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‘Somewhere inside ALL of us is the power to change the world’ Roald Dahl (Matilda)
Recently we wrote about how digestion can affect your immunity, now we are going to delve into how infection can affect digestion and the long term implications. Digestive symptoms are common in patients during any infection, these can include loss of appetite, nausea, vomiting and diarrhoea. In a recent study of hospitalised patients, 57% suffered with digestive symptoms.1 So let’s dig deeper into why this might happen and what you can do to support your gut and overall digestive health.
During an infection, symptoms such as lack of appetite and nausea can cause long-term nutrient deficiencies if not addressed with good diet and lifestyle choices. Those suffering with digestive disorders such irritable bowel syndrome (IBS) or poor fat digestion, are more likely to be in a preliminary nutrient-depleted state. Digestive support, such as probiotics and prebiotic fibre, is a key consideration to encourage nutrient absorption and subsequent replenishment of nutrients for gut and immune system health.
The use of medications during an infection can have long term consequences in the gut. For example, antibiotic treatment can disturb the gut microbiome and reduce colonisation of beneficial bacteria such as Bifidobacterium as well as potentially increasing pathogenic bacteria such as E.coli, salmonella, and H. pylori.2 Antibiotics can also cause a long-term reduction in short-chain fatty acids, this can reduce the functional state of the mucosa in the colon, thereby increasing the risk of inflammatory bowel disease (IBD).3 Other medications often taken during an infection are non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen for fever and symptomatic relief, however, research shows NSAIDs can damage the gut mucosa potentially leading to gastric ulcers.4 On the other hand, viruses have been shown to induce long-term effects on enzymes involved in drug metabolism (specifically CYP3A enzyme expressed in the intestinal mucosa),5 important for the detoxification of statins, omeprazole and prednisone. This can promote drug induced side-effects and toxicities.6
Another piece of the puzzle that could impact the gut microbiome is the long term effect of using larger amounts of detergents, household cleaning products, and hand sanitisers.7 This is particularly a concern for children who need a certain amount of pathogenic exposure for the immune system to mature. Research has found that extreme cleanliness could increase the risk of chronic inflammatory disorders such as multiple sclerosis8 and allergic conditions.9
Gut dysbiosis has also been linked to conditions such as IBD, and this can be exacerbated by chronic inflammation,10 either pre-existing or caused by an infection. Inflammation caused by viruses can also have long-term consequences, leading to chronic medical conditions such as dementia.11 Inflammation can also disrupt the tight junctions in the gut causing an increase in intestinal permeability and further disruption to gut function. Additional external factors can further drive intestinal hyperpermeability, such as stress12 and poor diet (gluten, dairy).13
A common symptom of infection is diarrhoea. This can be exacerbated by low levels of fibre in the diet. Dietary fibre is important as it ‘cleans’ the gut and removes static food that would otherwise encourage growth of pathogens.14 Insoluble fibres can add bulk to the stool and help with diarrhoea. Food sources of insoluble fibre include oats, beans, vegetables, nuts, and seeds.
If you are unsure on how to improve your gut health, a great starting point is increasing the levels of beneficial bacteria in your diet, either via foods such as sauerkraut, kimchi, kombucha or by using a well-researched, clinically effective, and stable probiotic supplement. And remember, even though you can’t see what is happening on the inside, your digestive system is always working hard for you, so prioritising gut health is key for optimum wellbeing.
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1. Han C, Duan C, Zhang S, et al. Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol. 2020;115(6):916-923. doi:10.14309/ajg.0000000000000664
2. Fouhy F, Guinane CM, Hussey S, et al. High-throughput sequencing reveals the incomplete, short-term recovery of infant gut microbiota following parenteral antibiotic treatment with ampicillin and gentamicin. Antimicrob Agents Chemother. 2012;56(11):5811-5820. doi:10.1128/AAC.00789-12
3. Holota Y, Dovbynchuk T, Kaji I, et al. The long-term consequences of antibiotic therapy: Role of colonic short-chain fatty acids (SCFA) system and intestinal barrier integrity. PLoS One. 2019;14(8). doi:10.1371/journal.pone.0220642
4. Rainsford KD, Stetsko PI, Sirko SP, Debski S. Gastrointestinal mucosal injury following repeated daily oral administration of conventional formulations of indometacin and other non-steroidal anti-inflammatory drugs to pigs: a model for human gastrointestinal disease. J Pharm Pharmacol. 2003;55(5):661-668. doi:10.1211/002235703765344577
5. Bezirtzoglou EEV. Intestinal cytochromes P450 regulating the intestinal microbiota and its probiotic profile. Microb Ecol Heal Dis. 2012;23(0):18370. doi:10.3402/mehd.v23i0.18370
6. Kiani J, Imam SZ. Medicinal importance of grapefruit juice and its interaction with various drugs. Nutr J. 2007;6:33. doi:10.1186/1475-2891-6-33
7. Ejtahed HS, Hasani-Ranjbar S, Siadat SD, Larijani B. The most important challenges ahead of microbiome pattern in the post era of the COVID-19 pandemic. J Diabetes Metab Disord. Published online 2020:1. doi:10.1007/s40200-020-00579-0
8. Rook GAW. Hygiene hypothesis and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):5-15. doi:10.1007/s12016-011-8285-8
9. Eder W, Ege MJ, von Mutius E. The Asthma Epidemic. N Engl J Med. 2006;355(21):2226-2235. doi:10.1056/nejmra054308
10. Lobionda S, Sittipo P, Kwon HY, Lee YK. The role of gut microbiota in intestinal inflammation with respect to diet and extrinsic stressors. Microorganisms. 2019;7(8). doi:10.3390/microorganisms7080271
11. Butler MJBRM. The impact of nutrition on COVID-19 susceptibility and long-term consequences. 2020;(January).
12. Collins SM. Stress and the gastrointestinal tract IV. Modulation of intestinal inflammation by stress: Basic mechanisms and clinical relevance. Am J Physiol - Gastrointest Liver Physiol. 2001;280(3 43-3). doi:10.1152/ajpgi.2001.280.3.g315
13. Visser J, Rozing J, Sapone A, Lammers K, Fasano A. Tight junctions, intestinal permeability, and autoimmunity: Celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009;1165:195-205. doi:10.1111/j.1749-6632.2009.04037.x
14. Desai MS, Seekatz AM, Koropatkin NM, et al. A Dietary Fiber-Deprived Gut Microbiota Degrades the Colonic Mucus Barrier and Enhances Pathogen Susceptibility. Cell. 2016;167(5):1339-1353.e21. doi:10.1016/j.cell.2016.10.043