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Medical Scribblings - 19 September 2007

I’m something of a cynic and rather doubted the TV ads for those drinks with bacteria in them. I thought that the clever advertising folk were trying to find a new way of selling us milk products. Well I was wrong, at least as far as how long diarrhoea lasts in children. According to a paper in the BMJ these bacteria seem to reduce the length of your gastric upset (only some bacteria helped – www.bmj.com). Next time I go to Egypt I will have to try the stuff. The last time I was struck down there my,so called, friends left me with a pot of tea to replace my fluids whilst they went off for a nice meal with French wine. They claimed that the wine was the way to stop them picking up Tut’s revenge. I suppose they may have been right as low concentrations of alcohol do reduce the number of bacteria in polluted water. No-one in the middle ages drank water, it was too dangerous.

It got me thinking as to whether anything else was good for the “gut rot” as we have recommended just fluid replacement with sugar and a touch of salt. Certainly the results from treating children in Africa showed this to be a remarkably effective and cheap answer to diseases that kill 10s of thousands every year on that continent. The French of course swear by their red wine and those smelly cheeses. It would be interesting to do a trial on the different cheeses to see if they were right after all.

We are of course totally dependant on bacteria for a healthy life and if they ever get men to mars they will have to look into the problem of what bacteria to feed them. As you are being born you pick up bacteria from your mother which will stay with you for the rest of your days and as the baby explores the world it starts to collect more and more. We had no idea what types were in our gut until quite recently as some are nearly impossible to culture. New techniques in genetic engineering have identified thousands if not millions of types. What do they all do?

Well we don’t really know. A few such as Helicobacter that live in the stomach seem to cause ulcers in some people. If we kill off this bug with antibiotics then other problems can start so it’s a complicated business. Others seem to change the ratio between types in the large bowel when people suffer from certain types of illness. This is the case with Crohn’s disease but whether it is cause or effect I have no idea. Then loads of people tell me that they have allergies to certain foods and get ill if they take a tiny amount. What can be causing this? If people years ago could not eat bread then they just died of hunger so it seems unlikely that we inherit genes that are making us more allergic to things. It must be somehow that the way we live now is affecting our digestive systems. Maybe we are upsetting the balance in our gut bacteria?

John Schofield