"Bell's Palsy of the Gut" and other GI Manifestations of Lyme and Associated Diseases
PRACTICAL GASTROENTEROLOGY — April, 2006
SUMMARY
Bell's palsy signifies
paralysis of facial muscles related to inflammation of the associated
seventh Cranial Nerve. Physicians may not realize that this
syndrome is caused by the spirochetal agent of Lyme disease
until proven otherwise. Whether it is a full or hemi facial
paralysis, Bell's palsy is cosmetically disfiguring when fully
expressed. Sudden loss of normal facial expression terrifies
patients who naturally fear they are having a stroke. When a
smile is asked for, normal countenances warp into bizarre grimaces.
The amount of tooth area exposed in this attempt to smile helps
doctors evaluate the degree of paralysis and its change over
time. In every case of Bell's, doctors need to carefully investigate
by history, physical, and laboratory work every shred of evidence
that might suggest the presence of cryptic tertiary Lyme, a
serious multisystem, gut and neuro-brain infection even though
about half of fully diagnosed patients have no evidence whatsoever
of having had a tick-bite.
Gastrointestinal Lyme disease may cause gut paralysis and a
wide range of diverse GI symptoms with the underlying etiology
likewise missed by physicians. Borrelia burgdorferi, the microbial
agent often behind unexplained GI symptoms—along with
numerous other pathogens also contained in tick saliva—influences
health and vitality of the gastrointestinal tract from oral
cavity to anus. Disruptions caused by GI borreliosis (Lyme)
may include, amongst many others, distortions of taste, failure
of other neural functions that supply the entire GI tract—paralysis
or partial paralysis of the tongue, gag reflex, esophagus, stomach
and nearby organs, small and/or large intestines ("ileus"),
bowel pseudo-obstruction, intestinal spasms, excitability of
gut muscles, inflammation of lumen lining tissues, spirochetal
hepatitis, possibly cholecystitis, dysbiosis, jejunal or ileal
incompetence with resultant small intestine bacterial overgrowth
(SIBO), megacolon, encopresis and rectal muscle cramping (proctalgia
fugax).
In cerebral hypothalamic and pituitary centers, usual sites
of borrelial disruptions of the brain's normal hormonal cascades,
there are strong influences on human attitudes, ideation, and
behavior relating to gastronomic issues. Newly discovered Lyme-endangered
cerebral hormones and renegade cytokines regulate brain-gut
interactions thus initiating behavioral tendencies such as anorexia
or a failure of satiety with resultant obesity.
Ticks and other vectors of Lyme disease attract their own infections
from many microbes, some known and some unknown (viruses, amoebas,
bacteria, and possibly parasitic filaria), which they then also
can pass on to humans. The GI tract is especially vulnerable
to machinations of such co-infections as bartonellosis, mycoplasmosis,
human anaplasmosis (HA), and human monocytic ehrlichiosis (HME).
Syndromes exactly similar to Irritable Bowel Syndrome (IBS),
Crohn's Disease, and cholecystitis, for example, may not have
readily suggested a borrelial etiology to the diagnostician
but Lyme increasingly is known to be a potential contributor
to each.
All known Lyme-gut syndromes are treated by combining several
effective antimicrobials (including use of azole medications
with specific antibiotics) with agents that boost gut lining
repairs and overall immunity enhancement. Azole medications
are borreliacidal (against the anti-Bb spirochetal cyst form)
medications such as metronidazole (Flagyl). Needed GI healing
agents may include gut stimulants or relaxants, Ph agents, bile
salts, nutriceuticals, immunity-enhancers, neurotoxin absorbents,
and sterilizers of gut-specific microbes.
Parallelism between Lyme borreliosis-caused paresis of facial
muscles supplied by Cranial Nerve VII and Lyme-caused gastrointestinal
paralyses suggested a pseudonym to the author—Bell's palsy
of the Gut—despite the fact that these syndromes are related
to different types of neural fibers and only occasionally occur
together. Since similar injury to all sites may be etiologically
related, however, otherwise unexplained gastrointestinal symptoms
should be considered as possibly related to Lyme borreliosis
and/or its co-infections until proven otherwise.
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Practice of Psychiatry,
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