Tuesday, May 14, 2013

Go to Health: Protect Your GI Tract!

There has been a lot of ‘stomach flu’ in our community this year – actually it is not flu, and is not caused by the influenza virus, which affects the respiratory system. We can call it gastrointestinal disease (the GIs) indicating that it affects the stomach and intestines. The most common cause of the GIs is the norovirus – a group of viruses that cause inflammation of the stomach and large intestine, leading to nausea, vomiting, diarrhea, stomach cramps, low grade fever, headache, muscle aches and fatigue. There is no specific treatment for this disease, but it is vital not to become dehydrated; if you are affected, drink water, diluted fruit juice, and clear soup with some salt or miso. You should recover in 3-4 days, but some cases have lasted longer. Babies and young children can get dehydrated fast – so contact your doctor immediately if your child has serious vomiting and diarrhea. People who are frail or have weakened immune systems should also see their doctor promptly. Prevention of norovirus infection includes avoiding people with the GIs – this virus is highly contagious from handshakes, air droplets, surfaces and food. Wash raw fruits and vegetables carefully. Although the virus is not always destroyed by heat, you should still cook food carefully and completely, and definitely stay away from raw oysters and ceviche if you are determined to avoid getting sick.

Bacterial contamination of food is another serious source of GIs, with resistance to antibiotics a growing problem. Three quarters of antibiotics used in the U.S. are given to animals, not people. They are given to sick animals, and to prevent healthy animals from becoming sick. Antibiotics are also given routinely, to stimulate growth, since animals given low doses of antibiotics grow more quickly on the same amount of food. However, bacteria in the intestines of these animals become resistant to antibiotics, and are excreted in waste. Entering water and soil, they are found on fish, fruits and vegetables. They colonize the GI tracts and skin of farm workers and food processors. They are found in animal meat. They spread to the human population, who may develop antibiotic-resistant infections.

The FDA, the CDC (Centers for Disease Control), and state public-health labs monitor chicken, ground beef and turkey, and pork chops at retail stores nationwide. The percentage of chicken contaminated with salmonella rose to 12% in 2011. More than a quarter of infected samples were resistant to at least five samples of antibiotics.

Here is what you can do: have thoroughly cooked meat and fish when eating out. Forget about medium rare hamburgers unless you are certain the meat is organic. Wash raw vegetables carefully before eating, and know where they were grown, to avoid contamination from nearby factory farming of animals. Avoid fast food restaurants with the exception of Chipotle Mexican Grill, which says it never sells meat from animals treated with antibiotics. Whole Foods makes the same pledge. Niman Ranch, Marin Sun Farms, Applegate organics, Rocky and Rosie chicken and some other companies are also antibiotic free. Organic poultry and meat is less likely to harbor resistant bacteria as organic standards ban meat and fish given antibiotics.

Elderly people in nursing homes are especially vulnerable to illness from antibiotic resistant bacteria. They can benefit – and people of all ages can benefit – from a daily dose of probiotic bacteria. These are healthy bacteria that will colonize your intestines with good organisms which help to fight off the resistant bacteria. Unsweetened yogurt with live cultures can help, but even more beneficial bacteria are found in probiotic capsules, which should be kept refrigerated. We have 3 or more pounds of bacteria in our colons, helping us by digesting fiber and creating important vitamins such as vitamin K and B12. They thrive on the residues of vegetables and fruits, with lots of fiber. These bacteria, and those on our skin, mouth, nose and ears, are called the microbiome. Take care of your microbiome, people!

Sadja Greenwood, MD , MPH

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