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Supplement Savvy for Cancer: Digestive Health

Your health may depend upon your digestive system, your gut. Your gut is the long tube that runs from your mouth down your esophagus into your stomach and all the way through your small and large intestines. We usually take our gut for granted when it's working well. But when it's not, it may affect our intestinal, immune, and overall health.

A GOOD GUT . . .

does a great job of breaking down, using food, and getting rid of food wastes.

A GOOD GUT . . .

has both healthy bacteria and unhealthy bacteria. The Good Gut Guys include hundreds of different kinds of friendly bacteria. These friendly bacteria help the cells of the gut form a protective barrier against toxins, yeasts, molds, fungi, parasites, chemicals, and other unfriendly bacteria…The Bad Gut Guys.

A GOOD GUT . . .

has a lot of Good Gut Guys and as few Bad Gut Guys As possible.

A GOOD GUT . . .

can begin to get bad when the Bad Gut Guys begin to take over and crowd out the Good Gut Guys. This can happen when you have allergies, food intolerances, take a lot of antibiotics, and for many other reasons. When the Bad Gut Guys like our foe below take over, the gut begins to change. We have tiny little fingers in our guts called villi where we absorb food that we eat. An overgrowth of Bad Gut Guys damages these villi and makes it harder and harder for us to absorb the nutrients we need. Also, the protective barrier begins to break down and our gut begins to leak. The Bad Gut Guys can then get into places where they're not invited and have a party.

The Bad Gut Guys can cause:

GAS, BLOATING, DIARRHEA, CONSTIPATION, and HEARTBURN. Lots of times these symptoms will go away if you follow the dietary recommendations below:

DIETARY RECOMMENDATIONS

To chase away The Bad Gut Guys and get your Good Gut Guys to grow again, you might want to eat the same high fruit-and-vegetable, high-fiber from unprocessed grains and beans, and high-fish diet that's recommended for cancer prevention. You might also want to use less refined sugar, alcohol, and foods that have lots of yeast. A good food way to get those Good Gut Guys is with yogurt and milk with live L. acidophilus, L. bulgaricus, or bifidobacteria added. If you can't digest milk, try soy yogurt. But make sure it says Live Cultures on the label.

If your gut isn't working right, it might be a good idea to try changes in your diet first. Dietary changes may not work, however, if your good gut gets really bad.

A GOOD GUT GETS REALLY BAD . . .

when you have cancer. Surgeries may cause poor absorption of fats, vitamins, and minerals. Chemotherapy, radiation, and antibiotics may make digestive problems worse. Chemotherapies such as Doxorubicin and 5-Fluorouracil work best on fast-growing cells. And the cells of your gut are among the fastest growing in your body. Chemotherapy changes the environment of these sensitive cells. These changes may kill off the Good Gut Guys and let the Bad Gut Guys grow. You may end up with a leaky gut like the one to the right. The leaky gut may eventually lead to things like Irritable Bowel Syndrome, Colitis, Diverticulitis, and other serious problems like Colon Cancer.

It may be hard to get the Good Gut Guys from food alone once the Bad Gut Guys get a strong foothold. You might want to consider the following nutritional supplements:

PREBIOTICS AND PROBIOTICS

Good Gut Guys in nutritional supplements are called Probiotics. They're live friendly bacteria and yeasts. Probiotic supplements may boost immunity, decrease diarrhea, lower cholesterol, reduce allergic reactions, serve as antioxidants, and generally prevent cancer.

There are many, many strains of Probiotics, but Lactobacillus acidophilus, casei, plantarum, reuteri, salivarius, rhamnosus, and GG and Bifidobacteria bifidum, longum, breve, and infantis are the most researched and most commonly used in nutritional supplements. There's also been a lot of positive research about Saccharomyces boulardii (SB), a Probiotic yeast, in the treatment of diarrhea and other symptoms caused by antibiotic use. SB, unlike other Probiotics, resists antibiotics and changes in the gut environment. SB can, therefore, easily travel through the gut unharmed to where it's needed in the large intestine.

The potency of Probiotics really depends upon their ability to survive your acidic stomach and alkaline intestines and colonize your gut. The best forms of these supplements are hardy strains like the NCFM® strain of L. acidophilus. You may also want to use a dairy-free variety as you may find that you're lactose intolerant with treatment. Many of these supplements are freeze-dried for stability and consistency. Most supplements with live bacteria have to be refrigerated. Other supplements, such as L. sporogenes and soil bacteria-based Probiotics, don't have to be refrigerated but may not be as effective as the live varieties.

Prebiotics are food for the Good Gut Guys, like bananas are food for your body. Prebiotics nourish Probiotic bacteria and yeasts so that they can grow faster. Most Prebiotics in supplements are in the form of Fructo-Oligosaccharides (FOS) or Inulins. The semi synthetic Prebiotic, Lactulose, is also sold as a prescription drug for constipation the United States. Oligosaccharides in soy, peas, and beans may be one of the reasons they might be cancer-preventive. Fermentation of Prebiotics in the colon produces butyrate, which may reduce cancer growth. There's also some animal research that FOS and Inulin may help your chemotherapy treatments work better. Prebiotics may also increase concentrations of calcium and magnesium in the gut and help in their absorption, thereby possibly aiding in the prevention of osteoporosis.

Supplements that contain combinations of Probiotics and Prebiotics are called Synbiotics. These combinations synergistically enhance the actions of each other and might be the best forms to use for those who tolerate them. When you have a sensitive system with lots of Bad Gut Guys, it sometimes can cause gut distress when you take too many Good Gut Guys all at once. Powdered Synbiotics may be a good bet because you can take a tiny bit of them and slowly increase the amount to the desired dose. Synbiotics also come in capsule form.

Make sure that you take whatever Probiotic supplements you are using between meals on an empty stomach. It's hard for the Good Gut Guys to get a foothold if they're taken with food or other supplements.

What to Watch Out For . . .

Pregnant women and nursing mothers should use Prebiotics, Probiotics, and Synbiotics only under a doctor's care, and these supplements are not recommended for anyone who's very sensitive to them. Lactulose isn't recommended for those with lactose intolerance. If you're prone to gas, bloating, and diarrhea with a high-fiber diet, you may want to exercise caution with Prebiotic supplements; doses of more than 10 grams per day may also cause the same symptoms less fiber-sensitive people. Probiotic supplements are generally well tolerated, but may occasionally cause gas and constipation. If you're having radiation treatments for the gut or the entire body, you shouldn't take Prebiotics.

DIGESTIVE ENZYMES

Enzymes help the Good Gut Guys build muscle to fight the Bad Gut Guys. Enzymes are more than 50,000 kinds of proteins that help in the chemical processes of your body. One of the things that enzymes do is split up the sugar, fat, and protein molecules in your food and get them ready for digestion. Enzymes that digest protein are called proteolytic, or protein-digesting.

Enzymes have been used for a hundred years to treat and prevent cancer. One way enzymes may do this is by breaking down the shield that helps cancer cells hide from the immune system. Another way is by removing circulating immune complexes (CIC) that suppress the immune system. Proteolytic enzymes clear out CICs and activate the immune system in other ways. Enzymes may therefore be able to help shrink tumors, stop the spread of cancer cells, and prolong survival.

Bromelain is a proteolytic enzyme from pineapples that may have wound healing, anti-inflammatory, antidiarrheal, and anti-cancer actions. Bromelain might also reduce water weight gain. Some studies have used a successful synergistic combination of Bromelain with other proteolytic enzymes including Trypsin, Chymotrypsin, and Papain. Others suggest that Bromelain may be effective all by itself. Bromelain can increase the absorption of supplements including Quercetin and the Curcuminoids found in turmeric. Bromelain may also boost the effects of many drugs, including antibiotics, anticoagulants like wayfarin, and anti-thrombotics like aspirin. Bromelain may increase the effects of antibiotics, like tetracycline and amoxicillin, and many chemotherapies, like 5-Flourouracil and vincristine. Other proteolytic enzymes may have similar drug enhancement effects.

Enzymes are most effective when taken with food as a digestive aid or between meals to decrease inflammation.

Pancreatin, an enzyme preparation, has a combination of Amylase, a starch-digesting enzyme, Lipase, a fat-digesting enzyme, and Trypsin, a proteolytic enzyme, and seems to be very helpful for pancreatic insufficiency and other disorders including pancreatic cancer. Wobenzym® is another multi-enzyme preparation manufactured by the Marlyn Healthcare Group. Wobenzym contains Papain, Bromelain, Trypsin, Chymotrypsin, and Pancreatin. Wobenzyme comes in oral and suppository forms.

What to Watch Out For . . .

Pregnant women and nursing mothers should avoid enzymes unless a doctor prescribes them. Using pancreatic enzymes for pancreatic insufficiency should only be done under medical supervision. If you do decide to take supplemental enzymes, please first discuss their use with your doctor. Alpha-galactosidase may cause cramping, diarrhea, and allergic reactions and should be avoided by Galactosemics. Other enzymes such as Amylase, Bromelain, Pancreatin, Pancrelipase, and Wobenzyme may also cause diarrhea, nausea and vomiting, cramping, and allergic reactions in rare cases. Pancrelipase can cause constipation and urinary issues unless the tablets are enteric coated. Bromelain may have blood-thinning effects in some people and is not a good idea for some on anticoagulants and antithrombotics, like coumadin and aspirin.

HYDROCHLORIC ACID

Hydrochloric acid (HCl) is like a Good Gut Guy for your stomach. When food enters your stomach, HCl helps digest it and get it ready to enter the small intestine. HCl signals your small intestine to empty your stomach. When your stomach doesn't make enough, it has a harder time emptying. If you don't have enough HCl, food doesn't get properly digested. The end result may be heartburn, gas, bloating, and what is called Gastroesophageal Reflux Disease (GERD).

Some people don't make enough HCl. Betaine hydrochloride supplements aid in digestion by increasing stomach HCl. More HCl helps your stomach empty so that your food can get digested in your small intestine. Betaine hydrochloride is often combined in supplements with pepsin, a proteolytic enzyme that's more active in an acidic environment. These supplements work well in combination with digestive enzyme preparations. Synergistic effects may also be noticed with folic acid.

Some people make too much HCl. The tough acid-resistant barrier of the stomach begins to break down. Acid can then leak through the barrier. You can experience irritation and pain from this kind of leaky stomach.

Try these dietary modifications before you try supplements. Avoid caffeine-containing, carbonated, or other acidic beverages. Eat smaller, more frequent meals so that you don't overfill your stomach. High-fat diets can delay stomach emptying; you might want to eat less fat. Spicy foods can also irritate your stomach, so eat less. And liquids can dilute the HCl that you already make, so try to drink liquids between instead of with meals.

What to Watch Out For . . .

If you decide that you'd like to try this supplement, please be cautious. It's very difficult to tell whether you have too much stomach acid. There is a medical test but it's not commonly used. You might have excess stomach acid if you have pain from gastritis, hiatal hernia, GERD, or peptic ulcer disease. Avoid the use of HCl supplements if you even suspect that you have excess stomach acid.

Having too little HCl may also produce gas, bloating, and GERD-like symptoms as your gut struggles to clear the food out of your stomach. Sometimes individuals will use antacids when they're actually producing less HCl. This may make matters worse as antacids can neutralize what little acid they're actually producing. If you're experiencing gas, bloating, and heartburn without a lot of pain, this supplement may really help. You might want to break up the tablet into quarters or crush it and add it to food in small amounts in the beginning to see if you can tolerate it. If you experience pain or more severe symptoms, please discontinue use at once.

Pregnant women and nursing mothers should avoid these supplements. Nausea, vomiting, and diarrhea are rare side effects.

WHEY PROTEIN

Whey protein may have many great benefits. It's the best quality protein you can get. It's even better than eggs and chicken. It also may be antiviral, antifungal, antibacterial, and antiparasitic. It has Lactoperoxidases, Lactoferrins, Globulin Proteins, and Immunoglobulins that starve, damage, and keep The Bad Gut Guys from sticking to intestinal walls. In this way, whey protein may help Probiotics colonize the gut. Whey protein is available as a powder that can be added to shakes when you just don't feel like eating anything else or as a part of your medical food shake. Whey protein may be used in may ways: to help the Good Gut Guys, to boost the immune system, to decrease diarrhea, to inhibit tumor growth, and as the basis for a nourishing shake. Whey protein is explained in more detail in another article.

MEDICAL FOODS

Medical foods powdered high-quality vegetarian combinations of food components, vitamins, minerals, and other nutritive substances that are formulated to provide nutrition support for the whole body while also targeting certain diseases or conditions. Cutting-edge scientific research goes into the creation of these products that may have profound positive effects upon inflammation, immune deficiency, liver health, diabetes, hormone imbalance, or digestive problems. Nutrients in all these medical foods are contained in a low-allergy rice base that can also help promote digestive health. Medical foods provide targeted, concentrated nutrition to provide nutrition support for body systems. They don't just target symptoms.

These products are nutritionally complete for each condition so that little extra supplementation is necessary. Condition-specific, low-allergy diets are also suggested. All foods that may cause sensitivities of any kind are limited or removed from your diet. These recommended diets are varied but most have lots of fruits and vegetables, lots of fiber from whole grains, beans, and legumes, and low-fat protein from fish, chicken, turkey, and game. A low-allergy diet is also a healthy diet.

You might want to kick-start your way to digestive health by spending two to four weeks on one of these programs. Medical foods and low-allergy diets might provide you with the nutrition support that you need to recover from cancer surgery and treatment. Medical foods are explained in more detail in a separate article and come with an extensive Medical Foods Plan for those who would like to try them.

© Copyright 2002 Jill Place, MA, RD