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Healing the Gastrointestinal Lining
 By Maureen Williams, ND

The gastrointestinal lining is a vast mucous membrane that interacts constantly with the external environment. Its complex task involves secretion of digestive chemicals, absorption of nutrients, and preparation of waste for excretion. Like other mucous membranes, it is prone to infection by organisms in the environment, and is protected by the presence of healthy bacteria along part of its length.

The epithelial cells that make up this lining are protected and supported by specific nutrients that strengthen immune defenses, prevent cell damage due to inflammation and oxygen free radicals, and promote healthy colonization of normal colon bacteria.

L–Glutamine is the most abundant amino acid in the body. It is a precursor of the potent antioxidant glutathione, is needed for proper immune function, and is a critical fuel source for the epithelial cells of the small intestine. It stimulates collagen repair and wound healing, [i] and its beneficial effects on intestinal mucosal integrity and inflammation in post-operative patients have been well established. [ii] [iii] [iv] [v] [vi] One preliminary study found that L-glutamine supplementation prevented esophagitis during chemotherapy. [vii]

Another promising role for glutamine is in the prevention and treatment of diarrhea. Glutamine levels are low in people with infectious diarrhea, including so-called swine dysentery, [viii] and in one trial, the severity of acute diarrhea in children was diminished by treatment with glutamine. [ix] Glutamine has been shown to be effective at relieving medication-related diarrhea in HIV-infected people being treated with antiretroviral drugs, [x] [xi] [xii] and has helped some cancer patients avoid the gastrointestinal side-effects of chemotherapy and radiation therapy. [xiii] [xiv] [xv]

Inflammation in the colon wall appears to disrupt normal glutamine metabolism in people with Crohn’s disease and ulcerative colitis. [xvi] Glutamine’s importance in these conditions might be due to its ability to enhance microcirculation in the colon wall [xvii] and improve the barrier function of the colon lining, preventing nutrient and water loss as well as the entry of endotoxins into general circulation. [xviii] [xix] [xx] [xxi] Glutamine supplementation was found to reduce the levels of pro-inflammatory biochemicals in an animal model of colitis, [xxii] and in combination with the amino acid arginine in people with Crohn’s disease. [xxiii]

N-Acetyl Glucosamine
N-Acetyl Glucosamine (NAG) is an amino-sugar that is incorporated into glycosaminoglycans and glycoproteins, the substrates for tissue repair. NAG is involved in the protection and repair of mucous membranes throughout the body, including the large and small intestines, stomach, and esophagus. The prognosis for people with inflammatory bowel disease (IBD) is related to their ability to synthesize NAG and these foundational molecules, [xxiv] [xxv] and there is preliminary evidence that NAG supplements promote healing in IBD-affected bowel mucosa and improve the course of the disease. [xxvi]

Slippery Elm/Ulmus fulva
Slippery elm is a tree in the elm family native to northern North America. It is the inner bark of mature slippery elm, rich in mucilage, that has been used medicinally for centuries. Its traditional uses include topical application for boils, ulcers, and wounds, and internal use for soothing all kinds of irritation and inflammation of the respiratory and gastrointestinal linings. Medical herbalists prescribe slippery elm powder for pharyngitis, cough, esophagitis, gastritis, peptic ulcer, colitis, and diarrhea. One preliminary study found that slippery elm had antioxidant and anti-inflammatory effects on inflamed cells from human colon mucosa. [xxvii]

Zinc L-Carnosine
Zinc L-carnosine is an amino acid chelate that has recently been recognized for its antiulcer effects. It appears to work by readily adhering to ulcer sites, [xxviii] reducing the inflammatory response to H. pylori in gastric epithelial cells, [xxix] [xxx] and preventing inflammation-induced DNA damage in those cells. [xxxi] Studies have found it able to prevent gastric ulcers in H. pylori-infected [xxxii] and NSAID-damaged animals. [xxxiii] Findings from a controlled trial in humans suggest that the effectiveness of the conventional triple antibiotic therapy for H. pylori might be improved by adding zinc carnosine. [xxxiv] Zinc L-carnosine has also been found to prevent drug-related gastrointestinal side effects in healthy people after taking a moderate dose of indomethacin (a non-steroidal anti-inflammatory drug) for five days, [xxxv] and in people with hepatitis C being treated with an antiviral cocktail. [xxxvi] Using animal models of inflammatory bowel disease, researchers have found that zinc L-carnosine prevented colon mucosal cells from inflammation and cellular damage. [xxxvii] [xxxviii]

Aloe vera
Aloe vera is a succulent plant and the juice from the inside of its leaves is a popular remedy for burns and skin wounds. [xxxix] [xl] [xli] Because of its soothing and healing properties, extracts from the inside of the aloe vera leaf have been used historically to treat gastritis, peptic ulcer disease, reflux esophagitis, and inflammatory bowel disease.

Results from animal studies suggest that aloe extract can stimulate the healing of gastric ulcers. [xlii] [xliii] [xliv] Aloe leaf extract has demonstrated antioxidant effects, [xlv] and a combination of aloe and coenzyme Q10 was able to prevent ulcerative colitis in animals. [xlvi] Aloe has also been shown to have anti-inflammatory and antioxidant actions in colon epithelial cell cultures from people with inflammatory bowel disease, [xlvii] and a clinical trial in people with ulcerative colitis found that aloe vera relieved symptoms. [xlviii]

Methylsufonylmethane (MSM)
MSM is a sulfur-containing compound that occurs naturally in some plants. It has become popular as a nutritional supplement because of its apparent effectiveness in treating osteoarthiritis. [xlix] MSM has demonstrated general anti-inflammatory effects in vitro [l] [li] and is commonly used to treat inflammatory conditions such as allergies and traumatic injuries, as well as generalized pain syndrome and some bladder disorders. [lii] Results from animal studies suggest that MSM can prevent colon [liii] and breast cancers, [liv] and in a preliminary study, people who reported taking any MSM within the previous 10 years were less than half as likely to have been diagnosed with colon cancer as people who had not taken MSM. [lv]

Rutin is one of a family of phenolic plant compounds known as flavonoids and is found in buckwheat, citrus fruits, some berries, and a variety of other plants. Its antioxidant, anti-inflammatory, and venotonic effects have been well documented and its common uses include treatment of allergies, varicose veins, chronic venous insufficiency and venous stasis ulcers, hemorrhoids, lymphoedema, capillary fragility, and glaucoma. [lvi] [lvii] [lviii] [lix] Treatment with rutin has been shown to effectively protect the gastric lining from ulcer-causing agents in several animal studies. [lx] [lxi] [lxii] It has also been found to reduce inflammation and oxidative stress in the bowel walls of animals with colitis, suggesting that it might be useful in treating inflammatory bowel disease. [lxiii] [lxiv] [lxv]

Lactoferrin is an iron-binding protein found in mammalian secretions where there is regular exposure to normal microflora, including tears, saliva, and respiratory and digestive fluids. Human colostrum has the highest concentration of lactoferrin, followed by human breast milk, then bovine milk. By binding free iron, lactoferrin can reduce oxidative damage and inhibit proliferation of pathogenic bacteria and parasites. [lxvi] It also appears to protect the gut against viral and fungal infections. [lxvii] [lxviii] Findings from a number of animal and in vitro studies suggest that lactoferrin can prevent pre-cancerous polyps and cancerous change in the colon, and colon cancer growth and metastasis. [lxix] [lxx] [lxxi] [lxxii] [lxxiii] [lxxiv] [lxxv]

Lactoferrin supplementation has been found to stimulate immune activity in healthy men. [lxxvi] Its use in preventing and treating dysbiosis and infectious diarrhea is supported by evidence showing its immune-enhancing and direct bactericidal effects. [lxxvii] [lxxviii] [lxxix] [lxxx] [lxxxi] [lxxxii] [lxxxiii] In one study, children taking a lactoferrin supplement were less prone to Giardiasis and had better growth than children who did not supplement with lactoferrin. [lxxxiv] Its ability to reduce inflammation in colon epithelial cells in the laboratory and in animal models of colitis suggest that it has potential as a therapeutic agent for people with inflammatory bowel disease. [lxxxv] [lxxxvi] [lxxxvii] [lxxxviii]


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