Research Alert: PREdiCCt

Looks like some investigators in the UK are looking to identify environmental triggers for Crohn’s and Colitis flares.

Basically, they’re going to sample people’s gut bacteria and given them questionnaires on their diet, lifestyle, and health over the period of 2 years, then attempt to find trends in the data.

This is the kind of study that makes me hate “evidence-based” science, because it is completely backwards. For the most part, we KNOW what those things are already. We don’t need some big data study to tell us what Sarah Wilson chronicles in herself, or what all the success stories at Mark’s Daily Apple point at.

Based on what I’ve talked about with other IBD people, and read about online, there are big triggers (ie, sugar), but then everything else is intensely personal.

And even then, it can be incredibly hard to tell. I once talked with a guy who kept a very detailed spreadsheet of his symptoms, food intake, sleep and then ran a statistical analysis on it. What did he find? Nothing helpful.

I wish these guys the best, but I’m not going to hold my breath that they find anything significant.

The Unexpected Importance of Mucus

I’ve only ever thought of mucus as a quick-n-dirty way to measure intestinal inflammation. Looks like the bowel/mucus/bacteria relationship is a bit more complex:

Viscous mucus covers the intestinal wall, disables bacterial movements, and protects epithelial cells from contact with bacteria. Leukocytes migrate into and patrol within the mucus layer executing surveillance functions without any collateral damage. The sticky outer mucus surface offers the opportunity for probiotic strains to grow and build protective interlaced layers, making it even more difficult for pathogenic strains to reach the mucosa.

The inflammation takes place only after the mucus barrier is broken and the defence is overwhelmed

I need to spend more time with the article to tease out a few of the themes, but the authors make an interesting case that the integrity of the mucus lining the intestines is critical in keeping bacteria (both good and bad) from invading the healthy epithelial cells that line our guts.

Which means that part of a healthy gut is a healthy layer of mucus (I know, eww). Mucus is broken down by emulsifiers in our foods, which are added to nearly everything processed. Common offenders include dairy products and toothpaste. The good news is that if you’re following a Paleo, low-FODMAP, or Specific Carbohydrate-type diet, you’re already on the right track. The SCD specifically bans emulsifiers like carrageenan and soy lecithin. Basically, if you aren’t eating processed foods, you aren’t eating emulsifiers.

Just don’t swallow your toothpaste.