Inflammatory Bowel Disease

We are live.

Bren, how are you?

Oh, great. Yeah, I've just gone for the buzz cut, you know, I just thought I'd—

I didn't want to say, but yes, it's very military-esque. Yes. I haven't, you may have noticed.

It's easier to slip into the balaclava, they say.

Yeah, yeah, absolutely. Okay, amazing. Brilliant. It's really, really great to be here. And it's really fantastic topic. I love IBD. It's just It's just an ocean of information and physiology and anatomy and biochemistry and bacteriology and psychology and neurology. It really is one of my favorites, I have to say. I'm going to be doing it actually for— I'm going to be doing a talk on IBD and IBS for the wonderful Judy Morgan in October, mid-October at the Orlando. So if you like what you're hearing here tonight, we're going to be laying out a whole lot more of that in, in Orlando. So yeah, uh, jump in on there. Just want to say a big thank you to our Patreon supporters. Couldn't do it without you, literally couldn't do it without you. We would not be half as, uh, prominent as we are. We'd like to be more prominent, so anything you can do to help, just go to patreon.com/rawpetmedics. Look at that, it's taken me 3 years to learn it, but now I can do it without the prompt. And we want to say thank you very much to everybody who follows us on podcast. That is a freebie, as is the YouTube. But I am now learning that on YouTube, if you can smash that like button, that helps. That, that means that all the, all the gadgets will and the search engines will be more attracted to our material. So if you're watching on— and subscribe, of course, subscribe. Yeah, please.

And, uh, you know, if you're out there on any other social media, please share if you like what you see. Um, you know, that's another great way of sharing the word. Okay, so let's spread that around the world. That would be wonderful. Thanks, guys.

Yeah, this is, uh, this is good. Um, and if you're not watching Why not? If you're watching late, that's okay, that's totally okay. Share, share to your worst enemy if it's a shite show, and share it with your best friends if it's a great show, I would suggest.

Yeah, and share it with Conor just so he realizes what he's missing.

Conor, who's that? Who he?

Who he? I think that's what he's hearing a lot of down there, isn't it? This—

I thought this has always been a two-man show, Brent. I forgot, I forgot.

Yeah, uh, what's holiday man?

Bray? Bray? Brainy?

No, it couldn't be.

What's his name? I don't know.

Oh, you're so cruel.

That's so cool. Out of sight, out of mind. I hope he watches this because he'll be going like this to the screen. So there you go, up yours, really. Very up yours. I'm wearing my RPM Live.

Oh, look at you. Still available on T-Mill if you want to find your way over there.

Can people still get hold of that vid? The vid? Because it's quite a punchy vid.

Which one?

That we did. That Fiona did. Did that go out onto YouTube or anything?

Yeah, no, that's still on the Facebook. If you search back to Christmas time.

Mate, I try and stay off Facebook as much as I can.

He says, currently broadcasting to thousands of people.

Currently supporting the Zuckerberg empire. Yes. No, I'm not happy with that, but needs must, needs must.

Empires come and fall.

We can hope. Now then, listen, we're doing IBD and you had a really nice idea to— first of all, let's differentiate between IBD, inflammatory bowel disease, and IBS.

Oh no, a step before that. Let's define, because right tonight we often talk about diarrhea and vomiting, and that sort of comes in, and we're talking really, we want to go beyond the acute phase of vomiting and diarrhea and talk about something that's maybe been going on for 2 weeks or more. You've had fluctuations, it's been up and down, so Tonight's show, realistically, you know, we've done many on acute diarrheas in the past.

Yeah, so go back and look at those. Acute diarrhoea is anything under 2 weeks-ish. Okay, but it's usually about 3, 4 days.

Yeah, so let's define the difference then between IBD, so inflammatory bowel disease as the title says, and IBS. Go on, you're talking about this in October, I'm going to give you some practice. I am.

Okay, so IBD Inflammatory or irritable, depending on who you talk to. Irritable bowel disease. Okay. And the other one is inflammatory bowel— no, irritable bowel syndrome. Important. Yeah, because so IBS is irritable bowel syndrome because we're not quite sure what it is. So let's start with that one. Basically, IBS is where you have every test known to man and they can't find anything wrong with the gut, but the dog or the human still can't form a decent stool. That's essentially it. Okay, so it's— there's something wrong with this dog, human, and we don't know what it is. Okay, and therefore we come to this thing, which is connected massively through the vagus and all sorts of connections to the gut. And what we're thinking is that there may be if this is upset, then your gut is upset. If your gut is upset, you can't— that can affect stool formation. Do you want to do IBD so that we share the work?

Yeah, okay. So, and absolutely, I'd back that with— yes, so the classic with IBS is usually those people that are suffering some form of stress. Yeah, usually exhibit the symptoms, and when their stress gets worse, their symptoms gets worse. And they see the same with dogs. If they're really stressed dogs, they suddenly get this irritable bowel and excessive stools. Now, inflammatory bowel disease is more of a structural thing. So we've got to a stage where there is structural change within the gut. And what I mean by that is that we are seeing infiltrates of inflammatory cells. Maybe we're seeing changes within the structure that signify inflammation is active and going on. Shall I pull up your wonderful diagram, or do you want to leave that for treatment?

I think just flash it up now, just so people— because people can freeze frame and admire my wonderful artistic capabilities in drawing. Listen, I'll tell you, FIFA, my daughter— Ophelia is her official name— she actually draws better than me. And as you can see from that dog, you see the dog at the bottom. She's better at art than me. Okay. And I've been on the planet almost all— just over— no, just—

why has it got bare feet? As in, you know, it's gone plantigrade.

Right. Well, I think you can vaguely see it's a dog. If it's not, maybe, maybe it's a zebra. Maybe it's an albino zebra or something. Anyway, that's kind of what we're looking at, guys. I'm just going to very basically— you can freeze frame and look. And what happened was I did this because I was doing some teaching for Vermex, my friends at Vermex, and I wanted to say where various herbs might be majorly activating or majorly acting. Okay, so if we just go around and look at the purple, we've got the mucous gland, we've got the circulatory system, we've got gut muscle, we've got microbiome, we have got lymphatics. Okay, so 1, 2, 3, 4, 5. So the 5 in there, what I'm talking about when I'm saying about vitality is this is where we are using herbs to improve or maintain that vitality. The red thing, we've got microbiome, lymphatic, mucus, and circulatory dysfunction. Dysfunction is a posh kind of vetty way of saying it doesn't work for some reason.

I'm going to hide that now because I can see where you got bored when you were just going blah blah squiggle blah blah.

I did do blah blah squiggle. Yeah, well, no, I'll tell you, I did this about 6 years ago and it was before I really got my head around the complexity and also the lack of information we have to a certain extent. You know, we know quite a lot. We know a vast amount more, but the more we know, It's a bit like making a clearing in a jungle. The bigger you make the clearing, yeah, the further you can see. But at the same time, the parameter of that clearing increases with every time you cut back the jungle, whatever. So that's what happens. We've got, you know, the clearing of what we know is bigger, but the parameter of what we don't know is getting bigger, which is kind of exciting.

Yeah, yeah, I guess.

So there you go. The gut is basically a glorified pipe, and it's got the internal level, which is just one cell thick. These are the enterocytes. Anything to do with the gut is entero, this, that, and the other. And then you've got layers of blood vessels and muscle so that you've got this motility, peristalsis, effect. And it all miraculously works to maintain a lymphatic effect, to maintain circulation, to maintain motion of the fecal matter, the digesta, as we call it, before it turns into fecal matter. Through there. So it is, it is a miracle. Absolutely. The fact that something can go from here down to there over 24 hours or so is nothing short of a miracle. And we take it for granted until it doesn't work. And that's kind of what we're going to be talking about today. We're not going to be talking about constipation and we're not going to be talking about cancer and we're not going to be talking to lots and lots of things, but we're going to be talking about one of the very common actually issues.

So I think it's more common than people imagine because, totally, you know, for humans, the number of people that are almost— they get used to this being a symptom of their life, um, and they're slightly embarrassed to talk about it, so they don't talk about it. So they then cope with it, and, you know, any dietary transgressions that put them into that phase, they sort of just accept, and they don't dare refuse foods because it may be socially not appropriate to say why they're using those foods. And so yeah, it gets to be a bit embarrassing. And, you know, unlike vets who like to talk about shit all the time—

we like talking about pee the whole time—

yeah, I think the general populace, yeah, don't raise it so much, you know, if there's a bit of an embarrassment of what's going on. And so do you remember yours?

I didn't, Pete. So sorry, talking about IBD. It's gonna absolutely kill us, murder us for that. I'm so stupid. And Brendan is as well. And if Brady was here, he'd be as bad. Yeah, we're just getting excited. So, uh, IBD Pete, sorry.

Oops. Um, and so from a point of view of the next, um, things that we need to talk about is actually that, that miracle of breaking food down and being able to absorb it. Um, I think we need to also talk about that extra structures that are on the inside, just how we get the surface area to be able to absorb those nutrients.

You know, do you want to take us through food going in the mouth?

No.

Yes. Here's a question for everybody, including you, Brent. When in the eating process— no, in the digestion process, if I'm going to be precise, when— if so, if the food is a mile away, when does the digestion process start? Let's, let's say you're out with the spear and you're, you're hunting deer or something like that. When does the digestive process start? I've kind of given it away.

As soon as the spear hits the animal.

And I'd say it starts before that. I would because you've got that expectation, you've got that dopamine thing, oh, maybe we're going to eat, maybe we're going to eat, this is really exciting. So I would say the psychological element of digestion, and that is pretty significant, could start 5, 10, 15, 20 minutes.

I'd say when you've got a spear in hand and you're running after this animal, okay, this is obviously our modern life compared to the rest of the world. When we've got a spear in hand, we're running around the place.

And in the modern world, that process— forgive me for this, everybody, but it might amuse you— that process takes place as you drive to McDonald's. Okay? And McDonald's knows that, and they actually, you know, that's why they put, you know, the posters on the outside, and they make the drive-through thing look so attractive, and you get wafts of smells from a distance, you know, supermarkets absolutely do. I read a book about how supermarkets operate and it's unbelievable. Their remit with you as a supermarket shopper starts about half a mile to a mile from when you actually arrive at the supermarket.

Yeah, so take us through the touch track. So anyway, we've got this process it's so important, you know, when talking IBS, and we're going to avoid that. So, you know, that we've got to try and normalize, you know, the normal digestive process as far as settling the animal into a parasympathetic phase and thinking about salivation, thinking about the normal eating process. So, you know, giving stuff on carcass can be just as good as giving it in the bowl. So, of course, putting all of that to bed for a moment and moving on, look, as that comes in through the mouth, mixed and lubricated in dog's case to get that swallowing, it's not going to be created into boluses as it is with ourselves, true omnivores, and then moving into the cases of herbivores and what they need to do to mix foods with material to aid fermentation, etc. For dogs, it's very much tear off chunks, swallow it, lubricate that swallowing process so that it hits the stomach. It doesn't get stuck somewhere else. Hitting the stomach, we're obviously going to get a really high acid peak, so a very low pH, often 100 to 1000 fold what we would have in the human stomach, just where we're at, trying to hit below pH 1. A lot of people get mixed up here as to why we don't mix high vegetable matter with our raw foods, especially when it comes to things like kibbles. And that can be just that disruption of the acidity that we gain. Okay, so I would put in just that acidity is often really good because it will eliminate a lot of pathogens in the stomach if you can maintain that. And that acidity is driven by the fats and protein levels hitting the stomach, the detectors that will effectively turn on the glands to produce high stomach acid. The acid may only last for 20 minutes, believe it or not. Okay. Doesn't stay there for the full hour. It has to start alkalizing so it gets back to a neutral phase by the time it ejects into the small intestine. So it is just the fact that it can kill stuff really rapidly if it's a very low pH, a high acidity. So that's useful because if that eliminates some of those bugs that can cause chronic inflammation in your— and what I mean by chronic is long-term inflammation in your gut— then that could be one of your preventions against IBD. So that's why I mention it. Coming into the small intestine, the addition of bile to help absorption of fats, the addition of further proteases and lipases. So protein and fat digestive enzymes from the pancreas can be really useful. And that's then potentiated into the rest of the gut, which is not only this first line of defense of cells, but as Nick was saying, we then have on the surface of that a finger, you know, those cells are organized into villi, so they're in fingers, and each of those cells on their surfaces have a further set of fingers which are microvilli. And on each of those microvilli, there is a surface layer of glycocalyx, so little spurs of sugar-type molecules which actually help to divert nutrients into the receptors and absorption through the cell membrane. Grains of that. And on top of that, you then have a mucus layer which further helps to trap and diffuse those nutrients down to that glycocalyx layer.

Can you remember, Brent, the, you know, they talk about your, the surface of your lungs, I think, is equivalent to a tennis court. What is the surface? I think it's more like a football or maybe 20 football pitch. I can't remember the figure off the top of my head, can you?

I can't, but I think you're right, it is massive. But remember, that is also down to gut length. So, you know, when we talk about humans, you know, where we're talking about 12 times— well, 10 to 12 times depending on the sources— your body length in gut length, you know, dogs, we're looking about 2.5 times their body length. So totally different levels of where things— and partly that's down to, you know, what fermentation processes can go on, you know, what pre-digestion they're coping with, i.e., is it coming from another animal source or is it going to come from a fairly hard to digest plant source that hasn't been processed. So that's really why dogs can cope with a much shorter gut length because they just generally don't go for fermentation of product, of plant product. Okay.

And much higher nutrient density. Yeah, there's a whole lot more nutrients in an ounce of, you know, sinuous, grotty elk than there is in a broccoli.

Indeed.

So nothing wrong with broccoli, but nutrient density-wise, you know.

Yeah, and there's some always good properties in some of these plants that we talk about. Almost like herbs. They have some herbal properties. So when we come back to then, where does IBD start? Okay, so what layer is disrupted all the way from that mucous layer all the way through to the underlying muscle layer that you were talking about for peristalsis? At what point do you think IBD can first affect animals?

I think it's, it's, it's often a microbiome change because you get a microbiome. So it's not even you that changes first of all, it's, it's your microbiome. And how do you change your microbiome? Answer: stress, wrong food, toxins, infection, maybe problems with other organs like pancreas or liver, that's going to influence microbiome and what have you. So that's possibly a good place to start. What are the possible causes of IBD? Where would you start with that, Brent?

Yeah, so I generally try and account for almost like an 80/20 rule here. You know, try and do the things which are one, simple to change Okay, and 2 are most likely to give you a benefit. All right, now you, you've got a law of diminishing returns that then as you move on to the more complicated stuff, it's about, well, how likely is that to push the next change? And when I see people come to me with 15 supplements that they're trying to use in one go to sort out a chronic disease you know, some of them are appalled when I have to go through a— well, we're going to strip that back first and then we're going to just come in with, you know, where are the most likely wins for that. So I think, you know, certainly as you've just alluded to, one of the main changes to the microbiome, the start point and what can cause irritation to the gut is through foods. So look at the foods. Of course, there are always going to be little cheat shortcuts that may be certain herbs that will help to change the microbiome, to speed things up in the change. We've talked about a Trantle in the past. Many people will acknowledge things like peppermint and what that can do as a tincture for calming the gut bacteria. Yeah, you add in a bit of heartworm— heartwood, sorry— and a little bit of, you know, the— I think it's chestnut that's in a Transtil, those three.

Those horses, I think, isn't it?

Yeah, it is. Yeah. Is a way to effectively reduce bacterial overgrowth. And I think so many people reach for probiotics first to try and change your microbiome. And there are some studies out there to show that actually if you do that and there's a bacterial excess, then it's really hard for those microbiome to reestablish from what you're putting in. And in addition to that, you've got a situation where you may have almost a situation where if you've got bacterial overgrowth, if you add in a probiotic and prebiotic in those circumstances, those are the occasions where you get that gurgly tummy. That, you know, response which is not what you're expecting, where actually almost gives them bloat, sort of colic episodes when you're just diving in with a probiotic. So have a little think about, one, how you can change the foods to calm things down, and then we can talk about bone broths and things like that. I can— let's talk about favorite foods next, and then look at where you can then reestablish a good bacterial flora. So what are your favorite foods to treat an IBD or change your microbiome first?

Okay, that's brilliant. So my favorite 6, I've got 6, and they're basically relatively easy to get proteins that are off the beaten track. And the list from memory goes goat, fish, pork, venison, duck, rabbit, in no particular order. Okay, take your pick because I can't predict what the dog is going to respond to or not, or the human is going to respond to or not. But if you absolutely know that they've had venison in the past and it's been a disaster, then I'd suggest you take that off the list. Okay. A lot of people will say to me, oh, well, he's had venison in the past, so should we try that? And I would say, well, we're going to be doing other things, going to be using prebiotics, probiotics, and we're going to try and modify the gut. So actually, it may be that we can use the proteins they have been exposed to previously. So that would be my, my, the first things. And definitely look at simplifying and maybe sometimes even going for single proteins is useful because if you're feeding a chicken and fish or a chicken and rabbit mix and your dog has drifted into chicken sensitivity, whereas it says rabbit on the front of the pack, you want to just be a little bit wary of that. However, I think it's really, really worthwhile talking to the vet and just making sure there's no Clostridia, as Bren was saying just now. Clostridia, Giardia, God forbid Salmonella, maybe overgrowth of E. coli and things like that. Yeah, just poo sample to the vet and they can tell you about that because you feel really foolish if 6 months later you've been trying food trials and all sorts of fancy things and it turns out that there's Giardia in the background. Okay.

Yeah.

So I think making sure that there's nothing obvious going on. So I think a blood is a good idea to make sure our liver and pancreatic function is okay. Not that you can tell much about pancreatic function from blood. You can only tell if it's significantly inflamed. Sometimes a scan in order to get those basics right. Talk to your vet just to say, dog's had diarrhea for 2 months or more. 'Can we just rule out common physical issues?' I think is a good place to start.

Yeah, so remember, you know, people get confused about pancreatic function and pancreatic inflammation. Often people will automatically reach for a CPLI, a canine-specific pancreatic lipase immunoreactivity test. So that's CPLI, and what they're looking for— and this is the same for cats, by the way, for those cat lovers out there, okay, I haven't forgotten you. Yeah, there is a cat in the background. There are things that will show up if there's inflammation, absolutely. But when we're talking about pancreatic function, we're talking about TLI, trypsin-like immunoreactivity, and that's when you're starting to look at, are they producing enough pancreatic enzyme? Often that's combined with folate and cobalamin. So that's the, you know, looking at the B vitamins as to where they are produced and where they are absorbed. And that's looking at bacterial overgrowth. It's looking at inflammation in the small intestine, either high up or low down. So let's, you know, remember there are certain tests. Don't just take that a standard general health profile will cover off those specific things when you're looking at chronic inflammatory and dysfunction of the gut. And then on top of that, you've got, you know, there are other tests that we can then start to expand on, you know, the microbiome tests that are out there, you know, trying to find out the right ones for you. But when you come to looking at pathogens and you're looking at poo samples, many people will just think, oh, well, just send that for a culture and sensitivity. And actually what you miss when you send that for a culture and sensitivity, you might capture Salmonella and E. coli and things like that, but you'll miss often the things like Giardia. You'll miss quite often things like Clostridia that don't culture very well, and you do need to ask for a separate PCR for those. So these are really important to understand. Look, a general screen is just that, it's a general screen. If your animal is going on with suffering for weeks because of chronic gut stuff, then this is the time to invest in further tests which will isolate. Now, many people will say that's the point when they've referred the case on to some more experienced clinician, maybe a specialist center, but this is stuff that can be done by your vet. And actually, there's no reason why you can't, you know, start to talk to your vet about doing this in their practice, often far more economically, you know, and speedily, so that you get that information sooner and you can start to act on it. So yeah, do look at that. Slightly nuanced tests you'll need to look into when that's more specific, especially when it's a waxing and waning disease. Clostridia and Giardia are notorious for that, where you'll think you've just about got there and then there'll suddenly be a flush of bacterial overgrowth and again you'll flood back into that. And I know that Conor will love me for saying that he loves to talk about the fecal microbiome transplants, that is his favorite topic of the moment, and why they can be really successful in some of those waxing and waning diseases. So have a little look out for those. So microbiome I think is really important. Foods, choosing your foods. I love your little list there. I would simplify. Too many people look at poultry as the sort of go-to, as a bland food initially. And as Nick's shaking his head, chicken and rice is the classic. No, please.

Don't do chicken and rice, guys. The dog may be fine with chicken and rice, but if you had to choose two proteins that are most likely to cause problems, it's beef and chicken. I usually say wheat, beef, and chicken because the dog may be getting a bone meal for bed. Okay.

And then the other one is gluten. So the gluten is within the grains and the rice.

Gluten, gliadin. Yeah, yeah, yeah. Wheat, beef, and chicken is the easy. I say that probably about 6 times a day. Every single day. Wheat, beef, and chicken. Many dogs are great with poultry, many dogs are great with beef, but if you had to pick two, those are the two. And that has been borne out. I've heard people saying that this is a load of tosh 20 years ago. Actually, it's borne out because I hear people say, oh, he can't take chicken, he can't take beef. Yeah, really, really commonly.

And so I would just say I agree with that, and I would also say that To some degree, that is worsened by what those animals are fed on. So you've got to understand those animals that we've just mentioned. So poultry and beef are all finished, if not mainly fed on grains, which actually also potentiates the problems that you would have within those situations. So look, what do I do? I tend, says a goat farmer, I tend to go for goat as as a great one if you want something that's novel. I tend to say to people, look, just choose the best form of, you know, organically, if not grass-fed raised animals that you can find and see where that gets you to. So there's lots of options, you know, out there. Lamb is often, for those that have got chronic inflammation already, too fatty in the current environment. You know, our lamb is fattened as well. And grain does fatten our animals potentially as well, so you'll get a fattier meat with many of those, believe it or not. So do, do think very carefully about if they're grain finished. If they're grass finished and they're lean, you know, this is where venison can come in, this is where goat comes in. They both are leaner animals. Fish can be great as an option. And remember, you know, a mackerel is as different from a salmon as a goat is from a cow. Okay, so you've just got to remember there are differences in the species of fish that you may be choosing. And again, coming away from overly farmed fish to wild-caught would be a better option in many cases.

And also, if fat is a problem, then you want to go for the less fatty. Yeah, salmon can be a bit fatty, so you might might not want to go for salmon, especially if it's farmed. You might want to go for kind of lean whitefish, the pollocks, the cods of this world. Okay, I'm leaving aside that the ecological issues of overfarming the oceans, because that's a whole other topic, which you should do.

Yeah, if you're stuck, however, you know, Nick has given another great list, and if you're stuck on meats, and they're not really taking much. Things that I often look at, and Billy Hope has a great line in this, and that's his fermented goat milk story of where he goes, you know, if you've got a dog that's got chronic issues with their gut, you know, you can pretty much feed them a fermented goat's milk as an option, you know, day in, day out for weeks without there truly being a deficiency. And that gives them all of those nutrients that they can need in those circumstances. So there are options like that where you can go for a liquid option. It would be wrong of me not to mention bone broths right now. For me, in those really sick cases that need the maximum support and are really sort of like, oh, they can almost get nothing past their lips because they're so poorly or they're so bad, I think just coming back to a bone broth can be really useful. We'll deal with the exceptions to all of this. Okay. But to get them hydrated, to get them in a structure that the liquid can be truly hydrating rather than just plain water, which often will quench your thirst but not necessarily stay in the body long enough to truly rehydrate the system. You know, that's the wonderful thing about sticking it in a collagen structure and hydrating them in that fashion.

And the other thing about bone broth is it contains glutamine, which is one of the prime sources of energy for our one-layer-thick enterocytes. Yeah, there's only one cell between you and death the same day, essentially, you know.

And, uh, let's panic everybody, shall we?

Look after your gut, guys. Look after your gut. And it's really funny, um, Robert Lustig, who wrote Metabolical, which is a brilliant book, he says, uh, to his, his, his watchword, he's boiled it down to protect the liver Feed the gut.

Do you think Nicola heard that? Metabolical by— yeah, she'll probably be— oh, that book from 5 years ago—

against her laptop as we speak. So apologies, guys, but that's what you're here for, so suck it up. Metabolical, Robert— Dr. Robert Lustig. Yeah, brilliant book. Brilliant, brilliant, brilliant.

Great.

Okay, so where have we got?

Nicola did say, I did, she did hear. Wonderful.

You'll, one day you'll thank me.

Yeah, one day, maybe one day. So we've got to, so that's favorite foods. So let's talk about, you know, just sticking with the microbiome for a few moments more. What is then your favorite prebiotic and probiotic that you would then put in?

Okay, my favorite prebiotics would be, you know, just putting some, some, you know, at the very, very, very simplest, it would be just, you know, making sure that you do have really finely blitzed greens going in. Yeah, because you've got to feed the dog something. Okay, you may have to just go meat, nothing else. Meat, that means meat, bone, and organ just for a few days. But sooner or later you're going to have to get some of this plant-based prebiotic in. And so that would be the first thing, you know, even a teaspoon or two of just a little bit of greens blitzed. I would, I would nowadays tend towards either having that as a fermented product or as a, um, lightly steamed product. Okay, you can batch, you can do, you know, batches twice a week or something like that. If we're looking for specific products, then what we use quite a lot is good old slippery elm, good old-fashioned slippery elm and marshmallow root. Okay, you can both get both of those powdered, you can get both of those put together, you can even get it from Amazon or somewhere like that, or Amrita. I'm sure they do some products like that. Really common. Or go down to your local health food shop, independent health food shop, to support them. I think there's a lot of value there.

And that's a really important point because those both create that increased mucinous layer, but that mucinous layer is often a good food for the good bacteria. Yeah. So, you know, it really is useful to help in those. It's not just a separating form, a barrier between what's in the gut irritating things and what is happening in the enterocytes in the gut wall. But it's actually, you know, where a lot of that activity happens for, you know, bacteria to disperse the vitamins that they're producing, all the chelated minerals and things like that, to actually give those over to the enterocytes. To help the healing. So, you know, they have really good, important roles to play.

Mucus. We could do a whole show just on gut mucus, guys. That would be quite an interesting—

we might have 3 follow-ups.

Mucus. Like, everybody would be running for the hills. They're going to talk about mucus for 45 minutes. I'm out of here. Yeah, yeah, yeah, yeah, yeah. But it's, it's, it's, it's It's dramatically interesting and important. Okay. Once you just get over the idea that it's glorified snot, it is dramatically important. Yeah. Imagine your upper nasal passage without a layer of just a fine layer of mucus. Yeah. You're going to be— you're going to have sinusitis. You can have infections. You're going to be a disaster. Okay. That's how important it is. Seriously amazing stuff. Indeed.

So, all right, so I think Cheryl's off. She said, that's it, you're talking about snot, I'm out of here. Cheryl, man up, man up, woman. So let's go a step further because we often will talk about the problems with feeding plant materials for ourselves and our dogs and, you know, the source of those. You know, one of my friends Rowan, you know, and your friend to eat, you know, often talking about things like lectins and the disruption that they caused to the lining of the gut, the enterocytes, the glycocalyx, the other things. There are also a couple of other bits that people don't really—

Lectins, just, yeah, I can't let you go. Lectins, just give us a few examples of foods, you know, lentils.

Okay, so lentils, beans, you know, all of the, all of those, um, uh, leguminaceae, is that right, for the, uh, the legumes? Yeah, the legumes. So they are effectively going to be, um, have those. So lectins are effectively something that protects the plants from being overly browsed, uh, so too much of them, they'll cause irritation. Um, some people will feel bloats, they'll feel uncomfortable. You know, it can cause that side of things. And that's often found in the grasses. So we do find them in the seeds of grasses, which is the wheats, you know, all of that side of things too. So that's why often if you've got IBD, people will talk about reducing grains within your diet as a first point and excessive amounts of the legumes. So any of the beans and peas that come in with that. Okay, so that's lectins.

Yeah, I'm just going to give it— give a reference there because, uh, sorry guys, the guy to read, the guy— the basically the godfather of the whole lectin hypothesis, because it is to a certain extent a hypothesis, but the guy who's done a really deep dive here is a guy called Dr. Stephen Gundry. Who's got a fantastic voice if you're doing it on Audible. And he's, he's done The Longevity Paradox, for example. Very, very interesting. The amount of information he packs into his books is, is, is pretty overwhelming, in fact. So if you're, if you're interested in the lectin thing, i.e., kind of legume screw your gut theory, then he's your man. The other thing is, if you sprout beans, for example, I think you're going to change the lectin profile, aren't you? Because there's going to be a lot of dissolution of those anti-nutrients.

Yeah, and phytates too. I think it also changes those down. So the sort of accessibility of nutrients— thing about lectins and the irritation is that each of those enterocytes is tied tightly together with tight junctions. Okay. And as soon as you start to get disruption to those, you are going to effectively open those tight junctions. And quite often that's where you get seepage of the sewage that's on the inside of the gut through into the subgut tissues. And that's going to potentiate inflammation. As soon as the blood cells are exposed to that, they suddenly become super reactive. You're going to start to get true allergies form because the immune system becomes exposed to what's on the inside of your gut with no barrier, no filter, if you like. So that's why it's quite important to try and keep those tight junctions tight as possible.

So that really is a phenomenon, Brent, called leaky gut syndrome. And it's 1945. And therefore I'm going to say, why don't we use that as a segue to say we're going to take one minute— no, we're going to take— we're going to close for now. We need to do an IBD Part Deux, and we can do that when Conor's back. What do you think? Because there's so much to go at.

Because I think that's going to be our favorite overall, you know, the difficult cases. I think Part Deux has to be the difficult, intractable cases that have not resolved with some more forms. But I think let's take some stuff over onto Patreon.

Yeah, let's do leaky gut. Let's do leaky gut over on Patreon. Yeah, just do 10 minutes on leaky gut.

But for now, the last little thing I'm going to give you is if you look in ultra-processed foods, okay, because we haven't talked between enterocytes and mucus, that glycocalyx layer, one of the most favorite things that's been stuck in ultra-processed foods for people and dogs right now is the gums, the xanthan gums and the guar gums. And if you think, oh well, they're fine, they're plant origin, that's harmless, they're absolutely fine, they're not a problem— no, they're bacterial origins, slime, they're slimes, okay, that are built effectively to texturally addict you to the food. So they make things softer, slippier, feel more pleasant in the mouth. Maybe look more pleasant when you're cutting them out of the tin, okay, for your dog. And this is the reason, but what you don't realize is that they are really responsible for gumming up that glycocalyx layer on your gut. So they can absolutely disrupt your ability to truly absorb foods in a great manner. So watch out If you want one thing to avoid when you're looking at ultra-processed foods in sauces, in breads, in anything that's ultra-processed, it would be the guar gums and the xanthan gums that are out there. There are one or two others. So if they're one of the gums and you look it up and it's a bacterial slime that's there to make your food look nicer, glossier, whatever, avoid. Okay, that's my leaving, departing moment for Facebook Live.

Yeah, nice, very nice, Bren. My final point is going to be a third recommendation for a book, and I could see Nicola is going to be jumping out the window soon. I apologize, Nicola. It is, it's, it's, we've mentioned it before, it's a book by Chris Van Tuliken, T-U-L-E-K-E-N or something like that. But it's very interesting, a very easy book to remember. It's called Ultra-Processed People, and I think it's a fantastic way, in a very entertaining way, learn about ultra-processed food. And you don't know the half of how bad it actually is. And everybody likes a bit of junk every now and again, and I am guilty as anybody, but I do realize what junk it is, more or less.

So, and round up for everybody who's waiting for part 2 for the difficult cases.

In the meantime, while you're waiting for part 2, it'll be in about a month or so.

If you can resort to goat's milk, bone broth, and fish, then you can't go much wrong for the start point for foods.

White fish.

But the rest, we're going to talk about leaky gut.

We're going to talk about leaky gut because it's kind of what the phrase that everybody knows about. So we're just going to just explain that a little bit over on Raw Pet Medics, which will be on patreon.com/rawpetmedics.

And we'll see you over there in about an hour. Okay. It takes us time to record it and then upload it. So, you know, bear with us. But if you want to join the community over there, please hop over.

Please do, please do.

Great, thank you very much.

God, it's peaceful without Brady, isn't it?

We've actually had a chance to say something.

Brilliant, I love it.

Okay, um, don't worry guys, it's been really good.

He'll be back sooner or later, probably.

Take care everyone, bye-bye.