Celiac Disease and Other Forms of Gluten Intolerance

Continuing with our "Causes of Irritable Bowel Syndrome" series.

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.

Celiac disease is diagnosed by measuring damage to the small intestine, either by blood testing or, traditionally, with a biopsy of the small intestine. A positive biopsy means that the villi, or small finger-like extensions of the intestinal lining, have been damaged; this is known as villous atrophy. However, recent studies have shown blood testing to be as accurate as a biopsy.

People with celiac disease will show a marked reduction in their villi, almost as if the villi have been worn off. Damage to the villi causes a dramatic reduction in the surface area of the small intestine, resulting in both poor digestion and the poor absorption of many nutrients.

Seattle Weekly: Food Banks Struggle to Keep Gluten-Free Items in Stock

Close to 1% of the population (roughly 1 of every 100 people) has celiac disease, but a much higher number - perhaps 10% or more, has a medical condition of gluten intolerance.

To help fight this, we need more whole foods in food banks to help those that are less fortunate have access to better nutrition.

Excerpt from the Seattle Weekly:

Ritzy restaurants have lately rushed to issue gluten-free menus, but activists say it's still difficult for low-income eaters with celiac disease to obtain the foods they need to stay healthy. In May, Lisa Garza, a Seattleite who maintains the Gluten Free Foodies blog, urged the Seattle Food Committee, a coalition of 27 local food banks, to consider creating dedicated gluten-free pantries.

"I don't want people to suffer the way I suffered," says Garza. "People are thinking this is a diet for weight loss, but this is a serious medical condition."

Committee member Joe Gruber, director of the University District Food Bank, says Garza's suggestion "made us more mindful," but doesn't foresee instituting it anytime soon. In fact, none of the city's food banks has yet found room for a gluten-free section: According to Gruber, cost and space limitations have severely hampered their abilities to regularly stock gluten-free food.

"To offer any form of carved-out space is a challenge," says Gruber, whose 800-square-foot food bank distributes about 45,000 pounds of food per week. "We try to identify gluten-free goods, but they will still end up with other pastas, grains, and cereals."

Causes of Irritable Bowel Syndrome: 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.

Candida can cause a huge variety of symptoms, including but not limited to all the symptoms of IBS, making it one of the most frustrating and confusing conditions to describe, not to mention endure.

Celiac Disease and Gluten Intolerance: Common Wheat Allergies

What Is Celiac Disease?


Celiac disease is a hereditary allergy to gluten that results in damage to the small intestine. Common symptoms include loose stools, fatigue, weight loss and generally poor health.

However, symptoms can vary widely and include constipation, weight gain, and a skin condition called dermatitis herpetiformis.

What Is Gluten? 


Gluten is a protein found in wheat, barley, and rye. Gluten is responsible for the springiness and stretchiness of bread. Without it, bread turns out heavy and dense. 



How Is Celiac Disease Diagnosed? 


Celiac disease can be assessed by blood tests or by a biopsy of the small intestine performed during an upper endoscopy. The blood tests include the tissue transglutaminase antibody test and the newer deamidated gliadin antibody test. The endomysial antibody test is older and is not as senstive as the newer tests. 



How Common Is Celiac Disease?


The occurrence of celiac disease is much higher than previously thought. A recent study put the prevalence at 1 in every 133 people, making it one the most common genetic diseases known.

Once diagnosed, 1 in 22 first degree relatives, and 1 in 39 second degree relatives, is also diagnosed positive.

Hypnosis and Irritable Bowel Syndrome

More and more articles are touting the benefits of hypnosis as a means of treating irritable bowel syndrome.

For people who have IBS symptoms - hypnosis can be effective in reducing their symptoms. However, as the article notes, "Hypnosis is not magic — it alleviates symptoms, but doesn’t cure disease."

If Irritable Bowel Syndrome is being caused by one of the many common physio/biochemical issues that are known to cause IBS symptoms, it is better to identify the problem and treat it than to simply mitigate symptoms by hypnosis. For example, many people with celiac have limited symptoms and can probably limit those with help from hypnosis. However, the celiac disease will continue to damage their health and shorten their life until they stop ingesting gluten.

That said, hypnosis can also help people to change behavior which is detrimental to their health, such as in smoking. So in some ways it can also address potential aggravating factors, such as stress.

From MSNBC.com:

In 1987, Marilyn Bellezzo was diagnosed with irritable bowel syndrome (IBS), a disorder that was, for her, debilitating.

"I was housebound," Bellezzo said. She spent hours curled up on the bathroom floor, suffering from abdominal pain and diarrhea. "I had to raise my children through the bathroom door," said the now 59-year-old resident of Glen Ellyn, Ill.

Over the next 12 years, Bellezzo tried medications and diets, to no avail. Then as a last resort, she started listening to audio tapes designed to treat IBS through hypnosis.

They made a difference. Now, she says her symptoms are virtually gone.

Case Study: Immunochemical and Mass Spectrometry Detection of Residual Proteins in Gluten Fined Red Wine

This article is not stating that gluten can be in wine. It's not yet used there. But dairy and egg are used to fine (or clarify) wines. This article points out that allergens like this can and do show up in wine.

From NIH.gov:

Recently, wheat gluten has been proposed as technological adjuvant in order to clarify wines.

However, the possibility that residual gluten proteins remain in treated wines cannot be excluded, representing a hazard for wheat allergic or celiac disease patients. In this work, commercial wheat glutens, in both partially hydrolyzed (GBS-P51) and nonhydrolyzed (Gluvital 21000) forms, were used as fining agents in red wine at different concentrations. Beside immunoenzymatic analyses using anti-gliadin, anti-prolamin antibodies and pooled sera of wheat allergic patients, a method based on liquid chromatography coupled to mass spectrometry has been proposed to detect residues of gluten proteins.

Residual gluten proteins were detected by anti-prolamin antibodies, anti-gliadin antibodies and sera-IgE only in the wine treated with GBS-P51 at concentration 50, 150, and 300 g/hL, respectively, whereas no residual proteins were detected by these systems in the wine treated with Gluvital 21000. In contrast liquid chromatography-mass spectrometry analyses allowed the detection of proteins in red wines fined down to 1 g/hL of Gluvital 21000 and GBS-P51.

Our results indicate that MS methods are superior to immunochemical methods in detecting gluten proteins in wines and that adverse reactions against gluten treated wines cannot be excluded.

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Source
Dipartimento di Biotecnologie, Università di Verona, Strada Le Grazie 15, 37134, Verona, Italy.
Simonato B, Mainente F, Tolin S, Pasini G.
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Image thanks to JeremyCWilson.com

Friday's Gluten Free Recipe: Strawberry Cake

This delicious recipe comes thanks to GlutenFreeMommy.com.

Gluten Free Strawberry Cake Recipe
Note: You can easily substitute 3 cups of your gluten free flour mix for mine- just watch the liquid content.

• 1/2 cup almond meal
• 1 1/2 cups brown rice flour
• 3/4 cup tapioca flour
• 1/4 cup sweet rice flour
• 2 1/2 teaspoons baking powder
• 1/2 teaspoon salt
• 2 Tablespoons strawberry Jello® mix
• 1 1/2 teaspoons xanthan gum
• 2/3 cup unsalted butter, softened
• 3/4 cup granulated sugar
• 1/2 cup powdered sugar
• 1/2 cup brown sugar
• 3 large eggs
• 1 teaspoon vanilla
• 1 cup pureed strawberries
• 3/4 cup milk (or until consistency of cake batter)

Frosting:

• 2 packages of cream cheese, softened
• 1 stick of butter, softened
• 3 cups or more of powdered sugar
• 1 teaspoon vanilla
• squeeze of lemon juice

Directions for Cake:

Gluten Intolerance Group: Understanding Dermatitis Herpetiformis

Thanks to the Gluten Intolerance Group of North America for this great content.

Dermatitis herpetiformis (DH) is a chronic disease of the skin marked by groups of watery, itchy blisters that may resemble pimples or blisters. The ingestion of gluten (from wheat, rye, and barley) triggers an immune system response that deposits a substance, lgA (Immunoglobulin A), under the top layer of skin. IgA is present in affected as well as unaffected skin. DH is a hereditary autoimmune gluten intolerance disease linked with celiac disease. If you have DH, you always have gluten intolerance. With DH, the primary lesion is on the skin, whereas with celiac disease the lesions are in the small intestine. The degree of damage to the small intestine is often less severe or more patchy than those with celiac disease. Both diseases are permanent and symptoms/damage will occur after consuming gluten.

Symptoms of Dermatitis Herpetiformis

The lgA deposits under the skin result in eruptions of red raised patches of skin, similar to the beginning of a pimple, that can develop into small watery blisters. The itching and burning of the eruptions are severe and the urge to scratch them is intense. Scratching will further irritate the eruptions. Eruptions commonly occur on pressure points, such as around the elbows, the front of the knees, the buttocks, back face, and scalp but can appear anywhere on the body. Eruptions are usually bilateral - occurring on both sides of the body. 60% of those diagnosed are men and the most common age at diagnosis is 15 to 40 years old. Although it is uncommon to diagnose young children with DH, we are seeing more cases of early childhood DH.

Digestive Problems: Never the Same Since

Does the story of your digestive problem start with the line “I never really had any problems until… I caught the flu one year.” or “…I got food poisoning.” or “…I had a major illness.” or “…I had surgery.” or “…I went to Mexico.” or “…there was a tragic death in my family.”?

And then does your story continue with the phrase “…and I’ve never been the same since.”?

This theme of digestive problems seeming to begin after an illness or important event is common among patients at the IBS Treatment Center. Digestive problems often start to manifest themselves more significantly after a sickness, international travel or stressful experience. Or, they simply seem to start altogether after such an event. Why does this happen?

Any type of physical or emotional stress, even if it seemed inconsequential at the time, can affect one’s overall health. And what impacts one part of your body truly does impact the entire system. Stress of any type takes energy to deal with and is a drain on your resources. When you do not recover normally from the flu, food poisoning, etc, it is generally a sign that there is a lot more to your problem than the issue that seemed to trigger it.

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.



Low Acid Production: Ironically, low stomach acid levels can result in heartburn. This is much more common than increased acid. This problem can be assessed clinically and is readily treatable. 



Medications: Many medications cause heartburn as a side-effect, including, several acid blockers.

Stomach Acid: Why You Need It

Stomach acid is vital to good health. It is the first major step in breaking down your food, which is so critical to proper nutrition. The myth is that you are what you eat. But in fact, you are what you absorb.

Acid is especially important for breaking down proteins into amino acids and is required for the optimal release and preparation of minerals such as calcium, magnesium and iron for absorption.

Vitamin B12 also isn’t adsorbed without it. The same cells that produce acid produce intrinsic factor, which is required for B12 absorption. Without B12 you become B12 deficient, leading to fatigue and neurological problems. 


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.

What is a Dairy Allergy?


An allergy is an immune response that results in inflammation and tissue damage. Such a response to food can be exhibited in any part of the body, therefore it can cause a wide range of problems.

Food allergies also interfere with nutrient absorption, resulting in conditions such as iron deficiency anemia, osteoporosis, and fatigue.

What Are the Possible Milk Allergy Symptoms?


A dairy allergy, like any food allergy, is capable of triggering a wide array of milk allergy symptoms.

Some of the most common complaints include ear infections in children, sinusitis, heartburn/reflux, constipation, diarrhea, and irritable bowel syndrome. A more complete list includes:

Case Study: Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics

This and many more case studies available at the research page of the Innate Health Foundation and 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 Class I 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.

Hypnosis & Irritable Bowel Syndrome

Several recent articles have cited the effectiveness of hypnosis as a means of treating IBS, including this most recent piece from MSNBC.

For people who have IBS symptoms - hypnosis can be effective in reducing their symptoms. However, if their IBS is being caused by one of the many, many common physio/biochemical issues that cause IBS symptoms, it is better to identify the problem and treat it than to simply mitigate symptoms by hypnosis.

For example, many people with celiac have limited symptoms and can probably limit those with help from hypnosis. However, the celiac disease will continue to damage their health and shorten their life until they stop ingesting gluten.

One key sentence from the excerpt below - "Hypnosis is not magic — it alleviates symptoms, but doesn’t cure disease."

From MSNBC:

Over the last decade, more and more research shows there are benefits of hypnosis for medical problems. In addition to IBS, a number of rigorous studies have found the practice is effective at mollifying chronic pain and reducing stress and anxiety before surgery. Studies have also shown hypnosis reduces health care costs — patients who use it stay in the hospital for shorter periods and use less medication.

So why don't more people and hospitals use hypnosis? Part of the reason may be its stigma — patients and doctors may think of it more as "hocus pocus" than science. Another reason may be problems with the quality of hypnosis studies, leading doctors to be wary that it wastes time and money.

Announcing Full Spectrum Probiotics

Supplemental probiotics can potentially help people with Irritable Bowel Syndrome in profound and wonderfully healthy ways. But not all probiotics on the market today are created equal. In truth, there are huge differences between the most commonly known and well recognizable probiotics out there. (More information about probiotics here.)

The IBS Treatment Center is excited to finally be able to offer what we believe is the finest, highest-quality probiotic product available. Not only does our new probiotic, The IBS Treatment Center™ Full Spectrum Probiotic contain 50% more species of good bacteria than any of the other well known products, it is also guaranteed to be 100% free of dairy, gluten, and soy which meets the needs of so many of our patients. And, because it is available in both capsule and powder form, it can be taken at virtually any dosage.

Slightly modified versions are also available for infants and children. These are the IBS Treatment Center™ Infant Biotic, and the IBS Treatment Center™ Children’s Chewable Probiotic. Both are also at the top of their class.

Research clearly shows that numerous species of good bacteria (probiotics), rather than just one or two different kinds, can have a multitude of positive effects on the digestive tract as well as on overall health. Although some physicians may recommend a certain, single bacteria probiotic, it is misleading to patients to suggest that one or two bacteria may be superior to others.

Friday's Gluten Free Recipe: Fish Tacos from Jules!

This recipe and over 149 more can be found in Jules Gluten Free's latest cookbook, Free for All Cooking: 150 Easy Gluten-Free, Allergy-Friendly Recipes the Whole Family Can Enjoy.

Ingredients:

• 1 pound white fish (like tilapia, mahi mahi or red snapper) cut into 1 inch pieces
• 1 lime
• 2 large eggs or 1/2 cup milk of choice, dairy or non-dairy
• 1/4 cup Jules Gluten Free® All Purpose Flour
• 1/2 tsp. sea salt
• High heat oil for frying
• 12 corn or gluten-free flour tortillas
• 2 tomatoes, chopped
• 1 avocado, diced
• Salsa of choice
• Coleslaw or shredded lettuce
• 1/2 cup chopped cilantro (optional)
• Sour cream, dairy or non-dairy (optional) – (e.g. Tofutti® or Follow Your Heart® soy sour cream)

Directions:

Cut the fresh or thawed fish into pieces and place into a large zip-top bag. Squeeze the lime into the bag with the fish, seal the bag, shake gently and set aside to marinate.

The Effects of Probiotics in Women with Irritable Bowel Syndrome

The following study is available on the IBS Treatment Center's Research page as well as at the National Institutes of Health.

Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.

BACKGROUND:

Probiotic bacteria exhibit a variety of properties, including immunomodulatory activity, which are unique to a particular strain.

Thus, not all species will necessarily have the same therapeutic potential in a particular condition. We have preliminary evidence that Bifidobacterium infantis 35624 may have utility in irritable bowel syndrome (IBS).

OBJECTIVES:

This study was designed to confirm the efficacy of the probiotic bacteria B. infantis 35624 in a large-scale, multicenter, clinical trial of women with IBS. A second objective of the study was to determine the optimal dosage of probiotic for administration in an encapsulated formulation.

METHODS:

After a 2-wk baseline, 362 primary care IBS patients, with any bowel habit subtype, were randomized to either placebo or freeze-dried, encapsulated B. infantis at a dose of 1 x 10(6), 1 x 10(8), or 1 x 10(10), cfu/mL for 4 wk.

Generic Dietary Changes and Elimination Diets

If you've done much reading about IBS diets, then you've seen advice urging you to increase fiber.

If you're constipated, increase fiber if you have diarrhea, cut back on sugar, drink more water, avoid lactose, avoid dairy, avoid bread, avoid red meat, cut back on yeast, reduce spicy foods, cut back on carbonated drinks and artificial sweeteners, eliminate chocolate, eliminate caffeine, eliminate alcohol, eat smaller meals, and so on and so on.

You may be wondering if you can ever eat again without triggering your symptoms.

The problem with this approach is that different foods trigger IBS in different people, and many foods can potentially trigger IBS symptoms - far more than in the list mentioned. Therefore the best diet for you may not be the best one for someone else. Certainly some people have been helped by one of the recommendations above, but most people have not.

Elimination Diets

Ideally, to create an optimal IBS diet, all you'd have to do is avoid a certain food or food group to discover whether it was triggering your IBS. Unfortunately this is easier said than done. It takes a great deal of time, persistence, and education to properly construct a diet that will adequately treat IBS. Proper lab testing can help you avoid all of this.

Irritable Bowel Syndrome & the Gall Bladder

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.

What is bile?

Bile is a highly concentrated yellow green fluid that contains bile acids. Bile acids are important for digesting fats. When you eat, your gallbladder contracts and secretes bile into the small intestine to help you digest your food. If your gallbladder has been removed then it will be more difficult for you to digest fats. In such cases, eating too much fat may cause loose stools.

When does that gallbladder need to be removed?

In some people, stones develop inside of the gallbladder. These stones, when small, can become lodged in the bile duct, which can cause severe pain and be very dangerous if they also clog the pancreatic duct. Larger stones are not able to pass into the bile duct, but their presence can cause severe pain. Sometimes this is worse when the gallbladder is contracting. In either case, removing the gallbladder usually relieves the pain and you feel much better.

When is it questionable to remove the gallbladder?

It is often tempting for physicians to blame the gallbladder for abdominal pain and digestive problems even when there is little or no evidence that the gallbladder is the culprit. It’s a relatively simple procedure, and most people don’t miss it too much. If stones are present, then the decision is easy to make.

Detection of IgE, IgG, IgA and IgM antibodies against raw and processed food antigens

This and many other IBS and food-related studies available at PubMed.gov.

BACKGROUND:
Despite the first documented case of food allergy to cooked food in 1921 by Prausnitz and Kustner, all commercial food antigens are prepared from raw food.

Furthermore, all IgE and IgG antibodies against dietary proteins offered by many clinical laboratories are measured against raw food antigens.

METHODS:
We developed an enzyme-linked immunosorbent assay for the measurement of IgE, IgG, IgA and IgM antibodies against raw and processed food antigens. Sera with low or high reactivity to modified food antigens were subjected to myelin basic protein, oxidized low density lipoprotein, and advanced glycation end products (AGE) such as AGE-human serum albumin and AGE-hemoglobin.

RESULTS:
Compared to raw food antigens, IgE antibodies showed a 3–8-fold increase against processed food antigens in 31% of the patients. Similarly, IgG, IgA and IgM antibodies against modified food antigens overall were found at much higher levels than antibody reactions against raw food antigens. Almost every tested serum with high levels of antibodies against modified food antigens showed very high levels of antibodies against myelin basic protein, oxidized low density lipoprotein, AGE-human serum albumin and AGE-hemoglobin.

CONCLUSION:
We conclude that the determination of food allergy, intolerance and sensitivity would be improved by testing IgE, IgG, IgA and IgM antibodies against both raw and processed food antigens. Antibodies against modified food antigens, by reacting with AGEs and tissue proteins, may cause perturbation in degenerative and autoimmune diseases such as diabetes, atherosclerosis, inflammation, autoimmunity, neurodegeneration and neuroautoimmunity.

This study available in great detail on PubMed.gov.
Image thanks to PublicDomainPictures.net

The Innate Health Group

The Innate Health Group was designed and created to reintroduce something that has been missing in medicine, a belief that you are capable of being healthier if given a better understanding of your body. We subscribe to the scientific method and the theory of evolution. We know that in most cases health is something that comes from the capacity of your body to perform according to its genetic design, with which you were born.

Health, excepting traumatic damage to the body, is usually not most effectively achieved by drugs or surgical procedures. Although these have their place, they are grossly overused. And frequently drugs and surgical procedures cause other significant problems that could be avoided by other techniques that not only solve the underlying problem, but avoid additional risk.

As a society we have lost touch with our innate health. We are confused by a medical system and a culture that prioritizes business over health, and by generic mass marketed treatments and fads that treat people as statistics and customers rather than as unique individuals with unique health care needs.

Our primary goal is to help you maximize your innate health. This is easier said than done, and the choices that will lead to improved health aren’t necessarily obvious, nor are they the same for everyone. As each individual is unique, so are the requirements for your body to be healthy.

However, at the Innate Health Group we are able to achieve great success with our patients by focusing on them as individuals and customizing each patient’s treatment plan. We utilize proven medical care and cutting-edge testing, and combine it with common sense to provide you with information about how your body works and what it needs to function optimally. Our promise to you is that we will not only try to solve your problem, but improve your overall health for the rest of your life.

The Innate Health Group includes the IBS Treatment Center, the Center for Food Allergies, the Food Allergy and Intolerance Foundation, and Innate Health Publishing.

Fiber: Soluble vs. Insoluble

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. Soluble fiber also prevents constipation, because the colon becomes filled with gel, as opposed to being clenched tightly around dry, hard stools.

Basically, fiber moves bulk through the intestines and helps to balance the pH (acidity) level in the intestines. It is also helps to keep healthy the good bacteria that live in your digestive tract. In particular, one type of plant fiber, fructooligosaccharides (FOS), feed these good bacteria.

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Image thanks to TheWholeGang.org via creativecommons.org

Food-specific serum IgG4 and IgE titers to common food antigens in irritable bowel syndrome.

This and other irritable bowel syndrome studies available on the National Institutes of Health website.

INTRODUCTION:
Food hypersensitivity is a common perception among irritable bowel syndrome (IBS) patients. Data from dietary elimination and food challenge studies support an etiopathological role of diet in IBS, but there are no well-established tests to identify food hypersensitivity.

AIM:
To compare IgG4 and IgE titers to common food antigens in IBS and controls.

METHOD:
One hundred and eight IBS [52 diarrhea-predominant (D-IBS); 32 constipation-predominant (C-IBS); 24 alternating (Alt-IBS)], and 43 controls were included in the study. IgG4 and IgE titers and skin prick testing (SPT) to 16 common foods including milk, eggs, cheese, wheat, rice, potatoes, chicken, beef, pork, lamb, fish, shrimps, soya bean, yeast, tomatoes, and peanuts were measured.

Understanding Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not produce adequate thyroid hormones, which are T4 and T3. Thyroid hormones are critical to health, contributing to metabolic rate, energy, and cognitive function.

There are several different types of hypothyroidism, but in most cases, people who have a hypothyroid condition will feel tired, lack focus, and may experience dry skin, cold extremities, constipation, or weight gain. However, other medical conditions can be present at the same time may mask many of these symptoms.

For example, hypothyroidism is commonly associated with celiac disease, which may cause diarrhea. Hypothyroidism is readily treatable, but there are several factors to consider when evaluating thyroid function.

TSH

Most physicians measure thyroid function by testing levels of TSH. TSH stands for Thyroid Stimulating Hormone. Thyroid Stimulating Hormone is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. TSH levels are supposed to automatically increase to compensate for low thyroid hormone production.

Causes of Irritable Bowel Syndrome: Parasites

Parasites, another cause of IBS symptoms, can cause diarrhea, constipation, gas, bloating, cramps, nausea, poor digestion, fatigue, muscle aches, bleeding, rectal itching, and abdominal pain. Parasites cannot live without you. You provide them living space and food, but unlike friendly bacteria, parasites do nothing for you in return. They only act against you.

Parasites vary in size from the very tiny, which can be seen only under a microscope, to inches long. Some can find their way into just about any area of the body, but most are found only in the digestive tract. The severity of your symptoms and the amount of damage they cause varies depending on the parasite involved, the number of parasites, and the level of resistance your body has.

Parasites damage the body in a number of ways, by absorbing nutrients that you need and by directly damaging your digestive tract; and, if they are capable of migrating, possibly damaging other areas of your body as well. They often reproduce rapidly and by the thousands, and are easily spread to other people. Unfortunately, a strong population of good bacteria does little to protect you from parasites.

Parasites are more common than generally believed. Although most Americans consider them to be a Third-World problem, they infect millions of Americans - even those who never leave the country or drink from mountain streams (a common source of the parasite Giardia). We live in a global community. Parasites enter this country every day through the importation of contaminated foods and seemingly innocent products such as clay pottery.

Friday's Review: Fast Facts about Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?

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).

Fast Facts about Irritable Bowel Syndrome:

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)

PubMed Case Studies: Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial

This study available in detail at NIH.gov:

Introduction:
It is well-known that specific foods trigger migraine attacks in some patients. We aimed to investigate the effect of diet restriction, based on IgG antibodies against food antigens on the course of migraine attacks in this randomised, double blind, cross-over, headache-diary based trial on 30 patients diagnosed with migraine without aura.

Methods:
Following a 6-week baseline, IgG antibodies against 266 food antigens were detected by ELISA. Then, the patients were randomised to a 6-week diet either excluding or including specific foods with raised IgG antibodies, individually.

Following a 2-week diet-free interval after the first diet period, the same patients were given the opposite 6-week diet (provocation diet following elimination diet or vice versa). Patients and their physicians were blinded to IgG test results and the type of diet (provocation or elimination).

Everyday Painkillers, High Blood Pressure and Stomach Damage

Americans consume an estimated $2 billion per year in over-the-counter painkillers like Tylenol, Advil and Motrin. The most common reason for taking them is for arthritis.

However, these drugs are not without side-effects. It also doesn’t take as much as you might think to cause damage. And the variety of side effects includes high blood pressure, stomach ulcers, and other problems.

A study of more than 80,000 women found that women who used acetaminophen, the active ingredient in Tylenol, for 22 days or more a month had the greatest risk of high blood pressure, estimated at twice that of non-users. And even those who used the drug as little as one to four days a month had a 22% greater risk of having high blood pressure than non-users.

The risk for those taking NSAIDS (nonsteroidal anti-inflammatory drugs), including ibuprofen products such as Advil and Motrin and naproxen drugs such as Aleve, was similar. Heavy users had a risk of high blood pressure 86% higher than those who didn't use the drug. Light users carried a 17% higher risk. (Journal Hypertension November 2002 20(11):2301-2307)

The Gluten & Allergen Free Expo - Dallas

The Gluten & Allergen Free Expo in Dallas is the premier gluten and allergen free event in the US.

Whether you are looking for specialty products that taste great or just trying to learn how to cook and bake to meet your dietary needs, the Expo is the place to be. With attendees flying in from around the country and Canada to attend this amazing event, there is plenty to see and explore.

This year's gluten-free presenters include Gluten Free Life and Food Coach Jen Cafferty, RealSustenance.com founder Brittany Angell, The Gluten-Free Italian Cookbook author Mary Capone, Living Without founder Beth Hillson, Gluten-Free Doctor Stephen Wangen, Simply...Gluten Free's Carol Kicinski and many, many more.

This year's Gluten Free and Allergen Expo schedule available here.

Tickets available here.

The Dallas GFAF Expo is hosted by The Lone Star Celiac GIG branch. For more information about this support group, to make a donation or to become a member, visit Dfwceliac.org. A portion of the proceeds from the vendor fair will be donated to the group.

Science News: Microbes and the Human Body

A recent piece in Science News discusses the relationship between bacteria and human bodies.

The most important point from this article is that we are very connected to the bacteria that live on and inside of us. Bacteria help us digest, avoid infections by nasty bacteria, help us regulate our immune systems, and probably influence lots of things, including our behavior.

More and more researchers are finding that the microbial community in the gut is important to many health systems and digestion. Most physicians can test for some of the microbes that cause illness, but few are familiar with the more recent research on healthy bacteria. Fewer still offer testing that can establish whether or not your intestinal microbial communities are healthy.

Antibiotics are still the first treatment offered for many illnesses, even when the cause of the illness has not been shown to be an infection that can be treated with antibiotics. It may be many years before the discoveries about the bacteria we live with are incorporated into common medical practice, but it is already clear that paying attention to these issues is important to health.

Digestion Basics: Diarrhea

The word diarrhea is derived from the Greek word diarrhein, meaning 'to flow through.' Basically, diarrhea is characterized by frequent, watery bowel movements. As you might suspect, diarrhea indicates that too much water is being retained (and therefore is not being absorbed) in the digestive tract.

There are several possible causes for this. For example, food may be moving through the tube too quickly for water to be absorbed, creating stools that are watery instead of formed.

This can happen if your muscular tube starts contracting faster than normal as a defense against something bad that you've eaten. The immune system signals to the tube that it should get the bad stuff out quickly. It can go up or down, whichever is faster. If it goes up, you vomit. If it goes down, you have diarrhea.

Another cause is an immune response that leads to irritation or inflammation of the intestines. This can slow the absorption of water through the tissue walls, causing an imbalance in the tube's water level. Toxins in the tube can also cause water to flow into the tube rather than being absorbed. Any of these problems will result in diarrhea.

Food Allergies, Sinusitis and Runny Nose

Chronic congestion of the sinuses, ears and/or the nose can be an extremely frustrating sinusitis problem that does not ever truly seem to go away.

All too often I hear patients state that they have not found relief even after many rounds of antibiotics or multiple surgeries. This is because antibiotics and surgery often don’t address the cause of the congestion.

What Causes Sinusitis and Runny Nose? 


Sinus infection (sinusitis) and runny nose are inflammatory conditions that result in mucous production and congestion. This leads to the resulting problems of sinus pressure headaches, a runny nose, or stuffy ears. 



What Causes Inflammation? 


Inflammation is caused by anything that can activate the immune system. It can be caused by a bacterial, fungal, or viral infections, or by environmental or food allergies. 
Bacterial and fungal infections are readily treated by antibiotics, and viral infections generally resolve on their own.

Food allergies are the most under-rated cause of inflammation and congestion, and frequently exacerbate known environmental allergies. 



How Do Food Allergies Trigger Sinusitis or a Runny Nose? 


An allergy is an immune response, resulting in inflammation and in this case mucous production. Such a response to food can be exhibited in any part of the body, because nutrients are digested, absorbed and circulated throughout the body. This is why food allergies can cause a wide range of problems, including sinusitis and runny noses. 
There are many other conditions that can be caused by food allergies.

Testing for IBS: DNA Microbial Profile: Measuring Intestinal Bacteria, Yeast (Candida), and Parasites

If you suffer from IBS and other digestive problems then it is very possible that you have a microbial imbalance in your digestive tract. The IBS Treatment Center is proud to be one of the few clinics in the country where you can now get DNA testing to measure the presence of the bacteria, yeast and parasites in your digestive tract.

This is done via a stool sample. All microbes have DNA, and that DNA can now be detected and quantified with Nobel Prize-winning PCR (polymerase chain reaction) technology, which is commonly used in other forms of DNA testing.

DNA testing is far superior to all previous tests that assessed the presence or absence of microbes in the digestive tract. In the past, bacteria and yeast had to be grown or cultured on a Petri dish, and parasites and yeast were looked for under the microscope. In both cases there were numerous factors that could affect the test and result in inaccurate results. With DNA testing these problems have been eliminated, and an incredible range of microbes can be detected.

This test will demonstrate the amount of all friendly bacteria, unfriendly bacteria, and yeast growing in your digestive tract. It also includes the presence of all forms of parasites. It is far more comprehensive than standard stool tests which typically only measure the presence of parasites, or the ugly bacteria that cause potentially life-threatening bloody diarrhea. Standard tests do not cover the wealth of other bacteria and yeast whose presence or absence can lead to IBS and related digestive problems.

Introduction: Lab Testing for Irritable Bowel Syndrome 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. IBS symptoms are almost always caused by either food allergies, bacterial imbalances, yeast, or parasites. If you want to learn more about these topics and how they relate to IBS, then this website is for you. You may also refer to the book, The Irritable Bowel Syndrome Solution.

Two kinds of tests are recommended – food allergy testing, which is a blood test; and testing for bacteria, yeast, and parasites, which is done by stool testing. Problems in any of these areas can alone cause IBS, but most people who suffer from IBS have a combination of both a food allergy and a bacterial imbalance.

Gluten Free Recipe: White Chicken Chili

This recipe comes thanks to The Food Philosopher Annalise Roberts.

Ingredients:

• 4 medium–size tomatilloes
• 
2 tablespoons olive oil

• 1½ pounds chicken, boneless, skinless and cut into 1 inch chunks 
(dark meat gives a richer flavor)

• 1 cup chopped onion
• 
6 cloves garlic, minced
• 
1 teaspoon cumin
• 
1 teaspoon dried oregano
• 
1 14 ounce can low sodium chicken broth
• 
1 19 ounce can white beans (cannelloni), drained and rinsed
• 
1 fresh jalapeño chili pepper, seeded and diced

• 1 cup whole green chili peppers (about 4), charred and chopped (if using canned, drain liquid)
• 
1½ teaspoons sea salt 
2 tablespoons fresh cilantro, chopped
• 
Freshly grated black pepper

Directions:

1. Preheat oven to 425°F. Place tomatilloes on baking pan lined with foil. Roast 10 minutes or until lightly brown and let cool. When cool, purée or mash. Set aside.
2. In a 6–quart saucepan, sauté onions and garlic over medium heat until soft. Remove from pan and set aside.
3. Add chicken to saucepan and sauté over medium–high heat until sides are lightly browned. Add cumin, oregano, onions, and garlic and stir for one minute.
4. Add chicken broth, white beans, jalapeño and green chili peppers, and roasted tomatilloes. Bring to boil and then simmer partially covered for 1 hour. Chili should have the consistency of a thick stew.
5. Stir in salt and cilantro and season to taste. Serve warm with cornbread.

This recipe can be doubled.
Serves 4

© 2002 by Claudia Pillow and Annalise Roberts

Image thanks to livingwithout.com

The Debate Over Colon Cleansing

Medpagetoday.com recently ran a piece discussing the possible adverse outcomes from colon cleansing.

Although colon cleansing is not supported by any robust scientific studies, the same can also be said many things that are done as part of the standard of practice of medicine. It's important to recognize that we still have a great deal to learn about colon cleansing. And like all procedures, we need reminding that there are potential negative side-effects of colon cleansing.

An excerpt:

Colon cleansing has no evidence to support its use, and can lead to pain, vomiting, and fatal infections, according to a new report.

"A search of the literature using the terms 'colon cleansing,' 'herbal colon cleanse,' 'colon detoxification,' and 'colon irrigation,' yielded no scientifically robust studies in support of this practice," wrote Ranit Mishori, MD, of Georgetown University in Washington, D.C., and colleagues, in the August Journal of Family Practice.

Colon cleansing has been practiced since antiquity as a means of enhancing health through ridding the body of toxins. These procedures are similar to enemas, except that volumes in excess of 50 liters sometimes are used, and the procedure may be done repeatedly.

The liquids used often contain herbal extracts such as cat's claw, burdock, and milk thistle, or other substances such as coffee, enzymes, and probiotics.

Among the benefits touted for colon cleansing are improvements in circulation, immune function, and alleviation of ailments such as headache and fatigue.

Users can perform the procedure themselves, but many visit hydrotherapists or colon hygienists. These providers may be certified by groups such as the International Association for Colon Hydrotherapy, but are not necessarily licensed healthcare providers.

Full article here.
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Image thanks to creativecommons.org

Why Probiotics Are Not All The Same (Part 3 of 3)

Probiotics are supplements that contain beneficial bacteria such as Lactobacillus acidophilus or Bifidobacterium. One of the biggest challenges in using probiotics is selecting a quality product.

The quality of the product has a dramatic impact on whether or not it will solve your digestive problem. There are four major issues that determine the effectiveness of probiotics: bacterial viability, quantity, strain, and contaminants.

Viability
The first issue is the viability of the bacteria. Basically, are they still alive? Unfortunately, in many cases there are little if any viable bacteria in many products on the market. If they aren’t alive, then they aren’t going to do you any good.

To try to avoid this problem, at the very minimum select a product that is refrigerated. Hopefully it was refrigerated in transit and in storage as well. Even if it is freeze-dried, which helps, it should also be refrigerated to help maintain viability.

Gluten Intolerance Group: Applying a Heart Healthy Diet to a Gluten Free Lifestyle

This great guideline comes from our friends at the Gluten Intolerance Group of North America. Please visit their site for a wealth of resources on gluten intolerance diseases and more.

From GIG.net:

After the celiac patient has improved functioning of their gastrointestinal tract, they need to be evaluated for cardiovascular disease risks that effect the general population.

Heart disease is currently the #1 leading cause of death for both men and women in this country. Sometimes after the celiac patient has healed their intestines, they have been consuming many gluten-free products that are easy on their gut, but still loaded with excessive calories, fat, salt and sugar. This can contribute to a weight gain and additional risk factors like high cholesterol and blood pressure that ultimately lead to heart disease.

Applying a Heart Healthy Diet to a Gluten Free Lifestyle

Fat
The type and amount is key when it comes to fat intake. Saturated and trans fats raise blood cholesterol and must be limited. Saturated fat is solid at room temperature and found mostly in meat, poultry with skin, whole milk, high fat dairy products, and even coconut milk.

Trans fat is found in many processed foods such as crackers, cookies, stick margarine and shortening. The best fats to use are unsaturated (both polyunsaturated and monounsaturated). These are liquid at room temperature and include foods such as vegetable oils, nuts, seeds, avocado, and fatty fish (salmon, herring, trout).

Probiotics Part 2: Bacteria We Need

The use of probiotics (acidophilus and bifidobacterium) in the treatment of medical conditions has increased dramatically in the past few years.

In our last article we discussed how the mix of microorganisms in our digestive tract is essential for good digestion. Now I want to address how to know when you should use probiotics.

The results of stool testing can reveal infection, imbalance, and/or a deficit of microorganisms (bacteria).

When a problem is discovered a treatment can be designed that will address any of these situations. That treatment most often involves probiotics. Probiotics are the strains of bacteria that would normally be present in a healthy human digestive tract. They are needed for proper digestion.

Treatment with probiotics is done for three main reasons:

1. Having the right kind of bacteria in the digestive tract helps you properly digest your food and can reduce the amount of gas that you produce.
2. Having healthy colonies of good bacteria helps to prevent overgrowth of the digestive tract by other bacteria and yeast, which can cause diarrhea, constipation, gas, bloating and abdominal pain.
3. Good bacteria produce some vitamins that are essential to health.

It is important to note that the only way to know if you have a condition that can be treated with probiotics is to test to see if you have a condition that probiotics can improve. Many people take probiotics without noticing any improvements. Or they take them, but feel like they have to continuously take them in order to experience their benefits.

Digestion Basics: Constipation

The two major factors for defining constipation are the frequency of bowel movements and their firmness. One sign that your digestive system is functioning optimally is that you have at least one bowel movement per day.

However, bowel movements that are difficult to pass, very firm, or made up of small rabbit-like pellets qualify as constipation, even if they occur every day. Other symptoms related to constipation can include bloating, distension, abdominal pain, or a sense of incomplete emptying.

If you don't have these symptoms but you rely on extra fiber (such as Metamucil), a stool softener, a laxative, or some other method to prevent these symptoms, then you also have constipation.

Constipation is a symptom of slow transit time, not unlike rush-hour traffic. When the colon is backed up, the small intestine is also backed up. And when the intestines are backed up, the stomach can be delayed in emptying itself of food matter. This is why some people with constipation also experience heartburn and reflux.

Probiotics (part 1): Bacteria We Need

In the last few years there has been a lot of media interest in probiotics. Probiotics are good bacteria, the most recognizable being acidophilus.

There are many misconceptions about how probiotics work and what they do and don’t do.
Hopefully this series of articles can help clear things up.

One of the most interesting areas of biology is the study of how interdependent all life is. The bacteria and other microorganisms that live in our digestive tracts are an example of symbiotic relationships – different organisms living together for mutual benefit. Our digestion depends on the presence of a complex soup of trillions of individual microorganisms that help us digest the food we eat. Without them, we would die.

Modern medical science still has much to learn about this ‘soup’ of microorganisms that live inside us. But we do know some of the problems that can develop and interfere with good digestion.

Digestive Problems and Heredity

Many patients describe having digestive problems similar to other members of their family.

A patient recently expressed that her sister, mom, and even grandma all had digestive problems. So she assumed that her problem was genetic.

Fortunately, she didn’t assume that there was no hope for helping her. That is why she came to our clinic. But many people do not understand that just because a problem runs in the family, does not necessarily mean they have to suffer from it.

What do we mean by that? In most cases these symptoms are caused by something external to the body. By this we mean caused by something in the environment, such as food, bacteria, or yeast.

In many cases the cause is a genetic problem, especially if a food allergy is the trigger. What we often do not realize is that the trigger can be avoided.

JACN.org: Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics

The following study was originally published in 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 Class I 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.

How IBS Can Cause Iron Deficiency and 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.