Heart Disease Might Start In Your Gut – A Recent Discovery

Heart Disease Might Start In Your Gut – A Recent Discovery


Hi everyone. This is Dr. Ruscio and let’s discuss the heart disease/gut connection. I want to share with you a study, and I’ll
put the abstract of the study up here on the screen, entitled, “Association Between Small
Intestinal Bacterial Overgrowth by Glucose Breath Test and Coronary Artery Disease.” So small intestinal bacterial overgrowth (also
known as SIBO) can be one cause of the symptoms of IBS. Gas, bloating, abdominal pain, constipation,
and diarrhea being the most notable. And there may be, as this study is suggesting,
a connection between SIBO (small intestinal bacterial overgrowth), your gut, and heart
disease. So let’s go through some of the details. A total of 1059 patients were tested for SIBO
and via coronary artery angiography—so essentially getting an assessment of the health of the
coronary arteries. Association Between Small Intestinal Bacterial
Overgrowth by Glucose Breath Test and Coronary Artery DiseaseAnd their results were quite
striking. Coronary artery disease was detected in essentially
80% of those with SIBO compared to essentially 40% of those without SIBO. So that’s a very significant jump. It’s essentially a doubling of risk. And there was also an increased prevalence
of diabetes, chronic kidney disease, blood pressure lowering agents and cholesterol lowering
agents in the patients with SIBO compared to the patients without SIBO. And to quote here, again, “Patients with SIBO had an increased number
of coronary arteries affected compared to SIBO negative patients.” So those with SIBO had more damage and blockage
of their coronary arteries than those without SIBO. Now, there’s another thing here that I’ll
put up here on the screen. And this may sound a little bit complicated. But I’ll quote again, “In the stepwise, multi-variant, logistic
regression analysis, SIBO remained an independent risk factor for coronary artery disease.” Essentially, what that means is the researchers
were trying to separate out for if the diabetes or the kidney disease or the use of high blood
pressure lowering agents because one had high blood pressure or cholesterol lowering agents
because one had high cholesterol were the reasons that the people with SIBO had the
decreased health of their coronary arteries. And what they found was that even after isolating
all those variables out and controlling for just the association between SIBO and coronary
artery disease, SIBO was still a significant contributing factor to the decreased health
of coronary arteries. And so their conclusion, “SIBO was found to be associated with coronary
artery disease and with a number of coronary arteries involved in this study. Further studies are necessary to confirm the
association of SIBO with coronary artery disease. In the presence of risk factors, patients
with SIBO may benefit from an assessment for coronary artery disease.” So that’s, I think, another area where we
are seeing the gut have such a far-reaching effect to many systems of the body, in this
case, your cardiovascular system. Now, I want to tie this in with probiotics. We’ve covered—and I’ll put a few links
in here. And we know that a few high-level scientific
analyses have been done showing that probiotics have the ability to lower cholesterol. Effects of probiotics consumption on lowering
lipids and CVD risk factorsThere have been a number of trials showing that probiotics—and
namely Lactobacillus acidophilus may be one of the more important ones—can lower cholesterol
levels. But there’s more to heart disease than cholesterol. And I want to make an important tie-in for
how probiotics may—and this is speculative—may help with heart disease. And quite simply, probiotics have been shown
to be able to combat and decontaminate or clean out from the small intestines, small
intestinal bacterial overgrowth. So if you take a probiotic, that is one way
of addressing and correcting small intestinal bacterial overgrowth. So there may be more than just the ability
of probiotics to lower cholesterol. It may be because probiotics can clean out
SIBO that they may have a potential benefit for heart disease. And I also wanted to draw a connection between
your heart, your coronary arteries, and your gut. We know that an independent risk factor for
heart disease is inflammation. And we know one of the main instruments used
by your immune system is inflammation. Or the immune system is one of the predominant
reasons for having inflammation released in the body. And we know that the largest density of immune
cells in your entire body resides in your small intestines. So small intestinal bacterial overgrowth,
this is where the bacterial overgrowth will be essentially interfacing with the immune
system in the small intestine. And that’s not a happy, harmonious relationship. And that high density of immune cells will
be likely reacting, causing inflammation. And inflammation is an independent risk factor
for heart disease. So some of these connections here, some of
these inferences, have yet to fully be proven. But that certainly is a mechanism that I think
is plausible. Effects of Probiotic Supplementation on Lipid
Profiles in Normal to Mildly Hypercholesterolemic IndividualsSo we’ve talked about the association,
at least according to this one study, between coronary artery disease and small intestinal
bacterial overgrowth. We’ve discussed how probiotics can lower
cholesterol and how probiotics can be a treatment for small intestinal bacterial overgrowth. And we’ve talked about the connection between
your heart (or said more definitively, more specifically, coronary artery disease) and
your gut via the immune system and inflammation as the connecting piece. Now, there are a couple counterpoints here
I should point out before we get too carried away with the potential utility of the gut-heart
connection. And that is, we don’t really have good outcome
data showing that interventions that improve one’s gut health will decrease the incidence
of coronary artery disease. So there’s more here to be documented. Would improving your gut health in any way
harm your heart? I very much so doubt it. I would only be inclined to think as long
as the intervention for the gut was reasonable and low risk, something like probiotics, a
low FODMAP diet, what have you, that you would only stand to gain from that. Also, IBS (irritable bowel syndrome)—abdominal
pain, altered bowel function, constipation, diarrhea, bloating—has not been shown to
increase, at least to the best of my knowledge, the incidence of heart disease—heart attack,
stroke, coronary artery disease, cardiovascular episodes. So that’s a good thing. But it also may be a bad thing. It may also indicate that even if one improves
their IBS, there may not be any spillover benefit to one’s heart health. However, I think it’s prudent to say that
improving the health of your gut may give you benefit for your heart and certainly has
no downside as long as you’re using noninvasive therapeutics to that endpoint. So this is very interesting. We’re seeing a connection between the coronary
artery health (obviously very important) and small intestinal bacterial overgrowth, the
gut. And hopefully, this information will motivate
you to take your gut more seriously. And this information will also help you get
healthier and get back to your life.