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IBS

Can a Common Medical Practice Change Candida Deadly? – (11-29-01)

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Can a Common Medical Practice Change Candida Deadly?

While this article relates to the use of heparin, it does raise many, many concerns. This article brings to light many of the nasty biochemical aspects of Candida albicans when it becomes a systemic infection. The question that arises is that, although this article looks at life-threatening systemic infection of Candida, could not a GI tract that has an overgrowth of Candida (without systemic infection) allow these same toxins mentioned in the article to leak into the systemic circulation? I am sure most functional medicine practitioners would answer that of course it does. It just seems so difficult for mainstream medicine to accept that there is a continuum of disease states. Overgrowth of Candida is very common and I believe is a key element in many cases of IBS, chronic fatigue, ulcerative colitis and especially Crohn’s disease.

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Common Disorder May Underlie Asthma and IBS – (06-25-01)

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Common Disorder May Underlie Asthma and IBS

Hey!! We’re getting closer to the mark!! One of these days it may occur to the medical powers that be that the GI tract has a major impact on our overall health. Antibiotics, poor lifestyle habits, acid blockers, stress, NSAIDs can all alter the flora of the GI tract and lead to IBS symptoms. Antibiotics have shown to increase risk of asthma and this risk is most likely mediated through alterations in the flora. So of course a common disorder may underlie–destruction of normal, healthy flora!

Am J Gastroenterol 2001;96:1511-1516 Asthma appears to be more prevalent among patients with irritable bowel syndrome (IBS) than among individuals without IBS, which suggests that there are pathophysiological processes common to both conditions, according to Turkish researchers. Dr. Aziz Yazar and colleagues, from the Mersin University Faculty of Medicine, in Mersin, performed pulmonary function tests and noted respiratory symptoms in 133 men and women with IBS and 137 controls. In the IBS group 33.8% of patients had respiratory symptoms, significantly more than in the control group, 5.8%. In addition, 15.8% of the IBS patients but only 1.45% of controls were diagnosed with asthma, Dr. Yazar’s group found. Compared with controls, IBS patients had impaired pulmonary function, including significantly lower forced expiratory volume in 1 second, flow after 50% of vital capacity had been exhaled, peak expiratory flow rate, and maximal midexpiratory flow rate. In a previous study, the research team notes, patient responses to a questionnaire showed that & quot;IBS, gastroesophageal reflux symptoms, and symptomatic bronchial hyper-responsiveness occur together more often than expected and that the conditions are independently associated with each other.” Some of the lines of evidence for an association between IBS and asthma, according to the researchers, are that in both disorders there is an altered contractility and smooth muscle tone, the autonomic nervous system is involved, and inflammation probably has an etiologic role.

Probiotics Significantly Reduce Symptoms of IBS, Ulcerative Colitis – (06-17-03)

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Probiotics Significantly Reduce Symptoms of IBS, Ulcerative Colitis

It’s nice to see that probiotics are finally making it into the limelight. Sadly, this is about a decade behind the research and probably another decade before it makes it into clinical practice. Currently, most docs that have some inkling that certain bacteria may benefit the GI tract tell their patients to eat yogurt–which is usually laden with sugar or aspartame and has relative minute levels of probiotics compared to supplemental usage.

DDW 2003: Abstract M1582, presented May 19, 20003; Abstract W1523, presented May 21, 2003.

May 21, 2003 (Orlando) — Probiotic therapy, primarily in the form of Lactobacillus acidophilus and Bifidobacteria infantis, significantly improves symptoms and quality of life in patients with irritable bowel syndrome (IBS) and other bowel disorders, researchers reported in a number of presentations here at Digestive Disease Week 2003.In a study designed to assess the efficacy of probiotics alone or in combination with antibiotics in patients with IBS, Stephen M. Faber, MD, from Albemarle Gastroenterology Associates, PC, in Elizabeth City, North Carolina, evaluated treatment in 44 patients with IBS. Twenty patients received probiotics alone and 24 received ciprofloxacin 500 mg twice daily for one week and two probiotic formulations, Lactobacillus (NCFM) 10 billion/g and Bifidobacteia infantis (Bifdo), 10 billion/g for four weeks. Patients completed the IBS-Quality of Life (IBS-QOL) questionnaire and the Symptom Frequency Index (SFI) before and after treatment. For the study group as a whole, IBS-QOL scores averaged 66.2 before treatment and 84.6 after treatment. SFI scores before treatment averaged 38, decreasing to 18 after treatment. In patients who received both probiotics and antibiotics, IBS-QOL scores averaged 67.6 before and 87.8 after treatment. SFI scores averaged 35 at baseline, decreasing to 18 after treatment.In the probiotic-only group, baseline IBS-QOL scores were 69.3, increasing to 86.4 after treatment. SFI scores were 39 at baseline and 17 after treatment.Differences in IBS-QOL and SFI scores between probiotic plus antibiotic treatment and probiotic-only treatment were statistically insignificant, Dr. Faber reported.A retrospective look at IBS patients treated with probiotics indicates that there is a deficiency of Lactobacillus in the gut flora in patients with IBS, Dr. Faber noted, “but we’re not ready to call IBS an infectious disease.”Probiotic therapy also improved symptoms of ulcerative colitis (UC) in a separate study presented by Richard N. Fedorak, MD, professor of medicine and director of the division of gastroenterology at the University of Alberta in Edmonton, Canada. In a safety and efficacy study of the probiotic formulation VSL3 (VSL Pharmaceuticals, Inc., Ft. Lauderdale, FL), which contains eight lactic acid bacterial species, Dr. Fedorak and colleagues evaluated 30 patients with active mild-to-moderate UC with recent flares. Patients continued with previous treatment that included mesalamine, corticosteroids, and/or azathiaprine, as long as the treatment regimen was stable prior to the study. Patients took two VSL3 sachets twice a day for six weeks. Ulcerative Colitis Clinical Scores were measured and sigmoidoscopy performed at baseline and after the six-week treatment period. Dr. Fedorak reported that remission occurred in 63% (19 patients) and there was a clinical response in an additional 23% (seven patients). There was no response in 13% (four patients). Worsening of symptoms occurred in one patient.Dr. Fedorak said that probiotic therapy was not associated with any adverse clinical or biochemical events. “I haven’t heard of getting into trouble with probiotics,” Dr. Faber told Medscape. “These are organisms that are supposed to be in the gut. The body knows how to control them, so it doesn’t seem that you can overtreat.”While probiotics have been recognized as beneficial components of food, Dr. Fedorak pointed out that “we don’t use it as a food product anymore but as a treatment.”Infantile diarrhea can be shortened by about a day from the usual three- to four-day course. That is very important in infants. Probiotics are effective with rotavirus symptoms, with antibiotic-induced diarrhea, in pseudomembranous colitis, and perhaps in radiation-induced diarrhea,” he said.But Dr. Fedorak cautioned that “we don’t know how they work. They appear to strengthen the mucosal barrier of the bowel and improve immune function. And we don’t know which probiotics to use or in what combination.”

 

Glaxo Unsure of Which Patients Suitable for Lotronex – (11-29-00)

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Glaxo Unsure of Which Patients Suitable for Lotronex

Sorry I didn’t get this news out to you sooner….Lotronex was just pulled off the market by the FDA. Remember, functional medicine practitioners have been treating IBS very successfully for many years now using various natural methods.

(article) Many patients with irritable bowel syndrome (IBS) alternate between the two main forms of the disease, Glaxo Wellcome said on Thursday as the US Food and Drug Administration (FDA) continued to investigate 70 reports of adverse events and five deaths in women taking the company’s IBS drug Lotronex. As of October 20, the FDA had received 49 reports of ischemic colitis, a condition in which blood flow to the colon is reduced, and 21 reports of severe constipation in women taking Lotronex (alosetron) for IBS. Five of these 70 women died, FDA spokesman Jason Brodsky said. A Glaxo spokesman denied a causal link had been established between the adverse events and the drug, which has been taken by some 300,000 women in the US since its launch in March, but which has not yet been approved in Europe. The spokesman told Reuters Health that some women had been misdiagnosed and prescribed Lotronex when they had the constipation-predominant form of IBS rather than diarrhea-predominant form for which the drug is indicated. According to the spokesman, a correct diagnosis is not straightforward because many patients — possibly as many as a third of all IBS patients — alternate between the two types.

Campylo enteritis, post-dysenteric IBS and increased gut permeability – (12-07-00)

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Campylo enteritis, post-dysenteric IBS and increased gut permeability

There is an important message to take home from this article. The damage inflicted on the GI tract following infection can persist beyond one year. I have talked with a GI specialist and an infectious disease specialist that refused to believe that an infection in the GI tract could have long term effects. This idea that the body comes back to homeostasis is WRONG. If we can accept that these changes become ingrained, then we can begin to treat the altered permeability and upregulated immune cells.

Gut — Abstracts: Spiller et al. 47 (6): 804

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Fish Oil Increases Acetylcholine, Eicosanoid-Induced Contractility of Ileum – (09-19-02)

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Fish Oil Increases Acetylcholine, Eicosanoid-Induced Contractility of Ileum

This article is very timely with the FDA’s conditional approval (see next article) of alosetron. Re-release of this drug after its withdrawal after fatal side effects is a subject of hot controversy. The drug is designed to help with diarrhea-dominant IBS. Here we see a natural approach to the opposite end of the spectrum; and I’d bet I would be hard pressed to find any fatal reactions to fish oil…

Nutrition.org — Abstracts: Patten et al. 132 (9): 2506

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Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome – (12-05-02)

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Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome

For those of you out there battling IBS, this study should really give you a sense of justification. Many patients with IBS have frequently been led to believe that there symptoms are psychosomatic in origin because there are few objective findings, and have been treating with such medications as antidepressants. That’s not to say that emotional factors do not influence the symptoms of IBS, but this study backs up the fact that there is a bonafide physiological alteration to be found. Also, stool analysis tests also frequently provide objective findings that can be effectively treated with natural therapeutics.

Gastroenterology Online

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Antibiotics increase functional abdominal symptoms – (03-07-02)

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Antibiotics increase functional abdominal symptoms

Much evidence, both experimental and anecdotal, point to alterations in the physiology of the GI tract as causative factors in IBS. Impaired digestion, poor diet and abnormal/pathogenic flora are all easily modified factors. Antibiotics greatly alter the balance of the flora in the GI tract, favoring the overgrowth of yeasts. Probiotics should follow EVERY course of antibiotics. I really think that antibiotic resistance is the least of our concerns with antibiotic use–alterations in GI physiology and subsequent systemic alterations are much more common and immediate.

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