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Bowel Toxemia: A Dusty Old Concept Reconsidered

By Patrick Donovan, R.N., N.D.

The colon and the concept of "bowel toxemia" have long been considered as having a major influence in the etiology and perpetuation of disease. The overall condition and state of health of the colon was thought to directly relate to the overall condition and state of health of the whole person. The importance of colon irrigation and detoxification in the maintenance of health and prevention of disease, therefore, was respected and practiced since the earliest of formalized medical disciplines (Hippocrates, early Egyptian and Tibetan medicine). With the advent of "modern medicine," however, the importance of the colon and the practice of detoxification and colon irrigation in the treatment and prevention of disease have been shelved away in some dark, dusty hospital storeroom with the rest of the antiquated ideas and devices, to make room for sigmoidoscopes, colostomy bags and other instruments of the "modern" bowel resection. Through the years, only a few clinicians have been wise and persistent enough to brave the dust and darkness, realizing the value of these ideas. Lately, though, more and more practitioners of contemporary medicine are also venturing through the dust, their curiosity stimulated by the results of recent medical research.

Recent scientific research has begun, and is continuing, to reveal new information supporting the role of the colon and "bowel toxemia" in the etiology and propagation of many diseases such as cancer, autoimmune and immune-complex mediated diseases (rheumatoid arthritis, nephritis, lupus, thyroiditis, myastenia gravis, and others), inflammatory diseases (colitis, thrombophlebitis, pancreatitis, meningitis, psoriasis, eczema), migraine headaches, asthma and allergies, liver disease, diabetes and AIDS. This is due to the local and systemic effect of bowel toxins in different tissues and organs. If colon health is compromised in any way (irritated, inflamed, or ulcerated), the microfloral homeostatic environment disturbed (candidiasis, or overgrowth of other pathogenic organisms), or there is increased putrefication due to prolonged fecal transit time and constipation, there may be a greater release of toxins from the bowel into the systemic circulation.

WHAT ARE BOWEL TOXINS?

Bowel toxins include macromolecules (large, intact, undigested proteins), organic amines, bacterial protein-lipopolysaccharides (endotoxins and exotoxins), bile acid metabolites (secondary bile acids), cholesterol, carcinogens and other tumor promoting substances, and other biproducts of incomplete digestion and putrefication. It has been clearly demonstrated that many of these toxins are absorbed by and transverse the normal intestine intact in sufficient quantities to be immunologically recognized (antigenic) by the body.42-53 This recognition causes activation of different immune functions such as the formation of immune complexes and the activation of complement (a non specific component of the immune system). The activation of complement results in the release of many factors which cause and augment inflammation. The formation of immune complexes, especially if they reach systemic circulation, can result in immune complex deposition in many different tissues including the brain.9,54,55 When these complexes are deposited they can compromise the normal functioning of these tissues and organs resulting in inflammation, pain, swelling, fibrosis and the release of oxidative products. The long term effects of these reactions, especially if chronic, result in crippling diseases, organ dysfunction and failure, and accelerated aging.

Other toxins, which are primarily bowel localized, are mainly the metabolites of bile acids (secondary bile acids) formed by bacterial activity, and cholesterol. They have been shown to be promoters of colon cancer and are implicated in the pathogenisis of breast cancer (two of the most frequently occuring cancers in the U.S.). '-8 By modifying colonic cell proliferation, they can stimulate mutogenicity in the gut and when reabsorbed they can have a stimulatory and mutagenic effect on breast tissue. Their concentrations are increased by slow fecal transit time and constipation, high fat diets and a deficient intake of fiber and other plant derived bile acid and cholesterol binders factors also implicated in the cause of other cancers such as prostatic and pancreatic cancer. '

THE LIVER AND THE RETICULOENDOTHELIAL SYSTEM

An important endogenous protective mechanism from systemic toxemia is the liver and the reticuloendothelial system or RES (a system of immuno-active cells called macrophages located in different tissues of the body, particularly the liver, spleen and lymph nodes, and lungs). The liver and RES act as a sort of filter, filtering out the toxins.41,56-59 The liver processes and eliminates the toxins through the bile and is the most important of the filters because it receives the blood (portal circulation) as it comes directly from the bowel. This means the liver is primarily responsible for preventing the introduction of toxins into systemic circulation. However, if the ,liver is compromised in any way from inflammation, fatty infiltration and degeneration, excessive alcohol consumption, drugs and chronic toxin overload (which itself can cause many of the pathologies mentioned), these toxins enter systemic circulation and generate disease.

WHAT CAN BE DONE TO MAINTAIN A HEALTHY COLON AND PREVENT BOWEL TOXEMIA?

Any therapeutic regime should approach toxemia from every possible parameter and should include both an oral and rectal approach.

1. Establish a Health Diet

First and foremost in an effective regime is the establishment of a healthy diet and nutritional baseline to work from. A healthy diet means one high in fiber and complex carbohydrates from fresh, whole, unprocessed vegetables, grains, legumes, and fruit and low in fats of all types. Protein should preferentially be obtained from grains, legumes, fish and skinned, white-meat fowl instead of red meat, eggs, and milk products and should be eaten alone or with green, leafy vegetables to maximize digestion.9 The link between the high-fat, high-simple carbohydrate, and low-fiber diet and degenerative diseases such as cardiovascular disease, cancer, diabetes, diverticulitis and others, is now well recognized.

2. Decrease Fecal Transit Time

• The increase and supplementation of fiber in the diet (oat bran and other brans, pectin, psyllium seeds and husks, flax seed, etc.) is the best natural way to shorten fecal transit time.
• Mild, natural laxatives, such as rhubarb, senna and cascara may be used when necessary and in small amounts, to encourage peristalsis and defecation. However, they should generally be avoided. Dependencies on cathartics and be established and precautions should be taken.

3. Decrease The Formation And Absorption Of Toxins And Increase Their Elimination

• Again fiber is helpful, particularly oat bran and pectin, both of which can bind cholesterol, procarcinogenic bile acid metabolites and endotoxins.9,6∞
• Natural plant compounds such as phytosterols and saponins, found in many edible plants, are effective binders of cholesterol, bile acid metabolites and endotoxins as well. The phytosterols can decrease the carcinogenic activity of secondary bile acids in the colon thereby reducing the risk of colon and breast cancer.61'62 The saponin (sarsaponin) from Smilax officinalis (Sarsaparilla) is a strong binder of endotoxin and was demonstrated to significantly improve psoriasis, a condition known to include high levels of circulating endotoxins."
• Bentonite clay is also a strong binder of endotoxin in the gut.64
• Fasting is a very effective way to decrease the toxin load in the colon, especially when those toxins are dietarily related. It can also be effective in eliminating further irritation of the bowel mucosa when there is active imflammation.

4. Drecrease Any Ulceration, Inflammation Or Irritation Of The Bowel Mucosa Which Can Make It More Permeable To Toxins/ Promote Healing

• Demulcents (mucilagenous substances that soothe mucous membranes on contact)
  Althea officinalis radix (Marshmallow root) and Ulmus fulva cortex (Slippery Elm bark) are effective and very well-known, widely-used demulcents. They are particularly employed in the treatment of ulcers and colitis to sooth inflammation and promote healing.65
  
  
• Anti-inflammatory Agents
  Glycyrrhiza glabra radix (Licorice root) is an effective anti-inflammatory and demulcent extremely effective in the treatment of gastric and duodenal ulcers in a number of studies.66-7I Its marked anti-inflammatory activity is similar to cortisone but without the significant side effects of elevated cortisol levels.
  
  Skutellaria baicalensis (Chinese Skullcap) is another effective anti-inflammatory agent traditionally used for the treatment of inflammatory diseases and diarrhea.72,73 Flavonoids present in this plant function similar to the flavonoid drug disodium chromoglycate, inhibiting the formation and release of potent, endogenous inflammatory compounds. These flavonoids are also potent antioxidants effective in reducing lipid peroxidation and total cholesterol and fat content in the liver.
  
  
• C. Astringents (substances that cause tisue to contract and/or precipitate the tissue proteins to stop bleeding and oozing and encourage healing) Hammamelis virginiana cortex (Witch Hazel bark) is a strong, effective astringent traditionally used as an antihemorrhagic and anti-inflammatory in the treatment of diarrhea, colitis and hemorrhoids.
  
  Chlorophyll is also an effective astringent and can enhance the regeneration and granulation of wounds and ulcerated tissue to promote healing.
  
  Hydrastis candadensis (Golden Seal) is another astringent agent traditionally used in the healing of wounds and ulcerations.65

5. Prevent The Proliferation And Overgrowth Of Pathogenic Microflora In The Bowel

• Besides its astringent qualities, Hydrastis can help balance intestinal flora. Hydrastis contains the alkoloid berberine (3.5-4%). Berberine has significant antibiotic and antifungal activity effective against Candida and other pathogenic bacteria.76-83 It has remarkable antidiarrheal activity, demonstrated in a number of clinical studies to be effective in relieving infectious diarrheas such as cholera, amebiasis, geardiasis, salmonellosis, and others.76-83 An added asset of berberine is its immune stimulating activity on the macrophages of the RES system involved in the filtering and elimination of toxins.
• Including many fermented foods in the diet such as miso, sauerlcraut, yogurt and keifer, can be beneficial in suppressing the growth of pathogenic organisms while populating the gut with beneficial bacteria like Lactobacilli.84-86

6. Decrease Any Spasming Of The Colon And Encourage Normal Peristalsis.

A. Matricaria chamomilla (German Chamomile) has a long and successful history of use in treating colonic spasms, colic, diarrhea and indigestion. It is considered the "mother of the gastrointestinal tract".

SUMMARY

It is interesting how medicine has come "full swing", in that the new medical research is substantiating many of the "antiquated" ideas about health and disease. So, as "modern medicine" begins to brush off the dust and reacquaint itself with some old forgotton friends the concept of bowel toxemia and the importance of colon health.

A formula I suggest as a rectal infusion/retention enema or colon irrigation in the prevention and treatment of bowel toxemia and imflammatory bowel disease (colitis, proctitis, Chron's disease) is:

TOXIN BINDERS
Sarsaparilla radix (4:1) 500 mg.
Bentonite powder 500 mg.

DEMULCENTS
Althea radix 400 mg.
Ulmus cortex 400 mg.

ANTI-INFLAMMATORIES
Glycyrrhiza radix (4:1) 500 mg.
Skutellaria (4:1) 300 mg.

ASTRINGENTS
Hammamelis cortex 400 mg.
Chlorophyll (water soluble powder) 500 mg.
Hydrastis rhizoma (12% alkaloids) 300 mg.

ANTI-SPASMOTICS
Matricaria 500 mg.
in 250 ml. of an isotonic mineral solution.

If you would like to have the extensive list of references that accompany this article, please send us a self-addressed stamped envelope, and we shall be happy to send them to you.

Copyrighted by Patrick M. Donovan, N. D. Reprinted with permission.

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