rabbit, quails, etc etc) and in some vegetables (garbanzo beans, flaxseed oil, green leafy veggies, etc).

In my case, I can absorb them a lot better than animal fats. Just to give you an idea, I can only eat 3% fats (in weight) if assorted fats, but I can digest without problem up to 12% omega3s (like fresh salmon - yes, sushi helps a lot).


Fourth big thing I discovered: some ways to cook food are more dangerous than others, and for specific reasons. For example, butter and margarine have LOADS of those nasty trans fats and, when heated (like in baking) they develop even more trans fats. Deep-frying also produces trans fats, unless one fries in oils that are very stable (coconut oil, palm oil, lard and pork fat). Problem is, these very oils are dangerous for other reasons (they raise cholesterol and raise the risk of strokes, heart attacks, etc etc). At any rate, do NOT fry in oils rich in omega3s (like flaxseed, canola, sunflower, safflower, etc), you could get diarrhea out of it.


Five big thing I discovered: I improve my diarrhea by supplementing my diet with 3 teaspoon of soy lecithin a day, because it helps with fat absorbption and it prevents unabsorbed fats from eliciting diarrhea. Also, benefiber (powder) can help. Do NOT take the pills, cause they too have mono and diglycerides.

If you still don't believe how pervasive trans fats are, read this WebMd article.

From Now On...

When you get diagnosed with Intestinal Lymphangiectasia (IL), you better not hope that doctors will help you, because most likely they won't. You'll be told blanket statements like

1. "stay on less than 30 grams of fat a day":
You will not be told that there are some (dietary) fats that are more digestible than some others (artificial) supplements.

2. "take MCT supplements"
You will not be explained that medium chain tryglicerides (MCT) also are naturally occurring in some foods (like butter, coconut, nuts and green tea).

There are many problems with such approach.

First off, dietary fats are not "all bad" for you even if you have IL. Some symptoms can be hugely ameliorated by eating foods rich in lecithin and omega3s, for example the pain and the shits. If you don't know anything about it, you could paradoxically eat a lot of saturated fats among those allowed 30 grams, and still have huge symptoms. If you know something more about it, you might need not be that restrictive in food intake and cooking methods. In other words, you might eat tasty foods that sit ok with you and aren't always the same few "balanced" dishes.

Some fats are essentials because, like vitamins, they cannot be manufactured by the body. When having restrictions in the amount of fats it's mandatory to know which fats can be safely avoided and which ones have not to be avoided.

MCT oil can give you diarrhea. There is absolutely no reason for you have to cope with that diarrhea, because MCT are not composed of essential fatty acids. If you can't tolerate them, don't take them.

Finally, you still have to eat food, and nobody teaches you its composition. You need to know what a food is composed of, how it is made, and how to make tasty, nutritional and safe food. You need to learn to avoid trans fats that can give you diarrhea and trigger IL.

Doctors won't tell you food information. Dieticians will usually put you on a diet. This blog is here to inform you and teach some tricks. But above all, use your brain, learn and be the master of your Fate.