The Gut-Brain Connection
The Microbiome and Laxative Use
Although most doctors, even most GI doctors, would admit to not understanding the microbiome and enteric nervous system, they seem obvious places to look for more answers. We have asked the FDA to include the effects of PEG 3350 laxatives on the microbiome and on nutrition, to no avail. In fact, CHOP has its own Microbiome Center, which could have collaborated on the study granted to the GI Department and accelerated research. In a phone conversation with Dr. Michael Gershon, MD “father of neurogastroenterology” and author of The Second Brain, he agreed with us that researching the gut-brain connection makes sense.
Laxatives Alter the Microbiome - "However, in an independent study of mice exposed to polyethylene glycol (PEG) showed a similar increase in Bacteroides. In this study, the induction of mild osmotic diarrhoea by administration of PEG induced long-term changes in the gut microbiome, transient disruption of the mucus barrier and subsequent innate and adaptive immune responses.40 After PEG administration, the S24-7 Family (within the order Bacteroidales) disappeared and was replaced entirely by outgrowth of the family Bacteroidaceae. This effect was permanent unless the S24-7 Family was replaced. Other taxa, like Verrucomicrobia and Gammaproteobacteria, showed transient changes, but eventually returned to their initial levels. Scarce human data in patients taking bowel preparations have also shown short-term transient changes in microbiome diversity metrics, but detailed studies are lacking.41 However, given the findings in mice, it is likely that the use of laxatives has both short-term and long-term effects on gut microbiome composition that are independent of stool consistency and bacterial quantities per sample."
www.ncbi.nlm.nih.gov/pmc/articles/PMC7398478/
A study in the Annals of Gastroenterology states, “The gut-brain axis (GBA) consists of bi-directional communication between the central and enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions. Recent advances in research have described the importance of gut microbiota in influencing these interactions.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/
In The Vagus Nerve and the Interface of the Microbiota-Gut-Brain Axis, the authors describe the intricate workings of the gut and nervous system that could be studied for changes caused by chronic laxative use – not only the balance of intestinal bacteria, but digestive fluids, enzymes, hormones, short and long chain fatty acids, and a multitude of other factors. The medical community acknowledges the dangers of laxative abuse to nutrition, but not of chronic laxative use, especially in the high adult doses prescribed to children.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808284/
A World Journal of Gastroenterology article states, “Indeed, different studies have reported that gut microbiota is able to shape brain physiology and thus behavior through the gut-microbiota-brain axis and have suggested gut microbiota as a key trigger factor in the development of many neuropsychiatric conditions…The critical gut microbiota development period occurs parallel to growth, maturation and sprouting of neurons in the young brain. In fact, childhood and adolescence represent the most dynamic and vulnerable periods for both gut microbiota composition and neuronal development.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558112/
Lisa Christian, PhD and Michael Bailey, PhD of Ohio State University conducted a study associating early childhood temperament and diversity of the gut microbiome. Dr. Bailey agreed to study our theory about PEG 3350 and the microbiome in mice (results due this year). https://wexnermedical.osu.edu/blog/research-indicates-link-between-child-temperament-gut-microbiome
In Laxative Causes Long-Term Changes to Mouse Microbiome, the authors say that PEG 3350 drugs like Miralax and others cause and ‘osmotic shock’ to the microbiome, affecting the balance of microbes and immunity. Some essential microbes became extinct during treatment.
https://www.the-scientist.com/news-opinion/laxative-causes-long-term-changes-to-mouse-microbiome-64311
Karen Feibus, MD, in her clinical review of Miralax for the FDA states, “PEG inhibited most of the metabolic activities of the fecal flora, and this was evidenced by decreases in total short-chain fatty acids, butyrate, acetate, and fecal bacterial mass. The authors concluded that PEG inhibits the colonic fermentation process usually considered beneficial to the host.”
https://www.dropbox.com/s/0vauhmdiu7eh5yk/Feibus.pdf?dl=0&fbclid=IwAR19mB9padx_7RGOTMe37DvToyTmGyBgYHaEGR_iaISXG5lJYVP5axRrDT8
In Common meds alter microbiome, increase antibiotic resistance risk, drugs with the biggest impact on the microbiome include laxatives ... https://www.upi.com/Health_News/2019/10/23/Common-meds-alter-microbiome-increase-antibiotic-resistance-risk/7321571837220/
In this study, four sucessive cleanouts in mice reduced microbiota by 90% ...
www.nature.com/articles/s41598-018-25300-3.pdf
Gut dysbiosis and mental illness ...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879184/?fbclid=IwAR2wJeo_A0QTdU_hJHrTsu-Tpaf1MU-IFqnIB9P1IYUFjHr6ft6jxm6AJLk