Happy Memorial Day and thank you to those who serve!
-From the IBS Treatment Center and your GlutenFreeDr
Happy Memorial Day!
Happy Memorial Day and thank you to those who serve!
-From the IBS Treatment Center and your GlutenFreeDr
The Rise of Gluten Intolerance and the "Risks" with a Gluten-Free Diet
Below is an interesting article from the HeraldOnline.com on the growing number of people being diagnosed with a gluten intolerance or dietary disorder.Unfortunately this article ignores non-celiac gluten intolerance that is a measurable antibody-mediated immune system activation, rather than just difficulty in digesting gluten. And they refer to lactose intolerance but ignore antibody-mediated dairy allergies.
Additionally, doctors very often tell patients not to avoid gluten unless they have a positive diagnosis for celiac. They say that doing so is needlessly risky - nutrients will be missed, the testing isn't valid unless the patient has been eating gluten, etc. These are valid points.
But if you feel that taking gluten out of your diet improves your health, you don't need a doctor to tell you you have celiac. Additionally celiac is only one form of immune response to gluten and is very likely to be only a small fraction of the total group of people who should not eat gluten.
Since very few doctors will test for or even acknowledge non-celiac gluten intolerance (immune response) it is entirely appropriate for people to try a gluten free diet and see what happens if they are patient, in-tune with their health, and conscious of the need to eat a healthy diet.
From the HeraldOnline.com:
Is it our imagination, or are gluten intolerance, and dietary disorders in general, increasingly in the news? Does this mean they're on the rise?
The answers are yes and yes, according to experts.
"It is indeed well documented that all autoimmune (and allergic) disorders are on the rise worldwide, but limited to developed areas," said Stefano Guandalini, founder and medical director of the University of Chicago Celiac Disease Center. "In general, it is safe to say the rates about double every 20 years or so."
There are various theories as to why, but the most prevalent is the "hygiene theory" -- in other words, as a society we're just too clean. As a result, the immune system, largely controlled by the gut, receives inadequate stimulation, Guandalini said.
With autoimmune disorders, which include gluten intolerance and type 1 diabetes (but not allergies), the body attacks itself rather than the invasive substance, causing permanent damage if allowed to continue.
Unfortunately, with all the attention given gluten intolerance -- a plethora of new cookbooks, gluten-free items on restaurant menus, new gluten-free food products -- some people are adopting a gluten-free diet on their own.-----------
This is always a bad idea, said both Guandalini and Carol M. Shilson, executive director of the center and a celiac disease sufferer herself.
"There's no scientific evidence that it's better for you if you don't have celiac disease," Shilson said.
The problem is, even in healthy people, gluten -- a protein found in wheat, rye and barley (and possibly oats) -- is not an easy substance for the body to digest. If you eliminate it from your diet for any amount of time, "it's very hard to go back to a regular diet."
That makes going gluten free a bad idea even for people with symptoms who suspect they are gluten-intolerant.
Original article posted HERE
Image thanks to Withoutadornment via Wordpress
This Week's Gluten Free Recipe - Shortcakes!
This week's recipe is thanks to JulesGlutenFree.com.Ingredients:
2 cups Jules Gluten Free™ All Purpose Flour
1⁄4 cup granulated cane sugar (Wholesome Sweeteners®)
2 tsp. gluten-free baking powder (Hain Pure Foods Featherweight®)
1⁄2 tsp. baking soda
4 Tbs. shortening (Earth Balance® Shortening Sticks)
2 large eggs (or egg substitute)
3⁄4 cup (6 oz.) vanilla yogurt (dairy or non-dairy) (So Delicious® Vanilla Coconut Yogurt)
cinnamon sugar mixture (3 Tbs. sugar + 1⁄2 tsp cinnamon)
Directions:
Preheat oven to 400° F (static).
Whisk together all dry ingredients in a large bowl. Cut shortening into dry ingredients using a pastry cutter or two butter knives. Add stirred, cracked eggs and yogurt and stir well with a fork until combined, forming a smooth dough that is not dry or sticky. (The dough may also be made using a large food processor).
Pat dough out onto a surface dusted with Jules Gluten Free™ All Purpose Flour to a thickness of about 1 ½ inches. Cut into circles with biscuit cutters or the rim of a drinking glass (note: the sharper the cutter though, the higher the rise in the shortcakes, as the edges will not be compressed, an
d thus can rise in layers).Gather any dough not already cut and press together to re-cut until all dough is used. Place shortcakes onto a parchment-lined cookie sheet and lay a small pat of butter or non-dairy substitute on each top (optional) then sprinkle with the pre-made cinnamon/sugar mixture.
Bake for 8-10 minutes, or just until the tops are lightly browned. Do not overbake! Serve topped with fresh berries, ice cream and/or yogurt.
Makes approximately 18 shortcakes.
Click HERE for the printer friendly version.
Copyright 2010 Jules E. Dowler Shepard
Gluten and Celiac Disease
This article comes from the CostcoConnection.com (hence the Costco member references when describing a person's credibility on the subject matter).
Overall, this excerpt does a good job of addressing what the gluten allergy is and how it relates to Celiac disease.
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Gluten, a protein found in wheat, rye and barley, is what gives baked goods that wondrful texture and keeps them from crumbling apart. Yet, despite its culinary goodness, gluten also triggers celiac disease and wheat allergies.
Celiac disease, which affects an estimated 3 million Americans, is a unique autoimmune condition. "Unique, because we know the environmental precipitant: gluten," explains Peter H.R. Green, M.D., professor of clinical medicine at Columbia University Medical Center in New York City, director of the Celiac Disease Center at Columbia University and a Costco member. "It is a multi-system disorder, with the small intestine as the main target of injury."
Celiac disease is not the same as gluten allergy or wheat allergy, explains Vandana Nehra, M.D., a Mayo Clinic gastroenterologist. "Celiac disease (gluten sensitivity) is a genetically determined autoimmune condition that damages the lining of the small intestine. An allergy to gluten (wheat allergy) is an allergic response similar to other food allergies," she explains, adding that treatment of both gluten allergy and celiac disease involves avoidance of wheat.
Pinning Down a Diagnosis
Because celiac disease disrupts the digestive process, delayed diagnosis increase the risk of developing neurological problems, osteoporosis, infertility, autoimmune disorders, including Type 1 diabetes, thyroid disease and even cancer, says Green.
Green refers to celiac disease as "The Great Pretender" because some of its most common symptoms - diarrhea, weight loss and fatigue-mimic those of other gastrointestinal disorders. Albertelli suffered from mild stomach problems for years. Doctors labeled it irritable bowel syndrome and lactose intolerance. Three gastroenterologists later, Albertelli was finally diagnosed. Her husband and daughter also have celiac disease.
The initial diagnosis is made by blood tests to determine the presence of specific antibodies in patients with celiac disease," explains Nehra. If the blood test is positive the diagnosis must be confirmed by intestinal biopsy. A positive biopsy is the medical gold standard of celiac diagnosis. However, an immediate diagnosis might be overlooked due to a lack of awareness of the full spectrum and varying symptoms of the disease; adequate biopsies and accurate tissue-smaple interpretation are crucial, says Green.
Going Gluten-Free
"The gluten-free diet is low in fiber, and non-wheat flours are not fortified. Some of the foods are high in calories," says Costco member Suzanne Simpson, a registered dietitian at the Celiac Disease Center. Celiac patients are often low in iron, calcium and vitamin D and /or vitamin B, and their bone mineral density is often compromised. Vitamin supplements can be tricky (they must be gluten-free), and taking too much of a good thing, such as vitamin A or vitamin B can be toxic, says Simpson.
Eliminating wheat breads and baked goods might seem like a no-brainer. But gluten also hides in prepared foods, marinades and even some brands of tea. Patients must learn to scrutinize product labels. Albertelli adds that a gluten-free diet requires a lot of preplanning, especially when it concerns her daughter's school parties, eating out and travel - anything where food is involved. Fresh fruits, vegetables, meats and poultry are generally safe.
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Click HERE to view the original article in it's entirety
Image thanks to the NuttyGallery.com
Understanding the Differences Between IBS and IBD
There is a lot of confusion concerning Crohn’s, ulcerative colitis, and irritable bowel syndrome (IBS). Crohn’s disease and ulcerative colitis are two forms of Inflammatory Bowel Disease (IBD). There are differences between the IBD and IBS, but they are not necessarily exclusive conditions and may occur simultaneously.Inflammatory Bowel Disease (IBD) often presents as a group of symptoms very similar to those of IBS, but usually with the additional symptom bright red blood in the stool. Diagnosis is made by performing a colonoscopy, and often a biopsy. Detection of ulcerations in the colon confirms the IBD diagnosis. IBD is diagnosed as ulcerative colitis if it is restricted to the colon and Crohn’s disease if it is also found in the small intestine.
The cause or causes of IBD have not been identified. However, evidence points to activation of the immune system via environmental triggers and to a potential genetic link. For example, people with family members who have IBD are more likely to have IBD. Treatment usually involves anti-inflammatory medications to try to control the inflammation.
People with Crohn’s Disease or ulcerative colitis, like many people with IBS, often get discouraged by the inability to control their symptoms and the unpredictable nature of the condition. Interestingly, people with Crohn’s disease or ulcerative colitis can also have IBS or IBS-related problems that are contributing to their symptoms.
At the IBS Treatment Center we have found that patients with IBD often have microbial imbalances or food allergies that are directly related to their poor digestion. Although treating IBS does not cure IBD, in many cases substantial improvement in digestion and a greater likelihood of remission of the IBD can be obtained by testing for and treating the IBS-related conditions. When those conditions are properly diagnosed and treated, these patients often experience significant improvement in their health.
Testing for and treating microbial imbalances includes DNA testing of the stool for diagnosing bacteria, yeast, and parasitic problems. And food allergy testing involves sophisticated blood testing for antibody reactions to foods commonly found in the diet.
Testing for and treating these problems is obviously a good idea for anyone IBD or IBS who wants to improve their overall health and give their body the best chance possible for a complete recovery.
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More about each of these types of testing can be found on our website, IBSTreatmentCenter.com
This article was originally posted in the IBS Treatment Center's e-newsletter. Click HERE to sign up.
Image thanks to SingularityHub.com
Last night I went to a Sounders FC match at Qwest Field in Seattle. It was a great game with the Sounders beating Boca JR from Argentina 3-0. Lots of great play and a fun crowd. At intermission I went to check on a rumor I had heard and it is true!!
At the Taco Ma restaurant stands in the southeast and southwest setions of the field you can buy gluten free beer! It is right on the menu. Sorry the picture isn't much better - it was taken with a cellphone, but you can see that they have Redbridge Gluten Free Beer on their regular beverage menu. They also have gluten free candy on the menu, (my picture of that was worse) but what they really mean is Gummi Bears. Still, it is great to know that you can get a gluten free beer to go with the game.
The food concessions at Qwest Field are operated by Levy Restaurants so contact them if you want more information or to praise them for providing at least a few gluten-free choices for those attending sports events at a major stadium.
Study Finds Contaminants in Many Supplements Sold in U.S.
Please see Dr. Wangen's comments following this excerpt.From the NYTimes.com:
Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found.
The levels of heavy metals — including mercury, cadmium and arsenic — did not exceed thresholds considered dangerous, the investigators found. However, 16 of the 40 supplements tested contained pesticide residues that appeared to exceed legal limits, the investigators found. In some cases, the government has not set allowable levels of these pesticides because of a paucity of scientific research.
Investigators found at least nine products that made apparently illegal health claims, including a product containing ginkgo biloba that was labeled as a treatment for Alzheimer’s disease and a product containing ginseng labeled as a treatment to prevent diabetes and cancer. They also described a salesperson at a supplement specialty store who claimed that a garlic supplement could be taken instead of blood pressure medication.
The article continues...
....In recent years, a vast majority of supplement suppliers have located overseas — principally in China. Nearly all of the vitamin C and many other supplements consumed in the United States are made from ingredients made in Chinese plants. Those plants are almost never inspected by the F.D.A. because the agency is not required to do so, has little money to do so and does not view the plants as particularly risky.
Thoughts from Dr. Wangen:
It is not true that all supplement companies test their products. There is a huge difference in the quality of supplements on the market, and this is just the tip of the ice berg. Most companies don't test the raw materials when they arrive at their facility, nor do they test the final product after they make it. This is one of the reasons we use Thorne supplements. They test for any possible contaminant, not just heavy metals. I've also visited their facility and can verify this first hand. We are extremely confident in their products.
It's also worth pointing out that many pharmaceutical companies have problems with contaminants. Children's Tylenol has been recalled at least twice in the last few years.
It would be a ideal to have a legitimate, independent testing of the raw materials at the point of manufacture, delivery, and of the finished products to prove that the indicated ingredients are present and the product is free of unwanted contaminants. Same for the food industry, really.
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Original article from the NYTimes.com by clicking HERE
Image thanks to Consumerist.com
But, I've Already Had All of the Tests!
This is something that many people with IBS say: “I’ve had all the tests.” But seldom is it true. There are literally hundreds of lab tests and procedures that could be done that might provide information about a person’s gastrointestinal health. No one ever gets all of them.The misconception is unfortunately partially supported by what many doctors tell their patients: “There is nothing else to do. You’ll just have to live with IBS.” If you don’t know what is causing your IBS, and you haven’t been able to resolve it, then it is highly likely that you haven’t had the right tests.
The standard of care for IBS in the medical community is unfortunately very limited. The recommendations provided by one respected international organization are to do only a few tests, or even no tests if your symptoms are consistent with their diagnostic criteria for IBS. The recommendation is to test as little as possible to avoid giving the patient false hope, excessive worry, and to avoid costs. Under these recommendations patients are often given minimal testing and told that there is nothing else to be done. But some patients do get some blood work, perhaps a stool sample, and even a colonoscopy or other visual examination of the bowel or bowel muscle movement.
On rare occasions, the patient will be tested for food allergies, but the testing is almost never the kind of direct measurement that is supported by the research. Unfortunately the tests and procedures that are done are often described as ‘all the tests’. Not only are they only a tiny fraction of the possible tests, but they generally don’t reveal the cause of IBS symptoms.
There are many possible causes of IBS symptoms. The right testing can uncover the cause or causes and enable a skilled and experienced doctor to interpret the results and develop an effective treatment plan.
For more information on testing, click HERE.
For information on the scientific research, click HERE.
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Image thanks to HealthJockey.com
This article originally appeared in The IBS Treatment Center's e-newsletter. Click HERE to subscribe.
The Innate Health Foundation's Wiki Site Needs You!
The IHFWiki is a place for people with food allergies, restaurant representatives, food producers and others to provide information on the restaurants, food products, ingredients, etc. that enables people with food allergies to eat healthy, tasty food.Think of it as wikipedia for people with food allergies and intolerances. It is a great resource for those interested in finding food alternatives, restaurants, cookbooks, and other resources to make eating easy and healthy.
The IHFWIki is a project of the Innate Health Foundation, a public charity devoted to the Irritable Bowel Syndrome and Food Allergy Communities.
The Innate Health Foundation supports the Irritable Bowel Syndrome (IBS) and Food Allergy Communities. The mission of the Innate Health Foundation is to:
- Collect and share IBS and food allergy research;
- Provide support to those diagnosed with food allergies or intolerances; and
- Provide information about IBS, food allergies, and the business of health care
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Click HERE to go to the IHFWiki page and help it grow!
Encopresis: An Intimidating Word and a Solvable Problem
If you have never heard of Encopresis then consider yourself fortunate. Those who are familiar with it wish they had never heard of it. It is a big fancy word used to define the symptoms of constipation followed by urgent and unpredictable bowel movements or explosive diarrhea.Needless to say, it is a very disruptive and embarrassing problem. However, if you have this problem then what you do not know is that it is almost always solvable. Encopresis is another way of saying that your bowels irritate you, so it essentially a more specific type of IBS. Like IBS, it is basically a meaningless diagnosis, it does not give you any more information about your problem then you already know.
However, there is good news, we have seen many patients who have been diagnosed with Encopresis and have found that it is usually preventable. It is caused by the same types of triggers, food allergies and bacterial imbalances, that cause most digestive problems. In the case of Encopresis, however, there is usually more than one trigger. Therefore you end up with a combination of problems, such as both constipation and diarrhea. Of course these symptoms end up being very unpredictable.
Treating Encopresis is not magic, it is simple common sense, looking for the cause of the problem, and testing for triggers that most doctors do not consider.
If you are not familiar with how food allergies and bacterial imbalance cause digestive problems, or the testing required to diagnose and treat food allergies and bacterial imbalances, then you should visit the IBS Treatment Center or read “The Irritable Bowel Syndrome Solution” by Dr. Stephen Wangen, the founder of the IBS Treatment Center.
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This article originally posted in the IBS Treatment Center e-newsletter. Click HERE to subscribe.
Image thanks to Parents-in-a-pickle.com
Q&A with Dr. Stephen Wangen
QUESTION:We have been doing the RAST test with my son every 6 months for 2 years, and I am just curious about average results for someone with allergies. Also, at what level would it be safe to do a food challenge? We haven't seen an allergist, nor have we done a skin test. We have just been relying on the RAST tests that our pediatrician has ordered. We have been hoping that he would grow out of these allergies faster than it looks like he really is going to, so I have considered getting an allergist. Any suggestions?
DR WANGEN:
RAST testing is the detection method often used for blood tests that measure IgE antibodies. These antibodies are typically associated with classic allergic reactions, such as hives and anaphylaxis. However, it's important to realize that elevated IgE antibodies do not necessarily mean that someone will have a classic allergic reaction, or even any visible reaction at all, when they are exposed to those foods.
Skin testing is typically used to assess the presence of any obvious immediate onset reaction. However, it is also important to realize that there are many different ways that an allergic reaction can be manifested, not just as hives or anaphylaxis. And many reactions are not obvious nor immediate. This is something that an allergist is unlikely to be familiar with.
However, I encourage you to see an allergist. They will at least be able to help you assess the seriousness of these allergies and rule out any potentially life threatening issues. This can be quite valuable, and may help to put your mind at ease.
QUESTION:
I was recently denied health care insurance because of CD. Do you have a list, website or resource I could go to find affordable health care? Thanks.
DR WANGEN:
I sympathize with your predicament. I encourage you to contact GIG, the Gluten Intolerant Group of North America(www.gluten.net), and the American Celiac Disease Alliance (www.americanceliac.org). They may have more information that will help you. The good news is that the new health care reform law, the Affordable Care Act, which just passed will prevent insurance companies from denying people coverage based on pre-existing conditions. Unfortunately, this will take some time before it is fully implemented. The following is a very recent quote taken from a letter from Secretary Sebelius, head of the U.S. Department of Health and Human Services.
"In 2014, discrimination based on preexisting conditions will be banned under the Affordable Care Act. [Note: It has already been banned with respect to children.] In the meantime, a new transitional high-risk pool program was included to help provide affordable health insurance coverage to people who are uninsured because of pre-existing conditions. This high-risk pool program will operate until health insurance exchanges are implemented in 2014. States may choose whether and how they participate in the program, which is funded entirely by the federal government. If states choose not to run the program, individuals can apply for insurance from a federal fallback high-risk pool. The program begins on July 1, 2010."
QUESTION:
I have been looking for a vitamin E not sourced from soy. This is one, but the ingredient list says "vitamin E covitol" etc. I called the company to ask what covitol is and was told it's a brand name. That does not clear things up for me. Can you tell me if this would contain soy, or have another suggestion?
DR WANGEN:
Vitamin E is derived from a variety of vegetable oils. This generally includes soy. Therefore, if you have a soy allergy then you may be wondering if you should be taking vitamin E. The good news is that during the distillation process for extracting vitamin E, any soy component is lost. The bad news is that soybean oil is often used to dilute the vitamin E before it is encapsulated.
Covitol is simply a brand name. It doesn't tell us anything about what is in the vitamin E. The company should be able to tell you whether or not there is soy in their vitamin E. If they can't, then you can find many vitamin E supplements that are soy free by doing an internet search.
QUESTION:
My daughter has been having problems with her behavior, hyperactivity and poor concentration. She has tested negative for celiac with the blood test. Celiac runs in my family and I have a great Aunt and my nephew are both biopsy tested positive. I have a positive blood test but negative biopsy but cannot tolerate celiac. Do you think these are early symptoms? We took her off gluten for two weeks and teacher saw an improvement on day three. I put her back on gluten last night and today - she has been crying and moody all morning.
DR WANGEN:
Many, many people are gluten intolerant who do not have celiac disease. Celiac disease is really only one manifestation of gluten intolerance. I frequently diagnose patients with gluten intolerance who have tested negative for celiac disease. And if it runs in the family then it is that much more likely that someone will be gluten intolerant. I encourage you to trust your instinct and your observations.
Gluten can and does cause these types of symptoms in many people who are gluten intolerant, regardless of whether or not they have celiac disease. If you would like more information about non-celiac forms of gluten intolerance, then I recommend that you read my book, "Healthier Without Wheat: A New Understanding of Wheat Allergies, Celiac Disease, and Non-Celiac Gluten Intolerance."
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This article originally appeared on the website Allergiesandme.com
Thanks to Ning.com for the image
Former ESPN Employee Sues Company Over IBS-Related Behaviors
See comments after article excerpt:
From Deadspin.com:
We'll call the plaintiff Jane Doe. In the lawsuit, filed earlier this month in New Britain, Conn., Superior Court, Jane says she was hired in 1980 as one of ESPN's original employees, and she worked in Bristol until the spring of last year. (For her sake, we won't say in what capacity.) For almost as long, she received treatment for an uncomfortable disorder that I'll leave to her lawsuit to describe:
This was a stressful time to work at ESPN. Layoffs were on the horizon, and employees labored in the shadow of George Bodenheimer's swinging axe. 
The situation was doubly bad for Jane. Her doctor had retired, and according to the lawsuit, Jane couldn't get an appointment with a new one for several weeks. Meantime, in March of last year, she began to experience "severe cramping." And as her suit puts it: "[W]henever she had moments of fear, she needed to use the bathroom immediately."
To clarify: Jane's symptoms — perhaps compounded by the stress of the workplace — would so overwhelm her that she would have to dash into a meeting room, lock the door, crap in a garbage can, double-bag it, and then dispose of her own waste. As it happens, this is also how ESPN makes First Take. Jane told no one, for perfectly understandable reasons. She had scheduled an appointment with a doctor for the last week of March, and one assumes that at this point, she thought she was in the clear. Not so fast, my friend.
Yes, Jane had been caught on camera. She explained to Hrisko that she was not disgruntled, merely incontinent — that in fact she had a medical condition but no medication. Jane was suspended one week without pay. According to the lawsuit, the personnel director promised to fight for her. 
Alas ...Jane is now suing for damages in excess of $15,000, claiming that ESPN violated the state's Fair Employment Practices Act. -------------
Thoughts...
Clearly the treatment she has been offered (apparently drug therapy) hasn't solved this woman's problem. If she had seen a doctor who was keeping up with the research and had tested her for the known causes of IBS symptoms (including food allergies, celiac disease, infections, parasites, and bacterialogical imbalances) perhaps all of this could have been avoided.
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Click HERE to read the original article and more on Deadspin.com
Popular Misconceptions About IBS
The biggest misconception is that IBS (Irritable Bowel Syndrome) defines a specific medical condition. IBS is, by definition, just a group of symptoms affecting the digestive tract that haven’t been explained.Unlike cancer, a stroke, or the flu, IBS is more of a starting point than a diagnosis, because it doesn’t provide any new information. Once a person has the symptoms it is necessary to do additional testing to identify the cause of those symptoms - what you might call an actual diagnosis. Once you have an actual diagnosis, then you can treat whatever it is that causes the symptoms and usually stop them.
A second common misconception is that IBS is only caused by one thing. Nothing could be further from the truth. The digestive tract is very complicated, but can only display a limited range of symptoms. There are many things that can cause constipation, diarrhea, abdominal pain, gas, bloating, etc. Any individual might have one or more of the causes at any one time. There is a wide range of causes of IBS and many patients have more than one cause, sometimes several causes, at the same time. For example, many patients have an allergy to a food, which causes them to have IBS symptoms. But not all IBS patients have food allergies. Many patients have bacterial or microbial issues, for example, not enough of the needed digestive bacteria are living in their digestive tract. But not all IBS patients have bacterial issues. Some patients have food allergies, bacterial/microbial issues, and other factors. To correctly diagnose the cause of IBS symptoms it is necessary to test for a range of potential causes. If you don’t treat all of the conditions you have, your IBS probably won’t be resolved.
The third misconception is that there is a single treatment for IBS. This misunderstanding goes along with the previous misconception- that there is only one cause. The reason that there isn’t a single treatment for IBS is that there isn’t a single cause. If all IBS were caused by dairy allergies, treatment would be simple – don’t eat dairy products. But because there are many, sometimes overlapping causes, there will never be a single simple treatment for IBS symptoms.
Lastly, but perhaps the most common misconception is that IBS is caused by stress. If this were true the world would be full of IBS patients. We see patient all the time that have been told by their doctor that stress is the problem, but once we identify the cause and treat it, the symptoms are resolved. What is even more interesting is that many patients report that while they had IBS symptoms they also had a heightened sense of anxiety, but that it went away when they treated their condition. That is not to say that stress can’t make IBS worse. Stress can affect the immune system and that can impact IBS symptoms. But stress is usually not the underlying cause of the symptoms.
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This article originally appeared in the IBS Treatment Center's monthly e-newsletter. Click HERE to sign up.
Image thanks to donself.com
Gluten-Free Friday Recipe - Super Simple Banana Bread
Super Simple Gluten-Free Banana BreadDirections:
Pre-heat the oven to 375 Farenheit
In a large mixing bowl, mix together 4 medium sized ripe bananas, mashed 2/3 cup canola or safflower oil
Then add 1 cup of sugar Mix in well,
Then add 2 cups of flour (gluten-free baking flour works fine)
Mix together and add
1 to 1-1/2 teaspoon baking soda
1/2 cup nuts (walnuts work best), optional
Mix just until the batter is uniform.
Spray a standard, non-stick loaf pan with cooking oil (or wipe oil on with a paper towel). Pour the batter into the pan and bake in the oven for 1 to 1-1/4 hours.
Check at 1 hour.
You may need to cover with aluminum foil near the end of baking to prevent the top from burning before the bread is baked through. Test with a toothpick in the middle. When it comes out clean, the bread is done.
Based on a recipe by Michelle Ryan
This recipe was originally posted in the IBS Treatment Center monthly e-newsletter, click HERE to subscribe
Case Study: Treating IBS with Food Elimination Diets & Probiotics
As you continue to research your IBS and/or related symptoms in the hopes of understanding and curing, it's important to note the considerable amount of research that is being done in the field. While obtaining new information that will actually help you on a day-to-day basis may be more difficult, there are still studies that can help you better understand what researchers are seeing work and what they are seeing that isn't.
This study, from the Journal of the American College of Nutrition discusses treating IBS with a food elimination diet and probiotics. This is one of many, many articles from the Innate Health Foundation's website. The mission of the Innate Health Foundation is to collect and share IBS and food allergy research; provide support to those diagnosed with food allergies or intolerance; and to provide information about IBS, food allergies, and the business of health care.
The purpose of sharing this article is for you to understand what scientists are finding and then utilize that data as it pertains to you, personally...
From the Journal of the American College of Nutrition:
Objective
In Irritable Bowel Syndrome, the gut-associated immune system may be up-regulated resulting in immune complex production, low-grade inflammation, loss of bacteria, and translocation of inflammatory mediators and macromolecules outside of the GI lumen.
Since food intolerance may be one of the reasons for this upregulation, our goal was to investigate the role of food intolerance in IBS patients.
Methods
In this open label pilot study, we enrolled 20 patients with IBS by Rome II criteria (15 women, ages 24–81) who had failed standard medical therapies in a tertiary care GI clinic. Baseline serum IgE and IgG food and mold panels, and comprehensive stool analysis (CSA) were performed.
Breath-hydrogen testing and IBS Quality-of-Life (QOL) questionnaires were obtained. Patients underwent food elimination diets based on the results of food and mold panels followed by controlled food challenge.
Probiotics were also introduced. Repeat testing was performed at 6-months. We followed up with this cohort at 1 year after trial completion to assess the reported intervention and for placebo effect.
Results
Baseline abnormalities were identified on serum IgG food and mold panels in 100% of the study subjects with significant improvement after food elimination and rotation diet.
Significant improvements were seen in stool frequency, pain, and IBS-QOL scores.
Imbalances of beneficial flora and dysbiotic flora were identified in 100% of subjects by CSA.
There was a trend to improvement of beneficial flora after treatment but no change in dysbiotic flora. The 1-year follow up demonstrated significant continued adherence to the food rotation diet, minimal symptomatic problems with IBS, and perception of control over IBS.
The continued use of probiotics was considered less helpful.
Conclusion
These data demonstrate that identifying and appropriately addressing food sensitivity in IBS patients not previously responding to standard therapy results in a sustained clinical response and impacts on overall well being and quality of life in this challenging entity.
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Image from HealingwithNutrition.com
Click HERE to visit the Innate Health Foundation's Research Articles page
Click HERE to read the original study from the Journal of the American College of Nutrition
Researchers Explore Possible Links Between Celiac Disease and C-Sections
A recent article from NationalPost.com reviews a study involving children and adolescents with Crohn's disease, ulcerative colitis, or celiac disease and whether children with those diseases would have a higher rate of cesarean birth.They also studied some children with other gastrointestinal problems, as well as a "control" group of children who were visiting local eye doctors and dentists for unrelated conditions. While the study doesn't really tell us much, it's important to make people more aware of celiac disease and the extent to which those with the disease can be impacted.
From NationalPost.com:
Celiac disease is a disorder in which eating gluten -- a type of protein found in wheat, barley, and rye -- causes the body's immune system to attack and damage the small intestine. In the U.S., researchers think nearly 1 out of every 100 people has celiac disease.
Dr. Mathias Hornef, from Hannover Medical School in Germany, and his colleagues knew that people with certain inflammatory bowel diseases - such as celiac disease, Crohn's disease, and ulcerative colitis - have a different mix of bacteria in their intestines.
The celiac children clearly had a higher rate of cesarean births compared to the other four groups. Twenty-eight percent of the celiac children were born by cesarean section, compared to no more than 19 percent of all the other groups. The celiac children were also diagnosed at a younger age, on average, than the other patients.
Hornef and colleagues are not sure why cesarean delivery might be associated with celiac disease but not Crohn's disease or ulcerative colitis, because the three disorders develop in some similar ways. They say one explanation might be that celiac disease can be triggered much earlier in life, so the newborns with abnormal intestinal bacteria might be particularly vulnerable. Hornef is quick to emphasize that cesarean sections can be lifesaving.
Much larger studies, and far more data, would be needed "before we recommend something like trying to avoid c-section" as a way to avoid celiac disease, he told Reuters Health by e-mail. If anything, the results "may mean we need to be looking for celiac disease in young women who want to become pregnant," Leffler said. He noted that when celiac disease is treated with a gluten-free diet, the risk for cesarean section is no higher than for the average woman.
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This is only an excerpt. The original article in it's entirety can be found HERE
Image of Celiac biopsy thanks to VCU's Pathology Department
Microorganisms: Balancing Immune Response and Tolerance
USNews.com is reporting on a large-scale effort to map out the genetic composition of hundreds of microorganisms that inhabit every human has produced its first results. Scientists report they have completed the genome sequencing for an initial batch of 178 human-hosted bacteria.This research, combined with better identification of the microbes in specific individual people with IBS and related disorders will be very valuable in helping us to identify and treat problems caused by over use of antibioitics, infections, poor diet, etc.
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From USNews.com
...Found in such places as the gastrointestinal tract, skin, mouth, uro-genital tract and respiratory tract, microbes such as the ones now sequenced are believed to play a central but as yet poorly understood role in daily human function, particularly with respect to the maintenance of health and onset of disease.
"This is just the beginning," said study author Karen E. Nelson, director of the J. Craig Venter Institute in Rockville, Md. "There's a lot of micro-diversity exclusive to our body, and we do not yet have comprehensive understanding of how these microbes interact with our bodies. So this is just the start of this exploration." "But I'm very encouraged," Nelson added. "Because over the past five to 10 years, we've begun to realize how significant the microbes are that live on and in us. "This is fundamental research into a brand new and important frontier," he said.
"The point here is that if you do a census of all the cells in the human body, the number of microbial cells outnumber human cells by 10 to one. That means you're 90 percent microbes, and just 10 percent you. And that's pretty phenomenal."
"And although many have assumed that we're just carrying these guys -- that it's just a passive co-existence -- there's more and more evidence that it's not passive at all, that there's an active interaction going on that influences possibly all avenues of metabolism and human physiology," he added. Jeffrey Cirillo, a professor of microbial and molecular pathogenesis at Texas A&M Health Science Center College of Medicine in College Station, reinforced the notion that the "bacteria in our bodies have a huge influence over all aspects of our own physiology, as well as over our susceptibility or resistance to infectious disease."
"The presence of these organisms coating our mouth and nose, and so on, help maintain a healthy balance between the immune response and tolerance," he said. "They serve as a sort of early warning system."
"About all of this, we're just starting to scratch the surface, about which interactions are beneficial, and which lead to a healthy individual and one who's sick," Cirillo said. "And this kind of analysis provides a first real picture of this, so we can begin to understand not just our own genetics, but the genetics of what colonizes us, which together make us who we are."
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Click HERE to read the original article at USNews.com
Image thanks to U.S. Department of Agriculture via Protomag.com
Understanding Non-Celiac Forms of Gluten Intolerance
In this article we will discuss forms of gluten intolerance that do not meet the definition of celiac disease. Celiac Disease is a common problem, but gluten intolerance is far more common than celiac disease. There is a great deal of debate about how to define gluten intolerance and the relevance of forms of gluten intolerance that are not celiac disease.
In this article I hope to clarify some of these issues and acknowledge the validity of all forms of gluten intolerance.
What do we mean by non-celiac forms of gluten intolerance?
As a reminder, gluten is a protein found in wheat, rye, spelt, kamut, barley and other grains. Many people find that they cannot tolerate gluten, but they do not test positive on any of the tests used to diagnose celiac disease. These tests include the biopsy of the small intestine, and the endomysial, reticulin, and tissue transglutaminase antibody tests. This is a common occurrence and one that I frequently see in my office. Notice that I did not say that they do not test positive for gluten intolerance. In fact, most of these people do have test results that indicate that they are gluten intolerant, even though they do not test positive for celiac disease.
How do you test for other forms of gluten intolerance?
One test that I haven’t mentioned yet is the gliadin antibody test. This test is commonly run and is often positive when the others are negative. It is then usually ignored or the physician states that it is a false positive. It makes you wonder why it was run at all. But it is only a false positive if you want it to predict celiac disease.
Gliadin antibodies are very poor predictors of celiac disease. However, they are positive for a reason. They indicate that the immune system has formed a reaction against gliadin, which is a fraction of gluten. This is very important. Just because someone has an immune reaction to gluten does not mean that they will get celiac disease.
Remember, celiac disease is really another phrase for villous atrophy. So we can rewrite that sentence to say, “Just because someone has an immune reaction to gluten does not mean that they will get villous atrophy.” Villous atrophy is a result of the immune reaction to gluten. But it is only one possible result. It is a reaction to gluten that results in an autoimmune reaction to the lining of the digestive tract which results in villous atrophy. (see image with this article)
I hope I didn’t get too wordy there. You may have to read that twice. What I really want to say is that celiac disease is just one type of gluten intolerance.
Are there other tests for gluten intolerance?
In my office I run a full panel of IgE and IgG antibodies for about 100 different foods and food components. I regularly see elevated antibodies to gluten, gliadin, wheat, barley, rye and spelt. These people usually do not have celiac disease, which I also rule-out.
A positive test for any of these foods indicates that they have an immune reaction to those foods. These patients invariably begin to feel better once they have eliminated these foods from their diet. They may have digestive symptoms such as constipation, diarrhea, IBS, gas, bloating, or heartburn, or they may have any number of other symptoms, such as fatigue, headaches, arthritis, chronic sinusitis, eczema, etc.
What if you haven’t run any blood tests, but know that you can’t eat gluten?
There are many people who discover through trial and error that eliminating gluten from their diet helps them to feel much better. These people often have not undergone any testing. And really, what is the point? You don’t need someone else to tell you that you feel better. I always honor my patients’ right to know that they can’t eat gluten. Who am I to tell them otherwise?
There usually isn’t any point in testing them, since any test for celiac disease or gluten intolerance will typically be negative once a person has stopped eating gluten for a while. And asking someone to eat gluten for at least a month so that I can verify their gluten intolerance seems illogical when you consider how ill that usually will make them feel. The common treatment for everyone. Whether you have celiac disease, are gluten intolerant, or just think that everyone on earth should avoid gluten (I don’t think this), then you are left with the same treatment plan, avoid gluten.
Some people believe that celiac disease is a more severe form of gluten intolerance, but the evidence does not necessarily support this. Many celiacs are basically asymptomatic. And many non-celiac gluten intolerant individuals are very ill. “Gluten intolerance” covers us all.
In the end, the words “gluten intolerance” cover anyone who can’t eat gluten, regardless of the reason.
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This article is from the IBS Treatment Center's monthly e-newsletter, click HERE to sign up Image thanks to Children's Hospital of Boston via YoungWomensHealth.org
Diagnosis & Management: Continuing the Food Allergy Discussion
As we mentioned in a post last week (click HERE to read), there is a great degree of variation in terms of information on food allergies and the symptoms related to such allergies. Often, if the patient isn't educated on how to ask the right questions they may get a diagnosis based on incomplete research or information.
This study (U.S. Library of National Medicine) makes a good reference when discussing the conventional food allergy argument that few people have food allergies.
This study reviewed the published research on just conventional food allergies, and did not address the research on allergies mediated by non IgE antibodies or allergies that result in non-conventional symptoms.
CONTEXT:
There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies.
CONCLUSION:
The evidence for the prevalence and management of food allergy is greatly limited by a lack of uniformity for criteria for making a diagnosis.
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Click HERE to read the article in it's entirety
Image thanks to minortroubles.com
Celiac Disease and the Elderly
The below findings from the National Institutes on Health (NIH) and the National Center for Biotechnology Information (NCBI) has some very interesting case studies regarding Celiac disease and the elderly.While this is certainly not a claim that alzheimer's is caused by celiac disease, it is important to note that some people who have been diagnosed with that kind of problem may have celiac disease and may recover if gluten is removed from their diet. The same thing is true for peripheral neuropathy.
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From NCBI.gov:
BACKGROUND AND AIMS:
In the past 20 years, a growing proportion of new cases of celiac disease (CD) are diagnosed in adults and in patients with extraintestinal manifestations.
Our understanding of the extremely wide spectra of manifestations and the profound effects on elderly patients is improving. Nevertheless, CD is still underdiagnosed in elderly patients. In this study, we describe a case series of CD patients diagnosed after the age of 60.
METHODS:
A retrospective chart review was preformed in cases of CD diagnosed after the age of 60. Patients were included if they had positive serology and histologic findings compatible with CD. Eligible patients were reinterviewed, and demographic, clinical, and laboratory information were recorded.
RESULTS:
During the study period, 7 patients with CD diagnosed after the age of 60 were identified. The most common presenting findings were weight loss, iron deficiency anemia, and diarrhea. Two patients suffered from severe early osteoperosis and 2 additional patients had elevated liver function tests. Neurologic manifestation was suspected in 3 cases. Two female patients presented with cognitive decline that was attributed to Alzheimer dementia but ameliorated after the initiation of gluten-free diet. The third patient had peripheral neuropathy that completely resolved after the initiation of gluten-free diet. Median lag in diagnosis was 8 years. Diet treatment led to complete resolution of symptoms in most cases and a significant weight gain (median 7.75 kg, range 5 to 11). One patient developed a fatal intestinal T-cell lymphoma.
CONCLUSIONS:
In this case series, we have described several cases of CD in patients over the age of 60 with a varied spectrum of manifestations. We have also found a significant lag in diagnosis and treatment. We believe that it is important to promote the identification of CD as a possible culprit in varied clinical conditions in the elderly population.
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Image thanks to Gantep.edu
Link to original posting HERE
Using the Proper Techniques For Accurate Diagnosis
This study is a beautiful, simple validation of the technique we use (through our lab) to detect parasites (specificallly this one - d. fragilis - see picture). By highlighting these techniques that are both scientifically validated as well as an effective means of truly tackling the problem, you are better able to seek out a medical practioner that is utilizing the most up-to-date information in helping you get better.
The source of this information is the U.S. Library of Medicine, National Institutes of Health.
The real-time PCR assay revealed 117 additional D. fragilis-positive samples as compared with conventional methods, showing 100% sensitivity and specificity in our experience. On the whole, D. fragilis infection was detected in 186 samples from 105 patients (21.4%, third in frequency among the diagnosed intestinal parasitoses).
The evaluated real-time PCR assay represents an effective tool to obtain both an accurate diagnosis and a reliable epidemiologic picture of dientamoebiasis.
Copyright © 2010 Elsevier Inc. All rights reserved.
Original article and much more by clicking HERE
Image of d. fragilis thanks to Provlab
Dr. Mark Hyman: 5 Steps to Curing IBS
We've posted several articles in the past few weeks debunking some of the many inaccuracies and myths that continue to circulate on the web in regards to IBS and related issues. So for a nice change of pace, we'd like highlight a recent article by Dr. Mark Hyman for The Huffington Post.This is a great example of someone who paying attention to the research being done and working to improve the approach, which is a a nice contrast to the articles lately about food allergies being rare. While his advice doesn't conform 100% with our protocols and practices, at least Dr. Hyman is paying attention to the research.
Below are Dr. Hyman's 5 Steps or recommendations on Curing Your IBS. Following these steps is a link to the original article (including video) on The Huffington Post.
1. Get tested. Try to get a test for IgG food allergies and eliminate the foods that test positive for 12 weeks. Or simply try an allergy elimination diet for a few weeks.
2. Test yourself. If you can't afford the test mentioned above, then just eliminate the most common food allergens for 12 weeks -- that's dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them to see if they cause symptoms. This is an effective way to isolate the foods that may be causing you problems. I have created a simple program to follow based on a comprehensive elimination diet called The UltraSimple Diet.
3. Get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin (Xifaxin) and take two 200 mg tablets three times a day for seven to 10 days. This is often the best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome. You may also need an anti-fungal such as nystatin or fluconazole for two to four weeks.
4. Repopulate your digestive tract with good bacteria. I don't usually recommend brands, but when it comes to probiotics the quality varies so much that I suggest taking two specific brands. Take one packet of VSL3 or other high potency probiotic twice a day for 1 to 2 months. This probiotic has over 450 billion organisms per packet. I also recommend a probiotic called S. boulardii take two capsules twice a day for 2 months. This is a special probiotic that helps to further normalize gut function.
5. Try digestive enzymes with meals to help break down food while your gut heals. You also may benefit from nutrients that help heal the lining of the gut including fish oil, GLA (from evening primrose oil, zinc, vitamin A, glutamine and others.
By taking these steps and seeking out the underlying causes of IBS, you can dramatically improve your health and overcome your digestive disorder.
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Original article, including video by clicking HERE - to go to The Huffington Post
Image thanks to GiantBomb.com
IBS & Anemia
Many patients who have digestive problems are also anemic due to low iron or low vitamin B12 levels. This problem causes fatigue, so it should be of interest to many people. Being anemic and having IBS is not unusual and there is a logical reason for it. First we’ll discuss anemia and then how it relates to IBS and digestive problems. What is anemia? Anemia is a common blood disorder that is a decrease in the number of red blood cells (RBCs) and/or poorly formed red blood cells. These are the cells in your blood that carry oxygen. If you are anemic, then you will be tired because you are not delivering as much oxygen to your body as someone who is not anemic. There are many different types of anemia, but the most common are due to iron deficiency or vitamin B12 deficiency. Iron deficiency anemia will show up on your complete blood count (CBC) as a low RBC count, low hematocrit (Htc), and/or low hemoglobin (Hgb). Vitamin B12 deficiency anemia typically shows up as an increase in the size of the red blood cells. On your CBC it is noted as the MCV.
How to catch low iron before you become anemic:
Iron is stored in the body in a protein form called ferritin. Ferritin levels can be measured with a simple blood test. Ferritin decreases long before iron deficiency anemia is apparent on a complete blood count. Therefore you can often prevent iron deficiency anemia by monitoring your ferritin level. It can take several months of iron supplementation to rebuild iron stores. If you are anemic and you take iron only long enough to correct the anemia, you likely have not built up your iron stores enough to last for very long. Then you are much more likely to become anemic again in the near future, which of course will cause you to be tired. This is another good reason to check your ferritin level.
What is borderline anemia?
It is not unusual for people to report that they have been told that they are borderline anemic. In most cases, they were not told to take iron. What you should know is that borderline anemia is not a technical term. You either are anemic or you are not anemic. If you have been told that you are borderline anemic, then you are probably anemic. Correcting this problem will help you to feel much better. If you are borderline anemic and it is due to an iron deficiency, then your iron stores will be very low. So have your ferritin checked. What about vitamin B12? If your anemia is due to a B12 deficiency, then taking B12 will solve your problem. Your doctor may prescribe B12 injections, which will improve the treatment and vastly increase the amount of B12 getting into your body. Vitamin B12 is also stored in the body, but its stores are unfortunately not so easy to measure.
What does this have to do with IBS?
The important question underlying anemia is “Why do you have low iron or B12 levels?” The answer may be that you don’t absorb them well. People with IBS and related digestive problems often have a problem absorbing nutrients. This is particularly obvious with diarrhea, which is clearly a malabsorption issue. However, constipation can also the same problem absorbing nutrients can also happen with constipation. This is why many people with IBS also suffer from chronic anemia. They are not absorbing the iron and/or vitamin B12 that is in their food. Their digestive problem can lead to other problems such as anemia.
Correcting the IBS allows the digestive tract to heal and will result in a much better absorption of these nutrients. It will also result in a much better absorption of other nutrients that are not so commonly measured. The end result is that you not only solve your digestive problems, you also solve your anemia. And ultimately you are much healthier and happier.
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Image thanks to 4.bp.blogspot
This article was originally posted in our e-newsletter, click HERE to subscribe
A Great Example of Generic Advice That Doesn't Address the Issue
This article is a great example of the normal advice given to people with IBS. This ignores the fact that there is lots of great, published evidence that IBS can be caused by hundreds of testable, treatable conditions. Just giving up and trying to deal with it is not a real solution.
Please note: We do not endorse this advice, but highlight it simply to show you the typical articles we see on the subject. Our goal is to help you educate yourself as much as possible on your specific issues.
From the DailyJournal.com:
Irritable bowel syndrome just sounds ugly. It's painful, sure, but who wants to talk about their plumbing like that?
But talking about it, and learning to control the symptoms of IBS is the key to successful recovery, according to Vineland-based gastroenterologist Dr. David S. Shields.
Irritable bowel syndrome was the topic of this month's Healthline. Shields answered one question submitted by a reader:
Question: How should I take pure peppermint oil? How should I dilute it with water and how often should I take it?
Answer: Peppermint oil most often comes in capsule form. You should take it 30 minutes before every meal.
Shields explained peppermint oil is thought to relieve the muscle spasms associated with IBS, along with excessive gas, cramps, and bloating.
He said more people are trying to treat their symptoms at home without speaking to a doctor.
"People see ads on TV or in the newspaper and see symptoms they recognize, so they try (peppermint oil) before seeing a doctor. If it works for them, then great. But if it doesn't work, they should see a doctor," he said.
Shields added that there isn't much danger in self-medicating with peppermint oil, but said that too much could lead to reflux because of the oil relaxing the muscles in the throat.While painful and unpleasant, Shields said IBS is manageable.
"It's benign, not a serious condition," he said.
But IBS can mimic other, more serious conditions such as colitis, Crohn's disease, and intestinal lesions.
Patients should have tests to make sure their intestinal problems aren't coming from something more serious.
If it is IBS you are dealing with, Shields offers this advice:
Get regular exercise
Make sure you are getting enough sleep
Limit caffeine
Avoid carbonated beverages (soda, beer)
Avoid chewing gum (you swallow a lot of air while chewing)
Eat slowly and don't talk with your mouth full.
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Full article HERE
Image thanks to homegain.com
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