LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Diarrhea / Constipation / Irritable Bowel

Zinc started during diarrhoea on morbidity and mortality – (11-14-02)

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Zinc started during diarrhoea on morbidity and mortality

This is the latest in a string of research supporting the use of zinc in children with acute diarrhea. Add to this list of therapeutic agents for diarrhea probiotic supplementation and rice. Of interest in this study is that zinc supplementation during onset of diarrhea also reduced risk of acquiring pneumonia within the next 2 to 3 months.

bmj.com Abstracts: Baqui et al. 325 (7372): 1059 –

Read entire article here

Link between irritable bowel syndrome and fibromyalgia – (03-29-04)

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Link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing

This is an interesting one. Although the diagnosis of fibromyalgia no longer seems to be the “flavor of the month,” patients with symptoms that would match those in FM are still walking around. Here is my concern: I firmly believe that a relatively small amount of true FM patients really exist. I feel that FM is more of a systemic manifestation of IBS. Dysfunction of the GI tract can explain all the symptoms of FM if you follow the physiology. In this study, the authors found evidence of small bowel bacterial overgrowth in both IBS and FM patients, and the patients with more overgrowth the more likely they had somatic (muscle) pain.

Research has shown that small bowel bacterial overgrowth can occur with anti-secretory therapy for GI complaints and from destruction of normal, protective bacterial flora. Some research has also shown the small bowel bacterial overgrowth will increase small bowel permeability–basically stuff is getting into the body that shouldn’t be and the body has no choice but to react and attach the invaders. Then, following that further, small bowel bacterial overgrowth has been linked to non-alcoholic steatohepatitis. So, not only could we have an upregulated immune system from the leaky gut, but the liver is now likewise burdened. Put these together and you’ve got a recipe for FM.

Ann Rheum Dis — Abstracts: Pimentel et al. 63 (4): 450 –

Read entire article here

In the Hospital? On Antibiotics? Prevent C diff Colitis with This

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Clostridium difficile. Nasty stuff. In someone not completely healthy, C diff colitis can kill from the near uncontrollable diarrhea that results.

Otherwise known as C diff, this bacteria is in the Clostridium family.  Siblings you may recognize in this family include Clostridium botulinum (botulism) and Clostridium tetani (tetanus).  Understand that the botulism toxin is one of the most potent toxins on the planet.  A mere thimbleful would be enough to wipe out the entire planet (and yes–this is the same stuff used in Botox–go figure).

C. diff infections occur when antibiotics destroy the normal, protective flora of the intestinal tract and this potentially deadly bacteria can now gain a foothold in the lining of your gut.  As it thrives, it produces toxins that severely irritate the entire GI tract, resulting in diarrhea that can be very difficult to control.  C diff colitis traditionally occurred only in the hospital setting (called hospital-acquired) following the use of broad spectrum antibiotics.  Since this occurs in a population that in which there was already something wrong (they were in the hospital, after all), this can be a very dangerous situation.

That was then, and this is now.  We are seeing an increasing number of community-acquired C diff colitis cases, when people are becoming infected with Clostridium difficile without ever having been in the hospital.  This is a consequence of indiscriminate use of antibiotics in humans and livestock, coupled with lack of recommendations for probiotics to follow up every course of antibiotics.

So what do we do about it?  You guessed it–probiotics.

But, just in case you don’t want to take my word for it, this particular study looked at 20 clinical trials on whether or not probiotics could help prevent or lower the risk of C diff colitis (specifically termed Clostridium difficile–associated diarrhea, or CDAD).   Here’s what they found:

  1. Probiotics reduced the incidence of C. diff colitis by 66%. (Tweet this)
  2. Using probiotics as a preventative, probiotic prophylaxis would prevent 33 episodes per 1000 persons (keep in mind that statins prevent 11 heart attacks per 1,000).
  3. Adverse events in probiotics occurred in 9.3% of patients, compared with 12.6% of control patients.

So across a large number of studies, probiotics clearly lowered the risk of C diff colitis.  No quite an elimination, but a 66% lower risk is not trivial.  Overall, treating everyone on antibiotics with probiotics is a more powerful intervention than is treating patients with statins to prevent a heart attack.  Let’s see if probiotic supplementation to prevent antibiotic associated diarrhea becomes standard practice…

Based on this information, do you think it should be the standard of care for physicians to recommend probiotics along with antibiotics?

 

REDUCTION IN FUTURE RISK OF INFECTIOUS DIARRHEA – (04-08-02)

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Lactobacillus for Acute Infectious Diarrhea in Children: A Meta-analysis.

Gosh, I just love meta-analysis that supports stuff we’ve been saying for years.

This study shows a reduction in length of diarrhea by .7 days. Not much, but for a therapy that may lower future risk of infectious diarrhea and is very inexpensive, I’ll take it!!

Pediatrics — Abstracts: Van Niel et al. 109 (4): 678.

Read entire article here

INTESTINAL PARASITE BEHIND DIARRHEA AND FLU – (05-29-03)

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Seasonal Prevalence of Intestinal Parasites in US During 2000.

Most people are blissfully unaware of the high prevalence of parasites here in the US and believe infection with parasites is limited to those outside of the US. Welcome to reality. A study of 5,792 samples showed a prevalence as high as 43% in the summer of several types of parasites. Think that course of diarrhea last week was the flu???… Thanks to DSD newsletter for bringing this to my attention.

American Journal of Tropical Medicine and Hygiene, June 2002 Abstracts –

Read entire article here

FOOD ELIMINATION ON ANTIBODIES RELATED TO IRRITABLE BOWEL SYNDROME – (10-04-04)

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Food elimination based on IgG antibodies in irritable bowel syndrome

Sometimes we really want to focus on long, complicated approaches to chronic diseases. This applies to both natural and conventional approaches. But, sometimes something as simple and inexpensive as an elimination diet can yield truly powerful results. I can use the analogy of goldenseal and echinacea. Many people take “immune boosting” formulas when they feel they’re getting sick. But, they neglect to avoid refined carbs/hydrogenated oils–two things known to depress the immune system.

They would be better off not putting the junk in that adding something to the mix. An elimination diet really hits home with this concept. There are many, many patients (if not all to some degree) in whom a portion or all of their symtoms are a result of allergens in their diet. Avoid them, and symptoms can improve dramatically. I remember a case years back. A patient came in at her mother’s urging. She was experiencing a weird skin rash and called herself the “dermatology poster child” at a major AZ university teaching hospital. After parading her in front of countless interns and residents, and multiple ineffective drug therapies, including severe swelling after steroid therapy she had enough. I started her on an elimination diet. I was wheat. Skin cleared up within days and returned with the re-introduction of wheat.

Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial — Atkinson et al. 53 (10.. –

read entire article here

BOWEL BACTERIAL GROWTH IS A COMMON CAUSE OF CHRONIC DIARRHEA – (08-11-04)

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Small bowel bacterial overgrowth is a common cause of chronic diarrhea

What I find interesting about this is that small bowel bacterial overgrowth has also been linked to increased risk of non-alcoholic steatohepatits and elevated TNF alpha levels as well. “So what?” you say? Acid suppressive therapy has been linked to bacteria growing where they are not supposed to (stomach acid is definately a sterilizing agent for most bacteria). We really need to re-evaluate just what side effects we can expect with chronic use of this class of medications. Funny–I don’t remember seeing anyone in the commercials for the “purple pill” running to the bathroom in the middle of the commercial…

Small bowel bacterial overgrowth is a common cause of chronic diarrhea – J Gastroenterol Hepatol, Vol 19, Issue 8, pp. 904-90..

read entire article here

Colon Irritable? Irritable Bowel Syndrome Diarrhea in the Head

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There are days when you’re a little grumpy. But, for some, every day finds their colon irritable. But is irritable bowel syndrome diarrhea all in your head?

Despite what some may think, irritable bowel syndrome (otherwise known as IBS) has been around virtually forever.  However, in 2002, a drug called Lotronex was approved for treatment of diarrhea predominate IBS.  And, as is wont to occur when big money gets involved, the direct to consumer advertising that ensued seemed to educate the world on IBS.

For a little background, IBS is a term that encompasses a variety of gut related symptoms that can include abdominal pain, bloating, gas or cramping with these characteristics:

  • Diarrhea or constipation, with the possibility of altering between the two
  • Mucus in the stool
  • The pain is relieved by having a bowel movement
  • The pain is linked to a change in how often you have a bowel movement
  • The pain is linked to a change in the appearance or consistency of your stool

The symptoms of IBS, of course, can be highly variable.  One thing that is consistent, however, is just how much this can impact the sufferers’ life.

It is also not uncommon to see IBS go hand in hand with fibromyalgia.

Spastic colon is referred to as a functional bowel disorder, meaning that there is something wrong with the way the gut is working.  Contrast this with a pathological bowel disease such as ulcerative colitis, Crohn’s disease, diverticulitis or colorectal cancer.  Traditionally trained gastroenterologists are in general, quite frankly clueless about how to treat functional bowel disorders.  It is almost as if they have completely forgotten how the gut works and have no real tools to help restore healthy function of the gut.

Maybe this stems from the tools in the toolbox–there are few, if any, pharmaceutical drugs on the market that support normal function in the body.  In almost every case drugs interfere with the normal processes that occur.  They block, they speed up, they slow down.  But none are designed to normalize.  So if you have a problem that stems from poor function of the gut and you have no tools to fix the function, that condition will be almost impossible to treat.

If you’d like my take (and even if you don’t…) on IBS, here it is in a nutshell:

  1. Stress is a massive, massive player in IBS
  2. Supporting digestion with digestive enzymes and / or hydrochloric acid can be a powerful tool
  3. Probiotic supplementation is a must (so much so that, if a physician you are seeing for your IBS has not recommended them, you need to run the other way)
  4. A healthy diet is necessary for long term benefit
  5. Magnesium is an almost guaranteed fix for constipation-dominant IBS

For this particular study, we need to focus on #1 above.  Stress.

Stress destroys the gut.  But the gut has been considered the “second brain” because it contains massive levels of hormones that effect the nervous system.  So, with irritable bowel, does stress cause the IBS or does IBS lead to stress?

It’s the proverbial chicken-or-the-egg dilemma.

Researchers tried to answer the question by looking at how much anxiety increased the risk for irritable bowel as well as whether those with IBS were more likely to develop anxiety.

They found that it works both ways.  Anxiety increases the risk of developing irritable bowel.  But IRS also increases the risk of developing anxiety.

The bottom line is that every aspect of your body and health interact with every other system.  No single part of your body lives in a vacuum unaffected by its neighbors.

Since stress is such a strong player in the development of IBS as well as the management of irritable bowel syndrome, have you had success in using tools like biofeedback or meditation to help with your symptoms?