Sunday, January 27, 2013

Arthritis, Inflammation and Leaky Gut




If you've got arthritis, you know how painful it can be.  Approximately half of all people over 65 report having arthritis with symptoms of swelling, limitation of motion, or pain.  The regions of the body most affected are the hands, neck, lower back, hip and shoulder.

There are three types of arthritis with a known cause:
  1. Traumatic Arthritis - Joints can be inflamed as a result of an injury, such as from tripping and spraining an ankle.
  2. Suppurative or Septic Arthritis – Joints can be infected with bacteria from the blood stream.  This tends to occur in infants and young children.
  3. Gouty Arthritis – Uric acid crystals can accumulate in the joints.
Other forms of arthritis are said by doctors to have “no known cause.” Arthritis of “no known cause” can be divided into two broad categories:
  1. Degenerative (osteoarthritis) - This is the most common arthritis found in people living in Western civilizations.  It is seen in x-rays of the hands in over 70% of people who are 65 years and older.
  2. Inflammatory - This includes juvenile rheumatoid arthritis, rheumatoid arthritis, psoriatic arthritis, lupus, and ankylosing spondylitis (AS). These aggressive diseases affect less than 5% of the people living in the United States today. 
Arthritis just means inflammation of a joint.  Arthritis is not a genetic disease, nor is it an inevitable part of growing older.  Many studies have linked the inflammation of arthritis to our Western diet.

As recently as 1957, no case of rheumatoid arthritis could be found on the continent of Africa.  These once unknown joint diseases have now become common as people have migrated to wealthier nations or moved to the big cities in their native countries.  With these changes people have abandoned their traditional diets of grains and vegetables for meat, dairy products, and highly processed foods.

Although unknown in Africa before 1960, African-Americans now lead in the incidence of lupus in the US.  The mechanisms by which an unhealthy diet causes inflammatory arthritis are complex and poorly understood, but involve our intestine and immune system.

Leaky gut syndrome has been theoretically suspected as a major factor in a wide range of food and chemical sensitivities, arthritis, asthma, headaches, digestive problems of varying seriousness and chronic fatigue.

Our intestinal lining (or gut wall) is a semi-permeable membrane, like a sieve, that allows small molecules (the products of digestion) to pass through, and blocks the larger molecules. These larger molecules then travel through our intestine and are eliminated. When functioning as intended, the gut wall prevents those larger molecules from stimulating food sensitivity and inflammatory reactions.

Infections, toxins (such as drugs, chemotherapy, anti-inflammatory medications) and an unhealthy diet (too high in fat, cholesterol, and animal protein) can compromise the barrier and allow large molecules to pass into the blood.  This condition of increased intestinal permeability is referred to as a "leaky gut."

Patients with inflammatory arthritis have been shown to have inflammation of the intestinal tract resulting in increased permeability.

What to do about "leaky gut?"

In scientific studies, fasting has been shown to decrease intestinal permeability, thus making the gut "less leaky."  This may be one of the reasons fasting has been shown to dramatically benefit patients with rheumatoid arthritis.  When patients return after the fast to a diet with dairy products, the gut becomes more permeable and the arthritis returns.  An unhealthy diet containing dairy and other animal products causes inflammation of the intestinal surfaces and thereby increases the passage of dietary and/or bacterial antigens (foreign proteins).

Some components of the rich American diet are known to impair the function of the immune system.  Vegetable oils (both the omega-3 and the omega-6 variety) are particularly strong suppressors of the immune system.  Low-fat diets have been shown to retard the development of autoimmune diseases, similar to lupus and rheumatoid arthritis, in experimental animals. Those vegan diets that have failed to help arthritis patients have been high in vegetable oils, which are known to damage intestinal integrity.

The importance of the overall diet cannot be overemphasized.  Proper foods such as whole starches, vegetables and fruits, keep the intestinal barriers strong and the immune system in a fighting condition. In addition to being free of animal products, the diet must be low in fat of all kinds - vegetable oil (even olive oil, corn, safflower, and flaxseed oil) and animal fat.  When it comes to blaming individual foods, dairy products seem to be the most troublesome foods, causing the most common and severe reactions.  Many reports indicate grains, such as corn and wheat can also aggravate the symptoms.  The truth seems to be almost any food can cause trouble, but few people react to vegetable foods.

The immune suppressing quality of oils (for example, fish oil and primrose oil) has been used to suppress the pain and inflammation of arthritis, but like too many drug therapies the ultimate outcome may not be best for the patient.  Suppression of the immune system prevents it from doing its work of removing invading foreign proteins.

One dangerous paradox in arthritis treatment is that the drugs most commonly used to treat arthritis are toxins to the intestinal barrier.  All commonly used nonsteroidal anti-inflammatory drugs (like Advil, Motrin, Naprosyn, etc.), apart from aspirin and nabumetone (Relafen), are associated with increased intestinal permeability in man. While reversible in the short term, it may take months to improve the barrier following prolonged use.

What won't change in either form of arthritis with a change of diet, is the permanent destruction, stiffness and deformity which has already happened through years of disease.

If you suffer from arthritis (either degenerative or inflammatory), try changing your diet for at least two  weeks.  Eat only whole starches (sweet potatoes, brown rice), vegetables (green and yellow) and fruits (except citrus).  Water is your beverage.

After 2 weeks, you should be feeling much better.  At that point you can add in grains and citrus.  If you start to have symptoms again, eliminate those and add them back in one at a time to see if you can decide which food(s) cause the adverse reaction.

Stop taking any nonsteroidal anti-inflammatory drugs, and if necessary, replace with aspirin or nabumetone (Relafen).

If you try this "anti-arthritis" diet, write a comment and let me know how it worked for you.