As often happens in our Wheat Belly conversations, we end up talking about bowel health. After all, our unwitting bowels are the primary means through which we (used to) ingest this thing that annoys, erodes, irritates, and generally wreaks havoc on our health. The gastrointestinal tract, probably more than any other organ system, is the unhappy recipient of most of wheat’s destructive properties.
The composition of your bowel flora, the little bacterial critters populating your gastrointestinal tract and outnumbering the number of cells in the rest of your body (yes: you are mostly a bacterial organism, judging by numbers! over 2 pounds in total), are increasingly appearing to be major players in overall health. Witness, for instance, this talk of “fecal transplants” in which the bowel flora/stool of a slender animal is transplanted into the intestinal tract of an overweight animal–and the overweight animal loses weight. Fecal bacteriotherapy may, in fact, be entering mainstream treatment for Clostridium dificile infection.
The 1) number, 2) species, and 3) locations (e.g., duodenum, jejenum, ileum, as well as colon and rectum) of bowel flora can vary from person to person. Obesity, for instance, is associated with greater numbers of Firmicutes and Staphylococcus aureus and reductions in Bacteroidetes and Bifidobacterium (Ley 2006).
Fact: Wheat-eating humans have different species and numbers of bowel flora compared to non-wheat consuming humans, judging from the celiac disease population who eliminate wheat/gluten and experience shifts in bacterial populations (though also modified by the disease itself).
Before wheat/gluten elimination, there are greater numbers of Bacteroides, Clostridium and Staphylococcus species and reduced numbers of Bifidobacteria. Wheat/gluten elimination results in reductions of those species and increases in Bifidobacteria and Lactobacillus species.
The challenge comes when a wheat-eating human decides to stop consuming this gastrointestinal toxin called wheat: Bowel flora has to make the shift to a healthier profile of species, numbers, and locations. Ideally, remove the wheat and normal bowel flora species repopulate the gut, and normal bowel function proceeds with good digestion, normal bowel regularity, and normal stool character. But sometimes bowel flora fail to promptly repopulate with the right species and there is a period of bloating, gas, diarrhea or constipation, and poor digestion.
This is when probiotics can come to the rescue. Probiotics are nothing more than a collection of healthy bacteria designed to repopulate the gastrointestinal tract with “good” bacteria and crowd out the undesirables. While understanding of bowel flora is still in its infancy, repopulating with Bifidobacteria and Lactobacillus seems to provide relief from many of these wheat-free “transitional” struggles. Most people do best with higher counts of bacteria, e.g., 50 billion “colony-forming units,” or CFUs, the usual method of quantifying bacteria.
It is not entirely clear just how much time is required to repopulate your bowel flora, a time period also influenced by how well other aspects of gastrointestinal health recover–or fail to–with wheat removal (e.g., pancreatic function, cholecystikinin release). Four weeks is too short to full repopulate and, provided other aspects of bowel health have recovered, we should not require them chronically. I have been advising 8 or so weeks and that seems to work well for most people.
Perhaps a high-potency probiotic should be something we all consider to smooth the shift to a life of wheatlessness?