Gluten Free Pho Recipe from Simply Gluten Free

This week's recipe thanks to Simply Gluten Free.

Ingredients

• ½ pound rice noodles (Banh Pho)

• 4 CelifibR gluten free vegetarian chicken bouillon cubes

• 5 cups boiling water

• 1 bunch green onions, thinly sliced

• Kosher salt and freshly ground pepper

• 1 handful cilantro leaves
• 
1 handful basil leaves

• 2 Thai or jalapeno peppers, thinly sliced

• 2 fresh limes, cut into wedges
• 
2 cups shredded cooked chicken (omit for vegan or vegetarian)

Directions

Soak the noodles in very warm water until softened, about 10 minutes.

Dissolve the bouillon cubes in 5 cups boiling water. Add half of the sliced green onions and season to taste with more salt and pepper if needed.

Once the noodles are softened, drained them, put into a strainer set in a large bowl and fill the bowl with boiling water. Let sit for 5 seconds, drain and divide the noodles among 4 large soup bowls.

Divide the hot broth among the 4 bowls of noodles. Serve immediately with all the additional ingredients on the side. Let each diner design their pho the way they want.

A gluten free recipe that makes 4 big bowls of magically restorative noodle soup.

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 ranges 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.

Most of these people are suffering from food allergies. But these allergies are not the typical kind that your allergist is looking for. These are food allergies that are often leading to digestive symptoms, but at the very least they are leading to the poor absorption of nutrients.

When you have a food allergy, your immune system is attacking that food whenever you ingest it. In a person without food allergies, the immune system ignores food. But all too often we eat things that our immune system does not recognize as food, even though our entire culture, family, and educational system may have told us that it is good for us.

One primary example of a food that often does more harm than good is dairy. Almost everyone grows up believing that dairy is essential for good health. Yet this is not supported by science, and it isn’t even supported by common sense. But the marketing of dairy has been so effective that it has overridden these other factors and the product has become part of our identity.

Unfortunately, all too often people do not tolerate dairy well. One type of problem is lactose intolerance, but many people are experiencing a far more profound and deeper reaching problem: a dairy allergy.

If you have a dairy allergy, then every time you ingest a dairy product your immune system conducts an attack against it, just as it would a virus. You may or may not realize it when it’s happening, but it is certainly affecting how you digest that food.

This causes inflammation, and for some people leads to a great difficulty in putting on weight, although it is just one of many potential food allergies and causes of poor weight gain. Let’s look at a couple of examples. It is not usual to see patients who are working out, eating lots of protein and calories, and trying to gain muscle mass or simply put on weight. However, they are frequently increasing the amount of one of the common allergens, such as dairy, egg, or wheat. When this happens they often feel worse rather than better. A particularly striking example is when people start including a protein shake into their diet. Protein shakes are usually dairy based. For many people this is the exact opposite of what they should be doing.

Another example is with infants. The first food usually introduced to infants is a dairy based formula. Infants that experience a failure to thrive or poor development may simply be reacting to the food that they are eating. In fact, even if they are just breast feeding, they can be reacting to the food that the mother is eating.

There are many more examples, but in all cases one of the best things that can be done is to be properly tested for food allergies. This is easier said than done, since most physicians are not skilled or versed in the full spectrum of potential food allergies or the wide range of symptoms that can be caused by them. More information about this type of testing at IBS Treatment Center.

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Great image thanks to samoeba

When is it questionable to remove the gallbladder?

It is often tempting for physicians to blame the gallbladder for abdominal pain and digestive problems even when there is little or no evidence that the gallbladder is the culprit. It’s a relatively simple procedure, and most people don’t miss it too much. If stones are present, then the decision is easy to make.


However, in some cases physicians recommended that the gallbladder be removed even when stones are not apparent on any exams. The recommendation is based primarily on symptoms and a lack of any other visible problem. Gallbladder function tests also may indicate that the gallbladder is not functioning at 100%. However, that does not mean that it is the cause of the problem. If the gallbladder is functioning at a below normal level, removing it will only guarantee that it will not function at all.

Studies (see below) have shown that patients with IBS symptoms and/or abdominal pain are more likely than others to have gall bladder removal surgery (cholecycstectomy) when they do not have gall stones. This exposes the patient to the increased (though small) risks of surgery and to further digestive problems caused by the abscence of a gall bladder. Testing for food allergies and other causes of IBS symptoms, and treating those conditions can enable patients to avoid unnecessary surgery and achieve good digestive health.

More information on the gall bladder at Center for Food Allergies
Image thanks to beltina.org

Innate Health Group

The Innate Health Group was designed and created to reintroduce something that has been missing in medicine, a belief that you are capable of being healthier if given a better understanding of your body.

We subscribe to the scientific method and the theory of evolution. We know that in most cases health is something that comes from the capacity of your body to perform according to its genetic design, with which you were born.

Health, excepting traumatic damage to the body, is usually not most effectively achieved by drugs or surgical procedures. Although these have their place, they are grossly overused. And frequently drugs and surgical procedures cause other significant problems that could be avoided by other techniques that not only solve the underlying problem, but avoid additional risk.

As a society we have lost touch with our innate health. We are confused by a medical system and a culture that prioritizes business over health, and by generic mass marketed treatments and fads that treat people as statistics and customers rather than as unique individuals with unique health care needs.

Stress Reduction and IBS

So you think that you carry your stress in your abdomen. It's a common belief. If you have been diagnosed with Irritable Bowel Syndrome, it is likely that you have been advised to reduce your stress level.

You may have been told to get regular exercise and adequate sleep, and to practice stress reduction techniques such as yoga, meditation, tai chi, deep breathing, journal writing, relaxation therapy, biofeedback, hypnotherapy, or psychotherapy.

All of these practices can indeed improve physical, mental, and emotional health. They provide a host of benefits, from improved personal relationships to enhanced productivity to increased energy and mental clarity, and they just might help with your IBS symptoms.

But chances are they won't cure your IBS.

Most physicians are trained to think of IBS as stress induced or as a type of psychosomatic disorder. Because there has not been a cure for IBS, it has been framed in a way that suggests that it is more your problem than the physicians. Although some cases of IBS are no doubt related to mental or emotional issues, and stress and anxiety can aggravate IBS (as well as most other medical conditions), they are not the predominant causes of IBS. More often, IBS causes you stress rather than the other way around.

Medicine has a long history of blaming medical conditions with no known organic cause on some form of psychological disturbance, such as stress - only to discover later the organic cause of the problem. One excellent recent example of this is stomach ulcers. While stomach ulcers were once thought to be a stress-induced disorder, it is now well accepted that the bacteria Helicobacter pylori cause them, and that they are treatable.

It is true that stress can make the symptoms of IBS worse, and that your digestive system depends on relaxation to function properly. Occasionally stress is the sole cause of IBS. But far more often it is due to something else. If you still have symptoms when you know that there isn't much stress, then there is more to the problem than stress!

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More information on IBS at IBSTreatmentCenter.com
Image thanks to shiyam06.ipower.com

Everyday Painkillers, 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)

Significantly, researchers report that patients with pre-existing kidney disease who took these painkillers at least twice a week for 2 months were two to three times more likely to have the beginning stages of chronic kidney failure, compared with individuals who did not use these painkillers on a regular basis. (The New England Journal of Medicine December 20, 2001;345:1801-1808)

If you think that you should be taking aspirin to thin your blood, think again. A recent study that investigated the effects of taking low-dose aspirin daily for close to four years found that only participants with compromised kidney function benefited significantly. And another study, in the Journal of the American Medical Association (JAMA), showed that fish oils have a blood-thinning effect similar to aspirin. (JAMA. 2001 Jan 17;285(3):304-12)

And it may affect your colon, too. A questionnaire of over 35,615 male health professionals showed that regular and consistent use of NSAIDs such as aspirin, acetaminophen, Advil and other prescription anti-inflammatory drugs was associated with diverticular disease, a serious type of colon damage. (Arch Fam Med. May 1998;7:255-260)

Finally, it is also well known that aspirin and NSAIDS are tied to stomach pain and bleeding ulcers. Yet nearly 30,000 people a year die from using these medications. Many of these deaths are due to bleeding ulcers.

If you have pain, whether it be arthritis or otherwise, you should know that there are a variety of healthy and effective alternatives for reducing inflammation and pain that will put you on the road to better health, not temporarily alleviate your symptoms while causing other problems. 
For more information, contact the IBS Treatment Center at info@ibstreatmentcenter.com or 888-546-6283.

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Image thanks to guardian.uk

Case Study from Nature.com: Epidemiology of Community-Acquired Clostridium difficile Infection: A Population-Based Study

C. Diff is becoming common in the non-hospital population, even among those without risk factors. Fortunately we don't run into it all that often. But we do have options for treating challenging cases.

From Nature.com:

OBJECTIVES

Clostridium difficile infection (CDI) is a common hospital-acquired infection with increasing incidence, severity, recurrence, and associated morbidity and mortality. There are emerging data on the occurrence of CDI in nonhospitalized patients.

However, there is a relative lack of community-based CDI studies, as most of the existing studies are hospital based, potentially influencing the results by referral or hospitalization bias by missing cases of community-acquired CDI.

METHODS

To better understand the epidemiology of community-acquired C. difficile infection, a population-based study was conducted in Olmsted County, Minnesota, using the resources of the Rochester Epidemiology Project. Data regarding severity, treatment response, and outcomes were compared in community-acquired vs. hospital-acquired cohorts, and changes in these parameters, as well as in incidence, were assessed over the study period.

RESULTS

Community-acquired CDI cases accounted for 41% of 385 definite CDI cases. The incidence of both community-acquired and hospital-acquired CDI increased significantly over the study period.

Compared with those with hospital-acquired infection, patients with community-acquired infection were younger (median age 50 years compared with 72 years), more likely to be female (76% vs. 60%), had lower comorbidity scores, and were less likely to have severe infection (20% vs. 31%) or have been exposed to antibiotics (78% vs. 94%).

There were no differences in the rates of complicated or recurrent infection in patients with community-acquired compared with hospital-acquired infection.

CONCLUSIONS

In this population-based cohort, a significant proportion of cases of CDI occurred in the community. These patients were younger and had less severe infection than those with hospital-acquired infection. Thus, reports of CDI in hospitalized patients likely underestimate the burden of disease and overestimate severity.

Soluble vs. Insoluble Fiber

Fiber can be soluble, meaning that it partially dissolves in water, or insoluble, meaning that it doesn't.

Although neither type typically cures IBS, soluble fiber (which is also called viscous fiber, and is found in foods such as oatmeal, okra, or legumes, such as garbanzo beans) can be helpful in treating IBS symptoms, especially constipation and diarrhea. Insoluble fiber is more of a "scratchy" fiber; it adds bulk to the stool. A good example of insoluble fiber is celery.

Soluble fiber forms a thick gel that helps to properly form the stool in the digestive tract and move it through the bowel; it also adds bulk to the stool. Because it slows the stool's transit time, it helps to prevent diarrhea. Soluble fiber also prevents constipation, because the colon becomes filled with gel, as opposed to being clenched tightly around dry, hard stools.

Basically, fiber moves bulk through the intestines and helps to balance the pH (acidity) level in the intestines. It is also helps to keep healthy the good bacteria that live in your digestive tract. In particular, one type of plant fiber, fructooligosaccharides (FOS), feed these good bacteria. You can supplement your diet with FOS, which are available at IBSTreatmentCenter.com.

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Image thanks to bryanking.net

Celiac Disease and Other Forms of Gluten Intolerance

Gluten is a protein found in wheat, barley, and rye, and is responsible for the springiness and stretchiness of bread. Allergies and intolerances to gluten have been the subject of intensive research over the past decade.

Much of this research has focused on celiac disease, which is a special form of gluten intolerance. It is a hereditary response to gluten that results in a very specific type of damage to the small intestine. Common symptoms, which can mirror those of IBS, include loose stools, constipation, or both; fatigue; weight fluctuation; dermatitis; and more.

Celiac disease is diagnosed by measuring damage to the small intestine, either by blood testing or, traditionally, with a biopsy of the small intestine. A positive biopsy means that the villi, or small finger-like extensions of the intestinal lining, have been damaged; this is known as villous atrophy. However, recent studies have shown blood testing to be as accurate as a biopsy.

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

Celiac disease is not the only form of gluten intolerance or allergy. Many people react to gluten by producing elevated IgG antibodies to gluten or wheat, but they do not have damage to the small intestine. Their test results for celiac disease are negative. They become quite frustrated with traditional medicine, with its narrow focus on celiac disease, because they are told that their negative test results meant that they are not allergic or intolerant to wheat, barley, or rye. Yet when they eat a piece of bread they become sick.

Gluten is found in nearly all bread products and all pastas, as well as in most breakfast cereals, cookies, muffins, cakes, soy sauce, pancakes, waffles, soups, sauces, and gravies. Beer, ale, lager, and stout contain gluten. Malt, malt extract, and caramel flavorings, which are used to add flavor to a wide variety of foods, contain gluten.

The treatment for celiac disease and for a gluten intolerance or allergy is identical. It means removing all sources of gluten from the diet. This is not an easy task, because so many of our foods contain gluten. Dietary counseling, such as that provided at the IBS Treatment Center, can make the job easier.

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Image thanks to glutenfreefoodies

Converting Wheat Flour Recipe to Gluten Free

Below are some general guidelines for how to convert a traditional wheat-flour recipe to a gluten-free one. Excerpted from Bake Deliciously! Gluten and Dairy Free Cookbook by Jean Duane, Alternative Cook.

One cup of wheat flour translates into 1/2 cup of grain flour, 1/4 cup of bean flour and 1/4 cup of starch.

Step One:

Start with a combination of flours in these ratios:

• 50% grain flour (brown rice or sorghum)
• 25% protein flour (navy, fava, garbanzo, soy, gafava flour)
• 25% starch (cornstarch, tapioca or potato starch)
• Use 1:1 for flour called for in the original recipe

Step Two:

• Add 25-50% more leavening (baking powder, baking soda or yeast) to the recipe dry ingredients

Step Three:

• Add 1/2 to 1 tsp. acid (vinegar, citric acid, cream of tartar or citrus juice) to the wet ingredients

Step Four:

• Add 1/2 tsp. of xanthan gum to the dry ingredients, or
• Add 1/2 tsp. guar gum to the wet ingredients for every cup of flour, or
• Add 1/4 tsp. of each the xanthan gum and the guar gum. (For smaller baked items, gums may be omitted)

Step Five:

• Let the batter sit for a few minutes before baking to allow the liquids to be absorbed

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More information on converting recipes at Alternative Cook.
Image thanks to recipeallfree.com

A Deeper Understanding of Probiotics

As many of you know, probiotics are products that contain bacteria. These bacteria are the “good” bacteria, and they are called probiotics to make it clear that they are designed to produce the opposite effect of antibiotics which kill bacteria. The most familiar of the good bacteria are the genera Lactobacillus and Bifidobacter.

The GI tract contains around 100 trillion bacteria. Everyone has good bacteria in their digestive tract, but not everyone has the same kinds of good bacteria, or in the same amounts.

For the last few decades we have seen the rise of antibiotics, considered wonder drugs because of the lives that they saved. Unfortunately, we have also seen that too much of a good thing can be harmful.

The overuse of antibiotics has directly contributed to the development of antibiotic resistant bad bacteria, such as MRSA. We are only beginning to appreciate that there is another downside to taking antibiotics – they kill good bacteria.

In response to this we are now seeing a rise in the popularity of probiotics. Probiotics are a wonderful tool when used properly, but they are not a cure all, and they are still largely misunderstood. Some processed foods, such as yogurt and acidophilus milk, contain good bacteria. It is now becoming fashionable to put probiotics into all sorts of processed food products in an effort to come up with new and creative ways to give people these good bacteria.

Good bacteria have been around for a lot longer than we’ve been around, and were available well before the invention of yogurt. Where did we used to get our good bacteria? You may be surprised to learn that many fruits and vegetables are naturally covered in good bacteria. For example, that natural wax on your organic apple (which by definition is not coated with man-made wax) is a film of Lactobacillus. Not only that, but plant foods also help to support the good bacteria in your digestive tract. These are two excellent reasons to eat more plants.

When we are born, there are no bacteria in our digestive tract. But as soon as we are born, bacteria begin to populate the gastrointestinal system. This is not only normal, but it’s imperative to life. Studies have shown that without bacteria animals do not develop properly and cannot live very long.

Some of the very first good bacteria to which we are exposed come from breast milk. One fascinating aspect of this is that studies now show that these bacteria are transferred directly from the digestive tract of the mother via the lymph system. This brings up an interesting question. Could problems in the mother’s digestive ecosystem carry over to her chilren?

It’s only recently that we have begun to gain a better appreciation for what good bacteria do for us. They inhibit the ability of bad bacteria and other microbes to affect us, both directly and indirectly. They modulate many immune functions and decrease inflammation. They are critical for digesting our food and for absorbing nutrients. They synthesize numerous vitamins. And they stimulate the motility of the digestive tract. Different bacteria have different positive effects. No two are quite alike.

Taking probiotics might seem like a no brainer. It is certainly worth trying if you are suffering from digestive problems, but there are numerous probiotic products on the market and they vary widely in quality, quantity, and effectiveness. Equally important, the ecosystem of the digestive tract is a very complex area that is often affected by numerous other variables. People with digestive problems often find that probiotics are of no benefit, or only help a little. And sometimes they even make symptoms worse.

The reasons for this are too numerous to get into here. However, we specialize in the testing and treatment necessary to help you gain a better understanding of your unique bacterial environment. And we only recommend probiotics, if they are needed at all, once we have a clearer understanding of what is causing your symptoms.

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Image thanks to wheatbellyblog

9 Primary Causes of Heartburn

In order to cure acid reflux disease, you must remove the cause of the problem and promote the healing process.

The 9 most common causes of heartburn: 



Food allergies: In my practice I have found that a majority of cases of heartburn are caused by food allergies. Food allergies often cause a host of other problems and can be diagnosed with a simple blood test. 



Foods: certain foods cause the lower esophageal sphincter to relax, thus leading to heartburn. These include peppermint, coffee, alcohol and chocolate. 



Hiatal hernia: This is a physical condition where part of the stomach protrudes through the diaphragm. It can generally be reduced without surgery, though even when present it is not necessarily the sole cause of heartburn.


Low Acid Production: Ironically, low stomach acid levels can result in heartburn. This is much more common than increased acid. This problem can be assessed clinically and is readily treatable. 



Medications: Many medications cause heartburn as a side-effect, including, several acid blockers. These include:

• Acid Blockers: Prevacid, Prilosec, Zantac, etc.
• Asthma inhalers (beclamethasone, flovent, etc).
• Corticosteroids
• Nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin, ibuprofen, and naproxen.
• Antianxiety medications, such as diazepam (Valium) and lorazepam (Ativan).
• Osteoporosis drugs such as alendronate (Fosamax).

Overeating: Of course. The stomach is only so big, even if the eyes and the mouth are bigger.

Pregnancy & Obesity: These are related in that both put pressure on the stomach, decreasing it’s volume and forcing food back from whence it came. 



Stress: Stress is a small word with big health consequences. Stress can be the sole cause of heartburn, but often it is exacerbating other causes. Regardless, there are nutrients, herbs and therapies that will help you deal with your stress. 



Smoking: Smoking also causes the lower esophageal sphincter to relax, leading to heartburn. 



If you experience heartburn please schedule an appointment so that we can sort through the possible causes and provide you with permanent relief. Even heartburn caused by necessary drugs can be treated in a way that is much healthier and more effective than acid blockers.

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More information on GERD and Acid Reflux at Center for Food Allergies
Image thanks to medicalboox

S. boulardii and Irritable Bowel Syndrome

Two recent studies say that S. boulardii did not help with Irritable Bowel Syndrome (IBS). It's something that many people try at some point.

As we know, there are hundreds of causes of IBS, so it's unlikely that a study on one treatment will find it effective. However, I have also not found S. boulardii to be effective in IBS.

S. boulardii study #1

Role of Saccharomyces boulardii in diarrhea predominant irritable bowel syndrome.

-Kabir MA, Ishaque SM, Ali MS, Mahmuduzzaman M, Hasan M.

Several studies with probiotics have shown promising results in the treatment of IBS. One of the probiotics used was saccharomyces boulardii. This is a randomized double blind placebo controlled clinical trial of S. boulardii in diarrhoea predominant IBS and was carried out in the hospital of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June 2004 to July 2005.

Thirty five (35) patients were included in each of the control and study groups. The study group was treated with S. boulardii 250 mg twice daily orally for one month. Patients were evaluated before therapy, at the end of therapy and 30 days after end of therapy by a scoring system which included symptoms as well as personal and professional life.

No significant difference between the two groups was found in any of the parameters evaluated on any of the observation days. S. boulardii treatment for 30 days in diarrhoea predominant IBS patients did not result in any improvement in this study.

S. boulardii study #2

A randomized, double-blind, placebo-controlled multicenter trial of saccharomyces boulardii in irritable bowel syndrome: effect on quality of life.

-Choi CH, Jo SY, Park HJ, Chang SK, Byeon JS, Myung SJ.

BACKGROUND:

Probiotics confer health benefits to the host. However, its clinical effect on irritable bowel syndrome (IBS) is controversial.

AIMS:

This study was aimed to evaluate the effects of Saccharomyces boulardii on quality of life (QOL) and symptoms in patients with diarrhea-predominant IBS or mixed-type IBS.

METHODS:

Sixty-seven patients with IBS were randomized either to receive S. boulardii at 2×10 live cells as a daily dose (n=34), or placebo (n=33) for 4 weeks. IBS-QOL was assessed at the beginning and end of the treatment phase. IBS-related symptoms, bowel movement frequency, and stool consistency were recorded on a daily basis and assessed each week.

RESULTS:

The overall improvement in IBS-QOL was higher in S. boulardii group than placebo (15.4% vs 7.0%; P<0.05). All eight domains of IBS-QOL were significantly improved in S. boulardii group; however, placebo group only showed improvements in dysphoria and health worry. Composite scores for IBS symptoms were significantly reduced in both groups to a similar extent. Bowel frequency and stool consistency did not change in either group.

CONCLUSIONS:

S. boulardii improved IBS-QOL better than placebo but was not superior for individual symptoms in patients with diarrhea-predominant IBS or mixed-type IBS.

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Image thanks to probioticsreviewed.com
More information on IBS case studies at National Institutes of Health
More information on treating your IBS and food allergies at IBSTreatmentCenter.com

Gall Bladder Q&A

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?


In some people, stones develop inside of the gallbladder. These stones, when small, can become lodged in the bile duct, which can cause severe pain and be very dangerous if they also clog the pancreatic duct. Larger stones are not able to pass into the bile duct, but their presence can cause severe pain. Sometimes this is worse when the gallbladder is contracting. In either case, removing the gallbladder usually relieves the pain and you feel much better.

When is it questionable to remove the gallbladder?


It is often tempting for physicians to blame the gallbladder for abdominal pain and digestive problems even when there is little or no evidence that the gallbladder is the culprit. It’s a relatively simple procedure, and most people don’t miss it too much. If stones are present, then the decision is easy to make.
However, in some cases physicians recommended that the gallbladder be removed even when stones are not apparent on any exams.

The recommendation is based primarily on symptoms and a lack of any other visible problem. Gallbladder function tests also may indicate that the gallbladder is not functioning at 100%. However, that does not mean that it is the cause of the problem. If the gallbladder is functioning at a below normal level, removing it will only guarantee that it will not function at all.

Studies have shown that patients with IBS symptoms and/or abdominal pain are more likely than others to have gall bladder removal surgery (cholecycstectomy) when they do not have gall stones. This exposes the patient to the increased (though small) risks of surgery and to further digestive problems caused by the abscence of a gall bladder. Testing for food allergies and other causes of IBS symptoms, and treating those conditions can enable patients to avoid unnecessary surgery and achieve good digestive health.

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More information at CenterforFoodAllergies.com

Hypoglycemia and Food Allergies

Do you find that you need to eat every 2-3 hours?
Do you feel like your blood sugar drops to a point where you can’t function anymore?
Do you get tired, shaky, or dizzy and find that if you eat something you feel better?
Do you get irritable when you get hungry?
Do your friends know when it’s time to get some food into you?

What is Hypoglycemia?

People suffering from one or more of these problems have what is commonly referred to as hypoglycemia, or low blood sugar. Technically, hypoglycemia is not diagnosed until it is very severe, so you are unlikely to have your doctor diagnose you as having hypoglycemia.

But in the general public this problem is commonly referred to as hypoglycemia. Unfortunately, many doctors will not explain the difference to you or acknowledge that you may have a form of hypoglycemia.

Some people assume that hypoglycemia is risk factor for developing diabetes. However, diabetes involves an elevation in blood sugar and is therefore the opposite of hypoglycemia.

The only connection is that when people who have diabetes are overmedicated they can develop low blood sugar, which can be very dangerous if blood sugar levels get too low.

How Do You Diagnose Hypoglycemia?

Extreme forms of hypoglycemia will show up on a general blood chemistry panel as a glucose level that is below normal. However, many people who experience hypoglycemia have glucose levels that are within the normal range.

Therefore testing your blood glucose level is generally not helpful for diagnosing the most common forms of hypoglycemia described above.

The most reliable way for the average person to determine whether or not they are hypoglycemic is simply to realize that their symptoms go away when they eat. This is a sure sign that you are suffering from hypoglycemia.

Why do people have hypoglycemia?

Unless you are starving yourself, experiencing extreme athletic activity, treating diabetes, or have a rare metabolic disorder, there must be some other reason for the frequent drops in your blood sugar. In the patients that we see and in my own personal experience, one of the primary causes of hypoglycemia is that people are not properly absorbing the nutrients from the food that they eat. Therefore even though they are eating a lot and eating frequently, they don’t benefit from their food the way the average person does.

These people get hungry within a couple of hours after eating, and they have to eat again, or ingest some candy to get their blood sugar back up. But it never lasts very long. These people have trouble gaining weight, though it’s not a prerequisite for having hypoglycemia. And people often will say that their need to eat is a sign of a high metabolism.

This is incorrect. It’s a sign of malabsorption. And ironically, there need not be any obvious digestive problems when someone does not digest their food well.
What is causing the malabsorption?

In my experience the primary cause of this problem is food allergies and intolerances. If you are eating something to which your immune system is responding (which is the case in most food intolerance and sensitivities), then that food isn’t just providing some nutrition, it’s also providing a reason to be attacked as if it were a foreign invader. That interferes with the absorption of nutrients, and it also takes a lot of energy. Eating will keep you alive, but it won’t keep you going like it should. The result being hypoglycemia.

How to solve the problem...

The goal is to improve your digestion and absorption of nutrients, whether or not you have problematic digestive problems. Sorting out your food allergens and intolerances with the proper blood tests is very important to resolving hypoglycemia. This requires specialized testing not run by most physicians. Then you must eliminate those foods from your diet in order to allow your digestive tract to heal. And finally, emphasize protein in your diet. It will help the healing process and support your energy and blood sugar levels much longer than carbohydrates can.

Other factors can also be involved that can also be sorted out, but most people will find that their energy and endurance will noticeably improve and continue to get better with time.

What is a Food Allergy?

Food allergies are much more complicated than most people, including most physicians, realize.

Food allergies are typically thought of as relatively uncommon reactions to a few select foods, such as peanuts, that usually result in anaphylaxis, hives, or maybe asthma. This is how most allergy specialists think of food allergies. However, there are numerous research studies that indicate that food allergies cause many other conditions.

Technically, an allergy is any reaction that involves the immune system. But the standard of practice in medicine is to use a much narrower definition of the word allergy. Therefore, in order to truly understand the breadth of allergic reactions, it is necessary to define some of the underlying mechanisms involved in allergies.

Conventional IgE Allergies

Classic food allergies are the result of an IgE (immunoglobulin E) reaction to a food. IgE is a type of antibody produced by the immune system. When the immune system is attacking a food, it may produce IgE antibodies. IgE antibody reactions are the kind of reactions that are involved in hives and other conventional allergic reactions as well as conditions such as reflux.

Many people are familiar with skin testing for allergies. Skin testing is the traditional type of food allergy testing. IgE reactions are the type of reactions that are being looked for when skin allergy testing is performed.

Skin tests, however, only assess whether or not the skin will react to something. They do not necessarily represent IgE levels in the blood, and they do not reflect other types of immune reactions, such as those more commonly found to cause reflux.

Some physicians are now using blood tests to measure IgE antibodies. This can be a bit more useful, but most cases of reflux are not caused by an IgE reaction to food. Therefore the food allergy will not show up on skin tests or on blood tests for IgE antibodies. Unfortunately, these tests will generally not be helpful in determining the cause of your child’s reflux.

Other Types of Food Allergy

As noted above, an allergy is any reaction that involves the immune system. And IgE antibody reactions are only one type of immune response to food. A majority of immune responses to food involve IgG reactions.

For example, let’s consider a gluten intolerance. Just to confuse you, the standard of practice in medicine is to call this an intolerance. However, it is an immune reaction, and it definitely involves an immune reaction against gluten, which is a protein in wheat and many other grains.

A gluten intolerance does not show up on skin tests or on IgE blood tests. But it does show up on blood tests for IgG antibodies. And yes, studies have clearly shown that these reactions to gluten can cause reflux.

As you can see, the use of the words “allergy” and “intolerance” can be very confusing. But to help clarify the picture a little, consider dairy.

Most people assume that a reaction to dairy is a lactose intolerance. Lactose is a sugar found in dairy products. A lactose intolerance is the result of an enzyme deficiency that causes an inability to digest lactose. This is not an allergy because it does not involve the immune system. However, a lactose intolerance can cause symptoms like gas, bloating, and loose stools. A lactose intolerance is not usually associated with reflux, while dairy allergy often is. Therefore, avoiding lactose but still ingesting dairy may not be enough to resolve reflux caused by a dairy allergy.

As a result, many people discover that in order to resolve reflux, all dairy must be avoided, not just lactose. Many studies have shown this as well. This is due to an all too common immune reaction to dairy. This reaction will usually show up on blood tests as an IgG antibody reaction to cow’s milk.

Dairy is usually the first non-breast-milk food introduced into the human diet, and is unfortunately the most likely to cause health problems, including reflux. What is even more interesting is that when you run IgG food allergy tests you frequently find reactions to dairy in reflux patients. And even more importantly, when you take them off dairy they get better.

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Image thanks to mercola.com

Candida and IBS: What's the Connection?

One of the more common causes of digestive problems is Candida, or yeast. Although there are other types of yeast, Candida is the word usually used to describe a problem with yeast.

Although many people think of yeast infections as a female problem, yeast is an organism that can colonize any orifice. In the mouth it is known as thrush. In the digestive tract it is often called a yeast overgrowth, or simply candida. These do not have to occur together. However, they are essentially the same problem.

What are the symptoms of Candida?

Yeast can cause a large number of symptoms, including all of those of irritable bowel syndrome – gas, bloating, constipation, diarrhea, and abdominal pain.

How do you get Candida?

Candida are a normal part of the environment. However, a problem occurs when they get out of balance with the normal good bacteria found in your digestive tract. Then they can develop into an overgrowth of yeast in the digestive tract and cause problems there as well as elsewhere in your body.

Why does this happen?

One of the most common things that cause yeast to get out of control is the use of antibiotics. There are other causes too, but antibiotics provide an excellent case study. Antibiotics kill bacteria, but they do not kill Candida or yeast. Only antifungals kill yeast. Therefore taking antibiotics kills off bacteria that are in direct competition with yeast for territory in your digestive tract. This is similar to any other battlefield. Everyone wants territory. In this scenario yeast can flourish, potentially creating an environment where there is more yeast than is desirable.

What other symptoms can Candida cause?

People with Candida or an overgrowth of yeast often describe having symptoms such as fatigue, brain fog, and headaches, to name a few. This does not necessarily mean that they have yeast throughout their body. That is highly unlikely and is an extremely dangerous condition. However, the yeast in their digestive tract can create toxins that affect the rest of the body.

How do you test for Candida?

The most accurate way to test for Candida is to culture it or find it on a stool test. At the IBS Treatment Center we now use DNA stool testing to measure genetic material from organisms in the digestive tract. This is by far the most advanced method for detecting candida or yeast and eliminates any guesswork. It also quantifies the amount of yeast present, telling us exactly what we are dealing with.

How do you treat Candida?

A serious yeast overgrowth usually requires strong antifungal medication. However, this does not always have to be pharmaceutical.

Many natural antifungals are also very effective. Both vary in effectiveness depending on the strain of yeast present. The proper treatment is determined as part of the lab test for yeast.

Will probiotics help?

Probiotics, or good bacteria such as Lactobacillus acidophilus, may help. But they can also stir up the problem and make it worse. Usually the yeast must first be treated with an antifungal.

Does diet affect Candida?

Yeasts thrive on sugars and refined carbohydrates. Many theories exist on the relationship between foods and yeast, and there are more anti-candida diets then can be counted.

However, there is no doubt that the less sugar in the diet the better when it comes to preventing or treating a yeast problem.

Summary

When it comes to solving IBS, you should always be tested for the presence of Candida (yeast). Candida is common and cannot be counted on to go away on its own. But understanding what you are dealing with will make a huge difference in your ability to get well.

Research articles about yeast are available on the Innate Health Foundation Research page.

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Candida image thanks to wikipedia

The Gall Bladder and IBS

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?


In some people, stones develop inside of the gallbladder. These stones, when small, can become lodged in the bile duct, which can cause severe pain and be very dangerous if they also clog the pancreatic duct. Larger stones are not able to pass into the bile duct, but their presence can cause severe pain. Sometimes this is worse when the gallbladder is contracting. In either case, removing the gallbladder usually relieves the pain and you feel much better.

When is it questionable to remove the gallbladder?


It is often tempting for physicians to blame the gallbladder for abdominal pain and digestive problems even when there is little or no evidence that the gallbladder is the culprit. It’s a relatively simple procedure, and most people don’t miss it too much.

If stones are present, then the decision is easy to make.
However, in some cases physicians recommended that the gallbladder be removed even when stones are not apparent on any exams. The recommendation is based primarily on symptoms and a lack of any other visible problem. Gallbladder function tests also may indicate that the gallbladder is not functioning at 100%.

However, that does not mean that it is the cause of the problem. If the gallbladder is functioning at a below normal level, removing it will only guarantee that it will not function at all.

Gall bladder studies have shown that patients with IBS symptoms and/or abdominal pain are more likely than others to have gall bladder removal surgery (cholecycstectomy) when they do not have gall stones. This exposes the patient to the increased (though small) risks of surgery and to further digestive problems caused by the abscence of a gall bladder. Testing for food allergies and other causes of IBS symptoms, and treating those conditions can enable patients to avoid unnecessary surgery and achieve good digestive health.

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Image thanks to wikipedia

The Colonics Debate Continues

We stumbled across a recent article titled "Dangers of Colonic Hydrotherapy" and wanted to pass it along to you.

Colonics have not been well researched, but some people have found them to be temporarily helpful. Although not risk free, the are certainly not any riskier than many treatments and procedures regularly used by gastroenterologists, when performed by properly trained technicians.

I prefer to work with patients to find out the true cause of their problem, but I feel that is important to point out that this article has an obvious bias against colonics. Please feel free to share your own thoughts in our comments section.

From Gastroenterology & Endoscopy News:

It is often billed as a natural therapy that can spur weight loss, reduce water retention, cleanse internal organs and increase energy. Yet, according to a meta-analysis published in the August edition of the Journal of Family Medicine, colon cleansing provides no known health benefits, only dangerous side effects including, in rare cases, death (Mishori R et al. 2011;60:454-457).

“There can be serious consequences for those who engage in colon cleansing whether they have the procedure done at a spa or perform it at home,” said the paper’s lead author Ranit Mishori, MD, MHS, a family medicine physician at Georgetown University School of Medicine, in Washington, D.C., in a statement.

Cleansing Chronicle

Colon cleansing—also called colonic irrigation or colonic hydrotherapy—often involves the use of chemicals followed by flushing the colon with water through a tube inserted in the rectum. The procedure has been around since ancient times and its purported benefits are based on the belief that trapped intestinal waste can poison the body. Colon cleansing became popular in the early 1900s but fell out of favor after 1919, when the American Medical Association condemned the practice on the basis of scientific observations finding no evidence that hardened waste accumulates on the intestinal walls.

In recent years, however, colon cleansing has staged a comeback, thanks to a major marketing campaign, said Dr. Mishori. The increasingly popular procedures are offered at spas, wellness centers, doctors’ offices and through do-it-yourself home remedies. Many practitioners and clinics advertise their colonic irrigation services, and celebrities such as Kim Kardashian and Beyoncé Knowles have endorsed colon cleansing as a natural way to improve health.

“It’s like cleaning baked lasagna from a pan,” according to one reviewer.

“Colon hydrotherapy is a gentle and painless treatment with incredible health benefits,” according to an online homeopathic clearinghouse, homeopathicremediesandtreatment.com.

The Web site states that the individuals who may benefit include those with Crohn’s disease, peptic ulcer, irritable bowel syndrome, food allergies, digestive problems, obesity and ulcerative colitis.

This article continues at the source, Gastroendonews.com.

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Image thanks to qito.co.uk

Gluten Free Fruit Cake Recipe from Jules

This week's recipe thanks to our friends at Jules Gluten Free!

Ingredients:

• 1 cup butter or non-dairy alternative (e.g. Earth Balance® Buttery Sticks)
• 2 cups granulated cane sugar
• 6 eggs
• 1/4 cup rum
• 1 Tbs. lime juice
• 1 tsp. gluten-free vanilla extract
• 1 Tbs. almond extract (optional)
• 1 tsp. grated lime zest (approximately 1 lime)
• 2 3/4 cup dried/candied fruit*
• 1/2 cup chopped walnuts (optional)
• 2 cups dry red wine
• 1 cup molasses or dark agave nectar
• 3 cups Jules Gluten Free™ All-Purpose Flour
• 1 1/2 Tbs. gluten-free baking powder
• 1/2 tsp. ground nutmeg
• 1/2 tsp. ground allspice
• 1 tsp. cinnamon
• 1 pinch salt
• 1/2 cup Cointreau, Grand Marnier or other citrus flavored (preferably) liqueur/liquor plus additional liqueur/liquor for brushing on finished cakes

*Dried/Candied fruit should ideally contain a mixture of several fruits such as cherries, cranberries, raisins, sultanas, dates, figs, pineapple, citrus peel (see my recipe).

Directions

In a small saucepan, gently heat the 1/2 cup of liqueur/liquor and add the dried (but not the candied) fruit, like raisins and cranberries. Heat and stir occasionally until the liquid is nearly absorbed.

Preheat oven to 350º F. Oil and dust two 9-inch round cake pans or 1 large bundt pan plus 4-6 small loaf pans with Jules Gluten Free™ All Purpose Flour. Set aside.

In a large mixing bowl, cream together the butter and sugar until light and fluffy. Beat in the eggs and beat until well mixed. Add in the rum, lime juice, extracts, wine, zest and molasses. Stir in the dried/candied fruits.

In another bowl, whisk together the dried ingredients: Jules Gluten Free™ All Purpose Flour, baking powder, spices and salt. Fold into the wet batter just until integrated. Pour into prepared pans.

Bake for 45 minutes in the small loaf pans or 60 minutes in larger pans, checking to be sure the cakes are not burning at the edges though. A knife inserted into the centers should come out clean. Brush the tops of each cake with citrus flavored liqueur/liquor. Cool in the pans for 15 minutes, then turn out onto a wire rack to finish cooling. Wrap cooled cakes in plastic wrap and then foil, if freezing.

Guest Author Katie McKenna, CN LMHC: Eating Disorders and Food Allergies

Today's article is courtesy of Katie McKenna, CN LMHC. As a certified nutritionist and mental health therapist, McKenna specializes in working with eating disorders, food allergies and sustainable weight loss for adults and teens.

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There are several physical, mental and emotional connections between eating disorders and food allergies. Eating disorders affect over 10 million people in the United States and an estimated 15 million people suffer from food allergies.

Eating disorders and food allergies affect women, men, and young children. These staggering numbers are a call to action and there is a vast array of new research and approaches that promote true health and well being.

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting or laxative use designed to undo or compensate for the effects of binge eating.

Binge eating disorder is characterized by recurrent binge eating without compensatory measures.

Orthorexia is not an officially recognized diagnosis but is a compulsion and obsession about eating healthy with a fixation on quality and purity.

Overweight is a Body Mass Index (BMI) between 25 -29.

Obesity is a BMI above 30. (17% of children and 34% of adults in the US are obese).
Many people find themselves in the spectrum of ‘Disordered Eating’ indicating less clinical severity of obsessive thoughts and actions regarding food and body image. In addition, many people do not fit neatly into one diagnosis.

The disordered eating spectrum is complex and symptoms vary on an individual basis.

Biopsychosocial Connections

Food allergies and sensitivities interfere with the hormonal balance of the endocrine system, including the thyroid and adrenal glands. This makes it harder for the body to burn stored fat. It also disturbs insulin levels, signaling the body to convert food energy into fat and also contributing to hypoglycemia which increases cravings for food. Food allergies and sensitivities can cause mood chemistry disruptions. They cause depleted serotonin, leading to anxiety, depression and compulsive urges — all of which may trigger food restriction or overeating.

Chicken or the Egg?

A person with an undiagnosed food allergy or sensitivity may find relief as they begin cutting food groups out of their diet or purging after they believe they’ve eaten a ‘bad/allergenic food’.

Without professional help, they may have inaccurate assumptions about which foods are triggering their symptoms. They may avoid eating as long as possible to avoid the pain that comes with eating. They may struggle with self esteem, hating their body when they feel bloated after eating an allergenic food. As their body weight drops and/or their brains become malnourished, the eating disorder takes a stronger hold. Eating disorders feel like addictions, and what initiates an eating disorder may be different than what maintains an eating disorder.

On the surface, eating disorders appear to be concern about food and body image. However, food and body image is just the tip of the iceberg. Eating disorders are unhealthy coping mechanisms that help people feel a sense of control in their life, deal with trauma or crisis or help them numb away their feelings. The underlying cause of the eating disorder, such as depression or anxiety, may be augmented by the biochemical effects of a food allergy. A restrictive eater may use a food allergy diagnosis to avoid eating. An overeater with a food allergy may be triggered by feelings of deprivation or resentment if they can’t consume certain foods; feelings of deprivation often lead to emotional eating and binging.

Finding Relief

If you struggle with food allergies, eating disorders or disordered eating it is important that you find qualified specialists to support you on your journey to health and healing. Managing food allergies and recovering from eating disorders requires a combination of education, motivation and mental health support. Health and healing is a process that takes time and is not meant to be done alone, in isolation. Make a commitment to take your life back; the process of learning and listening to yourself will rejuvenate you. True health is wealth!

References and Resources

www.cdc.gov/obesity/data/adult.html
www.nationaleatingdisorders.org

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For more information about Katie and her services please visit Mckennacounseling.com
Image thanks to kentuckianhealthwellness.com
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Understanding and Treating Abdominal Pain

People often think that Irritable Bowel Syndrome has to involve diarrhea or constipation, but often it does not.

For many people the only obvious symptom is abdominal pain. And the pain can vary from a mild discomfort to incredibly debilitating. Chronic abdominal pain is one of the top 5 reasons that people to go to the doctor.

Unfortunately, for many it is also very poorly treated. The typical approach is to rule out ulcers, appendicitis, gallstones, uterine problems, or cancers. This may be done with blood work, scopes, scans, ultrasound or other imaging, depending on the problem.

If you have one of the aforementioned problems and it’s found, then your problem should be solved. But many people with abdominal pain do not have an ulceration, appendicitis, gallstones, uterine problems or cancer.

For them, all of the tests come back negative. They are told that nothing is wrong and left with the impression that it’s all in their head.

Of course, something is very wrong. There is always a logical reason for a problem such as abdominal pain, and it’s rarely just a mental or stress issue. But it’s not something that is structural or that you can see with the kinds of tests mentioned above. Unfortunately, those are the only tests
most doctors have to offer.

The good news is that there are other tests that can help you to figure out why you have abdominal pain. There is absolutely no doubt that food allergies and intolerances can cause abdominal pain, even extremely debilitating pain that causes you to go to the hospital or to take powerful pain medications. And food allergy testing is not all created equal. Food allergy testing is a very complex area, and many food allergy tests are poorly done or improperly interpreted.

People often wonder how a food that they’ve eaten all their life could now be an allergen or could be causing abdominal pain. But for many people this is exactly what happens. They go along with relatively few or no problems at all until one day the symptoms start to manifest themselves, seemingly coming out of nowhere. After that they never seem to be the same again.

There are many theories for why this happens, but our focus is on resolving the abdominal pain, which is a very realistic goal for most patients. Although food allergies and intolerances are a common cause of abdominal pain, other causes must also be sorted out. Frequently there are bacterial problems, yeast (Candida), or even parasites, all of which can also cause abdominal pain.

Most conventional stool tests are not capable of finding all of these problems, which is why we only use state-of-the-art DNA stool testing at the IBS Treatment Center. This can be an important test to run even if you’ve previously had stool tests that were negative.

If you or someone you know has abdominal pain and has been offered little more than pain medication to help treat the problem, then please schedule an appointment with us so that we can help you. We listen, and we help people solve abdominal pain and get their lives back.

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Image thanks to health-topic.net

Case study: Gliadin causes intestinal permeability in both celiac and non-celiacs

This is a very interesting celiac case study from 2006. It indicates that gliadin (gluten) leads to increased gut permeability in everyone, whether or not they have celiac disease. Though it's a lesser degree of permeability in non-celiacs.

Find this in its entirety at National Institutes of Health.

Gliadin causes intestinal permeability in both celiac and non-celiac intestinal mucosa.

OBJECTIVE:

Little is known about the interaction of gliadin with intestinal epithelial cells and the mechanism(s) through which gliadin crosses the intestinal epithelial barrier. We investigated whether gliadin has any immediate effect on zonulin release and signaling.

MATERIAL AND METHODS:

Both ex vivo human small intestines and intestinal cell monolayers were exposed to gliadin, and zonulin release and changes in paracellular permeability were monitored in the presence and absence of zonulin antagonism.

Zonulin binding, cytoskeletal rearrangement, and zonula occludens-1 (ZO-1) redistribution were evaluated by immunofluorescence microscopy. Tight junction occludin and ZO-1 gene expression was evaluated by real-time polymerase chain reaction (PCR).

RESULTS:

When exposed to gliadin, zonulin receptor-positive IEC6 and Caco2 cells released zonulin in the cell medium with subsequent zonulin binding to the cell surface, rearrangement of the cell cytoskeleton, loss of occludin-ZO1 protein-protein interaction, and increased monolayer permeability.

Pretreatment with the zonulin antagonist FZI/0 blocked these changes without affecting zonulin release. When exposed to luminal gliadin, intestinal biopsies from celiac patients in remission expressed a sustained luminal zonulin release and increase in intestinal permeability that was blocked by FZI/0 pretreatment.

Conversely, biopsies from non-celiac patients demonstrated a limited, transient zonulin release which was paralleled by an increase in intestinal permeability that never reached the level of permeability seen in celiac disease (CD) tissues.

Chronic gliadin exposure caused down-regulation of both ZO-1 and occludin gene expression.

CONCLUSIONS:

Based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.

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Gliadin image tissue transglutaminase thanks to wikipedia

Changing Your Diet Can Reduce Migraines

From National Institutes of Health:

"Diet restriction in migraine, based on IgG against foods: A clinical double-blind, randomised, cross-over trial"

Introduction

It is well-known that specific foods trigger migraine attacks in some patients.

We aimed to investigate the effect of diet restriction, based on IgG antibodies against food antigens on the course of migraine attacks in this randomised, double blind, cross-over, headache-diary based trial on 30 patients diagnosed with migraine without aura.

Methods

Following a 6-week baseline, IgG antibodies against 266 food antigens were detected by ELISA. Then, the patients were randomised to a 6-week diet either excluding or including specific foods with raised IgG antibodies, individually.

Following a 2-week diet-free interval after the first diet period, the same patients were given the opposite 6-week diet (provocation diet following elimination diet or vice versa). Patients and their physicians were blinded to IgG test results and the type of diet (provocation or elimination).

Primary parameters were number of headache days and migraine attack count.

Of 30 patients, 28 were female and 2 were male, aged 19–52 years (mean, 35±10 years).

Results

The average count of reactions with abnormally high titre was 24±11 against 266 foods.

Compared to baseline, there was a statistically significant reduction in the number of headache days (from 10.5±4.4 to 7.5±3.7; P<0.001) and number of migraine attacks (from 9.0±4.4 to 6.2±3.8; P<0.001) in the elimination diet period.

Conclusion

This is the first randomised, cross-over study in migraineurs, showing that diet restriction based on IgG antibodies is an effective strategy in reducing the frequency of migraine attacks.

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Image thanks to homeopathic-remedies.com
More information on migraines at Centerforfoodallergies.com

GIG: Understanding Dermatitis Herpetiformis

From the Gluten Intolerance Group of North America:

Dermatitis Herpetiformis (DH) is a chronic disease of the skin marked by groups of watery, itchy blisters.

The ingestion of gluten (a protein contained in wheat, rye and barley) triggers an immune system response that deposits lgA antibodies under the top layer of skin. IgA antibodies are present in affected as well as unaffected skin.

DH is a hereditary autoimmune disease linked with gluten intolerance. If you have DH and do not follow a gluten-free diet, you may develop the intestinal damage of celiac disease.

With DH, the primary lesion is on the skin rather than the small intestine. The degree of damage to the small intestine is often less severe or more patchy than for those with only celiac disease. Both diseases are permanent and symptoms/damage will occur after consuming gluten.

Symptoms of Dermatitis Herpetiformis

The lgA deposits result in eruptions of a painfully itchy rash and may progress to red, raised patches of skin (similar to the beginning of a pimple) that develop into small, watery blisters. The itching and burning of the eruptions are severe and the urge to scratch them is intense.

Scratching will further irritate the eruptions. Eruptions commonly occur on pressure points - around the elbows, the front of the knees, the buttocks, back, shoulders, face, and scalp, but can occur anywhere. Eruptions are usually bilateral, occurring on both sides of the body. Sixty percent of those diagnosed are men and the most common ages at diagnosis are between 15 and 40 years old.

Diagnosis of Dermatitis Herpetiformis

If the eruptions appear to be DH, your dermatologist will take a small biopsy of unaffected skin, next to an eruption. The presence of IgA deposits confirms a
diagnosis of DH.

Treatment of Dermatitis Herpetiformis

Strictly following a gluten-free diet for life is the only complete treatment. This involves the elimination of wheat, rye, barley, and foods made from these grains from your diet. It may take two or more years for the lgA deposits under the skin to completely clear.

(Worth noting: A medication called Dapsone may also be prescribed. You will need to follow up with your doctor on a regular basis if you use this drug. Dapsone allows the eruptions to heal, but does not cure DH. Discuss the potential side effects of this drug with your doctor before starting it. Your goal should be to take as little as possible for as short a time as required to allow the diet to control the DH.)

If you have questions about Dermatitis Herpetiformis, please email the IBS Treatment Center and Center for Food Allergies at info@ibstreatmentcenter.com.

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Image thanks to fitbottomedgirls.com

Antibiotics and Surgery May Not Cure Sinusitis

Many people with sinus infection complain that after having taken multiple courses of antibiotics or even following surgery, in the end they feel the same as they did before their treatment. Their sinusitis problem returns with a vengeance. What is the problem? Aren’t they getting the right antibiotic?

The answer is that in these people, the antibiotics are only treating the bacterial infection that is secondary to the inflammation clogging their sinuses. Therefore antibiotics don’t get at the real cause of the problem. The same can be said for surgery. Surgery may scrape out the sinuses or open up a bigger hole for them to drain, but these treatments only address secondary problems resulting from the inflammation. Therefore the original sinus problem remains.

The inflammation that is causing the sinus pain requires a trigger. The real question is, “What is causing the inflammation?” Anything that triggers the immune system can be that trigger, because the immune system is what causes inflammation and mucous production. Bacteria, which are treated with antibiotics, are only one cause of inflammation.

One of the most likely causes of chronic sinus infection or nasal congestion is a food allergy. Food allergies constantly trigger the immune system, therefore the inflammation never permanently goes away. This can result in a persistent runny nose, or recurrent sinus infections due to the moist and poorly draining/inflamed environment that is maintained in the sinuses.

If you have either of these problems then be sure to rule out food allergies by undergoing a food allergy blood test. Contact us at the IBS Treatment Center for more information.

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Image thanks to genericlook.com

Understanding Gastroparesis

Gastroparesis is a symptom that patients with irritable bowel syndrome (IBS) and other digestive problems are sometimes given as a diagnosis. Like irritable bowel syndrome, it generally sounds more important and impressive than it really is.

The word gastroparesis often gives people the impression that their stomach is paralyzed and that there is nothing that they can do to solve their problem. Fortunately, this is often not the case, certainly not in the same way that someone with a serious spinal cord injury may suffer from paralysis.

The diagnosis of gastroparesis simply means that there is a delay in how long it takes the stomach to empty. It is then typically assumed that this is due to damage to the vagus nerve, which helps control the emptying time of the stomach.

In some cases this damage is actually seen or verified. But in many cases is only an assumption of nerve damage based solely on the delayed emptying time of the stomach.

What should be remembered is that a delay in gastric emptying time is a symptom with several potential causes and is not necessarily due to damage to the vagus nerve. Constipation and diarrhea are also symptoms with multiple causes. The fact that one represents a delay in bowel transit time (constipation) and the other represents an expedited transit time (diarrhea) does not mean that there is permanent damage to the nervous system, or even any damage at all to the nervous system.

These symptoms of gastroparesis, diarrhea, and constipation simply mean that the digestive tract isn’t working properly. In the case of gastroparesis, unless you have a confi rmed diagnosis of damage to the vagus nerve, it is very possible that something else is causing it and that you can resolve it.

Gastroparesis is frequently associated with diabetes, and sometimes people assume that if they have diabetes then they must have nerve damage and thus gastroparesis.

However, there is still a strong possibility that there is another cause of their gastroparesis and that it can be resolved, even in the presence of diabetes. This is also true for people who suffer from GERD, heartburn, irritable bowel syndrome, constipation, or other digestive problems.

Patients at the IBS Treatment Center often report that they have been diagnosed with gastroparesis, and those patients often get much better after discovering the true cause of their problem. In fact, studies in the medical literature have demonstrated the same thing. If you suffer from gastroparesis, don’t give up. There may be a solution for you!

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Image thanks to hbcprotocols

The Importance 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 IBS 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.

Most people in the IBS world separate soluble fiber from insoluble fiber, with the idea that soluble fiber is the proper fiber. But the issue is far more complicated than that.

One way to get more fiber in your diet is to purchase one of the popular fiber products on the market. What you may not know is how different these products are from each other. They have almost nothing in common. Most contain artificial colors and sweeteners. Benefiber contains wheat as well as dairy and corn. Metamucil and Konsyl use psyllium as the active ingredient. Psyllium has the potential to be either helpful or to cause problems, or do both at the same time. You may be surprised to learn that it’s not at all unusual for us to discover that patients are allergic to psyllium.

Citrucel’s active ingredient is methylcellulose, a chemical compound derived by chemical processing of an undisclosed source of cellulose. It is not a naturally occurring part of a plant and is not fermentable. Fibercon’s active ingredient is polycarbophil calcium, which is a synthetic polymer, not a plant fiber. Fibercon is recommended only for constipation, but Citrucel is recommended with either constipation or diarrhea.

The results and the effectiveness from the various forms of commercially available “fiber” (see above table for a comparison of popular options) will vary widely from person to person, so you will have to experiment with them to get the right fit. And don’t be surprised if fiber doesn’t solve your problem at all.

Most people are not suffering because of a lack of fiber in their diet, but for some the addition of fiber will help alleviate unpleasant symptoms. If you think, or know that you need more fiber, there is often no need to take a special, commercially processed and packaged product to get the additional fiber. You can buy psyllium powder in bulk, or all by itself.

There are many other fiber options available in pure form, such as bran, ground flax, or acacia. Arguably the best (and probably tastiest) sources of fiber are: vegetables, fruits, and whole grains. If the addition of fiber doesn’t help your IBS syptoms, or you’d like to figure out the cause of the problem, then be sure to see an IBS specialist.