Cancer and Intestinal Health

DAMAGE TO INTESTINAL LINING MAY UNDERLIE CHRONIC SIDE-EFFECTS OF CANCER TREATMENT

Sometimes, the problem with a powerful method of treatment is that it’s too powerful. Radiation therapy, for example, is often used to treat cancerous tumors. Unfortunately, it destroys much more than just cancer cells.

Electromagnetic rays from radiation used to treat cancers of the female organs can also severely damage the bowel. Called “actinic damage,” this injury often triggers temporary nausea, vomiting, and abdominal cramps. In up to 60% of women treated, the gut lining becomes chronically inflamed – making diarrhea and other bowel dysfunction persist.

What is it exactly that goes wrong in a gut exposed to this radiation?

To answer this question, researchers from the Institute of Nutrition and Food Technology at the University of Chile recently performed intestinal permeability (IP) assessment and other analyses on a group of 15 women before and after they underwent radiation therapy for gynecological tumors. These analyses, they hoped, might lead to improved therapeutic interventions for patients who develop chronic actinic damage.

One of the most striking findings was radiation’s ability to trigger “leaks” in the gut lining. The lactulose/mannitol ratio, which compares the rate that two nondigestable sugars permeate through the intestinal mucosal layer, more than doubled in the women after five weeks of pelvic radiation – a classic indication of “leaky gut.”

Biopsy of patients’ intestinal tissue supported these findings. Small finger-like projections in the gut lining called villi – which are pivotal for healthy absorption of nutrients – became significantly distorted by the radiation.

The degree of these “wasting-like” alterations in intestinal function could play an important role, researchers speculated, in determining whether patients exposed to standard pelvic radiation go on to develop acute actinic enteritis.

The small bowel was the most susceptible to radiation damage.

Increased production of free radicals – destructive, unstable molecules – tipped the balance toward increased cell death as opposed to cell regeneration.

Leaky gut is linked to the increased ability of bacteria and toxins to slip past gut barrier defense and gain entry into the systemic circulation, where they may incite chronic inflammation. The condition could also damage distant organs another way – by setting off a chain reaction of over-activated immune cells.

NOTE: Urinary infections were another complication developing in some women after pelvic radiation treatment. These could also be related to leaky gut. “Gut integrity problems that induce translocation of bacteria and yeast could promote such infections,” notes John Furlong, N.D., of the Department of Medical Science.

Two functional gastrointestinal assessments are important for helping to optimize and restore gut function in response to disruptions caused by chemotherapy, radiation therapy, antibiotic treatment, and other powerful interventions.

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Potential enemy or neutral bystander? Controversy has long existed over whether the protozoan Blastocystis hominis is able to act as a disease-causing pathogen. Is it just another harmless resident – one of several trillion – seeking safe haven in the warm, moist environs of the bowel or does it pose a serious health threat if it overpopulates?

One way of finding out is to look for telltale signs of damage to the inner lining of the intestine, the mucosa. A bona-fide parasite infection is likely to trigger ulcers, inflammation, and other structural damage to the mucosa.

Along this line of thinking, researchers recently examined intestinal permeability in a group of young adults with protozoan infections. The controlled study included individuals with three types of infections: Giardia intestinalis, B. hominis, and Entamoeba coli.

Giardia is a well-known parasite; E. coli is a commensal associated with abdominal symptoms when present in large numbers.

Laboratory test results revealed that the individuals with Giardia and B. hominis infections had significantly increased gut permeability (121% higher and 52% higher, respectively) compared to healthy controls. This concrete clinical evidence of mucosal damage supports the rapidly growing view of B. hominis as a potential gut pathogen.

“Many parasitologists now insist that when B. hominis is present in large numbers, even in the absence of other known bacterial, viral or parasitic agents, it should be recognized as a pathogen and should be treated,” the investigators observed.

Intestinal permeability testing is often used to assess the status and prognosis of gut disorders such as inflammatory bowel disease.

Studies have also linked increased gut permeability with rheumatoid arthritis, NSAID treatment, IgA nephropathy, food allergy and intolerance, malaria, and many other conditions that can damage the gut barrier.

The findings of the study suggest that protozoan infections should

also be added to this list.