What is Blastocystis?

Blastocystis spp. infection- Blastocystosis

Blastocystis spp. is a group of parasites that is sometimes found in the lower intestine (large bowel). Infection with Blastocystis spp. is called blastocystosis. Blastocystis spp. is thought to be transmitted through oral-fecal contact from poor hand washing and hygiene practices, ingesting contaminated food or water, and exposure to animals.

Our understanding of Blastocystis has been revised several times. Up until 1996, Blastocystis was thought to be some type of yeast or fungi. It was only when Blastocystis DNA was studied that we realized it was a parasite. For a long time, we thought there was only one type of Blastocystis- Blastocystis homminis. We now know that there are actually 9 different subtypes, which are collectively called Blastocystis spp. 

There is still debate about whether Blastocystis spp. is even an infectious agent. This is because Blastocystis spp. can be found in the fecal specimens of many people who appear healthy and have no symptoms at all. There is a huge variation in the symptoms people experience, and how well treatment works. Why would there be such variation in symptoms and treatment response? Researchers suggest it is because of the different subtypes of Blastocystis having different effects in the body, and reacting differently to treatment.

 

Signs and symptoms of blastocystosis

In people who do experience symptoms, signs and symptoms can include:

·         Diarrhea

·         Constipation

·         Nausea

·         Vomiting

·         Abdominal cramps

·         Bloody stools

·         Bloating

·         Excessive gas

·         Anal itching

·         Loss of appetite

·         Weight loss

·         Dizziness

·         Headaches

·         Depression

·         Fatigue

·         Rash

Diagnostic considerations

At The Health Lodge, if we suspect you have blastocystosis, we may be interested in performing some tests to give us more information. These include:

·         Testing for Blastocystis spp. A common method to test for Blastocystis spp. is by stool culture, however we prefer to use a variation on this method that involves extraction of DNA followed by polymerase chain reaction (PCR) testing. This is considered the most sensitive testing method.

·         Screening for nutrient deficiencies, as Blastocystis spp. can contribute to nutritional deficiencies, especially iron.

·         Screening for food allergies and intolerances. We find that many of our patients with Blastocystis infection also have food allergies or intolerances. Blastocystis spp. has been found to increase the permeability of the gut wall, which allows large proteins that are usually broken down to pass through into the blood stream. These proteins can interact with the immune system and trigger a reaction.

·         We may be interested in screening for Blastocystis spp. in patients with irritable bowel syndrome or irritable bowel disease (Crohn’s disease, ulcerative colitis). Blastocystis infection has been associated with these diseases, and it may be an underlying cause or contributing factor in some cases.  

Treatment considerations

Common treatment for Blastocystis infection includes the antibiotic metronidazole (Flagyl). However, the high failure rates of eradication using single drug therapy has led to the use of combination therapies of multiple antibiotic and anti-parasitic medications. At The Health Lodge, we find the best results are often achieved with a combination of antibiotic therapy and complementary therapies.

At The Health Lodge, our goals in treating Blastocystosis include eradicating the Blastocystis infection, correcting nutrient deficiencies, identifying and managing food allergies and intolerances, and repairing the gut wall and digestive function. We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of health. Depending on your individual needs, your multidisciplinary team may include general practitioners, psychologists, dietitians or nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.

Lyme disease - Integrative Treatment Approach Part One

Lyme disease, or Lyme Borreliosis, is caused by a species of bacteria called Borrelia. It is transmitted to humans by ticks. Some ticks carry Borrelia, and when they attach and suck blood, they can regurgitate the bacteria into their host. The most common strain is Borrelia burgdorferi. This is the cause of most cases of Lyme disease in America. In Europe, the main strains are B. garinii and B. afzelii.

 

What are the symptoms of Lyme disease?

Borrelia bacteria are slow growing. Symptoms may take days or months to appear. In some cases, the disease may lie dormant for years, and surface after a stressful event such as illness, surgery, or physical or emotional trauma. One of the earliest and most defining signs of Lyme disease is a rash that spreads out from the site of the tick bite. The rash resembles a bulls-eye. At this early stage you may feel like you have the flu- fatigue, fever, headaches, muscle and joint aches and pains, and swollen lymph nodes are common.

The later stages of Lyme disease can take months or years to develop, and can cause problems in the joints, heart, and nervous system, and may affect mood and cognition.

 

Lyme disease in Australia, why the controversy?

The question of whether Australian ticks carry the bacteria that causes Lyme disease is controversial. The Australian government denies that Australian ticks carry the Borrelia bacteria, and suggests that people with Lyme disease must have contracted it while overseas. However, switched-on health practitioners are finding that not all patients with Lyme disease have been outside of Australia.

So why is there so much disagreement on Lyme disease in Australia? In 1994 a study by Russell and Doggett set out to answer the question of whether Australian ticks carry Borrelia bacteria. They collected 12 000 common Australian ticks and did not isolate any Borrelia DNA, concluding that Australian ticks do not carry the bacteria that causes Lyme disease. However, there were a number of issues in this study. Of the 12 000 ticks, only 1038 were actually tested for Borrelia. Russell and Doggett also worked on the assumption that only the burgdorferi strain of Borrelia causes Lyme disease, yet European studies have found that B.garinii and B.afzelii can also cause Borreliosis.

In 1959 Mackerras isolated Borrelia from Australian kangaroos, wallabies and bandicoots. Russell and Doggett did not mention this study in their own work. In 1962 Carley and Pope discovered an Australian strain of Borrelia, called Borrelia Queenslandica. Again, Russell and Doggett made no mention of this in their study. In 1995 Barry, Wills and Hudson isolated and grew Borrelia bacteria from Australian ticks. They also tested people with symptoms of Lyme disease, and 20% were positive for B.garinii, B.afzelii or B.burgdorferi.

Given that three out of four studies isolated Borrelia species from Australian fauna, a review of the government position on Lyme disease in Australia would be wise. We need more research to fully understand Lyme disease in Australia, and more public awareness of Lyme disease, to ensure people receive the correct diagnosis and best treatment.

 

Why is Lyme disease so difficult to diagnose?

Aside from the clear roadblocks that the controversy of Lyme disease in Australia causes for diagnosis, a number of other issues make diagnosis difficult. Firstly, less than 30% of patients with Lyme disease can recall getting a tick bite. Secondly, the bulls-eye rash that is a defining feature of Lyme disease occurs in less than 30% of cases.

And the list of reasons goes on: Borrelia can live inside cells and inside the central nervous system, and so may not come up in blood tests, especially in chronic cases. The tests currently used are very poor at detecting Borrelia, and results may come back falsely negative. None of the tests, either in Australia or overseas, test for strains of Borrelia specific to Australia, like Borrelia Queenslandica.

Because Lyme is difficult to diagnose, and awareness of Lyme disease in Australia is poor, patients are being misdiagnosed. People with Lyme disease have been misdiagnosed with fibromyalgia, motor neurone disease, Parkinson’s disease, Alzheimer’s disease, and chronic fatigue syndrome.

 

The complexities of Lyme disease

Lyme disease is not your average bacterial infection. Ticks often carry other organisms, including Babesia, Anaplasma, Ehrlichia, and Bartonella. These can be transmitted to humans at the same time as the Borrelia bacteria, causing co-infection. It is incredibly important to test and treat these co-infections as well. Animal and human studies show that these co-infections can cause more severe and treatment-resistant Lyme disease.

Borrelia is also capable of creating a biofilm. A biofilm is a slippery, glue-like coating that some bacteria create to act as a protective shield. The plaque on your teeth is a type of biofilm produced by Treponema denticola, which causes gum disease. To create the biofilm, the bacteria clump together and build a complex matrix around themselves. They can do this on a range of surfaces including our soft tissues. Other organisms, including the co-infections common in Lyme disease, can live inside the biofilm. The biofilm protects the bacteria from attacks from the immune system and antibiotics.  The Borrelia biofilm is one of the reasons Lyme disease and its co-infections are so difficult to treat.

 

Diagnostic considerations for Lyme disease

At The Health Lodge, we understand that the diagnosis and treatment of Lyme disease is complex. Therefore, we suggest a comprehensive diagnostic work-up to gather information relating to your health, including:

  • Screening for Borrelia
  • Screening for co-infections
  • Testing for nutrient deficiencies. Practitioners have found vitamin B12 and magnesium deficiency are common in patients with Lyme disease
  • We may test levels of stress and thyroid hormones. Thyroid and adrenal function is often impaired in Lyme disease
  • Screening for markers of inflammation, as chronic inflammation is an issue in Lyme disease
  • Assessing the health of your detoxification organs. Lyme disease and its co-infections can release toxins that attack the body, especially the nervous system. It is very important that the liver, kidneys, and digestive system are working well to get rid of these toxins. Unfortunately, in many patients with Lyme disease, these detoxification organs are under-functioning.
  • Heavy metal screening. Heavy metals can be incorporated into the bacterial biofilm, and affect the body’s ability to detoxify.

 

Treatment considerations for Lyme disease

Treatment of Lyme disease can be a long and difficult journey. Many people with Lyme disease do not get the treatment they need due to misdiagnosis.  Lyme disease is incredibly complex, and best treated by a team of health practitioners. At The Health Lodge, our treatment plan for patients with Lyme disease may include:

  • Supporting detoxification
  • Breaking down the biofilm
  • Treating Borrelia and co-infections
  • Decreasing inflammation
  • Supporting affected organs and systems
  • Heavy metal chelation
  • Correcting nutrient imbalances
  • Psychological support

 

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Lyme disease. The multidisciplinary team may include general practitioners, psychologists, dietitians or nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support the patient’s physical, mental, and emotional well being.

For enquiries call The Health Lodge on 02 6685 6445

 

What is ulcerative colitis? An integrated treatment approach

Inflammatory bowel disease (IBD) is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss ulcerative colitis, and you can find out more about Crohn’s disease in last week’s blog.

What is ulcerative colitis?

Ulcerative colitis is a chronic autoimmune disease characterized by inflammation of the large bowel (colon and rectum). Unlike Crohn’s disease, it only affects the inner layer of the bowel wall.

Cause of ulcerative colitis

Like many of the conditions we see at The Health Lodge, the cause of ulcerative colitis remains unknown. Ulcerative colitis is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an abnormal immune response of the bowel mucosa to gut flora in genetically susceptible individuals.

While the exact cause of ulcerative colitis it not yet understood, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of ulcerative colitis in susceptible individuals.

Symptoms of ulcerative colitis

The most common symptoms of ulcerative colitis include abdominal cramping and pain, diarrhoea (which is often bloody), and rectal bleeding. Other common symptoms include loss of appetite, fatigue, and anaemia due to blood loss. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, liver disorders, and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms).

 Treatment for ulcerative colitis

Ulcerative colitis can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of ulcerative colitis is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Acupuncture: Several studies have found that acupuncture may be of benefit to people with ulcerative colitis.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms of ulcerative colitis. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques. Psychotherapy may also help you understand manage the emotional impact of your condition.

 

Naturopathic approach to ulcerative colitis

This section will discuss some of the naturopathic approaches to management of ulcerative colitis. We advise you to consult your health carers before considering commencing any of these therapies.

Diet

There is no single diet for ulcerative colitis. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with ulcerative colitis include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Identifying and avoiding problem foods- Certain foods may increase cramping and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with ulcerative colitis are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

Correcting nutritional deficiencies

People suffering from ulcerative colitis are at risk of a number of nutrient deficiencies as a result of chronic diarrhoea, blood loss, the use of certain medications, and chronic inflammation. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them.

Identifying food allergies

While there is much contention as whether food allergies play a role in ulcerative colitis, some researchers suggest that food allergies may trigger ulcerative colitis and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of ulcerative colitis. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.

What is Crohn's Disease - An integrated treatment approach

In the next two blogs we will be discussing inflammatory bowel disease (IBD). IBD is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss Crohn’s disease, and you can find out more about ulcerative colitis in next week’s blog.

What is Crohn’s disease?

Crohn’s disease is a chronic (on going) condition characterised by inflammation of all the layers of the bowel wall.  While the most common parts of the digestive tract that are affected are the large intestine (colon) and the last section of small intestine (ileum), Crohn’s disease may affect any part of the digestive tract, from the mouth to the anus.  

Causes of Crohn’s disease

Like many of the conditions we see at The Health Lodge, the cause of Crohn’s disease remains unknown. Crohn’s disease is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an immune deficiency state, where the immune system is unable to control bacterial growth in the bowel, leading to chronic infection and inflammation.

While the cause of Crohn’s disease remains a contentious issue, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of Crohn’s disease in susceptible individuals. 

Symptoms of Crohn’s disease

The main symptoms of Crohn’s disease are abdominal cramps and pain; frequent, watery diarrhoea; and weight loss. Other symptoms include fatigue, fever, and loss of appetite. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, jaundice (yellowing of skin), and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms). 

Crohn’s disease treatment

Crohn’s disease can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of Crohn’s disease is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques.
  • Acupuncture: In a study of 51 patients with Crohn’s disease, acupuncture was found to improve disease activity markers, and to improve general wellbeing.

Naturopathic approach to management of Crohn’s disease

This section will discuss some of the naturopathic considerations in managing Crohn’s disease. We advise you to consult your health carer provider before considering commencing any of these therapies.

 

Diet

There is no single diet for Crohn’s disease. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with Crohn’s disease include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Low fat diet – Many people with Crohn’s disease experience diarrhoea that contains undigested fats. These people may benefit from a low fat diet; however care should be taken to prevent weight loss and nutrient deficiencies.
  • Identifying and avoiding problem foods- Certain foods may increase cramping, bloating, and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Eating small frequent meals- Small meals are easier to digest and so you may feel better eating five or six small meals per day.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with Crohn’s disease are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

A word on smoking: If you have Crohn’s disease, smoking can lead to a worsening of your condition. Smoking increases your likelihood of having flare-ups, needing medication and requiring repeat surgeries. Quitting smoking can improve the health of your digestive tract, as well as your general wellbeing.

Correcting nutritional deficiencies

People suffering from Crohn’s disease are at risk of a number of nutrient deficiencies. If the last part of the small intestine is inflamed, you will have difficulties absorbing B12 from your diet and B12 injections may be needed. If the entire small intestine is inflamed there will be difficulties absorbing all nutrients. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them. 

Identifying food allergies

While there is much contention as whether food allergies play a role in Crohn’s disease, some researchers suggest that food allergies may trigger Crohn’s disease and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Crohn’s disease. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.