Monday, September 3, 2012

Let’s Talk Dirty: The Trouble with Cleanses, Colonics and Wipes

Cleanliness may be next to godliness, but it also may do us in.  A growing body of data suggests that a wide range of ills, from allergies and asthma to inflammatory bowel disease, may be the consequence of our fetish for clean.

A quick look at the shelves of pharmacies and supermarkets speaks volumes to the priorities of a culture. The aisles of cleaning products continue to metastasize claiming more space and new frontiers. The territory in need of a good scrub now ranges from our garage to our gut, from our teeth to our toilet. Whether it’s the surface of our kitchen counter or the surface of our face, cleaner is not just better but safer.

A kind of homeland security mentality has invaded the cosmos of clean. The axis of evil here is bacteria and all bacteria are bad. But nothing could be further from the truth. We can’t live without bacteria. The bottom line: we are part bacteria.

Our bowels are a perfect example.  There are way more bacterial cells living in our gut than the total number of our own cells in our entire body. We are, so to speak, colonized. These gut microbes turn out to be incredibly important. Anyone who has been on antibiotics, which kill many of these bacteria, can attest to the stomach misery caused by upsetting the balance of these little lodgers. Growing evidence suggests that a reduced diversity of these bugs is with inflammatory bowel disease, metabolic syndrome (prediabetes) and obesity. So why would you want to “clean” a colon?

Decreased exposure to the bacterial world has been cited as a cause of the explosion in childhood allergic conditions. For instance the rate of peanut allergies in children more than tripled between 1997 and 2008. Children living in urban centers are twice as likely to have peanut and shellfish allergies compared to kids in rural areas. 5.9 million children in the US under the age of 18 (1 in 13) have a potentially life-threatening food allergy. An allergic reaction to food sends an American to the ER every 3 minutes.

When a species develops an allergy to its food, that species is in trouble.

The explanatory theory for this phenomenon is called the Hygiene Hypothesis. Without the exposure to bacteria that we experienced historically and that our bodies evolved to cohabitate with, our immune systems go haywire. We develop hyperactive immune reactions to all sorts of things, i.e. we develop allergies and autoimmune disorders.

So how did we get here?

Let’s start with the new improved soaps, the antibacterial soaps. Studies have demonstrated that they provide no greater protection from contamination. In fact, they appear to be associated with an increased frequency of fevers, and upper respiratory tract symptoms. Apparently, these agents are non-specific killers. They knock out both the invading pathogenic bacteria that cause illness and the friendly “flora” or usual bacterial tenants. The problem here is that our bacterial flora actually provide protection from many invading bacterial bad guys, preventing them from finding a niche in our bodies.   

Don’t get me wrong. Hand washing is good. Just do it with regular soap.  Interestingly, good old-fashioned soap does not seem to kill off the non-pathogenic bacterial flora and is therefore ironically more effective in preventing contamination.

Another pervasive culprit is the “wipe”. What a great name, with its double-barreled implication of total elimination of the enemy (“wipe out”) and ease of victory (with a mere “wipe down”).

The “magic bullet” in antibacterial wipes is some form of the antibiotic called Triclosan. And it seems to be everywhere. Surfaces in food-processing plants, chopping boards, and refrigerator shelves are impregnated with this titan of the microbial battle. But in any confrontation between humans and bacteria we win pyrrhic victories only.

The bacteria have seen our ante and raised the bet. Not only have bacteria developed a resistance to Triclosan, there are now strains that eat it. As you might imagine, all this Triclosan finds its way into our waste grounds, sewers and water supply. In these fertile domains, the bacterial number has not diminished. In fact there has been an increase in the bacterial populations that are resistant to prescription antibiotics.

Any story of this kind would be incomplete without mentioning the bonfire of resistant bacteria steadily stoked by the misuse of antibiotics. This includes prescribing them for every sniffle (most of which are viral and therefore unaffected by antibiotics) and their pervasive use in the animals we consume. 75% of all antibiotics are used in the service of promoting growth in livestock.

Let me close with a plea for a dirtier world, a relinquishing of the desire for a squeaky clean colon. We are not dirty. We may feel dirty, but we do not need cleansing. There is a difference between guilt and contamination. It can be difficult not to fall prey to the idea of a Spring Cleaning of our bodies, a return to some innocent beginning.

We know the hard work of how to clean up our lives.  Attempting to sterilize the environment or our bodies won't do it. 

And when it comes to dangerous bacteria, we must cultivate the good bacterial part of us to survive them. Diversity is a good thing in man and microbe.

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