Majid Ali, M.D.

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Editor, The Journal of Integrative Medicine
Formerly, Associate Professor of Pathology (adj.), College of Physicians
and Surgeons of Columbia University, NY
Formerly, President of Staff and Chief Pathologist, Holy Name Hospital, Teaneck, NJ
Fellow, Royal College of Surgeons of England - Diplomate,
American Board of Anatomic and Clinical Pathology
Diplomate, American Boards of Environmental Medicine
Past President Capital University of Integrative Medicine

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Adapted from Majid Ali, M.D.'s book, The Canary and Chronic Fatigue

CLINICAL MANAGEMENT OF ALTERED BOWEL AND GASTRIC ECOLOGIES
The prevailing classification of various types of inflammatory disorders of the bowel is essential for the management of acute, life-threatening pathologic entities with drug regimens and/or surgical procedures. However, I do not address those issues in this volume. Several excellent texts exist to discuss the diagnosis and clinical management of such disorders. Here, my focus is on long-term, nondrug therapies that are designed and implemented to restore the normal bowel ecology and reverse the various disease processes that eventually lead to such bowel diseases as irritable bowel syndrome, spastic colon, inflammatory bowel disease and others. The optimal clinical management of altered states of bowel ecology, in my view, requires that the following issues be effectively addressed.

    1.    Bowel transit time
    2.    Bowel perfusion (blood supply)
    3.    Efficiency of digestive enzymes
    4.    Efficiency of absorptive mechanisms
    5.    Preservation and enhancement of normal bowel flora (LAPs)
    6.    Slow and sustained exclusion of pathologic microbes (TAPs)
   
    Acute, life-threatening bowel disorders, I wrote earlier, require precise diagnosis and prompt use of drug therapies. This is not the focus of this monograph. Rather, it is my purpose to outline nondrug therapies that I have found to be effective for addressing the above elements and for restoring the bowel and gastric ecosystems to their normal states.

BOWEL TRANSIT TIME
One of my criteria of health, I wrote in The Butterfly and Life Span Nutrition, is two to three effortless, odorless bowel movements each day.
   
This is one area in which I am very rigid in my clinical practice. I consider all treatment plans for diseases of the bowel utterly futile unless the problem of small, shrunken, infrequent stools is first resolved. The bowel transit time in health should range from 8 to 14 hours. This means healthy people should have two or three loose bowel movements a day. Indeed, in my own clinical experience, I find this approach equally important in the management of all chronic immune disorders. More often than not I see people who relate constipation to hard, dried-out stools. It does not seem important to them if they miss a bowel movement for a day or even for two or three days. It is the bowel transit time that is of central importance to us when we think in terms of the bowel ecosystem. The problem of hard, shrunken stools is but one aspect of this larger issue. I have had rather extensive experience with the use of nutrients and herbs for normalizing the bowel transit time. Vitamin C, nutrient protocols containing magnesium, bifidus and Acidophilus microbes, and several herbs (described later in my bowel ecology protocols) are the best remedies for this purpose. Synthetic chemicals can and must be avoided.
   
Colonic therapy may be necessary in a very small number of patients with long- standing constipation and impaired colonic motility. Long-term use of colonic therapy for normalization of bowel transit time is not desirable. Some professionals add an oxidative component to their colonic therapies — by bubbling oxygen through their colonic enema fluid. Notwithstanding some temporary benefits such therapy might offer, I do not approve of it because of an enormous potential for oxidative damage to LAPs in the bowel ecosystem.