All About Hives
Jean Chuang Menges, L.Ac.
Hives, medically known as urticaria, is a skin condition characterized by sudden outbreaks of raised, red, itchy welts that appear in different shapes, sizes and clusters. They usually emerge suddenly and can last from a few minutes or hours, to a few days or even weeks. It is estimated that 20 percent of all people will suffer from hives at least once in their lives, affecting more women than men.
An Inner Immunological War in the Skin
In brief, hives are the result of a hypersensitive reaction to histamine released by the mast cells found at the dermal layer of the skin. Like a key fitting into a lock, antibodies, produced by the immune system, search for foreign and harmful substances, called antigens, to which the body is exposed through skin contact, ingesting or inhaling. This antigen-antibody, the lock and key complex, then binds to the mast cells that are found in the skin and mucosa of the lungs, digestive tract, mouth, eyes and nose. The antigen-antibody complex signals the mast cells to release granules of histamine into the blood stream. As a result, local blood vessels become dilated and fluids leak out to cause swelling, itching and sometimes a painful rash on the skin.
The Likely Triggers
The cause of hives is more difficult to answer than what happens in the skin during an episode of hives. Urticaria is not always allergic in nature. Most cases of hives lasting less than six weeks, known as acute urticaria, are the result of an allergic trigger. However, chronic hives that last longer than six weeks are rarely due to an allergy. Despite detailed testing, the majority of people with chronic hives have an unknown cause.
Common factors known to cause acute hives:
Food particles: milk, eggs, nuts, shellfish, artificial and natural food additives and flavors.
Beverages: ethanol in beer and wine. Coffee and cigarettes can further aggravate or worsen
the condition.
Environmental factors: pollen, house dust and animal dander.
Drugs: antibiotics (penicillin and sulfa), NSAIDs, anti-inflammatory drugs, vaccinations,
hormonal preparations, contraceptive pills and cocaine.
Infections: insect bites and stings, frequent bacterial infections (strep throat, tooth abscesses),
viral infections (common colds, infectious mononucleosis and hepatitis), fungal, protozoal and
helminthiasis (worm infections).
Synthetic products: personal products such as deodorant, perfume, talcum powder, cosmetic
products and animal derivatives.
Common factors known to cause chronic hives:
Autoimmune or systemic disease: in approximately 50 percent of cases of chronic hives, the
immune system causes the release of histamine. In rare cases, it has been associated with
cancer.
Emotional factors: stress-related hives are common in people who experience extreme
anxiety in performance or social situations. The hives are the result of overwhelming feelings
of stress, nervousness, anxiety or even embarrassment.
Physical: the most common reason for long-lasting hives is dermographism. This type of
hives appears within a few minutes of scratching along an area of skin and follows the path
taken by the act of scratching. Delayed pressure hives appear as swelling on areas of
constant pressure, for example, from belts or constricting clothing, such as sock bands.
Temperature: Cold hives are the result of exposure to low temperature, followed by
re-warming. This condition can be severe and life-threatening if there is a generalized body
cooling, such as plunging into a swimming pool. Hot hives are caused by an increase in body
temperature, such as from sweating, exercise or hot showers. Sun-induced hives may occur
within minutes of exposure to the sun.
Diagnosis and Conventional Treatment
Your primary care doctor, allergist, immunologist or dermatologist can often make the diagnosis of hives based on looking at the skin. There are no specific tests for hives and finding the cause can be difficult, especially in cases of chronic hives. In addition to your health history and physical exam, your doctor may perform a skin allergy test and blood work to rule out an illness or infection. In rare cases of sever attack of hives, blood pressure can drop, accompanied by wheezing, fainting, tongue swelling and difficulty breathing. Call 911 immediately. An emergency injection of epinephrine and a trip to the emergency room are needed.
The best treatment for hives is to identify and remove the trigger, which can be challenging. Treatment for mild or moderate cases of hives is usually a non-sedating antihistamine to relieve the itching. For chronic hives, an antihistamine is often taken every day to prevent hives from forming. If antihistamine does not work, cortisone may be prescribed.
It’s that Wei Qi Again
As an Acupuncture or BodyTalk client of Jean Menges, you may hear her talk a lot about the “wei qi”. In Chinese medicine, wei qi protects the surface of the body (such as the skin and muscle) from external invading pathogens, controls the opening and closing of the pores, moistens the skin and hair, regulates body temperature, and warms up the internal organs. It’s often equated to the Western physiological functions of the autonomic nervous system, the central nervous system and the immune system. When the wei qi is weak or deficient, the internal organs and body are vulnerable to microbes and toxins (including toxic ingredients in vaccines), cannot recognize defective tumors or cancer cells to destroy them, and cannot recognize or differentiate “foreign” from “self” and thus acts against the “self,” causing autoimmune diseases.
Treating Urticaria Using Acupuncture
In Chinese medicine, hives are a hypersensitive reaction of the immune function due to a weakened or deficient wei qi. Descriptions of hives and treatment methods can be found in a famous Chinese medicine book, dating back 1,350 years. Recent research studies found that treatments using acupuncture therapy resulted in more than 90 percent of people with acute hives and 80 percent of people with chronic hives experiencing complete relief. In some cases of chronic hives, custom herbal formulas may be prescribed to boost the deficient wei qi. The points selected in acupuncture and herbal formula therapies are all designed to nourish the function of the spleen, a well-known organ in Western medicine that’s involved in the immune system function and is the primary generator of wei qi.
Supporting the immune system and avoiding the source of the hives-causing antigen, whenever possible, are the best options for relief of both acute and chronic hives. Whether or not you know the cause of your hives, the emphasis should be placed on boosting the proper function of the immune system or wei qi. There are many other overall health-supporting ways to resolve hives, such as, acupuncture, BodyTalk, bioenergetic medicine, homeopathology, vitamin supplements and herbal supplements. Whichever path you choose to heal your hives, Western medicine or holistic medicine, your body is a dynamic system that just needs to be given the tools that are right for you.
References
American College of Allergy, Asthma & Immunology.
http://www.acaai.org/allergist/allergies/Types/skin-allergies/hives/Pages/default.aspx
American Academy of Dermatology. http://www.aad.org/skin-conditions/dermatology-a-to-z/hives
/diagnosis-treatment/hives-diagnosis-treatment-and-outcome
Chen, Chung-Jen, Yu, Hsin-Su. Acupuncture Treatment of Urticaria. Archives of Dermatology:
Vol 124, Nov 1998 (http://archderm.ama-assn.org/cgi/reprint/134/11/1397.pdf)
Chen, Yu. Nei Wei Qi Represents Immune System in TCM, Part 1. Acupuncture Today. May 2008:
Volume 09, Issue 05 (http://www.acupuncturetoday.com/mpacms/at/article.php?id=31725)
Chen, Yu. Nei Wei Qi Represents Immune System in TCM, Part 1. Acupuncture Today. June 2008:
Volume 09, Issue 06 (http://www.acupuncturetoday.com/mpacms/at/article.php?id=31752)
Chinese Medicine Hospital for Chronic and Difficult Diseases.
http://www.tcmtreatment.com/images/diseases/urticaria.htm
Herbs2000.com. Hives. http://www.herbs2000.com/disorders/hives.htm
Hivecten. http://www.hivecten.com/about.html
Hsieh, Hai-Yu. A Closer Look At Allergies.
http://www.acupuncturetoday.com/mpacms/at/article.php?id=31302
Jiang, Yong Ping. Understanding Wei Qi. Acupuncture Today. March 2003: Volume 04, Issue 03
(http://www.acupuncturetoday.com/mpacms/at/article.php?id=28164)
Li L, Ding J. Treatment of Urticaria with Cupping at Back-Shu Points - A Report of 40 Cases. Journal
of Traditional Chinese Medicine. March 2001: 21(1):37-8
(http://www.acupuncturetoday.com/graphs/sept_01graph.php)
Linnemeyer, Paul. The Immune System - An Overview. The Body: The complete HIV/AIDS
Resource. http://www.thebody.com/content/art1788.html
MedicineNet.com. http://www.medicinenet.com/hives/article.htm
Montgomery, Kaleb. Allergies, the Immune System and Boundaries. Acupuncture Today.
December 2006: Volume 7, Issue 2
(http://www.acupuncturetoday.com/mpacms/at/article.php?id=31434)
Dr. Rajesh Shah. Life Force Homeopathy. http://www.urticaria.com/app/urticaria.asp
Dr. Tiffany Young. http://www.hives.org/
WebMD. http://www.webmd.com/allergies/guide/hives-urticaria-angioedema
Food and Healing for Leaky Gut Syndrome
Jean Chuang Menges, L.Ac.
Leaky gut syndrome is not generally recognized by conventional medicine, but there is more and more evidence that it is a real clinical disorder that is associated with increased intestinal permeability [1,2]. Leaky gut is the result of damages to the intestinal mucosal lining that makes it less able to protect itself from the environment and filter in only the needed nutrients and other biological substances [2]. Leaky gut syndrome affects millions of people worldwide and is a chronic debilitating condition that often goes undiagnosed by the mainstream medical professional, may not be provided testing for, or acknowledged that the condition even exists.
Under the Microscope
In a normal healthy person, the small intestine behaves like a selective sieve allowing only breakdown products of digestion into the bloodstream [3]. Properly digested fats, proteins, and starches are allowed to pass through this intestinal mucosal lining. At the same time, the mucosal lining provides a barrier to keep out bacterial products, foreign substances, and large undigested molecules.
Under the microscope, the surface of the intestinal lining is made of villi and microvilli that look like bristles on a brush. The cells of the villi and microvilli have tight junctions between them called desmosomes that do not permit large molecules to pass through [4,5,6]. However, when the area of the lining is irritated and inflamed, these junctions loosen up and larger molecules are allowed to pass through. These larger particles, such as potentially toxic molecules, go directly into the bloodstream and flood the liver. The liver’s ability to neutralize these toxic substances is diminished, and it expels them back into the bloodstream to be carried by the circulatory system to be stored in connective tissues and muscles [3]. As the intestinal lining becomes more and more damaged, larger and larger particles, such as disease causing bacteria, fungus, parasites, and even undigested food particles are passed through the desmosomes into the bloodstream. The antibodies and cytokines are triggered by the immune system and the lymphocytes are alerted to battle these foreign substances in the bloodstream. Toxic oxidants are then produced and cause further pain and inflammation to tissues of the body that are far from the digestive system [3,4].
Factors That Increase Gut Permeability
There are many factors that contribute to the development of a leaky gut. The major causes include chronic stress, hypochlorhydria, dysbiosis from a too hygienic lifestyle, over consumption of alcohol and recreational drugs, a diet high in processed foods and preservatives, and common drugs such as antibiotic, anti-parasitic, and non-steroidal anti-inflammatory medications [4,5]. Leaky gut syndrome is only one of a number of disorders associated with increased intestinal permeability, where the one-way gate of the gut is, in effect, open too wide. Other conditions shown to be accompanied by leaky gut include: ulcerative colitis; small-intestinal malabsorption; malnutrition; Crohn’s disease; chronic inflammatory joint diseases, such as rheumatoid arthritis or ankylosing spondylitis; skin conditions like acne, psoriasis and dermatitis; diseases trigged by food allergies or specific food intolerance in cases of eczema, urticaria, and irritable bowel syndrome; chronic fatigue syndrome; chronic hepatitis; HIV-positive patients undergoing radiotherapy or otherwise immune-compromised; major skin burns even without infection; atopic dermatitis and hives; even aging itself can gradually bring on this condition [6]. A recent theory by health writer Susie Cornell even postulates that leaky gut probably plays a central role in the development of multiple sclerosis [6}. Many symptoms of MS are also symptoms of a leaky gut syndrome.
As said, increased gut permeability may play a primary role in causing the diseases mentioned or it may be a consequence of them. Either way, four vicious cycles are created in leaky gut syndrome: food sensitivity with or without an immune reaction; malnutrition that includes pancreatic insufficiency; bacterial dysbiosis that alter metabolic or immunological responses; and hepatic stress from over-taxation [1,7]. In most cases, the role of the increased intestinal permeability in previously listed illnesses are often gone unrecognized.
Diagnostic Tests for Leaky Gut
The most common testing for leaky gut is called Polyethylene Glycol 400 (PEG) test. PEG is a form of inert sugar that isn’t digested by mammals. A solution of this sugar is swallowed and then all the urine is collected in six hours. Evidence of any of the 11 different molecular structures and weights of the PEG sugars in the collected urine determines the size of the hole or how leaky the gut really is [8]. Another test uses a solution containing lactulose and mannitol, two types of innocuous sugar, that is given and the urine also later collected. A high ratio of lactulose to mannitol collected is indicative of leaky gut syndrome [1,8,9]. Digestive stool analysis and blood level IgG antibody measurement of common foods and normal gut bacteria are also used, but they are not as useful as the standard permeability tests [8,9].
Reductionistic Approach to Healing the Gut
To heal a leaky gut, we must take on both a reductionistic and holistic approach. Unlike most diseased conditions, leaky gut is a small intestine permeability issue that leads to liver stress, pancreatic insufficiency, and pain and inflammation of joints and tissues in other parts of the body from toxic oxidant deposits.[1,3,7]. Using the reductionistic approach, which we seek to identify the parts that contribute to the whole [10], contemporary Western biomedicine dietary therapies focuses on correcting specific nutritional deficiencies and eliminating individual food components that crosses the gut lining barrier. This reductionistic approach is appropriate to help heal a leaky gut by: avoid enterotoxic drugs such as NSAIDS; follow a highly nutritious elimination diet; treat dysbiosis through reintroducing non-pathogenic yeasts and bacteria; and repair the gut integrity with epidermal growth factors and other adjuncts such as essential fatty acids and dietary fiber supplements [1,11]. However, our body and gut system is a complex, self-organizing, and living system with the emphasis on the whole, rather than individual parts [10].
Holistic Approach to Healing the Gut
The holistic approach looks factors like building a healthy gut starting at the moment we were born. The absolutely sterile gut was then introduced with beneficial flora through breast feeding, that which begins the training process for the immune system. Then the eating of whole foods that are grown in micro rich soil and regular exposure to common childhood diseases provide our gut and immune systems with further training. A loving stimulation and emotional bonding with parents and other adults further strengthens the gut integrity, especially when it is not exposed to drugs, vaccines, and antibiotics [5,12,13].
Using the holistic approach for looking at why someone can develop leaky gut syndrome, we must understand that the role of chronic stress, environmental contaminants, and poor food choices as few of the main factors that causes increased intestinal permeability. Prolonged or chronic stress changes the immune system’s ability to respond and affects our body's natural ability to repair and heal. Our body reacts to stressors by producing less secretory IgA and DHEA, thus slowing down the digestion and peristalsis, reducing the blood flow to digestive organs, and producing more toxic metabolites [4]. In this case, meditation, guided imagery, relaxation, and a good sense of humor can help reduce our daily stresses. It’s about letting small problems and trauma wash away and not taking them too seriously [4].
Modern Exposures
In our modern day, it is almost impossible to avoid exposure to hundreds of household and environmental chemicals that constantly put stresses on our immune system and impair our already stressed gut system. During toxic exposure, our immune system is busy paying attention to so may parts of the body that sometimes there is a delay in the necessary routine repairs to our gut system. At the same time, connective tissues begin to break down and we lose trace minerals like calcium, potassium, and magnesium. Toxic household and environmental chemicals further deplete our reserves of buffering minerals, leading to acidosis in the cells and swelling [4]. Clearly in this case, the repair of a leaky gut requires as much removal as possible of these toxic chemicals from our households and environment. Luckily, there are many less toxic or more green chemicals and household products, even personal care products, to replace the need to continue poisoning our bodies and the environment.
Poor food choices are a major factor leading to imbalance of probiotics and pH in our gut. A diet rich in highly processed foods does not have the right building blocks for a healthy gut. In addition, our already stressed gut is flooded with food additives, restructured fats and sugar, and dairy products, that further irritates the intestinal mucosal lining and causes toxic by-products of the digestion to accumulate [4.5]. In this case, the best solution is to follow the Seven Criteria of Food Selection by Annemarie Colbin for selecting healthy foods that will not further increase that toxic loads and is helpful to the repair and rebuilding of the intestinal lining and flora.[14].
Conventional Medical Treatment for Leaky Gut
In conventional medicine, there is no treatment that will resolve a leaky gut [15]. To reverse a leaky gut syndrome, diet must be changed and the intestinal flora needs to be replenished to allow healing and repair of the gut lining. Corticosteroids, prescription broad-spectrum antibiotics, and immunosuppressive drugs are just band-aid treatments that maybe prescribed for acute episodes of pain, bleeding, or severe inflammation of the gut [15].
The Anti-Inflammatory Diet
Dr. Andrew Weil recommends an Anti-inflammatory Diet as a way to select and prepare foods. It is based on scientific knowledge of how certain foods reduce inflammation and provide energy and vitamins, minerals, essential fatty acids, and dietary fiber for the body [16]. The general guideline for this type of leaky gut diet is to eat a variety of foods, including as much fresh foods as possible, minimizing the consumption of processed foods and fast foods, and eating an abundance of fruits and vegetables. The caloric distribution is 40 - 50 percent from carbohydrates, 30 percent from fat, and 20 - 30 percent from protein. For carbohydrates, Dr. Weil recommends whole grains, such as brown rice and bulgur wheat, winter squashes, sweet potatoes, and al dente pasta. Meanwhile it is important to reduce eating wheat flour, sugar, chips, pretzels, and high fructose corn syrup. For fats, he recommends reducing the intake of saturated fat from animal products, coconut, and palm kernel oil, avoiding partially hydrogenated oils, and eating more omega-3-fatty acids foods, such as salmon, eggs, and flax seeds. Avocados, nuts, nut butters, and olive oil are also suggested good fats. For people with liver, kidney, autoimmune diseases, or allergies, Dr. Weil recommends decreasing animal protein consumption, except fish, and reduced-fat dairy products, but eating more vegetable protein, especially soybeans. In addition, he recommends eating 40 grams of fiber a day, lots of fruits and vegetables rich in phytonutrients, and supplementing with vitamin C, vitamin E, selenium, carotenoids, calcium, and multivitamin/multimineral products to help heal the gut lining.
The Body Ecology Diet
For the dysbiosis cycle of the leaky gut syndrome, there is an overgrowth of yeast, harmful bacteria, viruses, or parasites in the intestines [4]. A Body Ecology Diet, a version of the Candida Diet by nutritionist Donna Gates, that can help to rebuild the natural balance of microorganisms in the gut system. The three principles are, first, adding cultured foods in the form of fermented vegetables (sauerkraut, kimchi, sour pickles), beans (miso, tempeh, dosas, and idli), and dairy (yogurt and kefir) into the diet [17, 18, 19]. The second principle involves eating good fats such as flaxseed oil, extra virgin olive, and coconut oils. Lastly, dramatically reducing carbohydrates and sugar intake like sweets and fruits at first, but later carefully reintroducing high carbohydrate vegetables, specific whole grains, and fruits back into the diet. Using these three principals, foods are combined in specific ways in order to reintroduce the natural balance of the inner flora back into the gut [17].
The Liver Cleansing Diet
To address the cycle of stress liver in leaky gut syndrome, a Liver Cleansing Diet, introduced by Dr. Sandra Cabot, can help reduce the load through increasing the elimination function in the colon. Many people with leaky gut symptoms may lack fiber because they eat too much refined sugar and carbohydrates, animal meat, and dairy products. Without fiber, the content of the bowel will stagnate, which leads to more inflammation and excessive toxin formation that is pushed into the liver to be detoxed [20]. At the same time, the lack of fiber will also force the bowel muscles to contract too strongly in an effort to stimulate a bowel movement. Also, excessive contractions increases the pressure inside the bowel, leading to spastic colon and the formation of pockets in the bowel wall that is packed with toxic feces. The Liver Cleansing Diet involves eating 30 to 40 percent of raw vegetables and fruits, with the ratio of vegetables to fruits being 4 to 1 [20]. For cases of candida in leaky gut syndrome, it may be necessary reduce the amount of fruits and increase raw vegetables. The raw vegetables and fruits also contain living enzymes, natural antibiotics, and phytonutrients that can help with improving digestion, fighting unfriendly microorganisms, and reducing inflammation of the bowel wall.
Acupuncture
In addition to healthful eating, leaky gut syndrome requires other modalities to assist with the healing process. My first choice would be acupuncture, a procedure that involves the placement of thin, sterile needles on specific points on the skin to help move blocked energy flow in the meridians. Because each meridian is connected to an organ, the placement of acupuncture needles will help unblock the flow of energy in the respected organ. Since all illnesses, in the scope of Chinese Medicine, are equated as some type of energetic blockage in the flow of the meridian, organ, system, or tissues, the purpose of acupuncture is to unblock and stimulate the flow of energy through the meridians networks that control the entire gut system.
Naturopathic Medicine
Another modality for healing the gut from the functional and biological level is naturopathic medicine. Naturopathic medicine is a vitalistic tradition in the Western world where the treatment of disease is through stimulation, enhancement, and support of the body’s inherent healing capacity [21]. The naturopathic doctor studies clinical nutrition, botanical medicine, homeopathic medicine, physical medicine, Oriental medicine, psychological medicine, and even minor surgery. Through this holistic approach, naturopathic doctors often prescribe nutritional and botanical supplements to help improve healing of the gut lining and address the subsequent cycles from the condition.
Colonics
Colonic irrigation, also known as hydrotherapy of the colon, is a process of passing several gallons of water through the whole colon with the use of a special equipment. The purpose of colonic irrigation is to flush out impacted fecal matter, toxins, mucous, and even parasites that often build up over the passage of time [22]. With the relief in the colon, the small intestine is also less backed up and the toxins injuring the liver and rest of the body can be removed. With a series of treatments, along with the healthful eating methods, toxic chemicals, immune byproducts, and microorganisms are eliminated to give the overall gut system the opportunity to heal and repair.
Leaky gut syndrome is often a condition that is missed diagnosed by both the conventional, and, even the holistic practitioners, due to lack of awareness of this issue. The symptoms of a leaky gut are often the symptoms of some chronic diseases, which in some cases causes the small intestinal lining of the gut system to be more permeable.
Healing the gut begins with removing of harmful food and medication triggers. Acupuncture, Naturoprathic Medicine and Colonics are examples of the natural ways to heal the gut lining. As we all know by now, a healthy gut is the foundation of healthy body and mind.
Resources
[1] Galland, Leo. Leaky Gut Syndromes: Breaking the Vicious Cycle.
http://www.mdheal.org/leakygut.htm
[2] Andrew Weil, M.D. website. http://www.drweil.com/drw/u/QAA361058/what-is-leaky-gut.html
[3] Leaky Gut Syndrome website. http://www.leakygut.co.uk/About%20Leaky%20Gut.htm
[4] Lipski, Elizabeth, Digestive Wellness: Third Edition. McGraw-Hill Companies, Inc., 2005. eBook.
[5] McTaggart, Lynne, Good Digestion Teleconference Transcript. April 25, 2010. p. 5 - 6
[6] McTaggart, Lynne, The WDDTY Guide to Good Digestion. A What Doctors Don’t Tell You
Publication, 2010. p. 18 - 20.
[7] McTaggart, Lynne. The WDDTY Guide to Good Digestion. A What Doctors Don’t Tell You
Publication, 2010. p. 22 - 25.
[8] McTaggart, Lynne. The WDDTY Guide to Good Digestion. A What Doctors Don’t Tell You
Publication, 2010. p. 26 - 27.
[9] Leaky Gut Syndrome website. http://www.leakygut.co.uk/testing.htm
[10] Colbin, Annemarie, Nutrient Synergy and Complexity Theory: A New Paradigm. The Journal of
Healing and Caring On-Line, 2004. 4(1): p. 1 - 5.
[11] McTaggart, Lynne. The WDDTY Guide to Good Digestion. A What Doctors Don’t Tell You
Publication, 2010. p. 28 - 32.
[12] Cobin, Annemarie, Variables to Optimal Health chart, 2008.
[13] Menges, Jean. Notes From Class Lecture by Annemarie Cobin and Dr. Lawrence Palevsky,
February 14, 2010.
[14] Menges, Jean. Notes from Class Lecture by Annemarie Colbin, October 17. 2009.
[15] Jigsaw Health. Leaky Gut Syndrome: Conventional and Prescription Medications.
http://www.jigsawhealth.com/resources/leaky-gut-syndrome-medicine
[16] Weil, Andrew. Anti-Inflammatory Diet & Pyramid.
http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet
[17] Wild Fermentation. http://www.wildfermentation.com/books_wildfermentation.php
[18] Body Ecology Diet. http://www.everydiet.org/diet/body-ecology-diet
[19] Menges, Jean. Notes from Class Lecture by Annemarie Cobin, December 15, 2007
[20] Cabot, Sandra. Leaky Gut Syndrome.
http://www.liverdoctor.com/index.php?page=liver-problems&subpage=leaky-gut
[21] Naturopathic Medicine. http://www.pandamedicine.com/naturopathic_medicine.html
[22] Colonic Irrigation. http://www.answers.com/topic/colonic-irrigation-4
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