The next several months we will look at the group of conditions that are characterized by pathologic evidence of inflammation of the intestinal tract. The clinical signs most commonly seen in pets with inflammatory bowel disease often reflect the location of the intestinal lesions. Vomiting, diarrhea, and/or weight loss are usually observed. Lesions affecting the upper GI (gastrointestinal) tract (stomach and upper small intestine) are more likely to cause vomiting, whereas lesions of the lower small intestinal tract and colon are more likely to cause diarrhea.
Causes of inflammatory bowel disease are numerous and include parasites (whipworms, giardia), fungi (histoplasmosis, protothecosis), bacteria (Salmonella, Campylobacter, pathogenic E. coli), food allergy/ hypersensitivity, cancer, and idiopathic (unknown cause named by the type of pathogenic white blood cells seen in biopsy specimens such as eosinophilic, lymphocyticplasmacytic).
Most commonly, the idiopathic classification of inflammatory bowel disease is seen in dogs and cats. While there is no known cause of the disease, most doctors suspect some type of allergy as this is an immune disease. The allergy or sensitivity might be due to the diet (mild cases can respond to dietary manipulation), bacterial antigens, or self-antigens (an autoimmune disorder). Allergies to food components usually involve cereal grains, meats, and rarely eggs.
Leaky Gut Syndrome, Intestinal Dysbiosis, Intestinal Hyperpermeability
Leaky Gut holds that in some people and pets, whole proteins leak through the wall of the digestive tract due to a hyperpermeable condition, and enter the blood, causing allergic reactions. These reactions may include food allergies, arthritis, autoimmune diseases, impaired nutrient absorption, and chemical sensitivities. It is theorized that many chronic diseases, often treated for years with various conventional medications, may in fact result from leaky gut syndrome.
One organism that has been postulated to be responsible for some of the signs seen in people and pets is the common yeast Candida albicans. This yeast has been observed to enter the bloodstream from the intestinal tract, and may cause chronic allergies. Overgrowth of this yeast and other organisms may occur in pets with chronic intestinal disease and in pets undergoing chronic antibiotic or NSAID therapy. The organisms can produce toxins that cause leaky gut syndrome. The increased intestinal permeability may allow greater absorption of the microorganisms and their toxins, causing further harm.
Holistic doctors often attempt gastrointestinal detoxification, using enzymes, prebiotics, probiotics, glutamine, and so forth, for pets with many diseases in an attempt to heal a leaky gut that may be contributing to clinical signs or disease.
Glutamine, or L-glutamine, is an amino acid derived from another amino acid, glutamic acid. There is no daily requirement for glutamine as the body can make its own. High-protein foods such as meat, fish, beans, and dairy products are excellent sources of glutamine. Severe stresses may result in a temporary glutamine deficiency.
Glutamine plays a role in the health of the immune system, digestive tract, and muscle cells, as well as other bodily functions. It appears to serve as a fuel for the cells that line the intestines, (it serves as a primary energy source for the mucosal cells that line the intestinal tract). Because stress on the intestinal cells that can occur in chronic inflammatory bowel disease can increase the need for glutamine as the body replaces the cells lining the intestinal tract, glutamine is often recommended for pets with chronic bowel disorders.
It has also been suggested as a treatment for food allergies, based on the leaky gut syndrome. Preliminary evidence suggests glutamine supplements might reduce leakage through the intestinal walls, and is highly recommended for pets with various bowel disorders.
Glutamine being one of the body’s amino acids, is thought to be a safe supplement when taken at recommended dosages. Because many anti-epilepsy drugs work by blocking glutamate stimulation in the brain, high dosages of glutamine may overwhelm these drugs and pose a risk to pets with epilepsy. If your pet is taking antiseizure medications, glutamine should only be used under veterinary supervision.
Maximum safe dosages for young children, pregnant or nursing women, or those with severe liver or kidney disease have not been determined; similar precautions are probably warranted in pets. Recommended dosages in pets are 250 to 3000 mg daily.
Most pets with inflammatory bowel disease are treated with various anti-inflammatory medications, including corticosteroids, sulfasalazine, or in serious cases the chemotherapy agent azathioprine. These therapies are often combined with antimicrobial medications (tylosin, metronidazole). Usually the pet is treated with a high dose of anti-inflammatory medication and is slowly, over several months, weaned off the medicine or weaned to the lowest dose that controls the clinical signs. There is potential danger in using high doses of corticosteroids, including side effects such as pancreatitis, increased susceptibility to infection, and gastrointestinal ulceration or perforation. Using gastrointestinal protectant medications such as sucralfate, misoprostol, or omeprazole may decrease some these side effects.
Next month we look at specific natural diets you can make that are designed for pets with inflammatory bowels disease. And in future months we’ll review orthomolecular therapy, plant enzymes, prebiotics and probiotics that may help with numerous gastrointestinal symptoms.