Escherichia Coli Nissle 1917: Mutaflor

Mutaflor is the only known Escherichia Coli probiotic. There have been many clinical trials demonstrating its effectiveness for Ulcerative Colitis, Chronic Constipation, Crohn’s Disease, Irritable Bowel Syndrome and many related conditions.

According to Wikipedia:

The Mutaflor strain was isolated by Professor Alfred Nissle in 1917 during the First World War. As such, the strain was named after him as Escherichia coli Nissle 1917.2 It has been clinically studied and reviewed for over 80 years to prevent and treat an assortment of gastrointestinal disorders.

Efficacy of Mutaflor for a variety of inflammatory bowel diseases has been tested through 80 years of clinical experience. There are numerous double-blind placebo-controlled studies showing the efficacy of Mutaflor in the treatment and prevention of gastrointestinal disorders.

Mutaflor (E. coli strain Nissle 1917) has no pathogenic characteristics: no production of enterotoxins (Shiga toxins, heat-stable and heat-labile toxins); no production of cytotoxins (CNF); no enteroinvasiveness; no pathogenic adhesion factors (e.g. no CFA I/II, P, M and S fimbriae); no hemolysins; no serum resistance; no uropathogenicity; no antibiotic-resistance genes.

Alternative Probiotics

The probiotics listed here are usually single species or unusual collection of species that have been demonstrated in medical studies to be effective in treating irritable bowel syndrome(IBS). Studies of the same probiotics for Crohn’s Disease are lacking, thus it is by inference only that they are recommended. Most commercial probiotics have failed to show any significant benefits in medical studies for IBS. Probiotics, like antibiotics are effective for some conditions and ineffectual for other conditions.
Bifidobacterium Infantis-35624

Some of the studies on PubMed are listed below. It is available as “Align Digestive Care Probiotic Supplement”

• Fecal excretion of Bifidobacterium infantis 35624 and changes in fecal microbiota after eight weeks of oral supplementation with encapsulated probiotic.(2013)
• Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis.
• Bifidobacterium infantis 35624: a novel probiotic for the treatment of irritable bowel syndrome.
• Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
• Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fermented Milk.
• Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.

Prescript Assist

This is an unusual commercial probiotic that lacks the traditional Lactobacillus species seen in most probiotics. It has had excellent results in the treatment of Irritable Bowel Syndrome. There have not been trials with other conditions. The species are listed below

• Anthrobacter agilis,
• Anthrobacter citreus,
• Anthrobacter globiformis,
• Anthrobacter luteus,
• Anthrobacter simplex,
• Acinetobacter calcoaceticus,
• Azotobacter chroococcum,
• Azotobacter paspali,
• Azospirillum brasiliense,
• Azospirillum lipoferum,
• Bacillus brevis,
• Bacillus marcerans,
• Bacillus pumilis,
• Bacillus polymyxa,
• Bacillus subtilis,
• Bacteroides lipolyticum,
• Bacteriodes succinogenes,
• Brevibacterium lipolyticum,
• Brevibacterium stationis,
• Kurtha zopfil,
• Myrothecium verrucaria,
• Pseudomonas calcis,
• Pseudomonas dentrificans,
• Pseudomonas flourescens,
• Pseudomonas glathei,
• Phanerochaete chrysosporium,
• Streptomyces fradiae,
• Streptomyces celluslosae,
• Streptomyces griseoflavus

Some of the studies on PubMed are:

• Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial. (2007)
• Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. (2005)
• Lactobacillus Reuteri

Not Effective

• Saccharomyces boulardii does not prevent relapse of Crohn‘s disease. [2013], To yeast or not to yeast: a probiotic question. [2013]

Experience with Probiotics

Our experience is that taking two probiotics are the same time had less impact then just taking one. Probiotics will compete with other. More is not better. The best time to take the probiotics is shortly before bed. Often the probiotic will result in a headache for the first few days (the Mutaflor inserts actually cites that as a side effect). Some diarehha and unpleasant smells may occur for a few days — this is typically caused by the bacteria being displaced by the probiotic (which is a bacteria).

Our usual practise is to do a probiotic for 7-10 days and then change to a different probiotic, or to one of the above herbs.

WARNING: These herbs should NOT be used with Chronic Fatigue Syndrome (unless you have Mutaflor!)

Rheum officinale: Rhubarb Root

This was the only herb of 178 herbs tested that had significant activity against bacteroides fragilis. There is only a single study. It can cause diarrhea or constipation — depending on dosage.

According to Wikipedia:

Rheum officinale is used in traditional Chinese medicine, where it is called yào yòng dà huáng, and is also a component in the North American herbal remedy called Essiac tea.

In modern medicine, R. officinale has been studied for the treatment of hepatitis B. However, a meta-analysis of published clinical trials concluded that the quality of existing studies was “poor”, but further study of R. officinale in combination with interferon is “justified”.

• Drug interactions are known.

Chitosan

Chitosan is reported to inhibit Peptostreptococcus in a single study.

Wikipedia has a long article on its biomedical uses for a wide variety of conditions.

• Drug interactions are known.

Zingiber officinale: Ginger Root (Inji root)

Ginger root is a member of the same family (Zingiberaceae) as turmeric, cardamom and galangal.

According to Wikipedia:

The traditional medical form of ginger historically was called Jamaica ginger; it was classified as a stimulant and carminative and used frequently for dyspepsia,gastroparesis, slow motility symptoms, constipation, and colic. It was also frequently employed to disguise the taste of medicines.

Some studies indicate ginger may provide short-term relief of pregnancy-related nausea and vomiting. Studies are inconclusive about effects for other forms of nausea or in treating pain from rheumatoid arthritis, osteoarthritis, or joint and muscle injury. Side effects, mostly associated with powdered ginger, are gas, bloating, heartburn, and nausea.

Tea brewed from ginger is a common folk remedy for colds. Ginger ale and ginger beer are also drunk as stomach settlers in countries where the beverages are made.

In Burma, ginger and a local sweetener made from palm tree juice (htan nyat) are boiled together and taken to prevent the flu.
In China, ginger is included in several traditional preparations. A drink made with sliced ginger cooked in water with brown sugar or a cola is used as a folk medicine for the common cold. “Ginger eggs” (scrambled eggs with finely diced ginger root) is a common home remedy for coughing. The Chinese also make a kind of dried ginger candy that is fermented in plum juice and sugared, which is also commonly consumed to suppress coughing. Ginger has also been historically used to treat inflammation, which several scientific studies support, though one arthritis trial showed ginger to be no better than a placebo or ibuprofen for treatment of osteoarthritis.
In Congo, ginger is crushed and mixed with mango tree sap to make tangawisi juice, which is considered a panacea.
In India, ginger is applied as a paste to the temples to relieve headache, and consumed when suffering from the common cold. Ginger with lemon and black salt is also used for nausea.
In Indonesia, ginger (jahe in Indonesian) is used as a herbal preparation to reduce fatigue, reducing “winds” in the blood, prevent and cure rheumatism and control poor dietary habits.citation needed
In Nepal, ginger is called aduwaand is widely grown and used throughout the country as a spice for vegetables, used medically to treat cold and also sometimes used to flavor tea.
In the Philippines, ginger is known as luya and is used as a throat lozenge in traditional medicine to relieve sore throat. It is also brewed into a tea known as salabat
In the United States, ginger is used to prevent motion and morning sickness. It is recognized as safe by the Food and Drug Administration and is sold as an unregulated dietary supplement. Ginger water is also used to avoid heat cramps.
In Peru, ginger is sliced in hot water as an infusion for stomach aches as infusión de Kión.
In Japan it is purported to aid blood circulation. Scientific studies investigating these effects have been inconclusive.

• Drug interactions are known.

Punica granatum: Pomegranate

This species has been repeatedly identified as effective against E.Coli. In one study of eight medicinal herbs, it was found to be the most effective. The seed cover and peel (and not the juice) appears to be part that is effective.

According to Wikipedia:

In the Indian subcontinent’s ancient Ayurveda system of medicine, the pomegranate has extensively been used as a source of traditional remedies for thousands of years.

The rind of the fruit and the bark of the pomegranate tree is used as a traditional remedy against diarrhea, dysentery and intestinal parasites. The seeds and juice are considered a tonic for the heart and throat, and classified as a bitter-astringent (pitta or fire) component under the Ayurvedic system, and considered a healthful counterbalance to a diet high in sweet-fatty (kapha or earth) components. The astringent qualities of the flower juice, rind and tree bark are considered valuable for a variety of purposes, such as stopping nose bleeds and gum bleeds, toning skin, (after blending with mustard oil) firming-up sagging breasts and treating hemorrhoids. Pomegranate juice (of specific fruit strains) is also used as eyedrops as it is believed to slow the development of cataracts.

Ayurveda differentiates between pomegranate varieties and employs them for different remedies.

Pomegranate has been used as a contraceptive and abortifacient by means of consuming the seeds, or rind, as well as by using the rind as a vaginal suppository. This practice is recorded in ancient Indian literature, in Medieval sources, and in modern folk medicine.

• Drug interactions are known.

Terminalia chebula: Haritaki

Several studies have found this is effective against E.Coli. This herb was found to be as potent as ciprofloxacin, gentamycin, kanamycin, ofloxacin and cephalexin against E.Coli. The same study found it more effective than punica granatum above. This superior performance was reported in another study of 66 herbs. It has no adverse effects on the growth of the lactic acid-producing bacteria.

According to Wikipedia:

Haritaki is a rejuvenative, laxative (unripe), astringent (ripe), anthelmintic, nervine, expectorant, tonic, carminative, and appetite stimulant. It is used in people who have leprosy (including skin disorders), anemia, narcosis, piles, chronic, intermittent fever,heart disease, diarrhea, anorexia, cough and excessive secretion of mucus, and a range of other complaints and symptoms. According to the Bhavaprakasha, Haritaki was derived from a drop of nectar from Indra’s cup. Haritaki is used to mitigate Vata and eliminate ama (toxins), indicated by constipation, a thick greyish tongue coating, abdominal pain and distension, foul feces and breath, flatulence, weakness, and a slow pulse. The fresh fruit is dipana and the powdered dried fruit made into a paste and taken with jaggery is malashodhana, removing impurities and wastes from the body. Haritaki is an effective purgative when taken as a powder, but when the whole dried fruit is boiled the resulting decoction is grahi, useful in the treatment of diarrhea and dysentery. The fresh or reconstituted fruit taken before meals stimulates digestion, whereas if taken with meals it increases intelligence, nourishes the senses and purifies the digestive and genitourinary tract. Taken after meals Haritaki treats diseases caused by the aggravation of Vayu, Pitta and Kapha as a result of unwholesome food and drinks. Haritaki is a rasayana to Vata, increasing awareness, and has a nourishing, restorative effect on the central nervous system. Haritaki improves digestion, promotes the absorption of nutrients, and regulates colon function.

• Drug interactions are known.

Withania somnifera: Ashwagandha

Several studies have confirmed its effectiveness against E.Coli. It contains sterol glycosyltransferases that interfere with the function of E.Coli under stress conditions. [2013]

• Methanolic extracts of Withania somnifera leaves, fruits and roots possess antioxidant properties and antibacterial activities. [2012]

According to Wikipedia:

The main active constituents are alkaloids and steroidal lactones. These include tropine and cuscohygrine. The leaves contain the steroidal lactones, withanolides, notably withaferin A, which was the first withanolide to be isolated from W. somnifera.

In Ayurveda, the berries and leaves of W. somnifera are locally applied to tumors, tubercular glands, carbuncles, and ulcers. The roots of W. somnifera are used to prepare the herbal remedy ashwagandha, which has been traditionally used to treat various symptoms and conditions.

In two published clinical trials of W. somnifera, the side effects were not significantly different from those experienced by placebo-treated individuals. A case report implicated ashwaganda as the cause of thyrotoxicosis in a 32-year old female who had taken ashwaganada extract capsules for symptoms of chronic fatigue.

• Drug interactions are known.

Epilobium angustifolium: Fireweed or Willow Herb

Several studies have confirmed its effectiveness against E.Coli, including increasing the effectiveness of ciprofloxacin significantly.

Antimicrobial activity of Willowherb (Epilobium angustifolium L.) leaves and flowers.[2013]

Wikipedia does not describe any medicinal uses.

• Drug interactions are unknown.

Salvia Plebeia

There has been one study finding that it is effective against E. Coli.

Wikipedia does not describe any medicinal uses.

• Drug interactions are unknown.

Rosmarinus officinalis: Rosemary

There have been several studies of its use in the food industry to reduce E.Coli. It is not effective against drug resistant E.Coli73. It inhibits quorum sensing of gut bacteria. It also contains essential oils which can cause secondary issues with Crohn’s disease (like Clove Oil which also impacts E.Coli). It is not an ideal herb for CD. A combination of galangal (Alpinia galanga), rosemary (Rosmarinus officinalis) and lemon iron bark (Eucalyptus staigerana) appears effective and uses multiple mechanisms.

According to Wikipedia:

Hungary water was first prepared for the Queen of Hungary Elisabeth of Poland to ” … renovate vitality of paralyzed limbs … ” and to treat gout. It was used externally and prepared by mixing fresh rosemary tops into spirits of wine. Don Quixote (Part One, Chapter XVII) mixes it in his recipe of the miraculous balm of Fierabras.

Rosemary has a very old reputation for improving memory and has been used as a symbol for remembrance during weddings, war commemorations and funerals in Europe and Australia. Mourners would throw it into graves as a symbol of remembrance for the dead. In Shakespeare’s Hamlet, Ophelia says, “There’s rosemary, that’s for remembrance.” (Hamlet, iv. 5.) A modern study lends some credence to this reputation. When the smell of rosemary was pumped into cubicles where people were working, they showed improved memory, though with slower recall.

Rosemary contains a number of potentially biologically active compounds, including antioxidants carnosic acid and rosmarinic acid. Other bioactive compounds include camphor (up to 20% in dry rosemary leaves), caffeic acid, ursolic acid, betulinic acid, rosmaridiphenol and rosmanol. Rosemary antioxidants levels are closely related to soil moisture content.

• Drug interactions are known.

Scutellaria baicalensis: Chinese/Baikal Skullcap

Several studies indicate that it is effective against E.Coli.

According to Wikipedia:

It is one of the 50 fundamental herbs used in traditional Chinese medicine, where it has the name huáng qín. As a Chinese traditional medicine, Huang Qin usually refers to the dried root of Scutellaria baicalensis Georgi, S. viscidula Bge., S. amoena C.H. Wright, and S. ikoninkovii Ju.

• Drug interactions are known.

Trianthema decandra: Gadabani

A single study reports its effectiveness against E.Coli.

Wikipedia does not describe any medicinal uses.

• Drug interactions are unknown.

Quercus infectoria: Oak Gall Tree

A single study reports its effectiveness against E.Coli.

Wikipedia does not describe any medicinal uses.

• Drug interactions are unknown.

[New] Hibiscus sabdariffa L: Roselle or Sorrel

• Physicochemical properties and antimicrobial activity of Roselle (Hibiscus sabdariffa L.).[2013]
• Fullerton M, Khatiwada J, Johnson JU, Davis S, Williams LL”Determination of Antimicrobial Activity of Sorrel (Hibiscus sabdariffa) on Esherichia coli O157:H7 Isolated from Food, Veterinary, and Clinical Samples.” J Med Food. 2011 May 6;

Wikipedia states:

Although Roselle has well documented hypotensive effects,^[8] Hibiscus has one of the highest levels of antioxidants of any widely available food; antioxidants have been shown in several studies to enhance nitric oxide production in the body, reducing blood pressure and oxidized lipidsHibiscus sabdariffa has shown in vitro antimicrobial activity against E. coli.^[13] A recent review stated that specific extracts of H. sabdariffa exhibit activities against atherosclerosis, liver disease, cancer, diabetes and other metabolic syndromes.^[14]

[New] Chrysanthemum lavandulifolium: Daisy

The multi-targeted effects of Chrysanthemum herb extract against Escherichia coli O157:H7.[2013]

[New] Cuminum cyminum: cumin

• Antimicrobial activity of the bioactive components of essential oils from Pakistani spices against Salmonella and other multi-drug resistant bacteria. [2013]

Wikipedia states:

In Sanskrit, Cumin is known as Jiraka. Jira means “that which helps digestion”. In Ayurvedic system of medicine, dried Cumin seeds are used for medicinal purposes. The dried cumin seeds are powdered and used in different forms like kashaya (decoction), arishta (fermented decoction), vati(tablet/pills), and processed with ghee (a semi-fluid clarified butter). It is used internally and sometimes for external application also. It is known for its actions like enhancing appetite, taste perception, digestion, vision, strength, and lactation. It is used to treat diseases like fever, loss of appetite, diarrhea, vomiting,  abdominal distension, edema and puerperal disorders.^[15]

A popular drink in southern India such as Kerala and Tamil Nadu is calld jira water, made by boiling cumin seeds in water.^[16] It is understood that cumin is beneficial for heart disease, swellings, tastelessness, vomiting, poor digestion and chronic fever.^[17]

Ahmad Reza Gohari and Soodabeh Saeidnia have reviewed the Phytochemistry of Cuminum cyminum seeds and its standards. They have reported many pharmacological effects such as anti-diabetic, Immunologic, anti-epileptic, anti-tumor and antimicrobial activities.’^[18] A study by researchers at Mysore University in India reports the potential anti-diabetic properties of cumin.^[19]

Efraim Lev and Zohar Amar have reported several medicinal properties and health benefits of cumin seeds.^[20] According to the authors, cumin seeds and warm jeera water is believed to improve saliva secretion, provide relief in digestive disorders.

[New] Allium hirtifolium Boiss: Persian shallot

Chemical composition and antibacterial and cytotoxic activities of Allium hirtifolium Boiss.[2013]

Wikipedia states:

Allium stipitatum is used as a medicinal plant in Central Asia. Extracts of the bulbs of the plant, which showed activity against Mycobacterium tuberculosis, were found to contain severalpyridine-N-oxide derivatives. Analysis of the cut plant using a mass spectrometer equipped with a DART ion source showed the presence of N-hydroxypyridine-2-thione, also known aspyrithione, a compound which is moderately cytotoxic toward human tumour cell lines, and highly active against fungi and Gram-negative bacteria. Pyrithione-containing plant extracts are used in herbal medicine for treatment of malaria