The Analyst™

Comprehensive diagnosis of your symptoms

Healthy

  IBS (Irritable Bowel Syndrome)  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations

 

Irritable bowel syndrome (IBS) is a common disorder of the intestines affecting perhaps 20% of the adult population that leads to pain, gassiness, bloating, and changes in bowel habits. Symptoms include constipation, diarrhea, or a painful but unsuccessful urge to move the bowels. Through the years, IBS has been called by many names - colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease. Most of these terms are inaccurate. Colitis, for instance, means inflammation of the large intestine (colon). IBS, however, does not cause inflammation and should not be confused with another disorder, ulcerative colitis.

IBS causes a great deal of discomfort and distress, but it does not cause permanent harm to the intestines and does not lead to intestinal bleeding of the bowel, serious organic diseases or to cancer. No link has been established between IBS and inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.

Often IBS is just a mild annoyance, but for some people it can be disabling. They may be unable to go to social events, to go to work, or to travel even short distances. Most people with IBS, however, are able to control their symptoms through medications prescribed by their physicians, diet, and stress management.

The colon, which is about 6 feet long, connects the small intestine with the rectum and anus. The major function of the colon is to absorb water and salts from digestive products that enter from the small intestine. Two quarts of liquid matter enter the colon from the small intestine each day. This material may remain there for several days until most of the fluid and salts are absorbed into the body. The stool then passes through the colon by a pattern of movements to the left side of the colon, where it is stored until a bowel movement occurs. Movements of the colon propel the contents slowly back and forth but mainly toward the rectum. A few times each day strong muscle contractions move down the colon pushing fecal material ahead of them. Some of these strong contractions result in a bowel movement.

Ordinary events such as eating and distention from gas or other material in the colon can cause the colon to overreact in a person with IBS, or certain medicines and foods may trigger spasms. Sometimes the spasm delays the passage of stool, leading to constipation. Chocolate, milk products and large amounts of alcohol are frequent offenders. Caffeine causes loose stools in many people, but it is more likely to affect those with IBS. Researchers also have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones may exacerbate the problem. People with IBS sometimes pass mucus with their bowel movements.

Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS but may indicate other problems.

Eating causes contractions of the colon and normally this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. In people with IBS, the urge may come sooner and be accompanied by cramps and diarrhea. The strength of the response is often related to the number of calories consumed, particularly the amount of fat in a meal. Fat in any form (animal or vegetable) is a strong stimulus of colonic contractions.

Treatment
Large meals can cause cramping and diarrhea in people with IBS. Symptoms may be eased if you eat smaller meals more often or just eat smaller portions. This should help, especially if your meals are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables.

For many people, eating a proper diet lessens IBS symptoms. Before changing your diet, it is a good idea to keep a journal noting which foods seem to cause distress. Dietary fiber may lessen IBS symptoms in many cases. High-fiber diets may cause gas and bloating, but within a few weeks these symptoms often go away as the body adjusts to the diet: IBS can be treated in most cases simply by increasing the intake of dietary fiber and eliminating food allergies.

Many have come to appreciate the value of a low starch diet. It has been demonstrated that altering the normal diet to exclude foods which contain higher levels of starch, can significantly reduce the quantity of Klebsiella pneumoniae (K. pneumoniae) in the feces of all individuals. Starch feeds the overgrowth of K. pneumoniae which is associated with gut inflammation. Cross-reactivity to bacterial antigens leads to immune-mediated damage. A low starch diet can reduce symptoms while colonic bacterial populations are being normalized.

Stress also stimulates colonic spasm in people with IBS. Stress reduction (relaxation) training or counseling and support help relieve IBS symptoms in some people.

Make sure your hydrochloric acid production is sufficient. People with spastic colon are often fiber-intolerant and have a tendency to like fats because they produce a feeling of well being. They often respond well, even dramatically so, to a multiple digestive enzyme formula.

Other herbs and products used with varying success include: fennel, dandelion, skullcap, licorice, peppermint, valerian, slippery elm, cranberry, glutamine, MSM, magnesium, and gamma-oryzanol.

See your doctor if a course of antibiotics is desired. Just remember, the more we use antibiotics, the more resistant the bugs become. If you chose this route, make sure to repopulate your colon with friendly bacteria afterwards.
 

 
 

Signs, symptoms & indicators of IBS (Irritable Bowel Syndrome):
 
 
Symptoms - Allergy  Bloating caused by specific foods

Symptoms - Bowel Movements

  Bowel movement changes
  Occasional/frequent/regular painful urge to defecate
  Mucous in stools
  (Tendency to/very) infrequent stools
  (Very) frequent stools or normal stool frequency

Symptoms - Food - General

  Weak appetite

Symptoms - Gas-Int - General

  Abdominal discomfort relieved by BM
  Meal-related bloating
  (Severe) abdominal discomfort
  General flatulence
  Unexplained nausea

Counter-indicators:
  Absence of meal-related bloating
 
 

Conditions that suggest IBS (Irritable Bowel Syndrome):
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 The presence of food allergy is concealed in a variety of diagnoses including irritable bowel syndrome. However, in IBS the mechanism of action does not seem to involve immune system reactivity, but increased prostaglandin E2 levels.This means that in IBS, there is a strong association with 'food intolerance' not 'food allergy'. This also means that blood testing for food allergies would not be helpful, but an elimination diet is needed to determine the which were the offending foods.

In one study of 21 patients without celiac disease but with IBS, 14 fully recovered during an elimination diet. The most common offending foods were wheat, corn, dairy, coffee, tea and citrus fruits. [Lancet 1982;2: pp. 1115-1117]

Immunity

  Chronic Fatigue / Fibromyalgia Syndrome
 Research has shown that IBS frequently co-exists with CFS and fibromyalgia. Depending on the study quoted, between 34% and 73% of CFS/FMS sufferers have Irritable Bowel Syndrome.

Mental

  Depression
 
 

Risk factors for IBS (Irritable Bowel Syndrome):
 
 
Autoimmune  Gluten Sensitivity / Celiac Disease

Childhood

  Vaccinations
 Studies from Europe indicate that there may be a link between the MMR (measles/mumps/rubella) vaccine and irritable bowel syndrome.

Circulation

  Hypercoagulation (Thickened Blood)

Digestion

  Hydrochloric Acid Deficiency
  Digestive Enzyme Need

Infections

  Dysbiosis, Bacterial
 Some bacterial infections of the small bowel increase passive intestinal permeability. IBS has been studied in patients with diarrhea, cramps and specific food intolerances. Abnormal fecal flora has been a consistent finding, with a decrease in the ratio of anaerobes to aerobes, apparently due to a deficiency of anaerobic flora. Previous exposure to antibiotics - metronidazole in particular - was associated with the development of this disorder.

  Yeast / Candida
 Some doctors believe that many patients who have been diagnosed with Irritable Bowel Syndrome or spastic colon, suffer to a degree from a fungus overgrowth of Candida. This condition is more prevalent in men who take repeated courses of antibiotics or who consume lots of sweets, breads and alcohol.

  Parasite, Dientamoeba Fragilis
 Complete data of long, post treatment follow up has recently been reviewed for 21 consecutive patents who presented with at least two months to a lifelong history of IBS-like symptoms and were positive (exclusively) for Dientamoeba fragilis (DF). From our prospective study it is clear that the use of SAF fixative is crucial in the detection of DF. Also, diarrhea predominant IBS should not be diagnosed until appropriately fixed and stained stools are examined by a parasitologist experienced in DF detection. Such observations also point to the need for a larger placebo-controlled multi-centre trial in eradication of DF in patients with diarrhea-predominant IBS. Until this is carried out however, since the therapy is of short duration, has an acceptable side effect profile, and DF can lead to colitis, those patients with ongoing chronic symptoms should probably seek diagnosis and treatment for DF. [Borody TJ, Robertson C, Wettstein A, Warren E, Leis S and Surace R. (Winter 2002 Edition of Ibis News and Views, pp. 4-5]

  Lyme Disease
  Mycoplasma Infection

Mental

  Anxiety

Metabolic

  Aspartame Intolerance
 There have been a few individuals who claim that their IBS symptoms went away after removing all sources of aspartame from their diet. Here is a quote from one of them:

"You know I had those symptoms for about 8mths and I had every stomach and blood test you can imagine done. The docs couldn't find a thing. So they called it IBS. I did alot of research on symptoms and started researching ingredients of all the things I eat or drink everyday and guess what! It was aspartame in the gum I chewed, the diet drinks I drink and the fat free sweets I ate. I stopped anything with aspartame and in about a week I was close to normal and every since then I haven't had a problem at all." Lynn Chaney.

Symptoms - Food - Intake

  (High) dairy product consumption
 Johne's disease is an infection that cows pass on to humans as irritable bowel syndrome. Johne's disease has no cure and costs dairy producers over $1.5 billion each year [Source: USDA]. The bacterium, Mycobacterium avium paratuberculosis (MAP) causing Johne's is not killed by pasteurization and is passed onto consumers in milk, cheese and ice cream.
 
 

IBS (Irritable Bowel Syndrome) suggests the following may be present:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 The presence of food allergy is concealed in a variety of diagnoses including irritable bowel syndrome. However, in IBS the mechanism of action does not seem to involve immune system reactivity, but increased prostaglandin E2 levels.This means that in IBS, there is a strong association with 'food intolerance' not 'food allergy'. This also means that blood testing for food allergies would not be helpful, but an elimination diet is needed to determine the which were the offending foods.

In one study of 21 patients without celiac disease but with IBS, 14 fully recovered during an elimination diet. The most common offending foods were wheat, corn, dairy, coffee, tea and citrus fruits. [Lancet 1982;2: pp. 1115-1117]

Metabolic

  Aspartame Intolerance
 There have been a few individuals who claim that their IBS symptoms went away after removing all sources of aspartame from their diet. Here is a quote from one of them:

"You know I had those symptoms for about 8mths and I had every stomach and blood test you can imagine done. The docs couldn't find a thing. So they called it IBS. I did alot of research on symptoms and started researching ingredients of all the things I eat or drink everyday and guess what! It was aspartame in the gum I chewed, the diet drinks I drink and the fat free sweets I ate. I stopped anything with aspartame and in about a week I was close to normal and every since then I haven't had a problem at all." Lynn Chaney.
 
 

IBS (Irritable Bowel Syndrome) can lead to:
 
 
Nutrients  Antioxidant Need/Oxidative Stress w/ Supplements
  Antioxidant Need/Oxidative Stress w/o Supplements
 
 

Recommendations for IBS (Irritable Bowel Syndrome):
 
 
Animal-based  Probiotics / Fermented Foods
 Whenever antibiotics are used to treat bacterial overgrowth, probiotics should be used during and/or afterwards to help restore a healthy balance of gut flora.

Additionally, in IBS there is a deficiency of bacteria that break down starch. Encouraging the growth or addition of these bacteria is advisable. The following study demonstrates this need and improvement with a specific probiotic formula.

Irritable bowel syndrome (IBS) represents one of three major forms of chronic inflammatory bowel disease. The aim of the present study was to investigate the composition and metabolic activities of faecal flora in IBS patients that may take part in initiation and/or maintaining of the disease state. All experiments were designed for three groups of stool donors: healthy individuals, patients with irritable bowel syndrome (IBS) diagnosis before and after treatment by prebiotic preparation Hylak Tropfen Forte.

The faecal short chain fatty acid (SCFA) profile of IBS patients was characterized by lower concentration of total SCFA, acetate and propionate (88.15, 60.16 and 18.06 mmol/l, resp.) and by higher concentration of butyrate (9.93 mmol/l). After Hylak Tropfen Forte treatment, the concentration of total short chain fatty acids (SCFA), acetate and propionate increased (100.66, 75.60 and 18.21 mmol/l, resp.). On the other hand the butyrate concentration was lowered (from 9.93 to 6.84 mmol/l). SCFA concentrations in the control group samples for total SCFA, acetate and propionate were as follows: 108.95, 73.26, 26.08 mmol/l.

Patients with irritable bowel syndrome diagnosis showed significant changes in faecal bacterial population. There were increased numbers of facultative anaerobes and sulphate reducing bacteria. Significantly lower were the counts of cellulolytic bacteria. Total counts of pectinolytic, proteolytic, lactate utilizing and lipolytic bacteria were not significantly different. After treatment with Hylak Tropfen Forte the counts of facultative anaerobes and sulphate reducing bacteria decreased and proportion of cellulolytic bacteria increased significantly and were closer to numbers in faecal samples from healthy persons. This activity could be therefore a possible indicator of irritable bowel syndrome.

Fecal bacteria from all three groups of donors were tested for their ability to degrade cellulose, pectin and starch in vitro. Starch degradation was significantly depressed in IBS patients and lower concentrations of acetate, propionate and butyrate were found. Pectin degradation in vitro followed a similar pattern. No degradation of cellulose was found. After treatment with Hylak Tropfen Forte bacterial degradation of these polysaccharides increased but not to the levels of the control group. [Kopecný J., J. Šimunek: Cellulolytic Bacteria in Human Gut and Irritable Bowel Syndrome. Acta Vet. Brno 2002, 71: 421-427]

Separately, a systematic review of the efficacy of probiotics in IBS that included 19 randomized controlled trials in 1,628 IBS patients found that "probiotics are effective in IBS, but we do not have enough information to be sure whether there is one probiotic that is particularly effective or whether combinations of probiotics are required," according to Dr. Paul Moayyedi, the study's lead researcher. [Moayyedi and co-investigators at Mayo Clinic in Jacksonville, FL and Rochester, MN; McMaster University in Ontario, Canada; University College in Cork, Ireland and Montefiore Medical Center in New York City, conducted this meta-analysis presented at the ACG Annual Scientific Meeting 2008 in Orlando.]

Here is someone's testimony about their experience with symptoms, fiber, and probiotics.

I have suffered with allium intolerance since I was about 16 or 17. Like most of you I worked it out for myself - I went to my GP and got told I had "IBS" and to "just deal with it". She was very unsympathetic and gave me these fibre supplement drinks (GROSS) which made me 100 x worse. I saw another doctor when I got really bad (diahorrea and cramps every day for a month) & he referred me to a dietician who was wonderful and helped sooo much. She said taking all that fibre was probably the WORST thing I could have done!

This is what she said (in a nut shell):

Your gut is meant to contain lots of good bacteria to help with digestion.
Bacteria living on the gut wall feed off fibre.
Apparently the gas, bloating, diarrheoa etc is caused by bad bacteria in the gut. Taking pro-biotics at this stage is no good because if there is so much bad bacteria on your gut wall - there is no space for the good bacteria to live.
Increasing your fibre intake (like I did) will just make the bad bacteria thrive.
First you need to kill the bad bacteria and to do this I was put on a fibre-free diet for 2 weeks. Basically all the stuff you're usually told is unhealthy - white bread no crusts potatos - no skins. The cramps and other symtoms almost instantly subsided - it was miraculous!!
After this I had lots and lots of probiotics - yoghurts and drinks etc to increase the good bacteria in my gut and slowly reintroduced fibre.
It really worked - I couldn't believe it after trying so many other things!

Anyway, whenever my IBS symptoms get really bad (luckily not very often now) I just follow the advice she gave me. I also avoid onions, leeks, chives and shallots like the plague.

I have set up a group on facebook (just search for "onion allergy/intolerance") or click on my website. I have started compiling some recipes and a list of onion-free supermarket finds on there. I hope people will find it useful and maybe help me add to it!

This and other stories found here make for some interesting reading.

Botanical

  Peppermint Oil
 Enteric-coated Peppermint oil has been used in treating the irritable bowel syndrome in Europe for many years. In one double-blind cross-over study, it was shown to significantly reduce the abdominal symptoms. Caraway oil is now being used in combination with peppermint oil and has been approved by the German Kommission E for use in IBS.

  Fennel
  Marijuana
 There are quite a few people who use marijuana to control the symptoms of abdominal pain and nausea associated with irritable bowel syndrome. Some make the claim that this helps more than any other thing they have tried.

Detoxification

  Supplemental Fiber
 Many medical professionals believe that soluble fiber helps regulate stool frequency and consistency in people with IBS. Food sources of soluble fiber include:

Oat/Oat bran
Dried beans and peas
Nuts
Barley
Flax seed
Fruits such as oranges and apples (without skins)
Vegetables such as carrots
Psyllium husk


Apple peels and potatoes contain starch, which IBS patients have trouble breaking down, and should be avoided until bacterial populations are restored that can handle the starches.

See also the story found under IBS and Probiotics.

Diet

  Dairy Products Avoidance
 Mycobacterium paratuberculosis (Para-T) RNA (a bacteria causing Johne’s disease in cows) was found in 100% of Crohn's disease patients, compared with 0% of controls.

This bacteria becomes cultured in milk, and is not destroyed by pasteurization. Para-T crosses the species barrier to infect and cause disease in humans. Occasionally, the milk-borne bacteria will begin to grow in the human host, and irritable bowel syndrome and Crohn's disease results. The USDA estimates that 30% of America's dairy herds contain cows infected with Para-T.

  High/Increased Fiber Diet
 The synthetic polymers methylcellulose and polycarbophil have been found to be the most effective fibers or bulk-forming laxatives for use in the treatment of Irritable Bowel Syndrome (IBS). Neither are found naturally in food sources. Methylcellulose is used as a food additive/thickener. Both are available over the counter in commercial products such as Citrucel (methylcellulose) and Fibercon (polycarbophil), among others.

What is frustrating for IBS sufferers is that they are often told to eat more fiber, but aren't told which kind is best for their condition. Insoluble fiber is difficult on the digestive tract and can trigger severe IBS attacks. According to a study of the effects of wheat bran on patients with irritable bowel syndrome, which appeared in the April 1999 issue of Lancet, 55% of IBS patients were made worse by eating wheat bran, which is an extremely high source of insoluble fiber.

Soluble fiber, on the other hand, is soothing to the digestive tract. It helps prevent painful spasms and relieves both the constipation and diarrhea of IBS. For the IBS individual, soluble fiber should always be the very first thing you eat on an empty stomach and it should be part of every meal. Foods that are naturally high in soluble fiber include oatmeal, pasta, rice, potatoes, sourdough bread, soy, barley, and oat bran.

  Grain-free / Low Starch Diet
 Please see comments in the IBS and Reading List link.

  Milk / Dairy Products
 Butyrate from butter may be useful in IBS presenting with diarrhea.

Fifty patients with IBS were treated using enteric-coated sodium butyrate tablets at a dosage of 1 g/day for 30 days. The patients were divided into two subgroups: constipation-predominant IBS and diarrhoea-predominant IBS. The IBS variant and symptom scores of patients were recorded before and after treatment.

Treatment with butyric acid reduced in normalisation of status in 68% and 71% of patients in the diarrhoea-predominant IBS group vs. 14% and 16% of patients in the constipation-predominant IBS group (respectively for the intent-to-treat and per-protocol analyses) (p < 0.005). The symptoms score for abdominal pain, meteorism and flatulence was significantly improved in patients with the diarrhoea variant compared with those with the constipation variant (p < 0.05).

Conclusions:
Oral administration of butyrate may be effective in regulating status and improving gastrointestinal symptoms in patients with the diarrhoea-predominant irritable bowel syndrome. [Digestive and Liver Disease Supplements Volume 1, Issue 1, September 2007, Pages 19-22 ]

  Fructose Avoidance/reduction
 Thirty to sixty percent (30-60%) of patients with irritable bowel syndrome have fructose intolerance and can be cured by avoiding foods made with fructose.

Drug

  Antibiotics
 Researchers at Cedars-Sinai Medical Center in Los Angeles think they may have identified the cause of this mysterious and very common condition, and found an effective way to treat it. The Cedars-Sinai researchers found that 78% of the IBS patients they tested had what they called small intestinal bacterial overgrowth (SIBO), a condition in which excessive amounts of bacteria are present in the small intestine.

The researchers treated the patients who tested positive for SIBO with a 10-day course of antibiotics. Tests at the end of that time found that 25 of 47 patients had no bacterial overgrowth present, and that 12 of them had no IBS symptoms, while the symptoms were "significantly reduced" in the other 13. The symptoms were also reduced in the patients in which some SIBO was still detected, suggesting that if treatment had been continued until it was completely eliminated, perhaps with an alternative antibiotic, better results would have been obtained. (Several common drugs were used: neomycin, ciprofloxacin, flagyl, or doxycyline.)

Rifaximin, an antibiotic, appears to ease the discomfort of chronic irritable bowel syndrome (IBS), researchers report, and these healthy effects continue long after patients stop taking the drug.

Rifaximin targets bacterial "overgrowth" in the small intestine. Some researchers believe this excess bacteria is the underlying cause of many, if not all, cases of IBS.

The antibiotic is already approved by the U.S. Food and Drug Administration (FDA) for the treatment of "traveler's diarrhea," a non-chronic condition that affects otherwise healthy men and women.

"The striking part is that IBS patients got better and stayed better over 10 weeks after taking rifaximin for only 10 days," said study author Dr. Mark Pimentel, director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center in Los Angeles. "This suggests that with the drug, we're actually doing something about what's causing IBS -- which we think is bacterial overgrowth in the bowels."

The study, conducted by Pimentel's team, was funded by Salix Pharmaceuticals, the North Carolina-based manufacturer of rifaximin, which markets the drug under the trade name Xifaxan.

Also see the link between IBS and Test for Microbiological Imbalance.

  Conventional Drugs / Information
 Please see the link between IBS and Antibiotics.

Lab Tests/Rule-Outs

  Test for Microbiological Imbalance, Stool
 Klebsiella overgrowth, if present, can account for and may be the cause of symptoms in IBS. This organism, among others is tested for in stool analyses such as the "Comprehensive Digestive Stool Analysis" from Genova.

Another test, the "breath test" is able to detect elevated concentrations of hydrogen in the expired air. In presence of a SIBO, dietary carbohydrates are metabolised with production of massive amounts of hydrogen that are eliminated with the breath. Thus, the "breath test" consists in administering 50-75 grams of lactulose and assaying the concentrations of hydrogen in the expired air; if these concentrations exceed 10 to 20 part per million, the subject is suspected to have a SIBO and should be appropriately treated with antibiotics.

Mineral

  Calcium
 See the link between IBS and Vitamin B12.

Miscellaneous

  Reading List
 The IBS Low-Starch Diet: Why Starchy Food May Be Hazardous to Your Health by Carol Sinclair (2007). Her diet shows that a gradual reduction of starch can dramatically reduce pain in days, often to a point where drug usage is reduced and—in some cases—eliminated completely. Details of the discovery—along with case histories and a practical guide—are provided along with 200 delicious starch- and gluten-free recipes and a comprehensive guide to eating out.

Dr. Mark Pimentel believes that the "missing link," or root cause of most IBS symptoms can be attributed to an overgrowth of bacteria in the small intestine. A New IBS Solution takes you through the historical evolution of conventional medicine's views on IBS in a way that can be easily understood. In addition, Dr. Pimentel presents a simple treatment protocol that will not only help you resolve your IBS symptoms, but will also prevent their recurrence.

Another book, Breaking the Vicious Cycle by Elaine Gottschall contains The Specific Carbohydrate Diet™ which has proven to be highly successful for many who suffer from various bowel disorders as well as the many related problems which actually stem from imbalances in the intestinal tract.

Oxygen / Oxidative Therapies

  Ozone / Oxidative Therapy

Vitamins

  Vitamin A
 See the link between IBS and Vitamin B12.

  Vitamin B12 (Cobalamine)
 Vitamins B12, A, D, E and K along with calcium and a lactose-free diet are often recommended by clinicians treating IBS.

  Vitamin D
 See the link between IBS and Vitamin B12.

  Vitamin E
 See the link between IBS and Vitamin B12.

  Vitamin K1/K2
 See the link between IBS and Vitamin B12.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended







GLOSSARY

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Anaerobic:  Of, relating to, or being activity in which the body incurs an oxygen debt (for example weight training or resistive exercises) and does not immediately burn off a lot of calories and fat.

Antigen:  A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.

Aspartame:  A low-calorie sweetener used in a variety of foods and drinks and as a tabletop sweetener. It is about 200 times sweeter than sugar and is commonly known by names such as NutraSweet, Equal, Spoonful or Equal-Measure.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Candidiasis:  Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.

Carbohydrates:  The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

Celiac Disease:  (Gluten sensitivity) A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Colitis:  Inflammation of the colon.

Colon:  The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.

Constipation:  Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.

Crohn's Disease:  Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.

Diarrhea:  Excessive discharge of contents of bowel.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Fibromyalgia:  (FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.

Glutamine:  A non-essential amino acid, glutamine is considered to be a brain fuel. Glutamine has been used therapeutically for alcoholism, mild depression and to reduce the craving for sweets. Glutamine is very important in the functioning of the metabolism and muscle maintenance. Glutamine supplementation can help prevent muscle and other tissue breakdown by providing the body with nitrogen and fuel.

Herbs:  Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.

Hormones:  Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Hydrochloric Acid:  (HCl): An inorganic acidic compound, excreted by the stomach, that aids in digestion.

Immune System:  A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Irritable Bowel Syndrome:  (IBS) A condition that causes upset intestines for a long period of time. It is very unpleasant to the sufferer but tends to be harmless and usually does not lead to more serious complaints. The symptoms vary from person to person and from day to day. In order to be diagnosed with IBS, a person must have at least three of the following symptoms: pain in the lower abdomen; bloating; constipation; diarrhea or alternating diarrhea and constipation; nausea; loss of appetite; tummy rumbling; flatulence; mucous in stools; indigestion; constant tiredness; frequent urination; low back pain; painful intercourse for women.

Magnesium:  An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Prostaglandin:  Any of a class of physiologically active substances present in many tissues, with effects such as vasodilation, vasoconstriction, stimulation of the smooth muscles of the bronchus or intestine, uterine stimulation; also involved in pain, inflammation, fever, allergic diarrhea, and dysmenorrhea. A potent hormone -- similar in structure to an unsaturated fatty acid -- that acts in extremely low concentrations on local target organs; first isolated from the prostate.

Spasm:  Involuntary contraction of one or more muscle groups.

Stomach:  A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Ulcerative Colitis:  (Colitis ulcerosa): Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.

USDA:  United States Department of Agriculture