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Mucoid plaque or mucoid rope is a term used by some alternative medicine advocates to describe an 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. Many such "colon cleansing" products are promoted to the public on websites that have been described as making misleading medical claims. Indeed, 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.

Mucus is a naturally occurring product of the digestive system and plays an important role in protecting the surface of the gut from damage and infection. 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. However, the concept that this mucus layer might form a 'mucoid plaque' has been dismissed by physicians as having no anatomical or physiological basis.

History

Various forms of colon cleansing were popular in the 19th and early 20th century. 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.”

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." 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." The preoccupation with such bowel management products has been described as a "quaint and amusing chapter in the history of weird medical beliefs." 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.

The term "mucoid plaque" was coined and popularized by naturopath Richard Anderson. 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

The mucoid plaque is described by Anderson as a "gel-like, viscous and slimy mucus that forms as a layer or layers covering epithelial cells in various hollow organs, especially all the organs of the alimentary canal." It is generally described as rubbery, ropey and often green.

Anderson further claims that the plaque is a health threat. He contends it can impair digestion and nutrient absorption, cause sugar intolerance, provide a haven for pathogens and parasites and cause diarrhea. In addition the condition is alleged to promote the development of bowel cancer, allergies and skin conditions. Anderson advocates the removal of mucoid plaque as a health benefit, and promotes a range of products he has developed that are said to accomplish this task.

Anderson insists his claims are backed up by papers and textbooks on digestive physiology. He provides as evidence a scanning electron microscope study that reports the presence of thick mucous layers in the small intestines of children with chronic diarrhea and food intolerances. One of Anderson's chief replies to his critics is that the reason there have not been confirmed reports of mucoid plaque by the medical profession is because current medical textbooks do not cover the concept and therefore doctors do not know what to look for.

Anderson claims that doctors are mistaken when they say that the mucus layer is needed for lubrication and protection of the mucosal surface. He says that the glycocalyx layer, which is underneath the mucus layer and contains alkaline buffering agents, actually peforms these important functions. He says that most doctors don’t know the difference between the mucus layer and the glycocalyx layer even though biopsies studied with the electron microscope demonstrate this important difference.

In response to concerns that his cleanse products might actually create mucoid plaque rather than remove it, he claims, in his defense, that mucoid plaque stools have been described in conventional medical literature long before his cleanse products have been used.

Anderson also alleges that a number of conditions recognised as distinct disorders or physiological entities by the medical community are actually varying manifestations of mucoid plaque – such as amyloidosis, gastric metaplasia, hypertrophia, inflammatory bowel disease, intestinal lymphangiectasia, malacoplakia, mucoviscoidosis, polypus and villous adenoma. However, other marketers of colon cleansing products have ackowledged that mucoid plaque holds no standing amongst the medical profession and is backed up primarily by anecdotal evidence rather than empirical data.

Medical evaluation

Practicing physicians have dismissed the concept of mucoid plaque as a hoax and a "non-credible concept". 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." 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. 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."

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.

Causes

Anderson says that mucoid plaque is generated by the human body in response to harmful toxins. Dietary sources of these toxins listed by Anderson include processed food, alcohol and salt. He further states that drugs exacerbate the condition, as do intestinal parasites, and that imbalance of internal microbiota caused by antibiotics promotes plaque formation.

In contrast, a doctor reviewing the websites that sell these 'colon cleansers' noted that one of the preparations marketed to remove mucoid plaque contains laxatives and bulky fibrous ingredients, and concluded that the "ropy residue" expelled from people who consume this product "certainly is a result of the figs and senna in this preparation." Similarly bulky stools are produced by the passage through the gut of the remains of "cleansers" containing other fibrous materials or bentonite clay.

References

1. ^ "Colon cleanses thrive despite scant proof". The Georgia Straight. Retrieved 2008-11-05.
2. ^ Hochster H. (2007). ""Colon Health" Websites" (PDF). Current Colorectal Cancer Reports. 2 (3): 105–106. doi:10.1007/s11888-006-0027-6.
3. ^ Joe Schwarcz "I have a gut feeling something's wrong here." The Gazette Saturday, April 05 2008
4. Allen A, Flemström G (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. {{cite journal}}: Unknown parameter |month= ignored (help)
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. (1994). "Thickness of adherent mucus gel on colonic mucosa in humans and its relevance to colitis". Gut. 35 (3): 353–9. PMC 1374589. PMID 8150346. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
7. Strugala V, Dettmar PW, Pearson JP (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
8. ^ Soergel, Dagobert (2004 accessdate=2007-02-21). "Helping Healthcare Consumers Understand: An "Interpretive Layer" for Finding and Making Sense of Medical Information" (PDF). MedInfo2004. IOS Press, Amsterdam. {{cite web}}: Check date values in: |date= (help); Missing pipe in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
9. ^ Uthman, Edward. "Mucoid Plaque". Quackwatch. Retrieved 2007-02-21.
10. ^ Friedlander, Ed. "Ed's Guide to Alternative Therapies: Colonics". Retrieved 2007-02-21.
11. Sullivan-Fowler M (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. PMID 7665877. {{cite journal}}: Unknown parameter |month= ignored (help)
12. Bastedo WA (1932). "Colonic irrigations: their administration, therapeutic application and dangers". 98. JAMA: 736. {{cite journal}}: Cite journal requires |journal= (help)
13. Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
14. ^ Judy Foreman "Beware of colon cleansing claims." Los Angeles Times June 30, 2008
15. Grady, Denise (May 23, 2000). "Cult of the Colon: From Little Liver Pills to Big Obsessions". New York Times.
16. Ernst E (1997). "Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science". J. Clin. Gastroenterol. 24 (4): 196–8. PMID 9252839. {{cite journal}}: Unknown parameter |month= ignored (help)
17. ^ Anderson, Richard (2000). Cleanse & Purify Thyself, Books One and Two. Christobe Publishing.
18. Richard Anderson (2007). "FAQ's". cleanse.net. Retrieved 2008-11-08.
19. "Some Skeptical Perspectives on Colon Cleansing". Retrieved 2008-11-05.

• Pseudoscience
• Alternative detoxification
• Digestive system