|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.
| ||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.|
| ||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.|
| ||Many medical professionals believe that soluble fiber helps regulate stool frequency and consistency in people with IBS. Food sources of soluble fiber include:|
Dried beans and peas
Fruits such as oranges and apples (without skins)
Vegetables such as carrots
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.
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).
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 ]
| ||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.|
| ||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.|
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.
| ||See the link between IBS and Vitamin B12.|
| ||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
| ||IBS (Irritable Bowel Syndrome) has been linked with a lack of vitamin D for the first time in a study published in the BMJ (British Medical Journal December 21, 2015). Of the 51 patients with IBS tested, 82% had insufficient vitamin D levels.|
| ||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.|
| ||See the link between IBS and Vitamin B12.|
| ||See the link between IBS and Vitamin B12.|| |