HIV disease can cause damage to the digestive tract by creating infection in the digestive system’s numerous lymph glands, or Peyer’s patches. This process begins early in HIV disease and can block absorption of nutrients by the villi in the small intestines. Cryptosporidium, shigella, MAI, isoporiasis, salmonella, and campylobacter are also intestinal pathogens that trigger diarrhea and can cause damage to the digestive tract. Parasites or amoeba, candida overgrowth, and long-term use of certain drugs like aspirin or ibuprofen are also very destructive forces in the intestinal system. Immediate diagnosis and treatment of any of these infections is extremely important in avoiding intestinal damage.(1)

Nutrients and Treatments

The following are some things you can do to keep your digestive system in good working order. There are a number of nutrients and treatments that have proven useful in decreasing inflammation of the digestive tract. Vitamin C, quercitin, and bioflavonoids are powerful natural anti-inflammatories. Ketotifen, another powerful anti-inflammatory is able to protect the digestive system cells from damage by HIV. It also decreases the levels of the detrimental cytokine, Tumor Necrosis Factor. It is available form the PWA Health Group in New York City at (212) 255-0520. Additionally, curcumin, an anti-viral used against the Long Terminal Repeat Gene of the HIV also works as an anti-inflammatory, and is found in the spice turmeric.(2)

It is also important to regrow healthy tissue in the small intestines with the amino acid, L-glutamine. Its use will help with the frequent removal of the cells of the small intestines, which is necessary for these cells to stay healthy and to absorb food well. L-glutamine can also restore the ability of the small intestines to block the uptake of pathogens, including bacteria and incompletely digested foods which can cause havoc with the immune system. A dose of 500 to 1000 mg, 4 times a day on an empty stomach (30-45 minutes before mealtime) is recommended. The large intestine is regenerated with butyric acid. Butyric acid is formed by the digestive bacteria (like acidophilus and lactobacillus) acting on medium-chain fatty acids. Medium-chain fatty acids are contained in high-pectin foods like apples, pears, plums, peaches, berries, and bananas. The way to get butyric acid is to use acidophilus supplements on an empty stomach first thing in the morning and to follow 30 minutes later with a fruit smoothie, made by simply blending your favorite high-pectin fruits in a blender. Smoothies can be a delicious way to start the day out with fruit.(3)

Additionally, pancreatic enzymes are needed for the digestion and absorption of the carbohydrates, proteins, and fats from the digestive tract. Many people with HIV have a poorly functioning pancreas and improve digestion with a pancreatic enzyme supplement. Sometimes improperly broken down components of foods can be taken into the blood stream by mistake due to a defective barrier function in the digestive tract.(4) These larger particles can then stimulate an immune response which in turn can activate the replication of the HIV. One way to tell if you are not breaking down your food adequately and may need pancreatic enzymes is to take the xylose absorption test. It is a test of the complex sugar, xylose, to see if it is passed out of the body. Its level is then measured in he stool.(5) If it is present, nutritional supplements as well as pancreatic enzymes may be helpful.

Supplementation with vitamin B-12 is often necessary for people with HIV either through nasal gel or by injection. The HIV is able to destroy cells in the body called parietal cells. It is these cells that make hydrochloric acid and intrinsic factor. Intrinsic factor is that factor which is necessary for the body to absorb vitamin B-12 from the digestive tract. Without its assistance, vitamin B-12 cannot be absorbed. Hydrochloric acid is necessary to break down proteins in the stomach. It can be supplemented and should be taken about one half hour before a meal containing protein. To stimulate hydrochloric acid and pancreatic activity drink green tea, apple cider vinegar, or lemon juice.(6)

Biotin, a B vitamin, normally made by friendly bacteria in the intestines, is also needed to use fatty acids for energy. The body is unable to use the fatty acids for energy and so they are converted back to fat. This process uses up the precious little energy that the body has and does no positive good. Since it continues repeatedly with HIV, it is called futile cycling. L-carnitine is an amino acid which acts as a fat burner and is able to transport the fatty acids into the cells to make energy. It is often needed in doses, as high as 1,000-6,000 mg/day by people with HIV. Supplementing with biotin and L-carnitine can reverse the bodies inability to use fat as a source of energy and can often be helpful with wasting and weight loss.(7)

The Importance Of A Healthy Diet

The first thing to do for a damaged digestive tract is to end all things that may be causing damage. A diet low in fat can play a large role in reducing inflammation in the digestive tract. One of the causes of inflammation is eating foods to which you have developed a sensitivity. Food sensitivities are usually the result of eating the same food on a regular basis. One way to discover if you have a sensitivity is by giving up a particular food for at least four days (try one you eat regularly) and then eating only that food after the four-day period is up. If symptoms become apparent then it is likely you have a sensitivity to that food. Symptoms usually include some loss of mental clarity and emotional stability. Physiological changes in pulse, blood pressure and blood sugar are sometimes also apparent with food sensitivities. If you are sensitive to a food it is best to stop eating that food, since eating it can cause damage both to your digestive tract and to your immune system.

Candidiasis is another cause of intestinal damage. Candida is a fungus which is present in everyone’s digestive tract. It tends to develop into an infection when the friendly digestive bacteria are no longer present in the intestines, primarily due to the use of antibiotics. Without these bacteria, the candida will easily multiply and take up the space in the digestive tract formerly occupied by the friendly bacteria. The intake of simple sugars (sugar, honey, and fruits), as well as foods containing yeast, also encourages candida overgrowth, since candida thrives on these foods. The best way to stop candida from becoming a problem in your digestive tract is to supplement your diet with acidophilus, taken about 30 minutes before eating each meal on an empty stomach, especially if you are taking an antibiotic regularly. Likewise, a diet low in simple sugars and foods containing yeast can keep the candida already present in your digestive tract from overgrowing and doing further damage.

Fiber can help to enhance movement of the digestive tract and thus help ensure formed stools, as well as improve the ability of the digestive tract to keep out pathogens and undigested foods, improving immune function. The best way to stimulate intestinal function is to get fiber in the diet by eating plenty of whole grains and fruits. A diet low in fat is recommended for anyone with HIV. A diet high in fat blocks the absorption of nutrients. This happens when the fat attaches to the villi where food is absorbed and consequently blocks their ability to absorb nutrients.(8) As well as it’s detrimental effect on the digestive uptake of nutrients, a high fat diet has been shown to be immuno-suppressive. High fat levels can inhibit phagocytosis, decrease lymphocyte replication and diminish the antibody response to foreign protein. Undigested fat can be a major cause of diarrhea and wasting. It’s best to stick to monosaturated oils, such as olive oil or canola oil, which are the least detrimental to the immune system. Hydrogenated oils are immunosuppressive and are found in: commercial salad dressings, baked goods, fried foods, chips.

Here are some final tips to stay healthy and to prevent digestive tract damage. Several things which are very useful in aiding digestion and which are good for calming nausea are ginseng and ginger tea.(9) The following nutrients are very useful for the digestive tract:

•zinc (100 mg/day)

•vitamin A (25,000 IU/day of water soluble form), beta carotene (50,000-200,000 IU/day)

•Vitamin E (1200-1600 IU/day)

•Vitamin C (6-20 grams/day), quercitin (500-1000 mg, 3-4 times per day) and other bioflavonoids

•glutathione (250 mg, three times per day)

•n-acetyl cysteine (1000 mg, three times per day)

•L-glutamine (500-1000 mg on an empty stomach, 30-45 minutes before each meal)

•Finally, a healthy, daily helping of protein, along with plenty of fiber from whole grains and fruits will help to stimulate intestinal function.”(10)

Much of the information in this article was taken from Lark Land’s new book, Positively Well: Living with HIV as a Chronic, Manageable, Survivable Disease. This book is scheduled for publication in April or May and is loaded with new, exciting information about surviving HIV. For a copy of this book call 1-800-542-8102, between 9:00 am and 5:00 pm, EST. The cost is $24.95.

2 Lands, L. (1995). Ibid. P.3,100. Back to Article

3 Lands, L. (1995). Ibid. p.101. Back to Article

4 Lands, L. (I994). The elements of health. Until There’s a Cure, VI, December 3, 1994, Brandenton, FL. Back to Article

5 Dharmananda, S. (1995). Help your doctor save your life, An AIDS survival guide from the Institute for Traditional Medicine, 2017 S.E. Hawthorne, Portland, OR (503) 223- 4907. Back to Article

6 Lands, L. (1995). Ibid. p.102. Back to Article

7 Lands, L. (1994). Ibid. Back to Article

8 Lands, L. (1995). Ibid. p.100. Back to Article

9 Lands, L. (1995). Ibid. p.101. Back to Article

10 Lands, L. (1995). Ibid. p.100. Back to Article