DIGESTIVE PROBLEMS / ISSUES

LACTOBACILLUS GG IN THE PREVENTION OF ANTIBIOTIC-ASSOCIATED DIARRHOEA IN CHILDREN

Outpatient use of antibiotics is common in paediatrics but certain antibiotics, especially those with a relatively broad spectrum, frequently result in diarrhoea. The mechanism by which antibiotic-associated diarrhoea occurs most likely relates to disturbances of microbial flora in the gastrointestinal tract. Disruption of the microbial flora may result in the overgrowth of pathogenic organisms such as Clostridium difficile or may disturb the metabolism of carbohydrates, resulting in malabsorption of osmotically active particles. Therefore, a study was carried out to determine the efficacy of Lactobacillus casei sps. Rhamnosus (Lactobacillus GG) (LGG) in reducing the incidence of antibiotic-associated diarrhoea when co-administered with an oral antibiotic. The study group consisted of 202 children between 6 months and 10 years of age. LGG or comparable placebo was administered in a double-blind randomised trial to children receiving oral antibiotics. It was found that 25 placebo-treated but only 7 LGG-treated patients had diarrhoea as defined by liquid stools numbering 2 or greater per day. Lactobacillus GG overall significantly reduced stool frequency and increased stool consistency during antibiotic therapy compared to placebo.
Vanderhoof, J.A. et al
J. PEDIATR. 1999, 135 (5) 564-8

THE HERB REPORT – OREGANO

Kathi Keville reviews Origanum vulgare,, of which there are many species and sub-species. Research has shown that oregano is one of the most antibacterial and antifungal herbs. Carvacrol is about 1.5 times and thymol about 20 times more powerful than phenol. In one study oregano essential oil inhibited growth of all food-born bacteria and fungi and proved a strong antioxidant, largely due to rosmarinic and hydroxycinnamic acids. Oregano was one of four spices out of 43 that killed 30 species of bacteria, including those responsible for Salmonella food poisoning. It inhibits Candida, E. coli and Pseudomonas aeruginosa. It is more active against fungi and moulds than 11 other herbs. It was found to be more effective than Flagyl in the treatment of Giardia, reducing it by 90%. It is also effective against head lice.
AMER. HERB ASSOC. NEWSLETTER, 1999, Vol. 15, No. 4.

PROBIOTICS AND THE TREATMENT OF DISEASE

Although it has been known for years that a wide range of illnesses can be alleviated by supplementation with probiotics, there has been little progress in recent times in advancing this area of knowledge. However, there is now fresh enthusiasm for research.

Beneficial bacteria break assist the digestion by breaking down fibre and resistant starches, produce short chain fatty acids and lactic acid, and manufacture vitamins such as vitamin K and some B vitamins. They increase macrophage activity and assist the immune system by producing antibacterial compounds. They prevent pathogenic bacteria from flourishing, improve elimination, and help to clear the body of toxins.

This article describes a number of ways in which probiotics can help to treat disease.

• Lactobacillus acidophilus has been found to alleviate migraines.
• Enterococcus faecium has been used successfully in the treatment of liver cirrhosis.
• Bifidobacterium bifidus helps produce vitamins B1, B6 and B12 and folic acid, and converts lactose into a digestible form of lactic acid which stimulates peristalsis. Bottle-fed babies are much lower in Bifidobacteria than breast-fed babies.
• By re-balancing the flora of the digestive tract, probiotics help to recycle oestrogen around the body. Oestrogen circulation is important in the prevention of hormonal cancers and the prevention of osteoporosis.
• Probiotics keep Candida in check to prevent thrush. Lactobacillus acidophilus produces hydrogen peroxide which directly kills Candida.

Probiotics could be useful in the prevention and treatment of infantile acute diarrhoea, pseudo-membranous colitis, and hospital-acquired and antibiotic-associated diarrhoea.

There is some evidence that lactic acid bacteria may play a role in the prevention of colon cancer – by enhancing the host immune response, binding and degrading potential carcinogens, and altering the metabolic activities of intestinal microflora.
BR. NATUROPATHIC J. 1999, 16 (4) 77-80

CONTRIBUTION OF FAMILY HISTORY AND HELICOBACTER PYLORI INFECTION TO THE RISK OF GASTRIC CARCINOMA

It is now well established that Helicobacter pylori infection is a risk factor for gastric carcinoma as is a positive family history of the disease. Researchers therefore, carried out a population-based, case-control study to assess the individual and joint contributions of family history and H. pylori infection to the risk of gastric carcinoma. It was found that H. pylori infection and family history were positively related, and both risk factors were more common among cases than among controls. Compared with uninfected subjects who had no family history, subjects with both a positive family history and infection with a CagA positive H. pylori strain had a more than 8-fold total risk of gastric carcinoma and a 16-fold risk of non-cardia gastric carcinoma.
Brenner, H et al
CANCER 2000,88 (2) 274-9

HANDS COULD BE KEY TO SPREAD OF HELICOBACTER PYLORI

A recent study has shown that the hands could play a key role in the transmission of Helicobacter pylori. In a study of Guatemalans living in an isolated village, 58% were seropositive for H. pylori; 87% had H. pylori in pockets around their teeth and/or on the tongue; 58% had it under a fingernail of the dominant hand. The findings could have implications for treatment as while triple therapy seems to eradicate infection in the short term, the potential for reinfection remains. If the mouth is a reservoir of reinfection, or if even a few of the bacteria found under the fingernails are alive, then the cycle is going to continue unchecked.
Larkin, M.
LANCET 1999, 354 (9179) 654

REFINED BREAD AND COLORECTAL CANCER

Researchers in Italy conducted a multi-centre case-control study including 1,953 cases and 4,154 hospitalised controls. Subjects from 6 Italian regions were interviewed, using a food frequency questionnaire, over a period of 4 years. Results showed that individuals with the highest consumption of refined bread had a 28% higher risk of colorectal cancer than those with the lowest. For refined sugar, an increase of one serving (4 teaspoons) per day showed an 11% increase in colorectal cancer risk. Both results remained statistically significant after adjustment for confounders. Eating either raw or cooked vegetables showed a protective effect. An increase of one serving of vegetables per day resulted in a 13% reduction in risk.
Franceschi, S .et al,
EUR. J. OF CANCER PREVENTION 7 (Suppl 2) S19-S23
Courtesy WORLD CANCER RES. FUND

PROBIOTICS FOR INFLAMMATORY BOWEL DISEASE

A study was carried out in which subjects suffering from inflammatory bowel disease were given a probiotic supplement containing Lactobacillus sp. After the study period the colonic microflora were found to have returned to a more normal balance and the onset or colitis had been significantly inhibited, possibly because Lactobacilli prevent the attachment of disease causing bacteria.
GASTROENT. 1999, 116, 1246-60

CROHN’S DISEASE AND SUGAR

A review of the association between Crohn’s disease and consumption of sugars found no relationship between national sugar consumption data and the incidence or mortality relating to Crohn’s disease. Low sugar diets did not appear to be of benefit for the disease.
EUROP. J. CLIN. NUT. 1998, 52, 229-238

CLINICAL, RADIOLOGICAL, NEUROPHYSIOLOGICAL, AND NEUROPATHOLOGICAL CHARACTERISTICS OF GLUTEN ATAXIA

The term gluten sensitivity refers to a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. Some individuals with genetic susceptibility to coeliac disease, however, may have serological evidence of gluten sensitivity without overt gastrointestinal symptoms or evidence of small-bowel inflammation. In such patients the sole manifestation of disease may be ataxia. Therefore, a study of the clinical, radiological, and neurophysical features of this disorder was undertaken.

Among 28 patients with gluten ataxia all had gait ataxia and most had limb ataxia. Those with more severe gait ataxia had longer disease duration. No patient had tremor or other extrapyrimidal features but 19 showed some form of peripheral neuropathy. 16 patients had no gastrointestinal symptoms, distal duodenal biopsy showed lymphocytic infiltration in 2 patients, and changes comparable with coeliac disease in 11. On magnetic-resonance imaging, 6 patients had evidence of cerebellar atrophy and in 2 patients who died there was lymphocytic infiltration of the cerebellum, damage to the posterior columns of the spinal cord, and sparse infiltration of the peripheral nerves.

The findings confirm that gluten sensitivity is an important cause of apparently idiopathic ataxia and may be progressive. The ataxia is a result of immunological damage to the cerebellum, to the posterior columns of the spinal cord, and to peripheral nerves.
Hadjivassiliou, M. et al
LANCET 1998, 352 (9140) 1582-5

IRRITABLE BOWEL SYNDROME, GASTRO-OESOPHAGEAL REFLUX, AND BRONCHIAL HYPER-RESPONSIVENESS IN THE GENERAL POPULATION

Symptoms of irritable bowel syndrome (IBS) and gastro-oesophageal reflux are common in the general population but only a minority of people with these symptoms consult a doctor about them. As the two conditions often coexist it has been proposed that they may share a common aetiology. Therefore, a study was carried out to explore the inter-relations between these conditions and also bronchial hyper-responsiveness (BHR) using a validated postal symptom questionnaire.

One year prevalences, in men and women respectively, of IBS were 10.5% and 22.9%, of dyspepsia 26.3% and 25.25%, of gastro-oesophageal reflux symptoms 29.4% and 28.2%, of BHR 13.2% and 14.6%, and of chronic bronchitis 8.3% and 4.9%. Logistic regression showed independent associations between IBS and BHR, gastro-oesophageal reflux symptoms and dyspepsia. However, there was no significant independent association between IBS and chronic bronchitis. In men and women the odds ratio for IBS and gastro-oesophageal reflux symptoms was 2.6 and for IBS and BHR 2.1. Also, IBS, gastro-oesophageal reflux symptoms, and bronchial hyper-responsiveness occurred more frequently together than expected, 2.5% of the sample having all three conditions compared with an expected prevalence of 0.7%.

These observations may indicate the presence of an underlying disorder producing symptoms in both the gastrointestinal and respiratory systems.
Kennedy, K.M. et al
GUT 1998, 43 (6) 770-4

A GUT FEELING

A report on the connection between junk food and bowel diseases. Sulphate-reducing bacteria can proliferate in the colon as a result of large amounts of animal protein and processed food, especially those which contain sulphur-based preservatives. One of the end products, hydrogen sulphide, is as toxic as cyanide, and can turn into sulphuric acid. A study showed that as meat consumption rises from 60 to 600 grams per day sulphates in the urine double, and sulphites in faeces increase tenfold. In people with ulcerative colitis the epithelial cells that line the colon lack the ability to oxidise butyrate, a vital fatty acid, and this abnormality could be the first step in the development of the disease, as exposure to sulphides selectively inhibits the ability of colon cells to use butyrate.
NEW SCIENTIST, 8th Aug. 1998, 26-30

POSTERIOR VAGINAL PROLAPSE AND BOWEL FUNCTION

The aetiology of rectocele is not completely understood and may encompass different mechanisms in different patients. A study was therefore carried out to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse. The mean age of the study group was 59.2 years and 78% of the women were postmenopausal. According to the furthest extent of posterior vaginal prolapse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage 1, 50 (35.2%) were in stage II, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV.

Most (92%) of the women reported having bowel movements at least every other day. 38 (26.6%) reported that they never or rarely strained when having a bowel movement, 71 (49.6%) reported sometimes, 20 (14%) reported usually, and 14 (9.8 %) reported always. 23 women (16.1%) had faecal incontinence. The study concluded that women with uterovaginal prolapse frequently have symptoms related to bowel dysfunction, but this is not associated with the severity of posterior vaginal prolapse.
Weber, A.M. et al
AM. J. OBST.GYN. 1998, 179 (6) 1446-50

DO GASTROINTESTINAL SYMPTOMS VARY WITH THE MENSTRUAL CYCLE?

It is generally believed that some women experience peri-menstrual alteration in bowel habit. This may be a normal, physiological phenomenon or it may be associated with pathology such as endometriosis. A review of the literature was carried out regarding the effect of the menstrual cycle on bowel symptoms in women with and without irritable bowel syndrome. The studies surveyed suggest that gastrointestinal symptoms do vary with the menstrual cycle. One-third of otherwise asymptomatic women may experience gastrointestinal symptoms at the time of menstruation, and almost 50% of women with functional bowel disorder report an increase in symptoms during menstruation. In addition, women who suffer from dysmenorrhoea are more likely to have functional bowel disorder. The physiological basis of these phenomena is unknown. It has been suggested that raised serum progesterone levels in the luteal phase may be one of the mechanisms responsible but little is known of the physiological effects of sex hormones on the gut in vitro. It has also been suggested that prostaglandins released by the uterus at the time of menstruation might cause diarrhoea. Further research is needed to explore what common hormonal or neurological pathways may underlie the covariance in gastrointestinal and menstrual symptoms.
Moore, J. et al
BR. J. OBST.GYN. 1998, 105 (12) 1322-5

MORE RESEARCH ON TEA

Researchers at the University of Kansas Lawrence have found that epigallocatechin gallate (EGCG), an antioxidant found in green tea, is at last 100 more times more effective than vitamin C and 25 times more effective than vitamin E at protecting cells and DNA from damage believed to be linked to cancer, heart disease and other potentially fatal illnesses. The antioxidant has twice the antioxidant benefit of resveratrol, found in red wine. Excessive amounts of EGCG are excreted, as it is water soluble.

Papers presented at the Second International Scientific Symposium on Tea and Human Health in Washington DC indicated that black tea is as high in antioxidants as green tea. However, the above research indicated that there is less than half as much EGCG in black and oolong tea as there is in green tea, because green tea is steamed immediately after it is picked, which prevents the leaves from oxidizing.

Furthermore, Dr. Yoshimasa Yamamoto of Showa University in Japan has found that green tea contains catechins that show strong antibacterial activity against helicobacter, which is a cause of stomach ulcers.

When EGCG from green tea is added to sulindac, the mixture was found to be 2-8 times more effective in killing lung cancer cells than sulindac alone, according to the Japanese Cancer Association. EGCG was also tested with tamoxifen, and the compound was twice as effective in killing the cells than the drug alone. In both cases the combined medication also reduced the risk of side effects.

Dr. Junshi Chen of the Chinese Academy of Preventive Medicine in Beijing studied patients who had been diagnosed with precancerous oral lesiions. One group of patients rinsed their mouths with the components found in green and black tea, and Chen painted a mixture of tea and glycerin on the patients’ lesions. After six months the size of the lesions had decreased in 38% of the treated group and increased in 3%, while the lesions in the untreated group decreased in 10% and increased in 6%.

Tea is a major source of manganese, according to experts at Britain’s Tea Council, and also contains potassium. It is one of the few natural sources of fluoride.

Kimron Shapiro, a professor of psychology at the University of Wales, has found that tea drinking increases concentration and the ability to learn and to do two jobs at once. The research demonstrated that caffeine was not responsible because those drinking tea out-performed those given a caffeine-only drink.
J. CHINESE MED. January 1999

TREATMENT OF IRRITABLE BOWEL SYNDROME WITH CHINESE HERBAL MEDICINE

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterised by chronic or recurrent abdominal pain and disturbed defaecation. No single available treatment is reliably effective for this condition. Therefore, a randomised, double-blind, placebo-controlled trial was carried out to determine whether Chinese herbal medicine (CHM) is of any benefit in the treatment of IBS. Patients were randomly allocated to 1 of 3 treatment groups: individualised Chinese herbal formulations, a standard Chinese herbal formulation, or placebo.

Compared with patients in the placebo group, patients in the active treatment groups (standard and individualised CHM) had significant improvement in bowel symptom scores as rated by patients and by gastroenterologists, and significant global improvement. Patients reported that treatment significantly reduced the degree of interference with life caused by IBS symptoms. Chinese herbal formulations individually tailored to the patient proved no more effective than standard CHM treatment but on follow-up 14 weeks after completion of treatment, only the individualised CHM treatment group maintained improvement.
Bensoussan, A. et al
J.A.M.A. 1998,280 (18) 1585-9

INTESTINAL PERMEABILITY AND INFLAMMATION IN PATIENTS ON NSAIDs

A major concern of non-steroidal anti-inflammatory drugs (NSAIDs) is the frequency and severity of gastrointestinal side effects. A trial was carried out to examine small intestinal permeability and inflammation in-patients on long term NSAIDs. Over 6 months the patients underwent combined absorption-permeability tests at 3 different test dose osmolarities (iso-, hypo-, and hyper-osmolar). The iso- and hyperosmolar tests showed significant malabsorption of 3-0-methyl-D-glucose, D-xylose, and L-rhamnose. Intestinal permeability changes were significantly more pronounced and frequent with the hypo- and hyperosmolar as opposed to the iso-osmolar test. There was no significant difference in the prevalence or severity of intestinal inflammation in the patients taking the various NSAIDs except that there was no evidence of intestinal inflammation for those taking aspirin or nabumetone.
Sigthorsson, G. et al
GUT 1998, 43 (4) 506-11

ABNORMAL COLONIC FERMENTATION IN IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome (IBS) is a common condition causing symptoms of abdominal pain and abnormal bowel habit. The cause is unknown but it may follow gastro-enteritis and be associated with an abnormal gut flora and food intolerance. Researchers carried out a crossover-controlled trial of a standard diet and an exclusion diet matched for micronutrients in IBS patients and controls. During the final 72 hours on each diet, faecal excretion of fat, nitrogen, starch, and non-starch polysaccharide (NSP) was measured, and total excretion of hydrogen and methane collected. It was found that the maximum rate of gas excretion was significantly greater in patients than in controls. Although total gas production in patients was not greater than in controls, hydrogen production was higher. In patients, the exclusion diet reduced symptoms and produced a fall in maximum gas excretion. Therefore, both symptoms and gas production in IBS sufferers are reduced by an exclusion diet. This reduction may be associated with alterations in the activity of hydrogen consuming bacteria so fermentation may be an important factor in the pathogenesis of IBS.
King, T.S. et al
LANCET 1998, 352 (9135) 1187-9

LEVEL OF CHRONIC STRESS PREDICTS CLINICAL OUTCOME IN IRRITABLE BOWEL SYNDROME

In the majority of patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD), life stress contributes to symptom onset and exacerbation. One hundred and seventeen outpatients who satisfied the modified Rome criteria for IBS (66% with one or more concurrent FD symptoms) participated in a trial to test the relation of chronic life stress threat to subsequent symptom intensity over time.

It was found that chronic life stress threat was a powerful predictor of subsequent symptom intensity, explaining 97% of the variance on this measure over 16 months. No patient exposed to even one chronic highly threatening stressor improved clinically (by 50%) over the 16 months; all patients who improved did so in the absence of such a stressor.
Bennett, E.J. et al
GUT 1998, 43 (2) 256-61

EFFECTS OF THE MENSTRUAL CYCLE ON MEDICAL DISORDERS

It is well recognised that certain medical conditions are exacerbated at specific phases of the menstrual cycle. Abrupt changes in the concentrations of circulating ovarian steroids at ovulation and premenstrually may account for menstrual-cycle related changes in these chronic conditions. Accurate documentation of symptoms on a menstrual calendar allows identification of women with cyclic alterations in disease activity.

The evidence supporting a relationship between oestrogen withdrawal and migraine headache is compelling. The frequency of migraine headaches in women increases considerably after menarche and 60% of women with migraine link attacks to menstruation. Seventy to ninety percent of women with menstrual migraine experience improvement during pregnancy but may experience migraine attacks in the postpartum period.

Menstrual exacerbations occur with all types of seizures. Catamenial epilepsy is believed to result from cyclic alterations in both ovarian hormone levels and drug metabolism.

In many women with asthma there is an increased frequency and severity of attacks premenstrually or at menstruation and may be related to changing levels of progesterone or prostaglandins.

Symptoms of rheumatoid arthritis often improve in the luteal phase when gonadal steroid production is maximal. A subjective increase in morning stiffness and arthritic pain during menstruation and the early follicular phase has been shown.

In women with irritable bowel syndrome symptoms tend to recur and become cyclic, with exacerbation during the postovulatory and premenstrual phases of the menstrual cycle, suggesting a hormonal influence.

Menstrual cycle-related alterations in glycemic control during the luteal and premenstrual phases have been reported in some women with diabetes.

Other disorders exacerbated by the postovulatory and premenstrual phases of the menstrual cycle include acne, endocrine allergy and anaphylaxis, erythema multiforme, urticaria, apthous ulcers, glaucoma and multiple sclerosis.
Case, A.M. and Reid, R.L.
ARCH.INT.MED. 1998, 158 (13) 1405-12

DECREASED SULPHUR AMINO-ACID INTAKE IN ULCERATIVE COLITIS

Recent evidence has implicated fermentative formation of sulphide in the disease process of ulcerative colitis. Excess bacterial formation of sulphide in the colonic lumen or failure of detoxification of sulphide in the colonic mucosa could result in damage to colonic epithelial cells, leading to inflammation. The main sources of sulphur for colonic fermentation and cellular function are the sulphur aminoacids (SAAs) of animal and plant origin.

Therefore, a pilot study was undertaken to see whether a reduction in the intake of SAAs would benefit patients with ulcerative colitis. Patients in the study were advised to completely avoid eggs, cheese, whole milk, ice-cream, mayonnaise, soya milk, mineral water, sulphited drinks (wine and cordials), nuts, cruciferous vegetables (cabbage, broccoli, cauliflower, brussels sprouts) and to diminish intake of red meat, using chicken, fish, and skimmed milk instead.

Diet and salazopyrin were maintained for 12 months before repeat colonoscopy and biopsy was undertaken. No relapses, attacks, or adverse nutritional changes were observed during this time where an expected relapse on salazopyrin would be 22.6%. All showed marked histological improvement and of the 4 patients with chronic ulcerative colitis, one ceased steroids and has not had a further attack for 18 months compared to 4 attacks for the same period before dietary change. The number of bowel movements per day for all four chronic patients diminished from 6 to 1.5 and their stools were more formed.
Roediger, W.E.W.
LANCET 1998, 351 (9115) 1555

IRON DEFICIENCY ANAEMIA

Three gastroenterologists wrote to the BMJ recommending gastrointestinal endoscopy in cases of iron deficiency anaemia, allowing small mucosal lesions to be seen, blood loss to be estimated directly, and biopsy samples to be taken (particularly from the second part of the duodenum for coeliac disease). They point out that only a small proportion of their patients have symptoms or signs pointing to the cause, and that diagnoses such as coeliac disease and carcinoma of the colon rarely have other symptoms.
Goddard et al
BMJ 314, p1759

IS THERE AN IRRITABLE BLADDER IN THE IRRITABLE BOWEL SYNDROME?

A group of 16 premenopausal women with irritable bowel syndrome and 16 controls answered a standardised bowel and urinary symptom questionnaire and underwent twin channel subtracted cystometry. The irritable bowel patients also underwent oesophageal balloon distension studies for perception and pain. Urinary frequency and urgency and the urodynamic finding of detrusor instability were significantly more common in women with irritable bowel syndrome. There was no relationship between first sensation of bladder fullness and oesophageal perception or between maximum bladder capacity and oesophageal pain thresholds. These findings suggest that there is an irritable bladder in the irritable bowel syndrome and support the concept that irritable bowel syndrome is part of a generalised disorder of smooth muscle.
Monga, A.K. et al.
BRIT. J. OBSTET. GYNAECOL. 1997, 104 (12) 1409-12

VITAMINS ASSOCIATED WITH LOWER COLON-CANCER RISK

A recent study has shown that supplements of of multivitamins and vitamin E are associated with a lower risk of colon cancer. American researchers assessed the frequency, duration, and daily dose of individual vitamin supplements and multivitamins, for a ten year interval ending two years before diagnosis of cancer. After controlling for other predictors of colon-cancer risk such as intake of dietary vitamins, alcohol, and fibre, the risk of colon cancer was lower in men and women who took supplements of vitamins A, C, E, folic acid, calcium, and multivitamins. But the association was strongest for vitamin E and multivitamins: people who used multivitamins daily for the entire 10-year interval had half the risk of those who had not taken multivitamins. Those who averaged 200 IU or more of vitamin E per day for the 10 years had a 57% risk reduction compared to non-users.
Macready, N
THE LANCET 1997, 350 (9089) 1452

UFOs OF THE INTESTINES

Interstinal parasites are much closer to home than we think. Antony Haynes reviews evidence which highlights the prevalence of previously unidentified faecal organisms (UFOs) and their significance to health. Parasitic infestations are now so widespread thay they affect about 150 million people in the US and at least 40% of the world’s population. Dr. Hermann Bueno, one of the world’s most experienced parasitologists, believes that parasites are the missing diagnosis in the genesis of many chronic health problems. Signs of parasitic infection in adults include:

• abdominal pain
• abdominal bloating
• aches and pains
• anaemia
• arthritis
• autoimmune disease
• chronic fatigue
• colitis
• constipation
• diarrhoea
• fever
• flatulence
• food allergy
• gastritis
• headaches
• inflammatory bowel disease
• immune system problems
• irritable bowel syndrome
• malabsorption
• skin conditions and itching
• sleep disturbances
• rectal bleeding
• vomiting

While over 130 different parasites have been found in Americans, the following are the most common:

• Blastocystis hominis, which can be asymptomatic, but can cause irritable bowel, chronic fatigue, arthritis and rheumatism.
• Dientamoeba fragilis, which can also be asymptomatic, or cause diarrhoea, tenderness and melaena.
• Entamoeba coli, often asymptomatic, but can cause systemic illness and auto-immune reactions.
• Giardia lamblia, which adhere to the upper part of the small intestine, preventing digestion and assimilation and causing a range of symptoms.
• Endolimax nana, the smallest of the intestinal amoebas, and suspected of being the cause of rheumatoid arthritis and collagen-related diseases.

Most NHS laboratories do not use techniques which could help to identify parasites, and some organisms are thought to be harmless. It can take an average of 16 investigations to diagnose the presence of Giardia.

The major sources of infection are tap water, badly cooked or stored food, human and pet faeces, and holidays abroad.

The best laboratories for detecting UFOs are:

• Parascope Laboratory, Tel: 01133 292 4657.
• Diagnos-Techs Labs., Tel: 0121 458 3407.
• Health Interlink (agents for Great Smokies Diagnostic Lab.), Tel: 01582 794 094.

OPTIMUM NUTRITION 1998, 11; 1; 22-7

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