• Dr. Juliet Ghodsian

Gut Instinct - The journey back

Updated: Sep 20, 2019

Let's Break it Down...

In my last entry I outlined for you the 6 main underlying triggers for activation of Crohn’s Disease in my body:

1) Genetics

2) Repeated Gastroenteritis

3) Post Infectious IBS and SIBO

4) Concussion

5) Overactive Stress Response and Sympathetic Dominance

6) Lack of clear boundaries between others and myself

We will now discuss the role of genetics and repeated gut infections together in order to set the stage for a more comprehensive explanation of why the treatment of Post-infectious IBS and SIBO became a pivotal step in my healing journey.

Having a “genetic predisposition” to a particular disease or having a disease in your family line, does not mean that you are 100% guaranteed to develop that disease over the course of your lifetime. As discussed previously, for many individuals in order for “ bad” genetics to become problematic, they need to be activated by some precipitating event. Some of these events we could perhaps prevent, but the vast majority we can do nothing more than clean up the aftereffects.

With my personal genetics for Crohn’s Disease, the major activating factor involved Repeated Gastroenteritis which resulted inSIBO/Post-Infectious IBS. We will focus on these two concepts because they were of critical importance to my process of healing.

Let’s briefly and simply explain the process of what happens when you get food poisoning from a bacterial exposure:

When the intestinal immune cells detects the presence of a foreign bacteria(pathogen), they activate several branches of the immune system. This process is what causes you to develop nausea, vomiting, diarrhea and even at times mucus or blood when you go to the bathroom. With exposure to a less “ triggering” type of bacteria or with many viral (stomach flu) infections, this process will simply normalize itself over time as the organism is cleared out of your intestine. Certain bacterial organisms have been identified as triggers for longer-term complications in your immune system. One, you may have trouble fully eradicating the bacteria and end up with a chronic low-grade infection. This is more common than you might think and also a potential underlying trigger for autoimmunity in the body! Second, in the specific example of post-infectious IBS, the bacteria that caused your infection often produces a toxic compound. This toxic compound is what causes your diarrhea! The problem is that your our own white blood cells make an antibody (kind of like a small flag) that labels that toxin as bad. This helps your immune cells find and remove the toxin. Why is that a problem? The process itself is not the problem. In certain people this little flag will not only attach itself to the toxin, but also to the nerves in the lining of your intestinal tract because they are close enough in shape/form that the antibody cannot differentiate them. When it does that it activates the full power of your immune cells and inflammatory chemicals that are for eradicating infection, and directs them at your own intestinal wall and nerves. This is NOT a good situation.

The patients who demonstrate this antibody cross-reactivity are much more likely to develop what we would diagnose as Post-Infectious IBS sometime in the 2-6 months following their initial food poisoning incident.

We can now test people for the presence of these antibodies in their system. If they are producing it, then they are actively damaging their intestinal nervous system and it is a major causal factor in the onset of their digestive compromise. The name of these tests are anti-CdtB andtibody and anti-vinculin antibody.

There are many causes of IBS depending on a person’s individual circumstances. However, in the specific case of an individual who experiences food poisoning and develops antibodies against their intestinal tract, this process is very likely to result in the development of Small Intestine Bacterial Overgrowth.

In my next blog entry I will discuss more in depth the normal, healthy physiology of the small intestine and how it maintains balance in the digestive tract and in the immune system. This will help us to understand more fully the cascade of events that ultimately results in a dysfunctional digestive tract and the onset of IBS and sometimes, as in my case, something much more complicated.