The microorganisms inhabiting the intestinal tract in people with autoimmune diseases are different when compared to people without autoimmune diseases. The altered bowel flora of autoimmunity worsen the inflammation of autoimmunity, allowing symptoms, such as the joint and muscle pain of polymyalgia rheumatica, bloating and diarrhea of Crohn’s disease, or the joint pain of rheumatoid arthritis, to be more dramatic than they should be (Chassaing 2012). Changes in bowel flora species, along with increased intestinal “leak” characteristic of autoimmune conditions, allow greater quantities of the bacterial byproduct, lipopolysaccharide, or LPS, a component of the cell walls of unhealthy bacteria, such as E. coli, to enter the bloodstream. LPS is a potent stimulant of inflammation in various organs (Frazier 2011).
Celiac disease is the prototypical autoimmune disease of the intestinal tract. It is associated with major disruptions of intestinal bacterial populations, with decreased healthy populations of Bifidobacteria that permits expansion of unhealthy species such as E. coli and Bacteroides (de Palma 2010). People with Crohn’s disease and ulcerative colitis experience similar dramatic changes in bowel flora with increased Enterobacteriaceae, such as E. coli, and reduced Firmicutes (Walker 2011). Bowel flora should be regarded as abnormal if any autoimmune condition is present and steps should be taken to reverse this process.
The full effort to reduce unhealthy bacterial populations and nourish desirable species should include at least several months of high-potency probiotic supplementation to begin the process of repopulation. We have had excellent results with doses of 30 to 50 billion CFUs per day using brands containing a wide spectrum of Lactobacilus and Bifidobacteria species, such as Renew Life, Garden of Life, and VSL3 brands. We then nourish and sustain healthy bacterial populations with lifelong intake of prebiotic fibers or resistant starches that enhance production of butyrate that helps heal the intestinal lining and reduce intestinal leak. The addition of prebiotic fibers requires some daily effort that many people are reluctant to make, but this is a big mistake, as nourishing healthy bowel flora can be a critical component of an overall effort to reverse an autoimmune condition.
Success requires patience
Many conditions respond to grain elimination within just days, but the pain, swelling, and other symptoms of autoimmunity typically require weeks, months, even years to improve. This is likely due to the nature of immune system activation: once activated, immune responses continue to be active and generate lymphocyte activation, inflammatory cells, and antibody production, even after the inciting cause—grains or other foods—have been removed. It means that you should not declare your efforts a failure if, say, you are grainfree, take the other steps discussed such as correcting vitamin D and omega-3 fatty acid deficiency, and still have joint pain and swelling after two weeks. More so than any other conditions (except neurological conditions that also require a longer time to respond), autoimmune conditions require an extended time for a response to develop. Patience is key.