Case Study: Gastrointestinal Candida colonisation promotes sensitisation against food antigens

This case study comes thanks to BMJ.com.

Gastrointestinal Candida colonisation promotes sensitisation against food antigens by affecting the mucosal barrier in mice

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Backgrounds and aims:

Controversy still exists as to whether gastrointestinal colonisation by Candida albicans contributes to aggravation of atopic dermatitis.

We hypothesised that Candida colonisation promotes food allergy, which is known to contribute to a pathogenic response in atopic dermatitis. We tested this using a recently established murine Candida colonisation model.

Methods:

Candida colonisation in the gastrointestinal tract was established by intragastric inoculation with C albicans in mice fed a synthetic diet.

To investigate sensitisation against food antigen, mice were intragastrically administered with ovalbumin every other day for nine weeks, and antiovalbumin antibody titres were measured weekly.

To examine gastrointestinal permeation of food antigen, plasma concentrations of ovalbumin were measured following intragastric administration of ovalbumin.

The Relationship Between Food Allergies and High Blood Pressure

According to the National Health Statistics Reports for the United States, the single most frequent diagnosis given out by doctors is “Hypertension,” commonly known as high blood pressure. (1)

In 2006, the most recent year for these statistics, over 35 million visits to doctors resulted in a diagnosis of high blood pressure.

In simple terms, high blood pressure is an increase in the pressure within your arteries (your pipeline) over 140/90. This increase in pressure is much like an increase in the pressure within a pipe. The higher the pressure, the harder the pump has to work, and the harder it is to contain that pressure within the pipe.

Therefore high blood pressure is well known to increase your risk for heart disease and heart attack (damage to your pump), and to increase the risk of stroke (blow outs in the pipe). An increase in blood pressure is well recognized to be related to weight gain.

Gluten Free Recipe: Pumpkin Muffins!

Big thank you to Jules Gluten Free for another wonderful recipe!

Gluten Free Pumpkin Muffins
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Ingredients:

• 1/2 cup brown sugar OR coconut palm sugar (unrefined, more nutritious & lower GI)
• 1/4 cup (4 Tbs.) shortening (e.g. Earth Balance® Buttery Sticks or Coconut Oil)
• 1 egg OR egg substitute (1 Tbs. flaxseed meal steeped in 3 Tbs. very warm water – let stand until viscous)
• 3/4 cup pumpkin purée
• 1 1/4 cup Jules Gluten Free™ All Purpose Flour
• 2 Tbs. flaxseed meal (optional, but healthy & nice flavor addition)
• 1 Tbs. baking powder, gluten-free
• 1/4 tsp. baking soda
• pinch of salt
• 1 Tbs. pumpkin pie spice
• 1/2 cup milk, dairy or non-dairy (soy, almond or coconut milk beverage)
• 1/2 cup dried cranberries or raisins (optional)
• 1/4 cup chopped pecans or walnuts (optional)
• sugar + cinnamon mixture to sprinkle on tops (optional)

Directions:

Preheat oven to 350 F (static) or 325 F (convection).

Recommended Fiber Intake

The USDA recommends that adults take in a minimum of 25 to 35 grams of fiber daily, and soluble fiber should account for one-third to one-half of the total. As many as 60 grams of fiber per day is required for optimal health.

If you eat at least five servings of fruits and vegetables as well as at least five servings of grain products per day, you are very likely meeting your fiber requirements. Unfortunately, the typical American eats only 10 to 15 grams of fiber daily.

One serving of vegetable is 1/2 cup cooked vegetable or 1 cup of a raw leafy vegetable (like spinach). One serving of fruit is one medium sized apple, pear, or 1/2 cup berries. One serving of grain is 1/2 cup cooked grain.

Do You Really Need a Biopsy to Diagnose Celiac Disease?

Celiac disease is traditionally diagnosed with a positive biopsy of the small intestine. The biopsy will demonstrate damage to the intestine known as villous atrophy. Villi are small finger-like extensions of the lining of the intestine that are visible only under the microscope.

People with celiac disease and other conditions 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 the poor digestion and absorption of many nutrients.

Biopsies are done in a hospital on an outpatient basis, but require strong medication due to the invasiveness of the procedure. An endoscopy is performed, which involves a tube being placed into the mouth, down the esophagus, and past the stomach. A tissue sample can then be taken from the small intestine.

Most Dairy Reactions Are Not Lactose Intolerance

Most reactions to milk are mistakenly considered to be lactose intolerance. Lactose intolerance is defined by a person having a deficiency in the enzyme lactase. Lactase is needed in order to digest the sugar component in milk called lactose.

Many people are lactose intolerant, but millions more have an immune reaction to dairy. Unfortunately, most people don’t recognize that there is a difference between the two issues.

These people usually do not figure out that dairy is causing their symptoms because they never actually eliminate dairy from their diet, only lactose. Avoiding lactose only partially helps their condition and often doesn’t help at all. What they don’t realize is that even though they are avoiding lactose, they are not avoiding dairy.

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. Conventional allergy testing looks for IgE reactions only.

These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea. These are the reactions that people usually think of when they hear the word allergy.

Everyday Painkillers Cause 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 Gallbladder and Irritable Bowel Syndrome

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.

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?

What is the Vitamin and Mineral Panel?

Vitamins and minerals play an important role in nearly every facet of our health. Knowing exactly what vitamins and minerals your body is deficient in allows you to give it exactly what it needs.

This can make a world of difference in the effectiveness of taking supplements. We are given lots of generic recommendations for taking them, but we are never offered the opportunity to test their actual levels. Now you can do just that.

The Vitamin and Mineral Panel is a blood test and includes the following nutrients:

• A
• B1 (Thiamin)
• B2 (Riboflavin)
• B6 (Pyridoxine)
• B12
• Folate (folic acid)
• C
• D
• E
• Ferritin (Iron)
• Zinc

More information on testing for food allergies at IBS Treatment Center.
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Image thanks to myaimstore.com

Vitamin & Supplement Studies Confuse Patients

Recent published studies that have questioned the effectiveness of supplements and vitamins have lots of people arguing over the issue. Supplements have their uses.

Not all supplements are good for everyone. The best way to get all the nutrition you need is to eat a well balanced diet. But that can be hard to do.

So it is best to make sure your doctor understands your health situation and helps you choose supplements, if you need any.

Supplement maker Thorne also issued a statement:

A recent study, "Dietary Supplements and Mortality Rate in Older Women," published in the Archives of Internal Medicine, 2011;171(18):1625-1633, has caused some concern among the public about the safety of dietary supplements. We have thoroughly reviewed this study and share this analysis in order to help you better understand the study's design and its findings, and to help allay any concerns you may have.

And a bit more from MedPageToday.com:

The alphabet soup of vitamin studies making headlines in the last few weeks has left more than one head spinning, and most clinicians scrambling for answers.

Intestinal Microorganisms and Parasites

Our intestines are a rich and thriving ecosystem, when we are healthy. The massive surface of our intestines (about the same as a tennis court) provides everything needed for life - space, moisture, and nutrients.

Given the ubiquity of anti-bacterial products in our society, many people are surprised to learn that they have about 10 trillion bacteria living in their intestines. But not only do we have bacteria lining our digestive tract, we desperately need them.

There are basically three types of micro-organisms living in our intestines: Good bacteria; Bad bacteria/microorganisms; and Disease organisms.

The good bacteria include species and strains that we evolved with, like acidopholus and bifidobacterium. These are an essential part of our digestive systems and we would not survive without them. They help us to digest food by producing enzymes, manufacture some of the essential nutrients that we need to live, assist in the development of our immune system, and prevent infection by occupying the space in the intestines that unwelcome organisms would thrive in, if they could.

The 2011 Halloween Gluten Free Candy List

Thanks to our friends at Gluten Free Life with Jen for compiling this great Gluten-Free Halloween Candy list.

As always, it is important to check the bags/packaging and make sure ingredients have not changed since I did my research. You can go online to the specific manufacturers to look up their gluten free lists or call the 800 number on the candy package and speak to a company representative to find out about the products.

**Please note that some small Halloween size versions contain gluten when their large “normal” size versions do not. READ ALL LABELS before purchasing.

Airheads
Airhead Bars
All Natural Pecan Divinity by Dillon’s Candy
Almond Joy
Ande’s Mints
Annie’s Bunny Fruit Snacks
Atomic Fireballs
Baby Ruth
Bazooka Bubble Gum
Bequet Confections Caramels
Big League Chew
Big Red Gum
Bit O’ Honey

The Business of Fiber

Fiber is big business. You’ve seen commercials for it on your TV. You’ve been told that it’s good for you and that you need more. And if you have Irritable Bowel Syndrome or many other digestive problems then you have probably tried fiber.

What is fiber, anyway? Well, this is an interesting question. Historically fiber was the term used to define the parts of plants that you ate, but which were not digested.

Typically this was the cellulose and other fibrous materials in plant foods. More recently fiber is being used as a word for any thing you might eat that provides bulk to the stool and is not digested. As a result we have “fiber” supplements that contain man-made materials including polymers, yet don’t contain any natural plant fibers at all.

If you’ve tried a fiber product and it didn’t work, or it even made you feel worse, then you are not alone. This is one of the most common complaints expressed by patients to the IBS Treatment Center. Fiber is definitely not a cure all for IBS, and its effectiveness can vary widely depending on a host of issues.

Bad Bacteria and Irritable Bowel Syndrome

What makes a bad bacteria bad? The worst bacteria (the ugly) either directly destroy tissue by feeding upon it or produce a toxin that destroys tissue.

Other bacteria (the bad) react negatively to food, or are poor fermenters of food, creating IBS symptoms like gas and diarrhea. And some species of yeast and bacteria are bad simply because they take up space, thereby crowding out the good bacteria and depriving your body of all the health-giving benefits that friendly bacteria provide, resulting in the poor digestion of food and the poor absorption of nutrients.

The ugly bacteria are never regarded as normal flora within the body. They are not usually considered to be causes of IBS, but they do cause severe, often life-threatening, conditions. Ugly bacteria include Salmonella, Shigella, Yersinia, Vibrio cholerae, Campylobacter, and certain strains of E. coli. Just a tiny amount of the most virulent strains of bacteria in a person's body is enough to begin the process of infestation.

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. These issues are discussed in this article.

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. 



Testing for IBS Triggers: Standard Food Allergy Profile

The Standard Food Allergy Profile test takes the guesswork out of treating your IBS and saves you a great deal of time, effort, and discomfort. And 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. If it does not evaluate both antibodies, there is a strong possibility that the testing will miss your food allergy.

For you the procedure is neither complex nor difficult. This blood test measures reactions to approximately 100 common foods, including dairy, eggs, corn, soy, almonds, peanuts, wheat, seafood, and many others. (complete list of foods that are tested)

Vitiligo and Food Allergies

We originally posted this piece in March of '09. It receives so many comments, that we thought we would re-share. If anyone has any resources, comments or other information on Vitiligo that they would like to share, please feel free to post to this article. Thanks!

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I want to share with you a case that I saw this week. A gentleman came to see me about a year ago for digestive issues. It turned out that he was allergic to dairy and to cane sugar. Avoiding these foods resolved his digestive problems, and he has been doing fine.

Interestingly, this individual had very noticeable vitiligo. Vitiligo is the name of a skin condition where one looses the pigmentation of the skin. That area then looses color in contrast with the skin around it. The cells that create the pigmentation of the skin are destroyed by what is assumed to be an autoimmune reaction. (Autoimmune reactions are when our immune system attacks our own body.)

Seeing him again this week he noted that his vitiligo had greatly improved, which was apparent upon seeing him. He also noted that his brother, who had the same condition, had also improved when he too had changed his diet and avoided dairy and sugar cane. (As a note, food allergies are usually genetic issues.)

I thought that this was a very interesting case because I had often wondered if there was a relationship between vitiligo and food allergies. There is very little record of this in the medical literature and I do not believe that it has ever been well studied. Hopefully someday it will be. It is certainly worth pursuing.

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Image thanks to nih.gov

Iron, Anemia, Ferritin and Fatigue

Iron, B12, and Folic Acid
Iron, vitamin B12, and folic acid are very important components of overall health. They are each required to make red blood cells, which in turn carry oxygen throughout the body. Without adequate iron we can become anemic. Anemia causes fatigue and poor cognitive function.

Anemia
Anemia is a common blood disorder, which is either a decreased number of red blood cells (RBCs) and/or poorly formed red blood cells. There are many different types of anemia, the most common types being iron deficiency, vitamin B12 deficiency, and folic acid deficiency anemias.

Iron deficiency anemia shows up on your Complete Blood Count (CBC) as a low RBC count, low hematocrit (Hct), or low hemoglobin (Hgb). However, low iron status will show up long before anemia if ferritin is measured. B12 and folic acid deficiency anemias show up as unusually large red blood cells.

Ferritin
Ferritin is the form in which iron is stored in the tissues of the body, particularly the liver, spleen, and bone marrow. Ferritin is a protein complex that contains iron. Ferritin decreases long before iron deficiency anemia shows up on your CBC. Therefore measuring ferritin is the optimal way to determine your actual iron status.

5 Reasons Why It's Hard to Detect Your Own Food Allergies

Number 1: Truly Eliminating on Your Elimination Diet

One major obstacle to figuring out which foods are problematic is that, even on an elimination diet, you may not have truly eliminated all of your allergenic foods.

Assumptions are often made about which foods are allergenic and which foods are not. These assumptions are often wrong. Even on an elimination diet you may still be eating something that will trigger your IBS, even if you are eating foods that you normally don't eat.

In order to solve your Irritable Bowel Syndrome, you may need to stay away from entire food groups, not just one or two foods.

Food groups are much more difficult to avoid than you might think. One food group that commonly causes problems for IBS sufferers is dairy. Dairy is not just milk. Dairy includes cheese, butter, sour cream, cream cheese, ice cream, and yogurt. It's found in many baked goods such as muffins, breads, and cookies, as well as in many cream soups, some salad dressings, and milk chocolate. Coffee and lattes are another common source of dairy. Even margarine contains dairy. The list goes on and on.

Two key components of dairy are whey and casein, which many people cannot tolerate. These are used as additives in a great variety of foods, even those you wouldn't consider to be dairy foods. Look at the labels on the packaged or processed foods you buy. Even non-dairy coffee creamer contains casein, for instance.

Washington Post: Microbes may play crucial role in human health, researchers discovering

Yay!! We're finally looking at the role of good bacteria in our lives!

Worth highlighting:

"The rising number of C-section babies denied this colonization, along with the casual use of antibiotics and other factors that can alter the microbiota, might help explain trends such as rising incidents of asthma and food allergies caused by misfiring immune systems. To explore this, researchers have begun following C-section babies, comparing their microbiomes and their health with babies delivered through the birth canal."

This excerpt comes thanks to the Washington Post.

Consider this: The average person’s body contains about 100 trillion cells, but only maybe one in 10 is human.

This isn’t the latest Hollywood horror flick, or some secret genetic engineering experiment run amok.

This, it turns out, is nature’s way: The human cells that form our skin, eyes, ears, brain and every other part of our bodies are far outnumbered by those from microbes — primarily bacteria but also viruses, fungi and a panoply of other microorganisms.

That thought might make a lot of people lunge for the hand sanitizer, but that impulse may be exactly the wrong one. Researchers are amassing a growing body of evidence indicating that microbial ecosystems play crucial roles in keeping us healthy.

Treating Ulcerative Colitis and Crohn’s Disease

We often receive calls asking if we treat Ulcerative Colitis or Crohn’s Disease, and the answer is an emphatic “YES!”

Though the clinic was originally founded with an emphasis on treating IBS, patients with Ulcerative Colitis and Crohn’s, which together make up IBD (inflammatory bowel disease), are also welcome and receive unique and highly specialized treatment at the IBS
Treatment Center.

Do These Issues Have Anything in Common?

IBD, like IBS, is not a particularly useful acronym for the person suffering from the problem. In both cases the acronym provides a label for describing the condition, but it does not provide any information for understanding the cause of the problem or to attempt to cure it. Our goal is to find the cause of the problem so that it can be cured. And IBD sufferers are just as surprised as IBS sufferers to discover that there is much more to learn about digestive health than what they learned from their gastroenterologist.

What is the difference between IBS and IBD?

IBD is much like IBS except in one major area. IBD sufferers are found to have ulcerations in the digestive tract. The difference between Ulcerative Colitis and Crohn’s Disease is the location of the ulcerations. In Ulcerative Colitis, the ulcers are predictably found primarily in the colon. In Crohn’s Disease the ulcerations are found primarily in the small intestine.

Causes of Irritable Bowel Syndrome: Intestinal Bacteria, Yeast, Candida, and Parasites

Your body is not yours alone. You are sharing it with over 100 trillion bacteria. This fact makes many people uncomfortable.
"I have germs living inside me?" you may ask, aghast.

Yes, inside the orifices of your body, and primarily in your digestive tract, live an enormous number of bacteria - single-celled organisms that have colonized areas of your body and exist happily there. This may alarm you, because we have been trained to view bacteria as the enemy.

However, we are not sterile beings. Our internal bacteria are actually critical to our health- so critical, in fact, that we cannot survive without them. They are fundamental to the development of our immune system, they help break down our food, and they even create nutrients that we need for good health. And most importantly for you, they play a large role in whether or not we experience diarrhea, constipation, gas, bloating, abdominal pain or IBS.

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.

Kids & Digestive Problems

Yes, we do treat children and infants at the IBS Treatment Center. However, children are not usually given the label of having irritable bowel syndrome.

Of course, children can suffer from constipation, diarrhea, abdominal pain, gas, or any combination of the four. But for some reason doctors don’t use the words IBS, and often don’t seem to think that children suffer as much as adults.

At the IBS Treatment Center we’ve found that children’s digestive problems are very similar to those of adults, and that the causes are generally identical. Digestive problems often get worse as you get older, so more attention is given to adults. But that doesn’t mean that infants and children can’t suffer tremendous discomfort and disruption from their upset tummy. It really isn’t normal to have these problems, at any age.

Infants have only two ways of demonstrating their maldigestion. You either see it, or you hear it. Colic and reflux are two of the most underappreciated and misunderstood problems in infants. A healthy baby is generally a happy baby. They cry when they are hungry, or lonely, or need a diaper change. But they shouldn’t be inconsolable.

What is an Allergy?

An allergy is what results when your immune system is inappropriately activated. Your immune system is designed to attack bacteria, viruses and parasites. It is not intended to attack the food you eat. But this is exactly what happens with some people. This is called a "food allergy" .

When your immune system is activated, antibodies (also called immunoglobulins) are produced. Antibodies in turn trigger an inflammatory response. Inflammation causes pain and tissue damage, leading to further symptoms. Increased mucous production is another aspect of an immune response.

When a food is broken down and absorbed, it is distributed through your bloodstream to all of your tissues. Therefore an allergic reaction can occur just about anywhere in your body.

We don't really understand why a food allergy can exhibit itself so differently in different people. However, every individual is unique and seems to have a unique weak point where symptoms of a food allergy show up first.

NIH Case Study: Detection of IgE, IgG, IgA and IgM antibodies against raw and processed food antigens

The following study comes from the National Institutes of Health and can be accessed in its entirety on their website.

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.

Advanced Testing for Gluten Intolerance

Testing for celiac disease and gluten intolerance has in the past been grossly oversimplified.

Traditional celiac testing has involved screening for one or maybe two tissue transglutaminase antibodies. Gluten, the culprit in celiac disease, is not really just one protein but rather is composed of a group of various gliadins and glutenins.

Until now none of the many gluten components have been available for antibody testing. And since reactions to wheat can involve proteins other than those involved in gluten, the testing has had its limitations.

Previously, physicians have only been able to offer testing for reactions to whole wheat, barley, rye, and spelt. Although these tests have been very successful in diagnosing individual food allergies, new tests are now available which can offer much more specific information about reactions to wheat and different kinds of gluten reactions.

IBS and the Inability to Gain Weight

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

This can be a problem at any age 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.

What is Behçet’s Disease?

The good news about Behçet's disease is that it is not really a disease. Unfortunately, the diagnosis provides no benefit to the patient other than to rule out other conditions.

Although most patients are told that there is no cure for Behçet's disease, there is a published study implicating food allergy as a cause of Behçet's disease. Even more importantly, we have seen Behçet's disease at our clinic and found that food allergies seem largely responsible for this condition. Yet most Behçet's patients are not adequately evaluated for food allergies, and testing for food allergies can be more complicated than most doctors realize.

We would like to help you too. We believe that there is a cure for Behçet's disease. It is not as simple as having everyone who has Behçet's eat the same diet, because not everyone has the same food allergens. But we think that there is an excellent chance that we can help you figure out what is triggering your problem

What Is Behçet's Disease?

Behçet's disease (also known as Behçet Disease or Behçet's Syndrome) is thought of as an autoimmune disease, but diagnosing Behçet's disease is very difficult because no specific test confirms it. There is no "Behçet's test". The diagnosis is based on the occurrence of symptoms and signs that are the definition of the disease.

LLW.com Case Study: Do Gastroenterologists Adhere to Diagnostic and Treatment Guidelines for Celiac Disease?

The Journal of Clinical Gastroenterology reports a study that indicates that physicians are still not up-to-date on when they test for celiac disease.

The experts recommend testing in many conditions that may be caused by celiac disease, but many physicians are still not getting the message and many celiacs are likely needlessly going untested and undiagnosed.

From LWW.com:

Aim: Our group hypothesized that significant variation exists between suggested clinical guidelines, the clinical practices of practicing gastroenterologists and academic experts in celiac disease (CD).

Method: We designed 4 CD vignettes comparing experts and practicing gastroenterologists. Practicing gastroenterologists (n=169) were surveyed during Digestive Disease Week 2009 and experts (n=22) answered e-mail surveys.

Ratings for answers in each vignette was done using a 9-point RAND Appropriateness Scale (RAS) with endorsement defined as RAS score of 7 to 9.

Gluten-Free Recipe: Dairy-free, Nut-free Sunflower Pesto from Living Without

This delicious gluten-free recipe comes from our friends at Living Without, a magazine for people with allergies and food sensitivities.

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This fresh pesto is an easy and delicious allergy-friendly adaptation of a summer classic. Serve it over gluten-free pasta for a light and satisfying switch from red sauce.

This recipe ups the protein with the addition of extra sunflower seeds, making it a darker color than traditional pesto. If nuts are tolerated, you can use pine nuts (traditional), walnuts or almonds instead of the sunflower seeds.

• 2 cups fresh basil leaves, packed

• ½ cup shelled unsalted sunflower seeds (raw or
 toasted) or nuts of choice (if tolerated)
• 
¼ cup coconut oil + 2 tablespoons olive oil or oil 
of choice

• 1 clove garlic or ½ teaspoon gluten-free asafoetida
• 
1 teaspoon lemon juice

• ½ teaspoon salt
• 
½ teaspoon pepper

• 1-2 tablespoons water, as needed

• Dairy-free Parmesan cheese or low-fat grated cheese of choice, optional

• Sprigs of fresh basil

Reuters: Gluten-free for All Drives Product Sales

Interesting piece from Reuters on the growth of the gluten-free industry. If you think you may have a reaction to gluten or other foods, come see us at the IBS Treatment Center. We have the tools and experience that can dramatically improve your health.

From Reuters:

Los Angeles voice actor Nancy Truman landed a new role as a full-time gluten-free baker after she tweaked her recipes to replace the wheat that was making her feel miserable.

Truman is among the estimated 18 million people in the United States who are sensitive to gluten -- a hard-to-digest protein found in wheat, rye and barley.

Another 3 million-plus Americans are thought to have celiac disease, a potentially life-threatening autoimmune disorder that is treated by eliminating dietary gluten.

Case Study: The Role of Intestinal Microbiota in Irritable Bowel Syndrome

The following case study comes from the National Institutes of Health.

The irritable bowel syndrome (IBS) is a chronic abdominal symptom complex that is heterogeneous in terms of its clinical presentation and underlying pathophysiology and pathogenesis.

It is now established that enteric infection can trigger the syndrome in at least a subset of patients. In addition, there is growing evidence of low grade inflammation and immune activation in the distal bowel of some IBS patients.

These observations now prompt the question as to what maintains gut dysfunction in these patients. The intestinal microbiota influences a broad array of host organs that include the gut and the brain, and is an important determinant of normal function in these systems.

Disruption of the delicate balance between the host and its intestinal microbiota (termed dysbiosis) results in changes in the mucosal immune system that range from overt inflammation as seen in Crohn's Disease, to low grade inflammation without tissue injury, as seen in a subset of IBS patients.

Digestion Basics: An Overview of the Digestive System

Think of your gastrointestinal tract as a long, muscular tube. This tube starts at your mouth and ends at your anus, and, if you were to stretch it out to its full length, would be about thirty feet long with a surface area approximately the size of a tennis court.

It is a highly specialized organ that is designed to do three very important things: convert food into something your cells can use for nourishment and then absorb it; protect you from invading organisms and toxins; and dispose of a large variety of waste products. It is truly amazing that these three vital functions are performed by one structure.

This tube is so specialized that it actually has its own nervous system, often called a second brain. It also has a significant defense system to protect it from outside threats; in fact, the largest part of our immune system resides in the lining of the digestive tract. And to top it all off, this tube contains a highly evolved ecosystem of organisms which are not only critical to proper digestive function, but which are also a vital part of the defense system. You can start to see that a problem in the digestive tract has the potential to indeed be a very big problem.

Case Study: Gluten causes gastrointestinal symptoms in subjects without celiac disease

The following case study comes from National Institutes of Health.

Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial.

Objectives:

Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism.

Methods:

A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored.

Most Dairy Reactions are not Lactose Intolerance

Most reactions to milk are mistakenly considered to be lactose intolerance. Lactose intolerance is defined by a person having a deficiency in the enzyme lactase. Lactase is needed in order to digest the sugar component in milk called lactose.

Many people are lactose intolerant, but millions more have an immune reaction to dairy. Unfortunately, most people don’t recognize that there is a difference between the two issues.

These people usually do not figure out that dairy is causing their symptoms because they never actually eliminate dairy from their diet, only lactose. Avoiding lactose only partially helps their condition and often doesn’t help at all. What they don’t realize is that even though they are avoiding lactose, they are not avoiding dairy.

The most blatant example is lactose free milk. Lactose free milk is still a major dairy product. If you are drinking lactose free milk you haven’t even begun to eliminate dairy from diet, only lactose. Dairy is used in many products that are considered to be lactose free. Whey protein powder is essentially dried milk, without the lactose. Whey is not only sold as a protein powder, it is also used as an ingredient in hundreds of different food products from bread to soup to candy.

Milk Allergies

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's 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:

What is Lactose Intolerance?

Lactose intolerance is the impaired ability to digest lactose (milk sugar). Lactose is a sugar naturally found in milk and is sometimes referred to as "milk sugar". 
It is digested by an enzyme called "lactase", which is found in the small intestines of most people.

However, many people don't produce enough lactase to adequately digest milk sugar. These individuals are " intolerant" to milk sugar.

How Common Is Lactose Intolerance? 


More than 50 million Americans are lactose intolerant. 
Nearly two-thirds of the world's adult population has some degree of difficulty with digestion of milk sugar because of a lactase deficiency:

• 97-100% of African Blacks
• 90-100% of Asians
• 70-75% of North American Blacks
• 70-80% of Mexicans
• 60-90% of Mediterraneans
• 60-80% of Jewish descent
• 10-12% of Middle Europeans
• 7-15% of North American Caucasians
• 1-5% of Northern Europeans

Lactose Intolerance Symptoms 


The most common lactose intolerance symptoms are:

• Intestinal cramps or discomfort
• Gas
• Bloating
• Diarrhea

One study has suggested that women with lactose intolerance are more likely to have depression or PMS (premenstrual syndrome). 
Lactose intolerance symptoms are almost identical with symptoms of other chronic disorders such as irritable bowel syndrome or celiac disease.

Testing for Irritable Bowel Syndrome: Comprehensive GI Functional Panel

The Comprehensive GI (gastrointestinal) Function Panel includes everything in the DNA Microbial Profile as well as several other tests that evaluate the overall function of the digestive tract.

These tests include inflammatory markers, digestive markers, measurement of absorption, pH, occult blood, and several other tests. Each is described below.

Inflammatory Markers

Beneficial Short Chain Fatty Acids (SCFA)
Beneficial SCFA come from dietary carbohydrates that have escaped digestion or absorption in the small intestine. They are also produced by bacteria in the large intestine via the fermentation of fiber. The production of SCFA in the intestine plays an important role in maintaining the intestinal lining. Beneficial SCFA include acetate, propionate, and butyrate. They affect the bacteria of the colon as well as the health of the colon and the entire body.

Lactoferrin

Lactoferrin is released in inflammatory condition such as Crohn's disease and ulcerative colitis. It can help to differentiate between IBS and these conditions, and to monitor improvement in inflammatory bowel diseases.

WBC (White Blood Cells)

White blood cells indicate inflammation in the digestive tract.

Mucus

Excess mucus indicates infection, inflammation, or injury of the lining of the digestive tract.

Digestive Markers

Elastase 1

Elastase 1 is a pancreatic enzyme that survives passage through the digestive tract. It is used to measure pancreatic insufficiency.

Consumer Reports: Probiotic pills might help with IBS—and colds, too

As we have noted in previous blogs, bacteria (certain strains) are a normal, healthy part of your digestive tract. There is a lot of interest in probiotics lately. Probiotics are simply pills or foods that contain those normal, healthy bacteria.

If you already have a normal, healthy ecosystem, probiotics won't hurt, but they probably won't help either. And we already know that the concentrations in yogurt are unlikely to be sufficient to be helpful (as this study confirms). The current trend is to treat probiotics as if they were a drug - take 2 and call me in the morning. But if you think about probiotics in this way you are misunderstanding what they are and what they do.

This article shows that doctors are beginning to connect the idea of a healthy digestive system with a healthy immune system, which is a good thing. But it also demonstrates that an underlying issue is being ignored: maintaining a healthy microbial community in the intestines. It is important to do testing to determine if the intestinal ecosystem is healthy.

Hopefully future studies will do a better job of determining whether the patients involved have problems involving their intestinal bacteria before they try to impact their health with probiotics. Studies like this are a bit like a study on cars showing that if you add oil, some cars run better, but not checking to see which cars were low on oil in the first place.

From Consumer Reports Health:

Probiotic pills ease irritable bowel syndrome and other stomach problems more effectively than yogurt with probiotics, a recent survey of Consumer Reports subscribers suggests. Probiotics are helpful bacteria that naturally occur in the intestines. Other recent research concluded that probiotics, in yogurt or pills, might also help prevent colds.