Taking a Look at Acid Reflux & Heartburn (Part II)

What Causes Heartburn? 


In order to cure acid reflux disease, you must remove the cause of the problem and promote the healing process.

The following are the most common causes: 



Food allergies: In my practice I have found that a majority of cases of heartburn are caused by food allergies.

Food allergies often cause a host of other problems and can be diagnosed with a simple blood test. 



Foods: certain foods cause the lower esophageal sphincter to relax, thus leading to heartburn.

These include peppermint, coffee, alcohol and chocolate. 



Hiatal hernia: This is a physical condition where part of the stomach protrudes through the diaphragm. It can generally be reduced without surgery, though even when present it is not necessarily the sole cause of heartburn 



Taking a Look at Acid Reflux and Heartburn (Part I)

Acid Reflux and Heartburn: The Underlying Causes

Heartburn or acid reflux or GERD -- whatever the name, if you are like millions of others, you are experiencing this gastrointestinal malady. 


You may take your acid reflux problem for granted and buy your antacids at Costco, but you should be aware of the negative effects this has on your entire body. You also should know that heartburn is a sign of other problems, and can almost always be treated without acid blockers. 



The Prevalence of Acid Reflux Disease


Acid rising from the stomach and irritating the lower esophageal sphincter (LES), the valve that separates the esophagus from the stomach, results in the feeling of what is commonly called heartburn. 
Some 35 to 45 percent of the population experiences heartburn, often called GERD or "gastroesophageal reflux disease".

Abstract: Natural History of Celiac Disease in US Cohort Since 1974

This abstract is a follow up to the previous USA Today article (click HERE to read) regarding celiac disease in adults later in life.

Natural History of Celiac Disease Autoimmunity in a USA Cohort Followed Since 1974

Abstract Background

The natural history and the possible changes of celiac disease (CD) prevalence over time are still unclear.

Objectives

1) To establish whether loss of tolerance to gluten may occur at any age;
2) to investigate possible changes of CD prevalence over time; and
3) to investigate CD-related co-morbidities.

USA Today: Study shows celiac disease can develop later in life

From USAToday.com:

Celiac disease, an autoimmune illness affecting about one in 133 Americans, is showing an increasing presence among the elderly, says a study released today.

The study in the Annals of Medicine was led by the University of Maryland School of Medicine Center for Celiac Research.

Celiac disease damages the small intestine because of an autoimmune reaction to gluten, a protein found in wheat, barley and rye — part of many common products such as bread, pasta and cookies. Symptoms include diarrhea, abdominal cramping and bloating.

Food Allergies: IgE and IgG

The immune system functions like a sentinel standing guard against foreign invaders. In the case of an allergy, the invaders are called allergens. The primary weapon that it uses against invaders is the production of antibodies.

The antibodies cause reactions that result in the offending allergens being removed from the body. In many people, foods act as allergens rather than nutrition. This can result in the symptoms of IBS.

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for the two different kinds of antibodies produced by the immune system in allergic reactions to food.

You might be asking why you need to know this.

Coping with Celiac Disease and a Life Free of Gluten

As health professionals study the cause and scope of digestion problems, many Canadians - mainly women - cope with Celiac disease, a painful intestinal disorder that mandates a life free of gluten.

From The Vancouver Carrier:

When Caitlin O'Leary finished her fall semester at Mount Allison University in 2007, she flew home from Sackville, N.B. to Vancouver for Christmas break. En route, her flights were delayed several times due to a blizzard, and she spent three days in small airports. It was one of the hungriest experiences she's ever had.

Unlike the average person who could make due with a limited airport menu and eat a deli sandwich or burger, O'Leary couldn't. The 23-year-old has an intolerance to gluten, a protein found in wheat, rye, barley and many processed foods. A whiff of flour makes her nauseous and eating a slice of bread sends her running for the toilet. Rather than be sick in an airport bathroom, O'Leary stuck to a three-day diet of potato chips and yogurt--the only available foods she could stomach.

Since O'Leary cut gluten out of her diet in 2006, the painful cramps and nausea that came after every meal have disappeared. Nowadays, the energetic redhead feels healthy and lives that way too, following a nutritious vegan diet and competing in half Ironmans.

The Causes of IBS - Fiber

Increasing fiber intake is one of the most popular treatments for IBS. Although your fiber intake might not be ideal, it's unlikely that it's causing your irritated bowel. By now you've probably already figured that out.

However, there are many good reasons to get fiber in your diet, so it's worth discussing. Below you will find some good information about fiber that will increase your understanding about this important component of food.

Soluble vs. Insoluble Fiber

Fiber can be soluble, meaning that it partially dissolves in water, or insoluble, meaning that it doesn't.

Although neither type typically cures IBS, soluble fiber (which is also called viscous fiber, and is found in foods such as oatmeal, okra, or legumes, such as garbanzo beans) can be helpful in treating IBS symptoms, especially constipation and diarrhea.

Insoluble fiber is more of a "scratchy" fiber; it adds bulk to the stool. A good example of insoluble fiber is celery.

Soluble fiber forms a thick gel that helps to properly form the stool in the digestive tract and move it through the bowel; it also adds bulk to the stool. Because it slows the stool's transit time, it helps to prevent diarrhea.

Boston Globe: Learning Why Men & Women Experience Pain Differently

From The Boston Globe:

It’s one of the more puzzling observations in medicine: The vast majority of chronic pain patients are women. Women suffer disproportionately from irritable bowel syndrome, fibromyalgia, headaches (especially migraines), pain caused by damage to the nervous system, osteoarthritis, jaw problems like TMJ, and much more. Women also report more acute pain than men after the same common surgeries.

In the lab, when researchers ask male and female volunteers to subject themselves to experimental pain — increasingly hot stimulation on the inner arm, immersion of the hand in very cold water, electrical jolts to the skin — women show lower pain thresholds (that is, they report pain at lower levels of stimulus intensity) and lower tolerance (they can’t bear intense pain as long).

Gastroparesis - What is It?

The word gastroparesis often gives people the impression that their stomach is paralyzed and that there is nothing that they can do to solve their problem. Fortunately, this is often not the case, certainly not in the same way that someone with a serious spinal cord injury may suffer from paralysis.

The diagnosis of gastroparesis simply means that there is a delay in how long it takes the stomach to empty. It is then typically assumed that this is due to damage to the vagus nerve, which helps control the emptying time of the stomach. In some cases this damage is actually seen or verified. But in many cases is only an assumption of nerve damage based solely on the delayed emptying time of the stomach.

The Inability to Gain Weight...

Strange as it might seem to many Americans, a fairly regular complaint of patients at the IBS Treatment Center is the inability to gain weight.

This can be a problem at any age and ranges and can be relevant for infants, children, teenagers, men and women of all ages, and athletes who work out and are trying to put on muscle mass. In fact, it’s common enough that it is well worth writing about.

The inability to gain weight, or in the case of infants and children, poor development or even a failure to thrive, often indicates a problem properly digesting and assimilating nutrients. The next logical question is, “Why isn’t that person able to properly digest and assimilate nutrients?”

There are several possible reasons for this, but the most common one is that they are ingesting things that their body isn’t handling well. These “things” are foods, or what most people consider foods. And in most cases these foods are usually considered healthy foods. Unfortunately, not everyone is meant to eat the same thing, and any food has the potential to be unhealthy for a particular individual.

Friday's Gluten-Free Recipe: Eggplant Parmesan

Recipe thanks to Jules Gluten Free!

Eggplant Ingredients:

• 1 large eggplant (1 1⁄2-1 3⁄4 pounds)
• 1 1⁄2+ cup dry bread crumbs, finely ground*
• 1⁄2 cup Jules Gluten Free™ All Purpose Flour
• 1⁄2 teaspoon salt
• 1⁄2 teaspoon freshly ground black pepper
• 2 large eggs
• 2 tablespoons milk, dairy or nondairy (Blue Diamond® Almond Breeze)
• High heat oil for frying

*To make breadcrumbs, take that hard loaf of GF bread out of your freezer, cut it in thirds, pulse one third in a food processor, then pour onto a baking sheet and toast in a 300F oven for 10 minutes, or until crispy. What a great use for the nasty store-bought GF bread we all have in deep freeze! If you prefer tastier crumbs, follow my Sandwich Bread Recipe, bake, cut and toast as described above. The best results really do start with the best ingredients!

Diverticulitis: What is It and How Does It Relate to IBS?

Diverticulitis, although not IBS, is closely related to IBS.

The real difference is that in diverticulosis doctors can see the damage, thus giving you the impression that they know why you are suffering.

Nothing could be further from the truth.

In reality people suffering from diverticulitis are no better off than those diagnosed with IBS (irritable bowel syndrome) when it comes to providing you with a solution to your problem. And both conditions are treated in the same manner.

What is Diverticulitis?

Diverticulitis is the diagnosis given to people who develop inflammation as a result of diverticulosis.

Diverticulosis is presence of weak pouches in the colon called diverticula. It is generally diagnosed from a colonoscopy or a barium contrast x-ray.

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Abbott Labs recalls beetle-tainted Similac baby formula

All large scale food processing has a risk of contamination.

It is simply too difficult to ensure that the massive amounts of ingredients being shipped, stored, and mixed together are completely free of extraneous materials.

The best way to be sure your food is safe and clean is to buy organic whole foods, like fresh vegetables, and unprocessed meats. When Tom Malterre (Whole Life Nutrition) came to speak to our support group he showed us that even bulk or packaged dried beans, lentils, rice and other grains can have rocks, other grains, or other contaminants.

Malterre recommends that you simply sift through your ingredients before you cook them. That way you can pick out anything that doesn't belong.

From Reuters:

Abbott Laboratories Inc said it is voluntarily recalling millions of containers of its top-selling Similac powdered infant formulas after beetles were found in the products and in a Michigan plant where they are made.

Abbott said on Wednesday that the recall, which could result in $100 million of lost revenue, comes after reports by two consumers of contamination, and its inspection of an area of the plant in Sturgis, Michigan, where beetles or their larvae were found.

What's the Difference Between Crohn’s, Colitis, and IBS?

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.

Milk Allergies and Lactose Intolerance

Milk allergy or dairy allergy are the most common food allergies seen in my practice and cause a multitude of health problems. 
Dairy may be the most misunderstood food of our culture.

It is often assumed to be of high nutritional value and even mandatory for good health, although it can create serious health problems. 


Lactose intolerance is frequently confused with milk allergy, but the two conditions are not the same. We'll discuss these two dairy food disorders below.

Celiac Disease & Gluten Intolerance

How Is Celiac Disease Different from a Gluten Intolerance? 


Although celiac disease is a gluten allergy, it is only one form of gluten allergy. Many react to gluten and may have elevated serum antigliadin antibodies, but they do not have damage to the small intestine. These people have a negative biopsy of the small intestine, as well as negative antiendomysial antibody and tissue transglutaminase tests. 



How Common Are Gluten Allergies? 


Although no studies have been done on the prevalence of gluten intolerance, the prevalence of gluten allergies is certainly higher than that of celiac disease alone. 



Diabetes and Celiac Disease

A brief overview of the relationship between Diabetes and Celiac Disease.

From GIG.net:

What is Celiac Disease?

• A malabsorption disease caused by eating gluten - a protein found in foods made with wheat, rye and barley.
• Causes damage to the small intestine.
• Can cause food and medications to be absorbed poorly. This can lead to symptoms of starvation, nutrient and medication malabsorption.
• The only treatment is a strict gluten-free diet. If the diet is followed, the intestinal damage will slowly heal. This can take several months.
• The disease is lifelong. Intestinal damage occurs each time gluten is consumed.
• Celiac disease affects one person in every 133 people in the United States.

Why Skin Testing Generally Isn't Effective

For several decades skin testing has been the standard way to test for allergies. The potential allergen is injected under or scratched into the skin, and any resulting inflammation (also known as wheal) is measured.

The size of the wheal supposedly determines whether or not an allergy is diagnosed. This technique leaves a lot to be desired because we don't inject food into our skin when we eat, nor do we necessarily get a red bump when we have a food allergy. This is also a subjective test. There is no scientific standard for the amount of swelling required for a positive result.

Equally important, this test can measure only an IgE antibody reaction. And even so, it often is negative, missing elevated IgE levels that are evident with a blood test. The IgG antibody is not tested for at all.

Many people are incorrectly told after skin testing that they do not have a particular food allergy.

Addressing Gluten-Free Diet Confusion

Seacoastonline.com recently published an article addressing gluten awareness and why so many are gravitating to a gluten-free diet, whether it be by choice...or necessity. It addressed many important points, especially that many of the foods being produced for the emerging gluten-free market are not very nutritious.

However, the article did not address the immunoglubulin type E and G mediated, non-anaphylaxis/asthma/eczema allergy to gluten.

The IgE and IgG mediated food allergy to gluten has been well documented in published research. Symptoms can range from digestive issues to skin conditions, headaches and beyond. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

Article excerpts, from Seacoastonline.com:

Until recent years, few people had even heard of the term "gluten." With increasing awareness and prevalence of people being diagnosed with celiac disease, interest in gluten and its possible relationships to health has skyrocketed.

As a result, more gluten-free products have been appearing in the marketplace. Research is now looking at other potential health benefits for a gluten-free diet besides celiac disease. There is thought that gluten may be involved in autism or other physical or mental health conditions. Celebrities are touting a gluten-free diet as a method of weight loss or because they believe it is a healthier pattern of eating.

IBS Treatment Center in Seattle Moves to New Building

After 5 years of successfully treating patients in the First Hill area of downtown Seattle, the IBS Treatment Center and Center for Food Allergies is relocating to a newly constructed professional and medical office building in north Seattle.

The new offices and clinic of the IBS Treatment Center will be on the first floor of the Northgate Pointe Office Building located in the Northgate Mall area. The new clinic space is conveniently located off of I-5, and easy to find at the intersection of Roosevelt Way and Pinehurst Way. Free parking for patients and visitors will be available in the on-site, covered parking garage.

The new space was designed specifically for Dr. Wangen and his patients. The clinic will feature a comfortable and attractive waiting area and pleasant, private exam rooms. Patients will have an easy, and improved check out procedure after meeting with the Doctor. The same outstanding support staff from the First Hill location will at the new office, providing patients with the same excellent patient service and care.

The IBS Treatment Center has not increased consultation fees since opening its doors in 2005. By moving to the new facility during this challenging commercial real estate environment, the clinic is able to avoid significant increases in rent costs, and thus avoid passing on any increases in fees to patients. To be able to keep patient fees consistent was an important factor in the decision to relocate the IBS Treatment Center.

The address of the new clinic is 11300 Roosevelt Way NE Suite 100 Seattle, WA 98125.
Entrance to the clinic and the parking garage are on Pinehurst Way NE, which is a wide, 4-lane arterial on the east side of the building.

PubMed.gov: Response to Gluten-Free Diet in Patients with Diarrhea-Predominant IBS

BACKGROUND & AIMS:

Gluten sensitivity might cause abdominal symptoms in the absence of villous atrophy. We examined the prevalence of celiac disease-associated serum antibodies in diarrhea-dominant irritable bowel syndrome (d-IBS) patients and their efficacy in combination with HLA-DQ2 expression to predict the response to gluten-free diet.

METHODS:

HLA-DQA1*0501/DQB1*0201 expression and celiac disease-associated IgA and IgG serum antibodies against gliadin and tissue-transglutaminase were measured in:

145 patients with d-IBS,
74 patients with untreated and treated celiac disease,
57 patients with active IBD.

Follow-up antibody levels, stool frequency, and gastrointestinal symptom scores were determined in 41 d-IBS patients (26 women, 15 men; median age, 46 years, range, 30-67 years) who participated in a nonrandomized evaluation of 6 months of gluten-free diet.

What Causes IBS?

The cause of IBS varies from person to person, which is what makes irritable bowel syndrome and the symptoms of diarrhea, constipation, gas, bloating and chronic abdominal pain so difficult for most doctors to treat.

However, through proper testing you will be able to identify the exact cause or causes of your symptoms and live a life free of digestive problems.

There are several hundred potential causes of IBS, but most cases result from issues in the following two major categories:

1. Food Allergies and Intolerances
2. Problems with Intestinal Bacteria, Yeast/Candida, or Parasites

Today, we're just going to focus on food allergies and intolerance.

Friday's Gluten Free Recipe - Fruit Cobbler!

From Jules Gluten Free:

Fruit Cobbler

Topping Ingredients:

• 1 cup Jules Gluten Free™ All Purpose Flour
• 1 cup granulated cane sugar (Wholesome Sweeteners®)
• 1 egg (or egg substitute of choice)
• 1/4 cup melted butter or non-dairy substitute (Earth Balance® Buttery Sticks)

Fruit Ingredients:

• 2 cups+ fresh or frozen berries or other sliced fruits (enough to cover the bottom of an 8 x 8 baking dish or 9-inch pie plate)
• 1/4- 1/2 cup granulated cane sugar (Wholesome Sweeteners®)
• 1 Tbs. cinnamon (I like extra cinnamon on peaches)

Colon Resection and IBS

It has been interesting to note the number of patients that have been seen at the IBS Treatment Center who have had part of or their entire colon removed, or to whom it has been suggested they have their colon removed.

Many thousands of people per year undergo this procedure for a variety of reasons. Unfortunately major surgery is not always the solution to their problem, nor does it always improve their symptoms.

A colon resection is also known as a colectomy. It is generally recommended when a person has significant damage to the colon.

In many cases this may be due to a major ulceration, severe diverticulosis, or cancer. A colon resection may also be necessary to prevent perforation of the colon, which will lead to a major infection and is life threatening.

Celiac Disease and Other Forms of Gluten Intolerance

Gluten is a protein found in wheat, barley, and rye, and is responsible for the springiness and stretchiness of bread.

Allergies and intolerances to gluten have been the subject of intensive research over the past decade.

Much of this research has focused on celiac disease, which is a special form of gluten intolerance.

It is a hereditary response to gluten that results in a very specific type of damage to the small intestine. Common symptoms, which can mirror those of IBS, include loose stools, constipation, or both; fatigue; weight fluctuation; dermatitis; and more.

The Sun: Why We Medics Hate the Mimics

Pretty entertaining article from The Sun (see below) on mimics in the world of medicine. The problem, however, is that it's too easy to diagnose based on symptoms alone.

EVERYONE loves a mimic.

Mike Yarwood, Jon Culshaw, swearing mynah birds and all that. Hilarious.

Not in the world of medicine, though. We docs hate them.

Because when one disease impersonates another - as they sometimes do - we can end up getting your diagnosis wrong.

What is IBS?

Irritable Bowel Syndrome (IBS) is defined by a set of symptoms affecting a patient’s gastrointestinal system. These symptoms, or immune system reactions, can be produced by a wide range of different medical conditions.

Most often, IBS symptoms are caused by one or more of the following: chemical mechanisms resulting from reactions to certain foods; microorganisms in the gut including bacteria and parasites; yeasts; or celiac disease (gluten intolerance).
________________________________________________________________
Facts About IBS:

• Irritable bowel syndrome (IBS) affects 10-20% of the general population, with women 20-40 years old accounting for the majority of patients. (Astegiano et. al. 2008)
• Irritable bowel syndrome affects approximately 10-15% of the European population and up to 70% of individuals with IBS may not be formally diagnosed. (Quigley et. al. 2006)

Peppermint Oil: Treating vs. Curing IBS

More and more articles are popping up touting the use of peppermint oil to treat IBS and related symptoms.

I stumbled across this excerpt in the Washington Post yesterday and wanted to pass along a few thoughts.

From The Washington Post:

Soothe tummy troubles

Before you try one of those widely advertised drugs for irritable bowel syndrome, consider peppermint oil. Research suggests that it improves symptoms in three of four people. Another effective alternative is soluble fiber from supplements such as psyllium (Metamucil and its generic cousins), preferably combined with plenty of water.

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Understanding Yeast (Candida)

Yeast infections, or yeast overgrowth, are a common result of antibiotic use. Yeast is also considered normal flora at low populations, since it is often found in the digestive tract.

However, remember that normal does not necessarily mean good. Yeast, especially the most common type called Candida, invades tissue and is a general irritant. Its growth inhibits the growth of good bacteria, and its life cycle produces the toxic effects of IBS symptoms in its host - you.

Candida will take advantage of every opportunity it has to flourish. If your system has been wiped clean of friendly bacteria due to antibiotics (which do not kill yeast), Candida will likely pounce, either in your digestive tract or elsewhere in your body. Once it gets hold, it can be difficult to get rid of.

Understanding the Differences Between IgE and IgG Food Allergies

The immune system functions like a sentinel standing guard against foreign invaders. In the case of an allergy, the invaders are called allergens.

The primary weapon that it uses against invaders is the production of antibodies. The antibodies cause reactions that result in the offending allergens being removed from the body.

In many people, foods act as allergens rather than nutrition. This can result in the symptoms of IBS.

Standard Food Allergy Profile

The Standard Food Allergy Profile test takes the guesswork out of treating your condition and saves you a great deal of time, effort, and discomfort.

If by chance your test happens to be negative, you can quickly move on to other potential causes of your problem without spending valuable time on an unsuccessful elimination diet and then wondering if you actually did it correctly.

Food allergy testing is a highly specialized procedure performed only by doctors trained in recognizing and treating non-anaphylactic food allergies, and only in laboratories especially equipped to handle the sophisticated testing required.

In order to give you an accurate result, this test must be a blood test, and must include both IgE and IgG antibodies.

Is Lactose Intolerance More than a Digestive Problem?

Lactose intolerance is a deficiency in the enzyme lactase. Lactase is the enzyme that digests the milk sugar lactose.

People with a lactose intolerance typically experience an upset stomach, bloating, gas, and loose stools. These are also common symptoms of a dairy allergy.

Many patients complain of a lactose intolerance. They usually say that taking Lactaid or a digestive product designed for lactose intolerance will resolve their digestive problems.

However, they obviously didn’t schedule an appointment just to tell me this and they are usually experiencing one of the other symptoms associated with a dairy allergy.

Not surprisingly, the lactose intolerance usually turns out to be a dairy allergy, which is an actual immune response to dairy.

The dairy allergy has apparently damaged the digestive tract to the extent that it has caused a deficiency in the enzyme lactase, which is produced by the cells lining the digestive tract. Many people mistakenly believe that they can continue to eat dairy products as long as they take a digestive aid, or they avoid milk but still eat cheese, etc. Unfortunately, most continue to suffer from their milk allergy even though their digestive symptoms have diminished.

If you have a lactose intolerance and experience any of the symptoms listed on page one then you should be tested for a dairy allergy via an ELISA blood test.

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Image thanks to Yaqoot on Photobucket

One Night Only - Volunteer with The IBS Treatment Center and Public Television!

We need your help!

The IBS Treatment Center is going to help support Seattle's KCTS 9 and Public Broadcasting by answering phones and taking donations during their Fall Pledge Drive next week.

And we need more volunteers to help answer phones!

If you believe in our mission, love public broadcasting or just like to be a part of a good cause, we would love to have you!

The Details

When: Thursday, September 23, 2010 – 6:30 to 11 PM
Where: KCTS Channel 9, Seattle, WA

What Will You Be Doing?

1. Answering phones and helping KCTS/PBS viewers make their donations
2. Eating free food & drink!
3. Meeting great people who also love The IBS Treatment Center, KCTS & Public Television!

How Do You Sign Up?

Just click here to send us an email - info@ibstreatmentcenter.com
Or if you prefer, feel free to call our office - 206-264-1111

Please come out and have a great time, support a good cause and help represent!

But above all else, thank you for supporting The IBS Treatment Center and helping to spread the word to others who haven't been helped, yet!

Five Steps to Help Heal Leaky Gut Syndrome

From The Huffington Post:

1. Get rid of anything that might be causing or contributing to increased intestinal permeability
2. Stop drinking alcohol for at least a month.
3. Stop using aspirin, ibuprofen, naproxen and other non-steroidal anti-inflammatory drugs (NSAIDS).
4. Have a stool test for intestinal parasites. There is extensive medical literature on intestinal parasites causing symptoms like fatigue, joint pain and skin disorders, without causing diarrhea.
5. Adopt an anti-inflammatory dietary pattern. The principles are simple to understand: avoid foods with added sugar and refined starches, made from white flour. Decrease consumption of saturated fat and most vegetable oils, using extra virgin olive oil instead. Eat at least 9 servings of fruits and vegetables a day and at least 4 servings of fish per week.

There are dietary supplements that help the small intestine heal and restore its functional integrity. The most important of these are the amino acid L-glutamine and the amino sugar N-acetyl- glucosamine, which are readily available in health food stores.

-------------

What is Leaky Gut Syndrome?

From The Huffington Post:

Because it connects apparently unrelated disorders, Leaky Gut Syndrome is one of the most misunderstood concepts in medicine today.

To begin with, Leaky Gut is not a single disease or syndrome; it's a pathological condition that occurs as part of many different diseases and syndromes.

The term refers to an abnormal increase in the permeability of the small intestine. Increased intestinal permeability is a component of many different disorders.

Leaky Gut Syndrome is associated with:

• inflammatory and infectious bowel diseases (6-12),
• several types of arthritis (13-18),
• acne (19),
• psoriasis, (19),
• AIDS (20),
• chronic liver disease (21),
• pancreatic disease (22)
• as well as numerous conditions triggered by food allergy, including eczema, hives, and irritable bowel syndrome (29-37).

Friday's Recipe: Chocolate Beer Cake

Chocolate Beer Cake

Ingredients:

• 1 cup dark gluten-free ale (Green's Dubbel Dark Endeavor Ale)
• 8 Tbs. unsalted butter or non-dairy alternative (Earth Balance® Buttery Sticks or Shortening)
• 3/4 cup unsweetened cocoa powder (not Dutch Alkalai Processed)
• 2 cups granulated cane sugar (Wholesome Sweeteners®)
• 3/4 cup sour cream, dairy or non-dairy (Tofutti® Better Than Sour Cream or Follow Your Heart® Sour Cream Alternative)
• 2 large eggs
• 1 Tablespoon (*not teaspoon) gluten-free vanilla extract (Nielsen-Massey® Madagascar Bourbon Vanilla)
• 2 cups Jules Gluten Free™ All Purpose Flour
• 1 Tablespoon (*not teaspoon) baking soda

Directions:

USA Today: More 'empowered' patients question doctors' orders

This article is essentially noting that more and more people are now questioning their doctor about tests - both questioning the need for them and asking for tests not recommended.

People should be aware of how much testing costs and what information will be obtained, how likely it is to be helpful to them, etc. The days of dictator doctors should be past now, for all but the most incapable patients.

From USAToday.com:

Jeff Chappell of Montgomery, Ala., recalls a visit a couple of years ago to a Charlotte emergency room, near where the family used to live, with his wife, Jacqueline, who has adrenal failure.

"I blew up loud enough for everyone in the ER to hear me explain that while we were insured, an MRI was about a $1,000 co-pay," Chappell says.

The couple knew her symptoms well (primarily stomach pain), knew that an MRI was not necessary under the circumstances and knew that a cortisone shot was what she needed.

"The doctor walked off in a huff," Chappell says, but later came back and "compromised" by agreeing to give his wife the shot, but not before taking an abdominal X-ray to rule out other problems first.

Many physicians say an increasing number of patients are getting involved in decisions about their medical care, including medication choices, whether they need a specialist, and especially whether they need expensive diagnostic tests, which some health economists say are driving up the cost of health care.

Shared Decision Model

"There have been big changes," says Patrick McManus, residency director of family and community medicine at Thomas Jefferson University in Philadelphia.

Reuters: Common Acne Treatments Linked to Bowel Problems

It is very good to see research starting to focus on the harmful effects of acne treatment.

Acne treatment is particularly problematic due to the long term nature of the treatment.

In my experience this will often result in digestive problems, because you can't continually kill of bacteria and expect it to not impact the huge ecosystem in the digestive tract.

And even though the study was primarily on Accutane, it was somewhat encouraging that the study authors suggested that antibiotics may be playing a role.

The article emphasizes how rare digestive disorders are in people who've been treated with acne.

But I doubt that is true based on two observations:

One, there are adds splashed all over TV by lawyers looking for people who have been harmed by the use of accutane. That right there tells you that the market for this problem is larger than rare. The second reason is because I've seen so many patients who've previously been treated for acne that I am certain that it's a risk factor for developing digestive problems.

From Reuters:

Acne is a difficult enough burden for a young person to bear. Now there's evidence that antibiotics commonly prescribed to help control severe breakouts may, in a very small number of patients, lead to inflammatory bowel disease.

Bowel disorders linked to acne treatment are "a rare outcome," cautioned Dr. David Margolis, a dermatologist and lead author of a study in the American Journal of Gastroenterology, in an interview with Reuters Health.

WSJ.com: Gluten Free Foods Treat a Variety of Conditions, But Not Weight Loss

The following article excerpt is from the Wall Street Journal.

One point worth adding to this piece is that it's good to remember that processed food substitutes for their gluten containing counterparts are often of lower nutritional value.

From WSJ.com:

Gluten-free foods are everywhere these days—but they're much more than just a health craze.

The bevy of new products, from gluten-free pasta to pizza and beer, are a boon to people with celiac disease, wheat allergies or gluten sensitivity who are on very restrictive diets. That group has grown dramatically in recent decades, for reasons not understood.

Are they beneficial to everyone else? Probably not.

The notion that a gluten-free diet can help people lose weight or avoid carbohydrates is a myth.

"Many packaged gluten-free products are even higher in carbs, sugar, fat and calories than their regular counterparts, and they tend to be lower in fiber, vitamins and iron," says Shelley Case, a registered dietician on the medical advisory board of the Celiac Disease Foundation.

First Annual Cider Summit NW This Saturday

The Northwest Cider Association, SBS Imports, and the Seattle Beer Collective are pleased to
announce the First Annual Cider Summit NW!

When: Saturday, September 11, 2010, 11:00 AM-7:00 PM

Where: Seattle's South Lake Union Discovery Center

What: The Cider Summit NW offers guests an opportunity to sample some 40 elegantly crafted ciders from producers in Washington, Oregon, British Columbia, England, and France.

Each featured cider is made from 100% pressed apples (or pears) and is crafted without concentrates or other additives.

Tickets for the Cider Summit are $20 in advance and $25 (cash only) at the door and are available online via Brown Paper tickets and at the area’s leading bottle shops.

Admission includes a tasting glass and 10 drink tickets.

From 11 a.m-12 noon arriving guests will receive 2 additional “happy hour” tickets. Additional drink tickets will be available for sale on site at $2 per ticket.

All samplings will be available in 3 and 6 ounce portions. The event is 21 and over only.

For more information including a list of participating ciders please visit their website at CiderSummitNW.com

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Image thanks to Tieton Cider Works

Understanding 'Celiac Crisis' versus 'Celiac Disease'

Celiac crisis is a rare but serious complication of celiac disease in adults.

This study points out that in some cases, celiac disease can be very severe. Public perception frequently underestimates the potential severity of celiac disease. However, the oppositive problem is just as common.

Celiac disease does not have to be life threatening or even involve digestive symptoms. And doctors still often only associate it with the crisis symptoms described in this study.

Interestingly, many times I've seen patients at the crisis stage who are gluten intolerant yet do not have celiac disease. This is another twist typically overlooked by the public and the medical community.

From PubMed.gov:

BACKGROUND & AIMS

Celiac crisis is a life-threatening syndrome in which patients with celiac disease have profuse diarrhea and severe metabolic disturbances.

Celiac crisis is rare among adults and not well documented. To improve awareness of this condition and to facilitate diagnosis, we reviewed cases of celiac crisis to identify presenting features, formulate diagnostic criteria, and develop treatment strategies.

Today's Food Allergy Q&A

Question:

I've recently been considering a total elimination diet, but have some questions prior to starting.

Can you help to explain what foods/liquids are actually acceptable during the diet? And are there specific instructions that I should follow? Such as eliminating one food at a time, etc...

Thanks!

Answer:

There are a variety of ways of doing an elimination diet. You can try completely eliminating one food at a time. If you’re lucky and you guess the right food, then that can really help. Or you can eliminate all of the major food allergens, such as dairy, gluten, eggs, soy, etc.

Fatigue, Thyroid Function and Hypothyroidism

Hypothyroidism is a serious condition found in people with and without food allergies.

However, people with food allergies, particularly those with celiac disease (a gluten allergy), frequently suffer from hypothyroidism.


Hypothyroidism causes fatigue and weight gain as well as other problems, and is often overlooked and misdiagnosed due to complexities in thyroid testing and symptoms which may overlap or contradict the symptoms of food allergies.

What Is the Thyroid Gland?


The thyroid gland sits in the neck in front of and on both sides of the trachea and secretes thyroid hormones. These hormones regulate metabolism and thus affect many aspects of health. 



What Are the Symptoms of Hypothyroidism? 


Lack of adequate thyroid hormone production may result in one or more of the following symptoms: fatigue, weight gain, constipation, cold extremities, inability to focus, forgetfulness, dry skin and depression. 



Last IBS Support Meeting at Our Current Location - Tonight!

Today, Tuesday, September 7th is the next IBS Support Group Meeting.

This marks the last meeting in the IBS Treatment Center's Nordstrom Medical Tower clinic!

Join us on Tuesday, September 7th at 6:30 PM and help us say goodbye to the old office as we prepare for the IBS Treatment Center to move in late September.

Gluten-Free Friday Recipe: Healthier Zucchini Bread

Ingredients:

• 1⁄2 cup granulated cane sugar (Wholesome Sweeteners®)
• 1⁄2 cup shortening, butter or non-dairy alternative (Earth Balance® Shortening or Buttery Sticks)
• 2 large eggs
• 1⁄2 cup sour cream, dairy or non-dairy (Tofutti Better than Sour Cream®)
• 1 teaspoon vanilla extract, gluten-free (Nielsen-Massey® Madagascar Bourbon Vanilla)
• 1⁄2 cup mashed, ripe banana (approximately 1 banana)
• 2 cups Jules Gluten Free™ All Purpose Flour
• 2 Tablespoons flax seed meal (optional, but recommended) (Flax USA Real Cold Milled™ Golden Flax)
• 1 Tablespoon cinnamon or pumpkin pie spice
• 1 Tablespoon baking powder, gluten-free (Hain Purefoods Featherweight®)
• 1 teaspoon baking soda
• 1⁄2 teaspoon fine sea salt
• 1 cup packed, fresh zucchini, grated (approximately 1 zucchini squash)
• 1⁄2 cup chopped pecans or walnuts (optional)
• cinnamon-sugar mixture to sprinkle on top

Directions:

25% of Celiacs Suffer for a Decade or More Before Accurate Diagnosis

From Celiac.com:

About a quarter of people who suffer from celiac disease or gluten intolerance spend a decade or more complaining to doctors before receiving an accurate diagnosis, according to a poll conducted by Coeliac UK.

According to the poll, nearly 25 percent of sufferers consulted doctors about their symptoms for over a decade, while eleven percent of people with celiac disease sought help from doctors for over 20 years before receiving a proper diagnosis.

Introduction: Lab Testing for IBS Triggers

Because IBS has been conventionally defined not by what it is, but by what it is not, successfully discovering its cause has been impossible, because the cause was thought to be unknown.

It's really been nothing more than a guessing game, and you get to be the guinea pig. Fortunately that has now all changed.

Now we can define the cause of your IBS, and therefore treat it.

Understanding the Gall Bladder

Patients with irritable bowel syndrome (IBS) and other digestive problems such as constipation, diarrhea or abdominal pain often wonder if they have a problem with their gallbladder.

Problems with the gallbladder can indeed cause these symptoms. However, many people find that having their gallbladder removed did little or nothing to help their IBS, or even made it worse.

What Does the Gallbladder Do?


The gallbladder does exactly what its name describes; it is a small bladder that stores gall.

Gall is more commonly known as bile.

Bile is produced by the liver and piped over to the gallbladder via the bile duct.

Acne and Food Allergies

Acne may be one of the most common conditions known to humans. It can be embarrassing, frustrating, and downright unfair.

Fortunately, most of the time, it is also avoidable.

The Traditional View of Acne and Its Treatment

Most people assume that getting acne is a normal part of life. But why do some people get acne when others do not? And why do certain people have such bad cases of acne? Commercial treatments for acne focus on keeping the skin clean and clearing clogged pores.

This sounds reasonable, but again, why do some people have to obsessively clean their skin when others do not? And why do some people cleanse, exfoliate, deep clean and still get acne?

The Role of the Immune System in the Digestive Tract

The huge surface area of your digestive tube must be protected against injury from bad bacteria, viruses, parasites, and other toxins that may get into the digestive system with food or by any number of other routes.

The immune system is critically important in helping the intestines respond to these challenges. Possibly the greatest challenge to the digestive tract's immune system is to correctly tell the difference between what is bad (such as viruses and bad bacteria) and what is good (such as nutrients and good bacteria).

Your immune system must determine whether or not to develop a tolerance to everything you put into your mouth. Whenever you try a new food, it must decide, "Do I like this or do I attack and kill it?"