Ian Spohn, ND, is a staff naturopathic doctor for Energique who enjoys challenging the dogmas of both conventional and alternative medicine. He is a passionate supporter of the paleo diet and classical homeopathy.
As we move into autumn, seasonal allergies will once more rear their ugly head. While the seasonal pattern of allergic rhinitis is well-known, autumn can also be a time of aggravation for patients with irritable bowel syndrome (IBS). Interestingly, IBS is reportedly more commonly in patients with allergic symptoms,[i] and various systems of traditional medicine, including Persian and classical Chinese medicine, believe the sinuses and bowels to be linked. While bowel cleanses have long been popular, especially for treating gastrointestinal symptoms, the ancient Ayurvedic process of cleansing the sinuses with a neti pot has also been gaining traction as a treatment for disorders of the nasal sinuses. According to some fascinating research exploring the sinus-bowel connection, the two processes might work synergistically.
In classical Chinese medicine, autumn is a season for letting go of extraneous things in one’s life. Just as trees shed their leaves in autumn, we are encouraged to eliminate things we hold on to which may no longer be serving us. According to the five element theory, autumn is associated with the metal element, like the blade which severs unneeded attachments, and metal rules the lung and large intestine meridians, which are believed to be linked. It is through the lungs that we take in fresh air and through the large intestine that we eliminate waste. While the meridian link between these two disparate organs, poetic though it may be, seems ridiculously arcane in the light of modern biochemical understanding, there might actually be a physical and neurological connection between these two organs. Not only would this mean that autumn allergy season has significant implications for digestive health, it may also suggest new reciprocal strategies for the holistic treatment of sinus and bowel disorders.
The physical link between the respiratory and digestive tracts can be illustrated through one common phenomenon: postnasal drip. Respiratory secretions are commonly swallowed, especially at night, meaning whatever accumulates in your sinuses or gets trapped within your nasal mucus may eventually end up in your gut, providing an avenue by which disorders of the nose and sinuses can physically spread to the intestines. In traditional Persian medicine, for instance, curing postnasal drip is considered instrumental in the treatment of intestinal ulcers.[ii] This may at first seem ridiculous; how toxic could your postnasal drip really be? As it turns out, it can potentially be very toxic. Here is another interesting correlation: chronic sinusitis is strikingly more common in patients with inflammatory bowel disease (IBD).[iii] Does this imply that the mystical lung/large intestine meridian is real, or can it be explained by a purely physical mechanism?
A group of ear, nose, and throat (ENT) doctors actually set out to prove that chronic sinusitis can cause inflammatory bowel disease. After treating more than 2,000 chronic sinusitis patients in their clinic, they noticed that the ones who had inflammatory bowel disease experienced marked improvement in their intestinal disease from the treatment of their sinus disease. They theorized that smoldering staph infections in the sinuses were causing patients to swallow Staphylococcus aureus enterotoxin B in their postnasal drip, a highly inflammatory bacterial toxin, which was damaging their intestines and leading to allergic sensitization to food antigens. In other words, swallowing toxins from one’s chronic sinus infection was inflaming the intestines and triggering food allergies, which holistic practitioners well know can play a causative role in colitis. To prove their theory, they collected sinus fluid from some of their patients who suffered from both chronic sinusitis and IBD and fed it to mice to simulate the swallowing of one’s own sinus infection. This caused intestinal inflammation in the mice and compromised their intestinal mucosal barrier, causing them to become allergic to egg protein. While the control group fed egg whites did not develop food allergies, the mice that were made to swallow postnasal drip from sinus-infected patients developed allergies and, subsequently, colitis.[iv]
Not only can the postnasal drip from sinusitis cause colitis in the intestines, it seems that the postnasal drip from allergic rhinitis can cause IBS. A study of patients with birch pollen allergies found they had increased numbers of mast cells in their intestines and that their intestines were actually making antibodies to birch pollen that correlated with their IBS symptoms.[v] In addition to being inhaled, pollen in the air can be swallowed, either directly from the mouth or from the swallowing of nasal secretions, triggering allergic reactions in the intestines similar to what occurs in the nose and sinuses and causing IBS symptoms. This could easily explain why IBS symptoms are more commonly reported in atopic patients. For some people, IBS might simply be a manifestation of their allergies, which would open up an entirely new array of treatment options. In place of restrictive diets or herbal bitters and carminatives, quercetin and immunomodulating herbs might prove to be more effective.
So you can treat digestive disorders by treating the respiratory tract; would it also be possible to treat respiratory disorders by treating the digestive tract? There are no digestive secretions that normally end up being inhaled, yet the link between these two organ systems may indeed go beyond the physical. To explore the meridian link between the lung and large intestine, another group of researchers studied the effects of traditional Chinese laxatives on lung function. They created mouse models of allergic asthma and chronic obstructive pulmonary disorder (COPD) and then treated the mice with Dahuang and Mangxiao, known more commonly as Chinese rhubarb and sodium sulfate, the former being a laxative herb and the latter a mineral known in homeopathy as Natrum sulphuricum (interestingly, the traditional homeopathic indications for Natrum sulphuricum include both asthma and colitis). They found that both treatments altered neuropeptide levels not only in the intestines but also in the lungs, and that this ameliorated the histopathological features of both lung disorders.[vi] Their results suggest that stimulating the enteric nervous system of the large intestine affects the nervous system of the lungs, and traditional herbal laxatives may be able to treat lung disorders, confirming classical Chinese medicine’s meridian link between the lung and large intestine.
[i] Tobin MC, Moparty B, Farhadi A, DeMeo MT, Bansal PJ, Keshavarzian A. Atopic irritable bowel syndrome: a novel subgroup of irritable bowel syndrome with allergic manifestations. Ann Allergy Asthma Immunol. 2008;100(1):49-53. doi:10.1016/S1081-1206(10)60404-8
[ii] Gorji N, Moeini R, Rezaeizadeh H, Khanavi M, Farhan F. Relationship between Post Nasal Drip (PND) and Inflammatory Bowel Disease (IBD): A New Concept on Gastrointestinal Disease Management in Persian Medicine. Iran J Public Health. 2014;43(12):1726-1727.
[iii] Book DT, Smith TL, McNamar JP, Saeian K, Binion DG, Toohill RJ. Chronic sinonasal disease in patients with inflammatory bowel disease. Am J Rhinol. 2003;17(2):87-90.
[iv] Yang PC, Wang CS, An ZY. A murine model of ulcerative colitis: induced with sinusitis-derived superantigen and food allergen [published correction appears in BMC Gastroenterol. 2006;6:23]. BMC Gastroenterol. 2005;5:6. Published 2005 Mar 3. doi:10.1186/1471-230X-5-6
[v] Rentzos G, Lundberg V, Stotzer PO, Pullerits T, Telemo E. Intestinal allergic inflammation in birch pollen allergic patients in relation to pollen season, IgE sensitization profile and gastrointestinal symptoms. Clin Transl Allergy. 2014;4:19. Published online 2014 May 30. doi:10.1186/2045-7022-4-19
[vi] Zhong XG, Zheng FJ, Li YH, et al. Specific Link between Lung and Large Intestine: A New Perspective on Neuropeptide Secretion in Lung with Herbal Laxative Stimulation. Evid Based Complement Alternat Med. 2013;2013:547837. doi:10.1155/2013/547837
Any homeopathic claims are based on traditional homeopathic practice, not accepted medical evidence. Not FDA evaluated.
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