Leaky gut is a surprisingly common problem.  Basically it’s a condition that occurs whenever there is inflammation and the “pores” lining of the GI tract remain open too long.  Then toxic by-products in the digestive tract can be absorbed into the bloodstream and transported to the liver.  The molecules of food and toxins “leaked” through the GI lining may eventually affect systems throughout the body by aggravating inflammation in the joints, expressing toxins in skin disorders, triggering food sensitivities, causing “brain fog” or hyperactivity.

Managing hyper-permeability is definitely preventive medicine.  Reducing this toxic load on the liver and the body can prevent illness or improve its outcome.  Like Dysbiosis, leaky gut is an example of a general process that can lead to disease, rather than being a specific disorder.  This condition is far more typical than many practitioners realize and is often overlooked in designing treatment.  Resolving hyper-permeability can produce very real benefits.

Leaky gut (or hyper-permeability) is associated with a wide range of general symptoms, such as fatigue, fevers of unknown origin, abdominal pain or bloating, diarrhoea, feelings of toxicity, memory problems and difficulty with concentration, and poor tolerance of exercise.

Hyper-permeability can be a causal factor in:

• Attention deficit disorder                                                                                     Joint and collagen problems
• Symptoms resembling autism                                                                                     compromised liver function
• Chronic and rheumatoid arthritis                                                                          Malnutrition
• Chronic fatigue syndrome                                                                                                Multiple chemical sensitivities
• Eczema                                                                                                                  Psoriasis
• Food allergies and intolerances                                                                             Skin disorders ranging from urticaria to
• Inflammatory bowel disease                                                                                             acne and dermatitis
• Irritable bowel syndrome                                                                                      Symptoms like Schizophrenia

Hyper-permeability can also be caused by any number of different conditions.  Any substance or condition that cause inflammation (such as GI infection), severe trauma (such as burns or surgery), or mechanical over-stimulation (such as certain medications or NSAIDs) – anything that over-stimulates the pores in the lining and keeps them open too long is said to cause leaky gut, known as hyper-permeability.

The following conditions sometimes cause hyper-permeability:

• The aging process                                                                                      HIV
• Aids with diarrhoea                                                                                  Intensive illness
• Alcoholism                                                                                                Malnutrition
• Burns                                                                                                         NSAIDs
• Cancer                                                                                                       Pancreatitis
• Celiac disease                                                                                            Psoriasis
• Certain Drugs                                                                                            Radiation therapy
• Chemotherapy                                                                                           Rheumatoid arthritis
• Chronic hepatitis                                                                                       Shock or anaphylaxis
• Crohn’s disease                                                                                         Toxic shock syndrome
• Cystic fibrosis                                                                                           Trauma
• Giardia or other parasites                                                                          Ulcerative colitis

Defining Leaky Gut Syndrome

The intestinal lining has two opposing functions:

• The absorption of nutrients from food in the digestive tract
• A barrier function, to contain microbes or large food particles (potential allergens) so they don’t go beyond the gut environment (translocate) and get into the bloodstream

The digestive tract has tiny porous openings between cells (called tight junctions) so that nutrients can be absorbed from our food.  If the pore-like structures open too wide, toxins from the gut can flood into the bloodstream, overwhelming the liver and causing allergies or any dozens of other ailments.

This is known as hyper-permeability because the lining has become too permeable (porous).  It’s also called leaky gut syndrome because the gut begins leaking larger food particles and toxins from the gut.  It’s not an illness but rather a natural process gone wrong.  Normally all these pores in the gut lining open and close whenever nutrients are absorbed from our food.  It’s only when the pores open too wide that leaky gut is said to occur.

When the tests Come out Normal, But…

Debbie had complained of stomachaches since she was a child.  Sometimes she would double over with cramps and dull, aching abdominal pains so severe she couldn’t do anything but lie in bed for hours.  Her symptoms seemed to come on a few minutes after eating.  She had several thorough medical workups that were normal.  Her doctor prescribed muscle relaxants and tranquillisers, which seemed to help most of the time, and she got along reasonably well until she was in her mid-forties.

Out of the blue, at a time when Debbie was under enormous stress, she began having repeated attacks so severe they caused intense abdominal pain, explosive diarrhoea, vomiting, hives and a shock-like state in which her blood pressure would drop to almost undetectable levels.  She was seen by many doctors and again had extensive testing that all came out normal.  This time she was put on steroids, antihistamines, and Tagamet.  Since the attacks were potentially life threatening, they had to be stopped.

When Debbie first saw me she was developing additional problems from the steroids.  Her physicians tried to taper her off the steroids, but whenever the doses were decreased her attacks recurred.  Her symptoms were consistent with a severe form of food allergies.  A workup for intestinal permeability provided striking evidence of leaky gut syndrome.  In addition she was found to have severe Dysbiosis that was associated with both yeast overgrowth and a parasitic infection due to Blastocystis hominis Debbie was successfully treated with nutrients and diet.  She’s been off all pharmaceuticals for five years now, and has not had a single attack.  Follow-up testing for leaky gut syndrome has been normal, and her Dysbiosis is continuing to gradually clear.

How Leaky Gut Occurs

Here’s a blow-by-blow account of how leaky gut occurs.  Let’s use the example of someone who has an allergy.  Suppose Sarah has a dairy allergy and unknowingly eats cheese, this can trigger a reaction in her body.  If she has an immediate food allergy, her immune system may begin reacting right away.  If she has delayed allergies, the reaction may not occur for as long as three hours, but it could take as long as forty-eight hours to occur.

What is amazing is that no matter when it occurs, Sarah may not even be aware that it’s happening.  She may have a vague feeling of discomfort that could include a mild stomachache, a headache, even joint or muscle aches.  Although she may not notice anything more than vague discomfort at the time, later she may have a flare-up of some chronic problem such as allergies, asthma, or arthritis.  And she probably won’t link it to this microscopic process going on in her digestive tract as the lining becomes too porous and begins leaking tiny particles.

On the other hand, she may have noticed that if she cheats on her allergy diet and has milk for breakfast, sometime that day or the next her joints may be achy and exercise will become a major effort.

The response of Sarah’s body to the offending food also activates her immune system.  To alert the system that an invader is present (the dairy food she just ate), her immune system sounds the alarm through chemical messengers, the cytokines.  They act like buglers calling out the cavalry, and their job is to bring infection fighters (the antibodies).  This sets the immune system in motion.  While we always have cytokines as an essential part of our system, when there are too many cytokines and other immune chemicals circulating in the bloodstream, the gut will start leaking.
 

            The ileocecal valve is located at the point where the small intestine opens into the ascending colon.  It is comprised of sphincter muscles, which serve to close the ileum (the Third and lowest division of the small intestine).  In this way the ileocecal valve helps to keep the digesting material in the small intestine until the food has been changed by the digestive juices and absorbed.  It also functions to prevent a reflux of material from the colon back into the small intestine.

The valve passes the mixture of unusable food residue, mucus, bile and other excretions from the small intestine into the colon in small successive doses.  This prevents an overload of material for the body to eliminate.  Dr. John Harvey Kellogg, M.D., a colon specialist at the turn of the century, says in his book Colon Hygiene:

One of the consequences of chronic constipation is incompetency of the ileocecal valve.  By over-distension, the intestine becomes so widely dilated that the lips of the valve no longer come in contact and so its check valve action is prevented, and putrefying contents of the colon readily pass backward into the small intestine.  When the ileocecal valve is incompetent, it is, of course, incompetent to gases as well as liquids.  In competency of the ileocecal valve is both a consequence and a cause of constipation.  The valve is often rendered incompetent by over stretching of the bowel, usually the result of obstruction in the descending or pelvic colon.  When once the valve is crippled, the constipation is made worse by the loss of Check valve action, which aids the forward movement of the bowel contents, so that the food residues oscillate back and forth between the large and the small bowel.  The stagnation resulting from this condition readily leads to infection of the cecum and appendicitis and to more remote affections, through extension of the infection backward along the small intestine to the duodenum, stomach, gallbladder, liver and pancreas, causing inflammation of the gall ducts and gallbladder, gallstones, Pancreatitis and possible diabetes, duodenal and gastric ulcers, and various other affections.

Ileocecal Valve disorder could be one cause of chronic conditions.  The toxic material of the colon can enter back into the small intestine and rapidly be reabsorbed.  This allows for various toxins to re-enter the body, which may lead to disease.

At a symposium held at the Royal Medical Society of Great Britain in 1918, sixty doctors presented their views on autointoxication and intestinal toxaemia.  The competency of the ileocecal valve was widely discussed.  Dr. James T. Case and Dr. W.Curtis Brigham, D.O. Chief of Staff and colon specialist at the Monte-Sano Hospital, routinely found that many diseases were caused by the incompetency of the ileocecal valve.  Dr. Brigham detected many dysfunctional ileocecal valves by X-ray examination after a barium meal.  While performing surgery he removed adhesions in the gastrointestinal tract and repaired the ileocecal valve.  Dr. Brigham discovered that these poisons were the cause of many cases of epileptiform seizures.  By eliminating the problem, he cleared up as many as fifty percent of his epilepsy cases

Ileocecal Valve syndrome and Parasites

Medical professionals often overlook the prevalence of parasites in the body, but some believe that parasite infestation can lead to ileocecal valve syndrome.  Irritation or inflammation caused by the parasites can somehow cause the valve to remain open or to close only partially.  When the valve remains open, toxins can be reabsorbed in the bloodstream.  The condition will persist until individual under-goes a parasite cleanse to rid the body of the invaders.

Causes of ileocecal Valve Syndrome

Some natural health professionals feel that ileocecal valve syndrome affects up to fifty percent of the population.  The reasons for the ileocecal valve to remain open are not entirely understood, but may be due in part to poor eating habits, parasites or a lack of fibre in the diet.

Symptoms of Ileocecal Valve Syndrome

• Constipation / Diarrhoea                                                               Duodenal Ulcers
• Irregular bowel movements                                                          fatigue
• Lower right bowel tenderness                                                      acne
• Immune weakness                                                                         migraines

Dietary Guidelines

• Eat a diet high in fibre, including whole grains.  Soak the grains and cook to avoid irritating the valve.
• Avoid constipating food, such as dairy, meat, bananas etc.
• Eat stewed prunes, figs and raisins for breakfast.
• Add more fresh fruits and vegetables to the diet.  The softer raw vegetables such as leaf lettuce, spinach, avocados, sprouts and tomatoes should be used first.
• Reduce the amount of meat eaten.
• Take a fibre supplement to avoid constipation
• Implementing a juice fast two or three days a week will help to speed the healing process of the digestive tract.
• Thermos-cooked grains are healing to the digestive tract.  They are rich in enzymes, vitamins, minerals and protein.  This slow-cook process prevents destruction of the vital enzymes.
• Millet, buckwheat and basmati brown rice can be eaten for breakfast.  They are easy to digest and very nourishing.
• Raw vegetables and fruits, steamed vegetables, yams and avocados are all helpful in healing the digestive tract.

Nutritional Supplements

• Acidophilus:  Acidophilus helps to destroy putrefactive bacteria in the intestinal tract.  Putrefactive bacteria liberate histamine, a toxic substance that is the result of undigested protein.  Vitamin K and B-complex vitamins can be synthesized in the small intestine when acidophilus is present.
• Antioxidants:  Vitamins A, C, E, selenium and zinc are antioxidants that support the immune system.  They help the body in healing and preventing infection
• Blue-Green Algae and Chlorophyll:  These supplements are cleansing and healing to the digestive tract and the blood.
• Calcium/Magnesium:  These minerals help improve the health of the digestive tract.  They help to strengthen the nervous system, regulate heartbeat, and strengthen the muscular system.  Minerals are necessary for enzyme function.
• Essential Fatty Acids (flaxseed oil, salmon oil, evening primrose oil, borage oil and black currant oil):  Essential fatty acids are needed for a healthy glandular system. They help to regulate hormone function.
• Plant Digestive Enzymes:  These help digest food when it is eaten.  When they are taken between meals, they help break down the protein in the blood and cells so the body can eliminate toxins.
• Vitamin A (Beta carotene):  This vitamin is necessary for tissue repair and strengthening the immune system.
• B-Complex Vitamins:  The B vitamins are essential for intestinal health.  They help strengthen the nervous system and are also essential to the digestion process.
• Vitamin C with Bioflavonoids:  These are necessary for the adrenal and thyroid glands to supply essential hormones.

Along with calcium, they also help improve collagen supplies and contribute to digestive tract health.

Herbal Supplements

• Aloe Vera Juice:  Aloe Vera juice helps to heal and repair tissue in the digestive tract.
• Cat’s Claw:  Cat’s claw is an herb with anti-inflammatory properties that enhances the immune system.  It helps to strip the colon walls of accumulated waste and promote intestinal healing.
• Comfrey:  Comfrey helps with digestion by promoting the production of pepsin.  It is healing and strengthening on the body.
• Goldenseal:  Goldenseal helps soothe and heal the digestive system.  It also improves digestion.
• Grape Seed Extract:  The proanthocyanidins in grape seed extract have impressive antioxidant properties.  They help to reduce inflammation and promote healing.
• Liquorice:  Liquorice is soothing on the digestive tract and has been used to prevent and treat ulcers.  It works as a laxative and reduces inflammation of the digestive system.
• Pau D’Arco:  This herb helps promote healing and fights disease.
• Slippery Elm:  Slippery elm is healing to the mucous membranes.  It buffers the effects of irritations and inflammations of the mucous membranes.

Everyone over the age of 60 should be encouraged to take Probiotic products daily to boost their declining levels of “good” bacteria and protect them against intestinal infections including hospital super-bugs experts say. A group of leading food microbiologists yesterday called for wider use of Probiotics, particularly among elderly people, as well as tighter rules on labelling, so that specific details are provided about the bacteria in products.

They say that about half the Probiotics available were inaccurately labelled and did not do what they claimed, while some were found to contain unhealthy pathogens.  Most of the serious offenders were sold over the internet and from unorthodox health food shops.  The warning did not apply to the mainstream brands used by the majority of people, such as those made by Danone, Yakult and Nestle and sold as supermarkets own brands.

“Friendly” bacteria aid digestion in the gut and reduce the chances of stomach upsets.  Research suggests that they also help to prevent bowel conditions and protect children against allergies, and may reduce the risk of colon cancer.  Recently there has been an explosion in the use of Probiotics, including yoghurt-style drinks, supplements and powders.

The group of scientists led by Glen Gibson, Professor of Food Microbiology at the University of Reading, said that people should be aware of the benefits of maintaining balanced gut flora, including high levels of good bacteria.  The most common types are species belonging to the lactobacillus and bifidobacillus families.

Experts believe that high-fat, low-fibre Western diets may contribute to a lack of friendly bacteria and an increase in harmful bacteria. About 90 % of the bacteria in the gut of a newborn infant are friendly microbes, but this is reduced to 10-15 % in the average adult.  After the age of 60 to 65, levels of friendly bacteria plummet 1,000-fold.  “The elderly are definitely an excellent market for Probiotic intake”.  Professor Gibson said.  “Awareness in the UK is increasing slowly but it is not great.  It is a tricky concept to get over to people”

He said it was no accident that in the world’s worst recorded case of food poisoning by the stomach bug E.Coli 0157, all those who died were elderly.  A total of 21 people were killed in Lanarkshire, Scotland, in 1996.

The research group said that one of the biggest obstacles in the way of useful Probiotics was price, with a week’s supply sometimes costing about £3. Probiotic products need to contain at least ten million bacteria to be effective.  It is also vital that the bacteria survive their passage through the gastrointestinal system.  A recent study indicated that nine patients with ulcerative colitis, a form of inflammatory bowel disease that causes bloody bowel movements and abdominal pain, had 30-fold reduced levels of Bifidobacteria. Four weeks after being given a bifidobacteria Probiotic, plus a sugary supplement to promote growth of the bacteria, they reported fewer symptoms.  Many less well-known products did not live up to the promises made on their labels, the scientists said.  They may not contain the numbers of bacteria advertised, and the microbes may not survive in the gut long enough.

Consumers were also advised not to trust brands of healthy yoghurt promoted as being Probiotic without any specific information about the bacteria they contain.  “There are a lot of products out there that no one has ever heard of, and this is where the problems arise.  There’s no legislation”, professor Gibson said. “You could buy a yoghurt maker from Tesco, make your own Probiotics, and sell them”.  There were moves under way within the European Parliament to introduce controls on Probiotics but the “wheels turn very slowly”.

 Gut Instinct

Bacteria can be healthy but not all products are what they claim

The subject of what lurks inside the human gut had not attracted much in the way of conservation beyond microbiology circles until recently.  The commercial success of a number of Probiotic products has changed all that, with hundreds of thousands of people now prepared to pay to “top up” the “good bacteria” in their bodies with reinforcements.  The claims made for Probiotics include a role in helping to treat conditions as varied as Crohn’s disease, irritable bowel syndrome, rheumatoid arthritis, chronic tiredness or teenage acne.  Rigorous scientific assessments of the benefits of these competing supplements has been slow in coming, but clear-cut benefits are emerging.

A number of leading researchers in the field, including Professor Glen Gibson, of the University of Reading, outlined yesterday their latest conclusions on a rapidly expanding industry.  These are broadly positive and could represent an advanced in the prevention of illness.  There are “good bacteria” and their relative strength is a significant factor in a person’s health.  Almost everyone can be assisted but Probiotics are particularly useful for those on antibiotics or over the age of 60.  Scientists also believe that they can be employed to lower significantly the chance of patients enduring hospital-acquired infections.

That does not, nevertheless, mean that every product, which advertises itself as a Probiotic, is equally valid.  While the researchers concluded that well-known names, such as Yakult, Vitality and Actimel, are worthwhile, many of those that retailed exclusively on the Internet or in the more esoteric fringe of the health food shop sector are distinctly dubious.  Their estimate is that about half of the 50 products that are marketed as Probiotics are pale imitations of Probiotics.

The regulation of products sold on the Internet is a notoriously complicated question.  It is hard to prevent cyberspace becoming the domain of snake oil salesmen.  Bodies such as the Food Standard Agency may, therefore, be better advised to publicise the names of those brands that they consider to be correctly labelled and allow consumers to reach the conclusion that anything else is not to be trusted.  An important innovation should not be undermined by mis-selling.

There is a far broader public health point here.  Reaching a consensus on what substances are unhealthy and how bad they are has proved a contentious business.  The argument over how much is too much salt is a classic example.  The “traffic light” system of labelling food has encountered difficulties.  It might be better to place more weight on highlighting the positive instead of arguing about the negative.

Promoting Probiotics

More than two million Britons regularly buy Drinks, yoghurts and capsules containing Probiotics, in a market worth an estimated £135 million a year.

About 20 % of the population suffer from irritable bowel syndrome, which is often traced to a bacterial imbalance in the gut.

Llya Mechnikov, a Nobel prize-winning scientist, was the first to link yoghurt to improved life expectancy in the early 1900s after observing that a group of Bulgarian peasants lived for much longer than their peers.  He discovered that they drank large quantities of sour milk.

Experts believe that the sale of prebiotics supplements that boost bacteria already in the gut rather than introduce more, as Probiotics do will soar in the next few years.

Prebiotics are a form of dietary fibre and do not create the same storage and consumption problems as live bacteria in Probiotics.

THE TIMES newspaper 8^th Aug. 2006

By Janine Leach ND, DO, PhD, HonMFPHM

What is the lemon diet?

The Lemon Diet is one of the easiest fasts I have used in my career as a naturopath. It is a liquid diet regime based on a totally natural drink made from a special organic tree syrup, mixed with fresh lemon juice, spring water, pinch of cayenne pepper and ginger.

The tree syrup is a blend of maple and palm tree syrups designed to provide a balance of minerals and trace elements. The fresh lemon juice provides vitamin C and potassium, and helps to dissolve mucus and waste. The cayenne pepper adds to the flavour, as well as a stimulatory heating effect, which speeds cleansing and elimination.

Origin of the regime

Fasting has long been an important part of the naturopathic approach to helping the body heal itself. Fasting rests the digestive system, permits detoxyfication, and stimulates the immune system to speed recovery. Naturopaths use fasting both for treating acute infestions, and also for chronic conditions where congestion is a feature, to stimulate elimination, such as asthma, sinusitis, cholecystitis, skin conditions and colitis. There are many types of fast, such as purely water, or mono-diet of grapes. Many naturopaths may remember the Stanley Borroughs “Lemonade Diet”. Stanley Borroughs was a naturopath who developed the Lemonade Diet in the 1950s for a patient with a stomach ulcer. His booklet called The Master Cleanser described the drink, which originally used organic maple syrup with lemon juice. He describes the fast and its varied uses. Then in the 1980s Burroghs went to Switzerland to work with a team of practitioners including a naturopath, a homeopath and an Ayurvedic and orthodox doctor to develop an improved version. They developed a mix of syrups that would give a better balance of minerals to support the body during the fast and improve the patient’s nutritional status. This unique syrup blend is the basis of the Lemon Diet.

The product was first marketed in Switzerland in the mid-1980s. The present company director was one of the original team who developed the syrup blend. The booklet The Lemon Diet quickly became a bestseller in Denmark. It was translated into Spanish in 1992 and is now in its 28^th edition. Currently, over one-and-a-half million litres of the tree syrup are consumed each year in 33 countries, mainly prescribed by naturopaths, homeopaths and Ayurvedic doctors.

What does it contain?

The syrup comes from the sap of five types of trees – the maple tree and four rare Asian palm trees – all growing naturally and organically. The maple sap comes from Bird’s Eye maple trees of North America. Trees need to be over 40 years old to extract sap without harming the tree, and the sap can only be extracted during a few months of the year. This pure syrup is very different from most maple syrups sold in shops, which can be over 90% artificially synthesized from sugar and corn syrup.

The palm syrup comes from the sap of the Arenga, Kita, Nipah and Palmyra palm trees, which grow in forests in different areas of South East Asia. The sap from each type of tree is extracted using techniques introduced and monitored by Swiss aid workers. The sap is carefully turned into syrup, and then the syrups are blended and canned. No sugars, preservatives or chemicals processes are used.

Nutritional Content

The syrup is high in natural plant sugars, which provide the body with energy during the fast and satisfy hunger pangs. The calorie content is about 300 calories per 100 g. A typical daily intake of ten glasses therefore provides about 600 calories.

The mineral content is rich in potassium, manganese and zinc. The ratios of calcium to magnesium and sodium to potassium are almost ideal for the human body’s needs.

Table 1. Mineral Content of the Syrup

Table 2. Syrup Composition

The Diet Regime

The diet originated as a ten-day regime (five days for those not used to fasting) under the supervision of a practitioner. The ten-day fast should not be carried out too frequently. Even for weight loss, the maximum frequency is repeated ten-day fasts with four weeks or more between each one.

Most adults benefit from a fast once or twice a year. However, because of the high xenobiotic load most of us carry due to chemical pollution in the environment, many toxins are released into the blood stream during a fast. These are more toxic to the brain than in the past, and naturopaths now may recommend more frequent, shorter fasts, such as three days per month.

As with any fast it is extremely important to start with motivation! It is equally important to break the fast very slowly; to waken a sleeping digestive system with proteins and fats can cause serious illness such as kidney damage. First fruit juices are introduced, then fruits, followed by light foods over a few days.

During the fast, only the recommended liquids are taken, together with any prescribed medication as advised by the patient’s doctor, or homeopathic medication prescribed by a practitioner. No solid foods are taken, or vitamins, non-prescription drugs or other supplements. Patients should be able to continue their normal activities because the drink contains a good balance of nutrients and provides 600-800 calories per day, though endurance may be somewhat reduced, and during the fast the first 1-2 days they may experience headache or dizziness as the toxins enter the bloodstream.

Light exercise and breathing exercises are a great complement as they increase blood flow and elimination of toxins through the skin and mucous membranes. Similarly saunas and steam baths are helpful. Colon cleansing is also very important. We recommend at least 3 colonic irrigation treatments with your detox: before during and after the cleanse.

Before the Fast

Patients need to stock up with lemons, spring water, cayenne pepper, herbal teas, ginger and a litre of Madal Bal tree syrup.

The day before starting your detox – have colon hydrotherapy.

Daily Regime during the Fast

Make 1-2 litres of lemon drink. For a 1 litre bottle use 70 ml Madal Bal tree syrup, 70 ml fresh lemon juice (about 2 lemons) topped up with spring water or hot water you normally use to make tea. This is the daily supply to be taken either warm or cold with a pinch of cayenne pepper and some ginger.

During the day, drink at least 1.5 litres of water and herbal teas in addition. Mint teas complements the lemon drink well.

After the fast

The first day after the fast take only fruit or vegetable juices. The second day, take juices and then some veg soup in the evening. The third day after fasting, eat healthy food.

Safety

Fasting is not recommended for patients with chronic degenerative diseases, such as cancer, tuberculosis, neurological disorders, diabetis or hyperthyroid patients. Although useful for regulating underweight as well as overweight, it would not be advisable in true anorexia.

The Lemon Diet does provide balanced nutritional support to the body, but there is no formal evidence about adverse effects. Research into the benefits and risks is badly needed. The only known adverse effects are the dizziness and nausea typical of any fasting regime, as mentioned above. Its widespread use and continuing popularity are some indication of its acceptability.

The diet can be conducted unsupervised by a healthy person for short periods, but both practitioners and the supplier, recommend having support, advise and supervision from a practitioner. Special caution is needed if the person is taking medical drugs of any kind. Patients with low blood pressure (hypotension) may need to take a cup of coffee daily when fasting.

Underweight patients can use proportionately more tree syrup (but not lemon juice) per litre of drink, in order to minimise weight loss. Any weight loss is rapidly regained after the fast is completed because of the improvements in appetite, digestion, absorption and organ function.

The regime is not recommended for diabetics. Naturopaths may be interested to know Stanley Borroughs used a modified form of his Lemonade Diet for insulin-dependent diabetic patients, but close supervision would be essential.

Alcoholics and smokers should aim to reduce their intake before the fast; the company claims that cravings are reduced or even eliminated by the fourth day and do not return.

Table 3. Conditions that may Benefit from the Diet

Overweight    – not only for the weight loss, but also for retraining of appetite and taste, reducing cravings for sugars and junk food

Digestive complaints – the diet’s original purpose, resting and cleansing all levels of the digestive tract

Catarrh and sinus syndromes

Skin conditions

Circulatory disorders

Weakness and joint pain

Depression and anxiety

Childhood illness (suitable for children over the age of six years)

Viral infections, coughs and colds

Evidence of Effectiveness

Fasting in various forms has been used for centuries in many cultures for its cleansing and health

promoting effects. Adults and children who are Hindu or Muslim regularly practise fasting (e.g. Ramadan)

in the East and the West. Fasting has not been extensively researched, but there is perhaps more formal

evidence than you might imagine, especially in studies of patients with rheumatoid arthritis.

In France, the fast is taught and used by the homeopathic training college set up by Dr. Catherine   Kousmine, and is used in her clinics as a basic preparatory treatment to retrain patients in healthier eating habits. Practitioners report that homeopathic medicine are outstandingly effective during the diet.

“RICTAT is an International Association and Register of Integrative Colon Therapists and Trainers. Established in 2010, we now have over 100 members based around the world and continue to grow on a daily basis.

Our motto, as an organization, is SALUS AEGROTI SUPREMA LEX, which means, in Latin, “patient’s health rules supreme”, i.e. that the practitioner should always act in the best interest of the patient.

All our members believe that colonic irrigation is an effective tool when used in conjunction with client education in the field of nutrition, stress management, physical exercise and bodywork.

We accept that everyone is unique and we respect everyone’s personal beliefs of what constitutes health and illness.”

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