Mucoid plaque

Mucoid plaque or mucoid rope is a term used by some alternative medicine advocates to describe a combination of allegedly harmful mucus-like material and food residue that they say coats the gastrointestinal tract of most people. The term was coined by Richard Anderson, a naturopath and entrepreneur, who sells a range of products that claim to cleanse the body of such plaques by causing them to be eliminated.^[1] Many such "colon cleansing" products are promoted to the public on websites that have been described as making misleading medical claims.^[2] The presence of laxatives, clay, and fibrous thickening agents in some of these "cleansing agents" have led to suggestions that the products themselves produce the excreted product regarded as the plaque.^[2][3]

Mucus is a naturally occurring product of the digestive system and plays an important role in protecting it from damage and infection.^[4][5] This mucus layer is less than a millimetre thick, but may become thinner or be removed entirely in diseases such as ulcerative colitis, which exposes the surface of the intestine to damage.^[6][7] However, the concept that this mucus layer might form a 'mucoid plaque' has been dismissed by physicians as having no anatomical or physiological basis.^[8][9][10]

History

Various forms of colon cleansing were popular in the 19th and early 20th century.^[11] In 1932, Bastedo wrote in the Journal of the American Medical Association about his observation of mucus masses being removed by a colon irrigation procedure: "When one sees the dirty gray, brown or blackish sheets, strings and rolled up wormlike masses of tough mucus with a rotten or dead-fish odor that are obtained by colon irrigations, one does not wonder that these patients feel ill and that they obtain relief and show improvement as the result of the irrigation."^[12]

While colonic irrigation enjoyed a vogue in early 20th century as a possible cure for numerous diseases, subsequent research showed that it was useless and potentially harmful. With the scientific rationale for "colon cleansing" disproven, the idea fell into disrepute as a form of quackery, with a recent medical review stating that "there is no evidence to support this ill-conceived theory that has been long abandoned by the scientific community."^[13] Similarly, in response to claims that colon cleansing removes "toxins" Bennett Roth, a gastroenterologist at the University of California stated "There is absolutely no science to this whatsoever. There is no such thing as getting rid of quote-unquote 'toxins.' The colon was made to carry stool. This is total baloney."^[14] The preoccupation with such bowel management products has been described as a "quaint and amusing chapter in the history of weird medical beliefs."^[15] Nevertheless, interest in colonic "autointoxication" as a cause of illness, and in colonic irrigation as a cure, enjoyed a revival in alternative medicine at the end of the 20th century.^[16]

The term "mucoid plaque" was coined and popularized by naturopath Richard Anderson.^[3][17] However, Anderson acknowledges that a similar concept has been described previously by practitioners of alternative medicine. Victor Earl Irons and Bernard Jensen used the terms "toxic mucous lining" or "toxic mucous layer" in their books. Robert Gray referred to "mucoid matter" in his 1990 book on colon health.

Statements by Anderson

Anderson describes a mucoid plaque as a rubbery, ropey, generally green gel-like mucus film that covers the epithelial cells of the hollow organs, particularly of the alimentary canal. Anderson also claims the plaque can impair digestion and the absorption of nutrients, hold pathogens, and cause illnesses such as diarrhea, bowel cancer, allergies and skin conditions. Based on these claims, he promotes efforts to remove the plaque, and sells a range of products to this end.^[17]

Though Anderson states his beliefs are backed by scientific research, his claims are primarily supported by anecdotal evidence rather than empirical data^[18] and doctors have failed to note the existence of mucoid plaques. Anderson claims this is due to medical textbooks failing to cover the concept and therefore doctors not knowing what to look for.^[1]

Medical evaluation

Practicing physicians have dismissed the concept of mucoid plaque as a hoax and a "non-credible concept".^[8] A pathologist at the University of Texas School of Medicine addressed Anderson's claims directly, saying that he has "seen several thousand intestinal biopsies and have never seen any 'mucoid plaque.' This is a complete fabrication with no anatomic basis."^[1][9] Another pathologist, Edward Friedlander, has noted during his experience that he has never observed anything resembling a "toxic bowel settlement" and that some online photographs actually depict what he recognises as a blood clot.^[10] Commenting on claims that waste material can adhere to the colon, Douglas Pleskow, a gastroenterologist at Beth Israel Deaconess Medical Center, stated "That is the urban legend. In reality, most people clear their GI tract within three days."^[14]

In a review of websites promoting products that claim to remove 'mucoid rope' or plaque from consumers' intestines, Howard Hochster of New York University wrote that these websites are "abundant, quasi-scientific, and unfortunately convincing to a biologically uneducated public." He noted that although such sites are entertaining, they are disturbing in that they promote a belief that has no basis in physiology.^[2] Hochster also noted that a preparation marketed to remove mucoid plaque contains laxatives and bulky fibrous ingredients. Thus, the ropy residue expelled from people who consume this product "certainly is a result of the figs and senna in this preparation," rather than any sort of pathologic 'plaque'.^[2] Other 'colon cleanser' products contain bentonite clay that, when ingested, would also result in production of bulky stools.^[3]

References

1. ^ ^{a b c} "Colon cleanses thrive despite scant proof". The Georgia Straight. http://www.straight.com/article/colon-cleanses-thrive-despite-scant-proof. Retrieved 2008-11-05. 
2. ^ ^{a b c d} Hochster H. (2007). ""Colon Health" Websites". Current Colorectal Cancer Reports 2 (3): 105–106. doi:10.1007/s11888-006-0027-6. http://www.springerlink.com/content/ek65mh78p0k25595/fulltext.pdf. 
3. ^ ^{a b c} Joe Schwarcz "I have a gut feeling something's wrong here." The Gazette Saturday, April 05 2008
4. ^ Allen A, Flemström G (January 2005). "Gastroduodenal mucus bicarbonate barrier: protection against acid and pepsin". Am. J. Physiol., Cell Physiol. 288 (1): C1–19. doi:10.1152/ajpcell.00102.2004. PMID 15591243. 
5. ^ Schenk M, Mueller C (2008). "The mucosal immune system at the gastrointestinal barrier". Best Pract Res Clin Gastroenterol 22 (3): 391–409. doi:10.1016/j.bpg.2007.11.002. PMID 18492562. 
6. ^ Pullan RD, Thomas GA, Rhodes M, et al. (March 1994). "Thickness of adherent mucus gel on colonic mucosa in humans and its relevance to colitis". Gut 35 (3): 353–9. doi:10.1136/gut.35.3.353. PMC 1374589. PMID 8150346. http://gut.bmj.com/cgi/pmidlookup?view=long&pmid=8150346. 
7. ^ Strugala V, Dettmar PW, Pearson JP (May 2008). "Thickness and continuity of the adherent colonic mucus barrier in active and quiescent ulcerative colitis and Crohn's disease". Int. J. Clin. Pract. 62 (5): 762–9. doi:10.1111/j.1742-1241.2007.01665.x. PMID 18194279. 
8. ^ ^{a b} Soergel, Dagobert; Tony Tse, Laura Slaughter (2004 accessdate=2007-02-21). "Helping Healthcare Consumers Understand: An "Interpretive Layer" for Finding and Making Sense of Medical Information". MedInfo2004. IOS Press, Amsterdam. http://cmbi.bjmu.edu.cn/news/report/2004/medinfo2004/pdffiles/papers/5509Soergel.pdf. 
9. ^ ^{a b} Uthman, Edward. "Mucoid Plaque". Quackwatch. http://www.quackwatch.org/04ConsumerEducation/QA/mucoidplaque.html. Retrieved 2007-02-21. 
10. ^ ^{a b} Friedlander, Ed. "Ed’s Guide to Alternative Therapies: Colonics". http://www.pathguy.com/altermed.htm#colonic. Retrieved 2007-02-21. 
11. ^ Sullivan-Fowler M (July 1995). "Doubtful theories, drastic therapies: autointoxication and faddism in the late nineteenth and early twentieth centuries". J Hist Med Allied Sci 50 (3): 364–90. doi:10.1093/jhmas/50.3.364. PMID 7665877. http://jhmas.oxfordjournals.org/cgi/reprint/50/3/364. 
12. ^ Bastedo WA (1932). Colonic irrigations: their administration, therapeutic application and dangers. 98. JAMA. pp. 736. 
13. ^ Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A (January 2005). "Myths and misconceptions about chronic constipation". Am. J. Gastroenterol. 100 (1): 232–42. doi:10.1111/j.1572-0241.2005.40885.x. PMID 15654804. 
14. ^ ^{a b} Foreman, Judy (June 30, 2008). "Beware of colon cleansing claims". Los Angeles Times. http://www.latimes.com/features/health/medicine/la-he-toxic30-2008jun30,0,4875078.column. 
15. ^ Grady, Denise (May 23, 2000). "Cult of the Colon: From Little Liver Pills to Big Obsessions". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9A05E2DA1E3AF930A15756C0A9669C8B63&sec=health&spon=&partner=permalink&exprod=permalink. 
16. ^ Ernst E (June 1997). "Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science". J. Clin. Gastroenterol. 24 (4): 196–8. doi:10.1097/00004836-199706000-00002. PMID 9252839. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0192-0790&volume=24&issue=4&spage=196. 
17. ^ ^{a b} Anderson, Richard (2000). Cleanse & Purify Thyself, Books One and Two. Christobe Publishing. 
18. ^ "Some Skeptical Perspectives on Colon Cleansing". http://www.colonsource.com/skeptics.html. Retrieved 2008-11-05.