Mucoid Plaque is a Scientifically Proven Reality

Take a look at this photograph. Have you ever eliminated something like this? Some of you will recognize this as mucoid plaque. If you never heard of mucoid plaque before then look it up. Now, I have a little bit of a surprise for you. This photograph did not come from a colon cleansing enthusiast. It came from a conventional textbook called A Colour Atlas of the Digestive System.[13] It was actually removed from a young woman with irritable bowel syndrome.

You will hear different explanations as to what mucoid plaque actually is. Walter Bastedo [15] spoke of it as some sort of tough mucus. Benard Jensen [18] and Robert Gray [19] both thought it was primarily a mixture of old compacted feces and sticky mucus. Richard Anderson thinks it's coagulated mucus that compounds with other unspecified elements.[20] Skeptics, on the other hand, want you to believe that it is simply the psyllium and bentonite shake that cleansers typically ingest.[17]

But all these people are wrong. What mucoid plaque actually is, in reality, is a mixture of primarily necrotic epithelium cellular debris, fibrin and mucus that naturally forms over damaged areas of the gastrointestinal tract. It may be composed of other things as well such as bacteria, digested food, albumin, and inflammatory cells. But it's primarily necrotic tissue, fibrin and mucus.

If you open up a textbook of wound healing you will see that it is referred to as "eschar" or "slough" and is clinically described as "black", "brown", "gray", "yellow", "green", "hard", "soft", "mucoid", "stringy", "sticky", "rubbery", "leathery", "putrid" and "foul".[21] Incidentally, this is exactly how Richard Anderson, Robert Gray, and Benard Jensen clinically described mucoid plaque! [22] In the fourth edition of Clinical Gastroenterology by Howard M. Spiro there is a nice endoscopic photograph of mucoid plaque.[14] It's plate 83. Here it is:

This is plate 83. It depicts acute ischemic colitis. The caption reads "The necrotic mucosa is sloughing off extensively, producing temporary bridges across the lumen of the colon." Medical science sometimes calls this "mucoid plaque". See reference number 1.

This is probably in need of an explanation. So let me explain. Everyone knows about the adherent mucus layer. But there is another layer that is distinct from the adherent mucus layer that everyone is ignoring.[2][3][4] Medical science calls it "mucoid cap". [2-12] But occasionally, medical science also calls it "mucoid coat"[4] or "mucoid plaque".[1] You see, everyday the food that you eat is causing damage to your mucosa.[5] This causes a type of chronic inflammation whereby fibrinogen and necrotic cellular debris mixes in with the adherent mucus layer forming a "cap" over the damaged mucosa. Mucoid cap is substantially thicker than the adherent mucus layer. [4] It is over ten times thicker. [3] It protects the damaged mucosa from digestive acids while it undergoes repair.

Normally, to endoscopists peering into the intestines, mucoid cap has a "granular" appearance.[4] It will also cover up any blood vessels or villi so you can't see them. Endoscopists are so used to seeing this that they think it is "normal".[23] But they don't realize that what they are actually looking at is a mucus-exudate mixture covering up the eschar underneath.[4] Exudate itself is a mixture of variable amounts of albumin, fibrinogen, inflammatory cells, and red blood cells. It may be green, white, pink, red, tan or yellow. But it is most commonly pink or tan. Within the mucus, the fibrinogen coagulates into rubbery fibrin.[4] I believe the albumin might also coagulate within the mucus as well. Forstner observed that when a mucus-albumin mixture is exposed to a pH of 4.5 or lower, it forms into a dense white precipitate.[24] In any event, this mucus-exudate mixture forms a continuous cover over the eschar. To the uninitiated it can look like tissue.

But during acute inflammation, protein and white cells leach from blood vessels and percolate through the mucoid cap layer and into the lumen. The protein may enhance the growth of proteinase producing bacteria. The proteinase are also derived from white cells. In any event, the proteinase enzymes break down the mucus.[27] What follows is the disintegration of the mucoid cap layer.[28] This is called autolytic debridement. At first, the enzymes disintegrate the mucus-exudate mixture revealing the eschar underneath. Gastroenterologists sometimes call this "focal necrosis".[29] Later, the eschar rehydrates and swells up turning toward a yellow or tan "slough" that is soft and loose.[25] You can see this happening in plate 83. It depicts acute inflammation of a colitis patient. The eschar is "sloughing off" extensively producing temporary bridges across the lumen of the colon.

This is precisely what bonafide intestinal cleansers are designed to do. They contain either proteolytic enzymes or mucolytic herbs, which disintegrate the mucoid cap layer. It's called chemical debridement. The Journal of Family Practice published a critical article about the dangers of colon cleansing.[26] They give a case of a 49-year-old African American man who came to their hospital because of vomiting, diarrhea, and abdominal pain. He had used a colon cleanser a few days earlier. A computed tomography scan suggested an early or partial small bowel obstruction while a colonoscopy and biopsy revealed "chronic and acute inflammation". What is actually going on is what you see in plate 83.

Look, Brian Dunning is woefully misinformed. On his podcast Skeptoid he claims that the only recorded instances of mucoid plaque "snakes" in "all of medical history" come from the toilets of people who take these cleansing pills. This is not true. The two photographs I showed you came from patients who did not take any psyllium or bentonite. And let's not forget that mucoid plaque originally had nothing to do with psyllium or bentonite. As far as I can see, Walter Bastedo is the first person to advocate colon cleansing to remove mucoid plaque from the intestines as a way to alleviate autointoxication.[15] He writes in the Journal of the American Medical Association:

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.

His colitis patients never took any psyllium or bentonite. Byron Robinson's [16] colitis patients also never took any psyllium or bentonite:

The clinical symptoms are colicky pains and the evacuation of masses of mucus. The mucous masses may consist of flat (even membranes) long bands, ribbons, shreds or rolled-up tubes. Some portions assume a spiral form. . .The mucous masses are white, grayish white, or a color due to the mixing of mucus and feces, yellowish brown. . .A female attended by Dr. Lucy Waite and myself, would occasionally evacuate nearly half a pint of mucous membranes, masses, bands, tubes or unformed substances. In a male the evacuation showed more string or ribbon-like processes. . . The mucous masses may be transparent like slime, or opaque like fibrin, of a grayish white, or a dirty color with pigment in it. Sometimes the masses consist of large, wide and thick leathery-like membranes; at other times, long ribbon-like bands or rope-like coils.

Skeptics are spreading unscientific nonsense. They're claiming that psyllium and/or bentonite comes out looking like mucoid plaque. Experiments published in peer-reviewed medical journals have always shown that psyllium comes out as "soft" and "smooth" stools. There is no mention that it comes out rubbery, stringy or that it forms a cast of the intestines.

I know that Edward Uthman from quackwatch.org is a pathologist, and he claims that mucoid plaque is "a complete fabrication with no anatomic basis". But he is ignorant. Peer-reviewed medical journals and textbooks talk about mucoid plaque. See my references 1 through 12. Mucoid plaque is a conventional medical concept.

References

[1] See the 1973 edition of Diseases of the Colon & Rectum. It is volume 16 and number 6. The title of the article is "Ischemic Proctosigmoiditis: Report of a case". It was written by Won Sik Cynn & Robert R. Rickert. You can get it here. Go to page 539. It says "Early superficial zones of infarction may be covered by a mucoid plaque". On page 540, it defines mucoid plaque as a membrane of mucus, fibrin, necrotic cells, and a variable inflammatory exudate.

[2] See book called "Glycoprotein Methods and Protocols: The Mucins". It was published in year 2000 and written by Anthony Corfield. The ISBN is 0-89603-720-7. You can read it at books.google.com. Go to page 58. It speaks of a protective "mucoid cap" on the surface of damaged mucosa. It says it is "quite different" than the adherent mucus layer "consisting primarily of a fibrin gel and necrotic cells with some mucin".

[3] See article called "The Role of Mucus in the Protection of the Gastroduodenal Mucosa". It's in the Scandinavian Journal of Gastroenterology. I'm talking about volume 21 and supplement 125. It's dated 1986. Somewhere on pages 71-78, it talks about how the epithelial repair process is protected by a gelatinous coat of primarily a fibrin-based gel, mucus and necrotic cells that is "over ten times" thicker and "distinct" from the adherent mucus layer.

[4] See the book called "Gastric Cytoprotection: A Clinician’s Guide". The ISBN is 978-1-4684-5699-8. You can read it at books.google.com. It was published in 1989. Go to page 84. It speaks of a "mucoid coat" that is "quite different" than the adherent mucus layer. It says it is "substantially thicker" and visibly more "granular and sloppy" in appearance than the adherent mucus layer. It says it is composed principally of fibrin gel and necrotic cells with mucus as a relatively minor component. Also on page 84, it talks about how the "coagulation" of fibrin is "facilitated" by the adherent mucus layer providing a "template" for the deposition of fibrin. On page 85 there is actually a drawing of a cross section of mucoid plaque. It depicts the eschar as being completely covered by "mucus" (It's actually a mucus-exudate mixture). On page 87, it calls it "mucoid cap".

[5] See the book called "Pharmacology of Peptic Ulcer Disease". The ISBN-13 is 978-3-642-75860-7. It was written by Martin Collen and Stanley Benjamin. It was published in 1991. Go to page 194. It says that "mucoid cap" has been likened to an "everyday" phenomenon that forms in response to the ingestion of food and the mechanical grinding of digestion.

[6] See textbook called "Fundamentals of Inflammation". You can read it at books.google.com. The ISBN is 978-0-521-88729-8. It was published in 2010. Go to page 283. It talks about how a "mucoid cap" consisting of "cellular debris, mucus, and plasma proteins" forms over damaged regions of the epithelial surface.

[7] See textbook called "Physiology of the Gastrointestinal Tract". The ISBN is978-0-12-382026-6. It's the fifth edition, and it was published in 2012. Go to chapter 43.6.3. It talks about how when the mucosa becomes damaged, a "mucoid cap" composed of "mucus, cell debris, fibrin" as well as other undefined constituents forms a coating over the mucosa surface.

[8] See textbook called "Gastritis". It was written by Robert A. Kozol. You can read it at books.google.com. The ISBN is 0-8493-5497-8. It was published in 1993. Go to page 17. It talks about how a "mucoid cap" consisting of cellular debris, mucus, fluid, and protein forms over injured mucosa.

[9] See textbook called "The Stomach: Physiology, Pathophysiology and Treatment". You can read it at books.google.com. The ISBN-13 is 978-3-540-56613-7. It was published in 1993. Go to page 89. It says that when the mucosa becomes damaged, "plasma proteins and cellular debris" mixes in with the adherent mucus layer, increasing its thickness considerably. It calls it the "mucoid cap".

[10] See "Gastroduodenal mucus bicarbonate barrier: protection against acid and pepsin" in the American Journal of Physiology-Cell Physiology. You can read the full text here. The doi is 10.1152/ajpcell.00102.2004. It talks about a "mucoid cap" on top of damaged and repairing mucosa that is composed of "primarily a fibrin gel with necrotic cells" and mucus from the adherent mucus layer.

[11] See textbook called "Sucralfate: From Basic Science to the Bedside". The ISBN is 978-1-4757-7019-3. You can read it at books.google.com. It was published in 1995. Go to page 100. It says that damaged mucosa may be covered by a thick layer of sloughed cells, fibrin, and mucus called the "mucoid cap".

[12] See "Pathogenesis of NSAID-induced gastroduodenal mucosal injury" in the journal called Best Practice & Research Clinical Gastroenterology. It was published in 2001. The doi is 10.1053/bega.2001.0229. You can read the full text here. It talks about how a "mucoid cap" consisting of mucus, cellular debris and plasma proteins forms within seconds of stomach or duodenum epithelial injury.

[13] See the 1989 book called A Colour Atlas of the Digestive System. It is by R.E. Pounder, M.C. Allison and A.P. Dhillon. The ISBN is 0723408866. Open to page number 155 and see photo number 439. (Note: the page numbers are at the bottom, not the top; do not confuse page numbers with photo numbers.) The book also goes by the title Color Atlas of the Digestive System. It's the exact same book; it just has a slightly different cover and different publishing information. You can search both titles at worldcat.org to find the nearest library near you.

[14] The ISBN is 0-07-105434-0.

[15] See the 1932 article called "Colon irrigations: Their administration, therapeutic application and dangers". It's actually a subtitle under the main title of "Council on Physical Therapy". You can get it here. It's in The Journal of the American Medical Association and is volume 98 and number 9. Go to pages 734-736. It was written by Walter Bastedo.

[16] See the 1899 book called "The Abdominal Brain and Automatic Visceral Ganglia". It was written by Byron Robinson, M.D. You can read it at books.google.com. See pages 209-219.

[17] See Stephen Barrett from quackwatch, the confessions of a quackbuster at quackfiles, Brian Dunning on his podcast Skeptoid, the Skeptical Raptor, the "Full of It" section of Joe Schwarcz's book Is That A Fact?, and page 211 of Rose Shapiro's book Suckers: How Alternative Medicine Makes Fools of Us All.

[18] See book called "Tissue Cleansing Through Bowel Management". It was written by Bernard Jensen.

[19] See "The Colon Health Handbook" by Robert Gray.

[20] See the book called "Cleanse and Purify Thyself, Book 2: Secrets of Radiant Health and Energy". It was written by Richard Anderson. Go to page 59.

[21] There are three textbooks I got this from. The first is the third edition of "Wound Care: A Collaborative Practice Manual for Health Professionals". It was published in 2007 and written by Carrie Sussman & Barbara Bates-Jensen. Turn to page 197. It describes it as "gray", "yellow", "brown", "black", "mucoid", "stringy", "leathery", "hard" and "soft". The second is the second edition of "Comprehensive Wound Management". It was published in 2010 and written by Glenn Irion. Turn to page 150 and 151. It describes it as "yellow", "greenish", "hardened", "grayish", "brownish-yellow", "stringy" and "foul". The third is the fourteenth edition of "Tidy's Physiotherapy". It was published in 2008 and written by Stuart Porter. Turn to page 340. It describes fibrin as "sticky", "rubbery", and being visible as yellow-white "strands".

[22] Go to each of their books. See Richard Anderson's book called "Cleanse & Purify Thyself". I'm talking about book two. Go to pages 92-94. He described it as "soft", "gray", "yellow", "green", "brown", "black", "foul", "mucoid", and like "wet leather or rubber". Go to Robert Gray's book called "The Colon Health Handbook". See pages 8 and 67. He described it as "rubbery", "black", "hardened", "grey", "brown", "green" and "mucoid". See Bernard Jensen's book called "Tissue Cleansing Through Bowel Management". He described it as "black", "foul", "putrid", "stringy", and "hard as truck tire rubber".

[23] See book called "Helicobacter pylori, Gastritis and Peptic Ulcer". It was published in 1990 and edited by P. Malfertheiner and H. Ditschuneit. The ISBN-13 is 978-3-642-75317-6. The e-ISBN-13 is 978-3-642-75315-2. The DOI is 10.1007/978-3-642-75315-2. On page 198, it talks about a "granular" mucosa. On page 196, it says that it is one of the abnormalities that indicates the presence of "inflammatory alterations in the mucosal membrane". On page 195, it talks about how endoscopists are so used to seeing this that they mistakenly think it represents the "normal spectrum". Apparently, this ignorance has not changed any. I went to healthtap.com. A patient asked a real-life gastroenterologist the following question: what does "granular and decreased vascular pattern" of the mucosa mean? The gastroenterologist, who had 44 years experience, responded that it is usually a variant of "normal".

[24] See the 1978 edition of the journal called "Digestion". I'm talking about volume 17. The title of the article is "Intestinal Mucins in Health and Disease". It was written by J.F. Forstner. On page 245 he talks about how he observed a mucin-albumin mixture form into a dense white precipitate at pH 4.5 or lower. He guessed it was the mucin that formed into a precipitate, but I think he guessed incorrectly. It seems more probable that it is the albumin that forms into a precipitate. Think of cooked egg whites. The mucin and acid, I think, helps the albumin to coagulate like heat helps egg whites to coagulate.

[25] See the fourth edition of "Wound Care: A Collaborative Practice Manual for Health Professionals". It was written by Carrie Sussman & Barbara Bates-Jensen. The ISBN-10 is 1608317153. Go to page 447.

[26] See "The dangers of colon cleansing" in The Journal of Family Practice. You can read it here. It's volume 60 and number 8. It's dated 2011.

[27] See article called "Thickness of adherent mucus gel on colonic mucosa in humans and its relevance to colitis" in journal called gut. It's volume 35. It's dated 1994. The DOI is 10.1136/gut.35.3.353. Go to page 358.

[28] See article called "Diffuse gastric cancer" in journal called Gastroenterology Nursing. It's volume 29 issue 3. It's dated 2006. Somewhere within pages 232-236, it talks about how when the "gel structure of mucus" is destroyed, disintegration of the mucoid cap layer follows.

[29] See book called "Helicobacter pylori, Gastritis and Peptic Ulcer". It was published in 1990 and edited by P. Malfertheiner and H. Ditschuneit. The ISBN-13 is 978-3-642-75317-6. The e-ISBN-13 is 978-3-642-75315-2. The DOI is 10.1007/978-3-642-75315-2. On page 203 it suggests that active inflammation is associated with mucin depletion and "focal necrosis".

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