Dysbiosis is promoted by the consumption of antibiotics, which destroy 'friendly' (useful) bacteria such as lactobacilli and bifidobacteria much more readily than undesirable putrefactive varieties such as E coli and Clostridium. A reduced ability to produce gastric acid may also lead to an overgrowth of bacteria in the small intestine. Such an overgrowth may promote nutrient malabsorption, particularly that of vitamin B12.

One particularly common form of dysbiosis is known as candidiasis, where the intestinal tract becomes colonized by the yeast Candida Albicans.

Natural medicine practitioners treat dysbiosis and conditions promoted by autointoxication, by using herbal antimicrobials, gut healing products, and Probiotics together with an appropriate dietary programme.

    A healthy person lives in harmony with his or her intestinal flora. The person provides a home and food to over 400 species of bacteria.¹⁷ The bacteria, which in a healthy person will be predominantly "friendly" types, do a myriad of health-promoting things for the person, including detoxification, the production of vitamins, and protecting us from unfriendly organisms. This state is called “symbiosis." 

    Sometimes this state of happy balance does not exist because of the presence of frankly pathogenic organisms, the overgrowth of unfriendly organisms that are often not considered pathogenic, or the absence of friendly bacteria. Then, dys-symbiosis, or dysbiosis exists. Dysbiosis can be caused by protozoan parasites (Entamoeba histolytica, Entamoeba coli, other Entamoeba, Dientamoeba fragilis, Endolimax nana, Giardia lamblia, Blastocystis hominis, Chilomastix mesnili, and others); yeast (Candida albicans, other Candida species, Torulopsis glabrata, and others); or bacteria (Salmonella, Shigella, Campylobacter jejuni, Yersinia enterocolitica, Klebsiella pneumoniae, Citrobacter freundii, Citrobacter diversus, Proteus mirabilis, Pseudomonas aeruginosa, some strains of Escherichia coli, Staphylococcus aureus, some strains of Bacteriodes, Clostridium difficile, and others). Some of these organisms are not considered "pathogenic" by conventional medicine. However, weak pathogens, or a predominance of "unfriendly" organisms can cause severe illness in a chronically ill, weakened, or malnourished patient.¹⁸ The eradication of these organisms can make a dramatic difference in the patient's health. 

    A very common cause of bacterial or fungal dysbiosis is often the repeated or long term use of antibiotics. Antibiotics kill both the bacteria you want them to kill and the "friendly" bacteria in the intestine and the vagina. This leaves these areas open to be colonized by yeast, unfriendly bacteria, and parasites. 

    Parasitic infestations are on the increase because of changes in our lifestyles that have occurred over the last few decades. International travel is now commonplace. If you are not a traveler, the world and its parasites will come to you, brought by imported produce and immigrants from countries where sanitation is sub-standard. Eating out in restaurants frequently and the close contact of day care centers contribute to the spread of parasites. 

    Maldigestion can also promote dysbiosis. Dr. Martin Lee says, “Colonic flora is a reflection of what it is fed.”¹⁹ If food is completely and rapidly digested and absorbed in the small intestine, it is not available to nourish unfriendly bacteria or yeast in either the small or large intestine. Almost all that is left to reach the large intestine is fiber, which is a favorite food for friendly bacteria such as Lactobacillus and Bifidobacterium and promotes their growth. 

    Diet can also contribute to dysbiosis. A diet high in flesh protein and low in plant foods promotes the growth of Bacteroides species, but a lacto-vegetarian diet, based on milk products and plant foods, promotes the growth of Lactobacillus and Bifidobacterium.²⁰ Elaine Gottshalls's book Breaking the Vicious Cycle prescribes the “specific carbohydrate diet" for patients with inflammatory bowel disease.²¹ This diet eliminates all grains, sugar, lactose, other disaccharides, and some starches that such patients may be unable to digest and absorb. This leads to a shift in bowel flora towards normal and improvement in symptoms. 

    The ideal diet for patients with candidiasis is the subject of considerable debate. Several years ago, high-protein, low-carbohydrate diets, on which the grams of carbohydrate may have even been counted, were used. Then Dr. William Crook began using diets higher in complex carbohydrates for his patients. Simple carbohydrates, such as fruits, were still restricted initially.²² When Dr. Crook was in Colorado in 1995, 1 heard him speak to a group of health professionals, and the question of the best diet for candidiasis was raised. Dr. Crook said that, in his many years of experience, the only absolute he had determined to be essential for the diet was that sugar had to be avoided. He said that all the Nystatin^TM or Diflucan^TM in the world will not eradicate Candida if a patient continues to eat sugar. Recent German studies suggest that very low carbohydrate diets may be counterproductive because they cause the Candida to become invasive and penetrate deeper into the tissues in search of food.²³ 

    Dysbiosis caused by bacteria or yeast can be diagnosed using a stool test called a comprehensive digestive stool analysis (CDSA). The microbiology part of this test differs from a standard “stool culture,” which usually only reports the presence or absence of aerobic (oxygen-loving) bacteria considered "pathogenic" by conventional medicine, such as Salmonella and Shigella. A CDSA tests for the presence and amount or absence of all aerobic organisms and the friendly facultatively anaerobic organisms Lactobacillus and Bifidobacterium. The organisms a CDSA reports include yeast of all kinds, all normal and abnormal aerobic bacteria, Bacteroides, Lactobacillus, and Bifidobacterium. A CDSA also gives your doctor chemical information that reflects the health of your digestive system. This information includes the presence and amount or absence of undigested protein and plant fibers, fats, fatty acids, occult blood, and other metabolic markers. This information may be suggestive of conditions that are affecting your health in general. Tests for dysbiosis, such as a CDSA or a parasitology test, as discussed below, may be the most important tests you do and should not be omitted for any patient with severe food allergies or digestive problems. Great Smokies Diagnostic Laboratory can refer you to doctors in your area who use the CDSA to evaluate their patients. (Click here to go to the Great Smokies website). 

    In-depth parasitology testing should also be done to determine if parasites are causing dysbiosis. Such in-depth testing can be done best by a specialized parasitology lab such as the Institute for Parasitic Diseases. (To find out about having an IPD test, call 602-955-4211). The parasitology testing you should have done differs from the standard “ova and parasites” test done at most hospital laboratories in several ways. This testing will report organisms that would not be reported on a standard test because they are not considered “pathogenic” by many in conventional medicine, such as Blastocystis homonis. Also, since specialized laboratories have more experience in looking for parasites, they are more likely to find any that are there. However, even when the test is done by an experienced laboratory, Dr. Leo Galland says that parasitology testing should be “taken with a grain of salt.”²⁴ Stool samples, by their very nature, contain a lot of debris mixed with a very few parasites, eggs, or cysts. It not always easy to distinguish a degrading white blood cell or other material from something significant. For this reason the test may be reported as negative when the patient DOES have parasites, even if it is done by a competent technician at an excellent laboratory. The more samples submitted, the more likely a parasite will be picked up. The use of purged stool specimens or rectal swabs also increases the chance of recovering parasites because they are dislodged from the intestinal wall. A patient may have several negative tests and still have parasites. 

    Intestinal dysbiosis can be treated with a variety of prescription and botanical medicines to rid your body of unfriendly organisms. Your CDSA results include sensitivity testing which indicates which medicines are effective against your particular unfriendly bacteria and yeast. Treatment of dysbiosis caused by bacteria and/or yeast will also usually include supplementation with friendly probiotic organisms such as Lactobacillus and Bifidobacterium. Dr. Leo Galland does not recommend taking probiotics while under treatment for parasitic infestations because bacteria are “food” for protozoal parasites: save your probiotics to take after the course of anti-parasitic treatment is completed.²⁵ Your doctor may also direct you to take nutrients that help your intestine heal, such as L-glutamine (the major source of nourishment for the cells lining the small intestine), N-acetyl-glucosamine (which stimulates the production of intestinal secretary IgA, a protective factor), and butyric acid (which promotes healing in the large intestine), or other nutrients. 

    A few supplements you may be taking can be counterproductive to the treatment of dysbiosis and are mentioned here so you can avoid them. Iron supplements feed unfriendly bacteria and protozoan parasites.²⁶ Fructooligosaccharides (FOS) also feed some unfriendly bacteria, especially Klebsiella pneumoniae, hemolytic E. coli, Bacteroides species, and Staphylococcus aureus.²⁷ As mentioned above, protozoal parasites “eat" bacteria, so your doctor may advise you to avoid probiotics during the course of anti-parasitic treatment. Cysteine, glycine, and glutathione, while important antioxidants, can stimulate the growth of yeast in some patients with candidiasis.²⁸ If you are taking botanical remedies for dysbiosis, your doctor may tell you to temporarily avoid all antioxidants because botanical medicines kill parasites and bacteria by oxidizing them, and thus, antioxidants reduce the effectiveness of these remedies.²⁹ 

Click here for more of “Getting to the Root of the Problem.” 
 

FOOTNOTES 

17. Chaitow, Leon, et al, Probiotics, p. 11. 

18. Lee, Martin J., Ph.D. "Parasites, Yeast, and Bacteria in Health and Disease," Journal of Advancement in Medicine, Volume 8, Number 2, Summer 1995, pp. 121 and l27-128. 

19. Lee, Martin J., Ph.D. "Gastrointestinal Function," Solving the Digestive Puzzle Symposium, May 1995. 

20. Galland, Leo, M.D. "Dysbiotic Relationships in the Bowel," American College of Advancement in Medicine Conference, Spring 1992. 

21. Gottschall, Elaine, B.S., M.Sc., Breaking the Vicious Cycle: Intestinal Health Through Diet, The Kirkton Press, Kirkton, Ontario, Canada, 1994, pp. 53-59. 

22. Crook, William G., M.D. and Marjorie H. Jones, R.N., The Yeast Connection Cookbook, Professional Books, Jackson, TN, 1989, pp. 39-45. 

23. Naugle, Elizabeth, "Dietary Update," Candida and Dysbiosis Information Foundation, P.O. Drawer JF, College Station, TX 77841, p. 1. 

24. Galland, Leo, M.D. "Gut Parasites," Enzyme Potentiated Desensitization Conference, October 1995 

25. Ibid. 

26. Galland, Leo, M.D. "Gut Parasites and Bacteria," Enzyme Potentiated Desensitization Conference, October 1995. 

27. Barrager, Eleanor, R.D. "Clinical Therapeutics and Case Studies," Solving the Digestive Puzzle Symposium, May 199S; Mitsuoka, Tomotari, "Intestinal Flora and Aging," Nutrition Reviews, Volume 50, Number 12, December 1992, p. 442-443; and Mitsuoka, Tomotari, Hidemasa Hidaka, and Toshaki Eida, Effect of Fructo-oligosaccharides on Intestinal Microflora," Die Nahrung 31 (1987), 5-6, p. 427-436. 

28. Rogers, Sherry, M.D. Tired or Toxic, Prestige Publishing, Box 3161, Syracuse, NY 13220, 1990, p. 252, also personal communication from Dr. Sidney Baker to nutritionist Katherine Gibbons. 

29. Galland, Leo, M.D. "Dysbiotic Relationships in the Bowel, American College of Advancement in medicine Conference, Spring 1992.