Mastic Ventures into New Territory
Mastic Helps Treat
It reduces inflammation and improves
antioxidant potential in
this inflammatory bowel disease
By Will Block
Government is like a baby: an alimentary canal with a big
appetite at one end and no sense of responsibility at the other.
— Ronald Reagan
ere’s something you probably never thought about: from mouth to anus, your alimentary canal constitutes one long, convoluted, fibromuscular tube through your body, and the inner surface of it is contiguous with your skin: they constitute a physical continuum—a single, unbroken surface. In effect, your body is like a doughnut, in that all of its material substance surrounds a single “hole”: your digestive tract.
Theoretically, it would be possible to smoosh your body into the shape of a doughnut without breaking any part of the surface, inside or outside (you wouldn’t like it, though). Conversely, and still in theory, one could fashion a doughnut into the shape of a human—digestive tract and all—just by stretching and molding it, without breaking the crust anywhere.
Why is this important? Who cares? Mathematicians do, as well as regular folks who relish oddities. Transforming a human shape into a doughnut shape is a simple example of concepts that are studied via a branch of higher mathematics called topology. This is the study of the “nonbreaking” transformations of geometric shapes, including complex shapes in spaces of not just two or three dimensions, but many (higher-dimensional spaces figure prominently in mathematics and in theoretical physics and chemistry).
Topologically speaking, a doughnut—called a torus in techspeak—is equivalent not just to you and me but also to a garden hose, an empty picture frame, a car key, a coffee mug, and countless other things that have just one hole passing through them. A torus cannot be mathematically transformed into a sphere (the simplest geometric shape with a single surface), because a sphere has no hole through it. Nor does a bowling ball, which is topologically equivalent to a top hat, a trowel, a trident, a tree, etc., each of which has just one surface with no hole through it.
Enter Crohn’s Disease—The Fun Is Over
Wasn’t that fun? Now let’s get serious about that roughly 30-foot-long tube running through your body—in particular, the part called the ileum (about 12 feet long), which is the last of the three segments of your small intestine. (After the stomach comes the duodenum, then the jejunum, then the ileum, then the large intestine, or colon.) You probably don’t spend much time thinking about your ileum, which is just as well—it’s no place you’d want to visit. If something goes wrong with it, though, it might be hard to think of anything else.
Among the things that can go wrong with the ileum is Crohn’s disease, which is one of the two types of inflammatory bowel disease, the other being ulcerative colitis.* They are chronic disorders of the small and large intestines, of unknown cause, characterized by inflammation and by distinctive but overlapping signs and symptoms.
Ulcerative colitis is an inflammation of the colon (and sometimes the rectum), with ulcers. Its primary symptoms are rectal bleeding, diarrhea, and abdominal pain, and it often causes anemia, low protein levels in the blood, and electrolyte imbalances. That’s bad enough, but Crohn’s disease (also known as regional enteritis) is worse. First of all, it can affect any part of the gastrointestinal tract, from mouth to anus, although the ileum is the most common site, with the colon second. Crohn’s disease is characterized by patchy, deeply invasive ulcers and by a narrowing and thickening of the bowel by fibrosis (formation of fibrous tissue). The disease is episodic; in the active phase, the inner wall of the intestine often shows a characteristic “cobblestone” effect caused by interconnecting ulcerations.
The symptoms of Crohn’s disease include fever, bloody diarrhea, cramping abdominal pain, and loss of appetite, which leads to weight loss. The ability of the intestinal lining to absorb vital nutrients and deliver them to the bloodstream is also impaired, which can cause malnutrition and anemia. The most serious vitamin malabsorption is that of B12, which is already deficient in many older people.
Crohn’s disease in a colon (endoscopic image), showing the characteristic deep, painful ulcerations.
A recent study in Europe showed that, 10 years after a diagnosis of Crohn’s disease, the risk of death is increased by as much as twofold, in both men and women. The increased risk is largely attributable to gastrointestinal causes related to the disease. Worldwide, the disease afflicts about one million people (including half a million in the United States), mainly in the age range 15 to 35; it can also occur in the elderly, however.
Enter Mastic, a Gastrointestinal Benefactor
Whereas ulcerative colitis can be corrected by surgery in severe cases, Crohn’s disease usually cannot—and there is no cure. It can, however, be treated with powerful drugs, including sulfa drugs, corticosteroids, other anti-inflammatories, and antibiotics. Not surprisingly, most of these drugs have adverse side effects that can make their use decidedly unpleasant even as they help alleviate the misery of Crohn’s disease. Thus there is an incentive to find nutritional supplements that can help Crohn’s victims without causing significant side effects.
One such natural remedy is an extract of frankincense, a gum resin that comes from the deciduous tree Boswellia serrata in India (see
“Blessed Relief for Inflamed Bowels, Lungs, and Joints” in the January 2002 issue). Others that may be useful are: the omega-3 fatty acid DHA (docosahexaenoic acid), which is found in coldwater fish oil; the vitamin A precursor beta-carotene; and the bioflavonoid rutin. To that short list of possible remedies can now be added mastic, the gum resin of the mastic tree (Pistacia lentiscus), which is native to the Mediterranean region.
Mastic has been used for millennia for treating gastrointestinal ailments and is now known to kill Helicobacter pylori, the bacterium responsible for most cases of nonerosive gastritis (a chronic inflammation of the stomach) and most gastric and duodenal ulcers, collectively known as peptic ulcers; H. pylori is also implicated in stomach cancer.*
Trust Greeks Bearing Supplements
Because of mastic’s therapeutic history and because of its known antibacterial, anti-inflammatory, and antioxidant properties, researchers in Greece decided to test its efficacy on patients with Crohn’s disease. They recruited ten patients with mild to moderate cases, based on their scores on the Crohn’s Disease Activity Index (CDAI), a rating scale that encompasses eight elements:
- Daily number of liquid or very soft stools
- Severity of abdominal pain or cramping
- General sense of well-being
- Presence or absence of other-than-intestinal
manifestations of CD
- Presence or absence of an abdominal mass
- Use of antidiarrheal drugs
- Hematocrit (a measure of the concentration of
red blood cells in the blood)
- Body weight
Also included in the study were eight healthy controls; none had any inflammatory condition. For 4 weeks, all 18 subjects were given 2.2 g of powdered mastic (in capsules) daily. They were not allowed to consume mastic in any other form, such as chewing gum or candy or as an ingredient in bread (mastic is a common food item in Greece), nor were they allowed to consume fish oil in any form. Their dietary intakes were monitored via food-frequency questionnaires and 24-hour recall interviews. There were no significant side effects from the mastic treatment.
Before and after the 4-week period, the researchers measured the subjects’ CDAI scores as well as their scores on the Nutritional Risk Index (NRI), a rating scale that evaluates a person’s risk for malnutrition due to any cause, including malabsorption of ingested nutrients. Malnutrition is very common in CD patients. Also measured were four known markers of inflammation: C-reactive protein (CRP); interleukin-6 (IL-6); tumor necrosis factor-α (TNF-α); and monocyte chemotactic protein-1 (MCP-1). Finally, the researchers measured the subjects’ “total antioxidant potential” (TAP), a measure of their ability to combat the increased production of free radicals associated with inflammatory processes.
Mastic Improved Patients’ Health and Nutritional Status …
Although this was a small pilot study with no placebo control (a serious weakness), the results were sufficiently encouraging to warrant further research on a more ambitious scale. The CD patients’ overall scores on the CDAI showed substantial improvement; the two elements most strikingly improved were the daily number of liquid stools and the patients’ sense of well-being.
The CD patients also showed improvement on the NRI, although it was not considered to be statistically significant, and they remained in the moderate risk category. (The healthy controls had normal NRI scores, i.e., no risk, throughout.) The measured improvement was seen primarily in the form of weight gain, and the researchers attributed this to the fact that mastic treatment had reduced the number of liquid stools, thereby improving the absorption of nutrients from the bowel.
… And It Reduced Inflammation and Increased Antioxidant Status
At the outset of the study, not surprisingly, the CD patients had much higher levels of the four markers of inflammation than the controls. After the 4-week mastic treatment, these levels had not changed in the controls, but all four had decreased in the CD patients—significantly so for CRP and IL-6, but not significantly for TNF-α or MCP-1.
By contrast with the inflammation markers, the CD patients had lower initial levels of total antioxidant potential than the controls, meaning that they were less able to resist the damaging effects of oxidative stress. Mastic treatment resulted in significant increases in TAP in both groups, but by greatly differing amounts: 25% higher in the controls vs. 280% (3.8 times) higher in the CD patients. Maximizing one’s TAP is important for many reasons, including the salient fact that inflammatory processes, such as those involved in Crohn’s disease, are both a cause and an effect of oxidative stress.
A Peek at Our Intestines
When you eat a meal, most of your food spends about 2 to 4 hours in your stomach, being chemically broken down and physically churned before your pyloric valve releases it, as a pasty mess called chyme (pronounced kime), into your small intestine. There, during the next 3 to 5 hours, the lion’s share of your digestion takes place. Most of the nutrients your body needs are extracted from the chyme and absorbed through the intestinal wall into the portal blood circulation, which takes them to the liver for chemical processing before they’re released into the general circulation. (The stomach, by the way, is a convenient but relatively unimportant organ and is dispensable—most people who have had their stomach surgically removed because of cancer do very well without it.)
After the small intestine completes its work, what’s left of your food (most of it, actually) passes into your large intestine (the colon). Under normal circumstances, it remains there for another 10 hours to several days, depending on various factors, including your regularity. Thus, for most foods, the transit time from beginning to end (in a healthy person) can be as little as about 15 hours, but it’s usually much longer than that.
The waste entering your colon—it’s no longer chyme but is not yet feces—is a soupy gruel consisting mainly of indigestible fiber, mucus, and a lot of water from the spent digestive juices that processed the food in your stomach and small intestine. It has little value except for the fiber content, which helps move things along—a desirable outcome, so to speak, in terms of cancer prevention. Nonetheless, the colon still has much work to do. Mainly, it reabsorbs most of the water (if it doesn’t—diarrhea) and returns it to your circulation; this is a long, slow process.
The billions of bacteria your colon harbors (which are harmless as long as they stay there) are actually very beneficial. Among other things, believe it or not, they help produce several vitamins, most notably B12, as they feed on the waste material and turn it into feces. Ironically, as the accompanying article mentions, Crohn’s disease results in such poor absorption of vitamin B12 that a deficiency of it is common.
Where Does Mastic Work?
An intriguing question is whether the biologically active components of mastic, especially the polyphenolic and triterpenoid compounds, exerted their effects systemically, via the circulation, or locally by direct contact with the mucosal surface of the ileum—or perhaps both. The answer is unknown, but what is known is that many polyphenolic compounds are poorly absorbed through the intestinal walls and wind up exiting the body via the back door. The same may be true of many triterpenoid compounds, about whose bioavailability even less is known than about that of the polyphenolics.
On their way out, though, these compounds come in contact with the inner lining of the colon, where they may wind up doing good in terms of reducing inflammation and even combating cancer.* Mastic is known to kill colon cancer cells in the laboratory, and it may be effective in real life as well (see
“Mastic Kills Colon Cancer Cells,” September 2005). It’s also effective against inflammation, both locally (in the mouth) and systemically (see
“Mastic Helps Curb Inflammation,” September 2006).
© iStockphoto.com/Joey Nelson
A Holesome Conundrum
When someone asks, “Do you feel like a doughnut?” they probably mean: would you like to eat one? But now that you know all about topology, you might think they’re asking if you feel as though you are one. It would be unwise to answer, “No, I feel like a human,” because that too could be misinterpreted. See how tricky this gets? Rule of thumb: it’s better to eat a doughnut than to be one.
In any case, it’s good to know that anything you eat will almost certainly be efficiently processed by your digestive system—a true marvel of biochemical engineering—so as to extract from it the nutrients you need. And if one of those nutrients is mastic, you can be sure that it will benefit your health, all the way down to your bowels.
- Anon. Crohn’s disease ups risk of death. Reuters Health, April 14, 2006.
- Kaliora AC, Stathopoulou MG, Triantafillidis JK, Dedoussis GVZ, Andrikopoulos NK. Chios mastic treatment of patients with active Crohn’s disease. World J Gastroenterol 2007;13(5):748-53.
Will Block is the publisher and editorial director of Life Enhancement magazine.