A Deeper Look at 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.

"Diverse Gut Flora Protects Kids from Allergies"

According to a new study published in the Journal of Allergy and Clinical Immunology and reported by FoodProductDesign.com, high diversity and a variety of bacteria in the gut can protect children against allergies.

From FoodProductDesign.com:

Researchers at Linköping University conduced at comprehensive study of intestinal microflora in allergic and healthy children. Stool samples from 40 children were analyzed—20 children with atopic eczema and allergic IgE antibodies to foods, and another 20 in a control group that lacked these conditions.

Using the so-called 454-pyrosequencing, the researchers identified DNA sequences that were then simultaneously linked with a database to determine which bacterial genera was present in the samples.

Results show that diversity was significantly greater in the healthy children at one month of age compared to those children who later developed allergies. Diversity in certain groups appears to be particularly important: Proteobacteria consists of so-called gram-negative bacteria which are associated with protection against allergies and are common in children who grew up on livestock farms with cattle, and even Bacteroides which as shown in the experiments counteract inflammation.

“We conducted the study in collaboration with Karolinska Institute and the KTH Royal Institute of Technology that substantiates the so-called hygiene hypothesis. Children acquire intestinal microflora from their environment, and in our society they are probably exposed to insufficient bacteria that are necessary for the immune system to mature," they said.

The findings seem to discredit results of other studies. For example, Bifidobacteria was abundant in the study however the researchers could not identify support for any protective effect.

The full study can be found at National Institutes of Health.

From Our Office: Gluten Allergy Case Studies

Gluten Allergy Case #1:

27 year old male with loose stools, gas, Irritable Bowel Syndrome, inability to gain weight, acne on back, poor endurance, and hypoglycemic/needing to eat every 2-3 hours. Patient was very athletic and in most respects would be considered extremely healthy. Allergy testing demonstrated a severe allergy to gluten.

Removal of gluten from his diet resulted in complete resolution of his Irritable Bowel within 2 days. Over time acne cleared, endurance improved dramatically, and he is no longer hypoglycemic.

Gluten Allergy Case #2:

24 year old female with a long history of sinus infections including two sinus surgeries, asthma, diarrhea, headaches, chronic fatigue, and dizziness. Food allergy testing was positive for allergies to gluten, dairy, and eggs. This patient also tested positive for hypothyroidism and iron deficient anemia.

Removal of these foods from the diet and treatment of hypothyroidism and anemia has resulted in significant improvement in energy and the resolution of diarrhea and dizziness. Sinus infections have been greatly reduced, as have headaches, and her health continues to improve with time.

Gluten Allergy Case #3:

30 year old female with infertility, gas, bloating, acne, headaches, and insomnia. This patient has been attempting to get pregnant for 1 1/2 years. Her menstrual cycle was consistently abnormally long at 35 days. All female hormone and standard fertility related tests were negative.

Food allergy testing was positive for gluten (a known cause of infertility), dairy, corn, and garlic. After removal of the food allergens, this patients next menstrual cycle returned to a normal 28 days. Pregnancy next?!

Gluten Allergy Case #4:

3 year old with frequent upper respiratory infections and a history of reflux as a baby. Patient allergic to gluten and dairy and is doing significantly better off these foods. Mother also positive for gluten allergy.

More information on testing and treating gluten allergies by contacting IBSTreatmentCenter.com

Gluten Free Recipe: Stuffed Portobello Mushrooms

This week's gluten free recipe thanks to DelightGlutenFree.com

Ingredients:

• 8 large portobello mushroom caps
• 3 tablespoons butter
• 1 large Vidalia onion, sliced thinly
• ¼ teaspoon sugar
• ¼ cup olive oil
• ¼ cup dry red wine (Chianti will work well)
• 2 cups diced eggplant (peeled and chopped in small pieces)
• 6 ounces goat cheese, crumbled
• ½ cup oil-packed sun-dried tomatoes, finely chopped
• 2 garlic cloves, minced
• 2 tablespoons fresh basil, chopped
• 1 1/2 cups Parmesan cheese

Directions:

1. Preheat oven to 375 degrees F. Lightly coat a baking sheet with olive oil. Place cleaned mushroom caps rounded side up and bake for 10 minutes to drain excess liquid.
2. Remove from oven and set aside, leaving oven on.
3. Meanwhile, in a medium nonstick pan, melt 3 tablespoons of butter over medium heat. Add the sliced onion and sugar and slowly cook for 10 minutes, until golden brown. Turn heat to medium-high and cook for an additional ten minutes. Remove from pan and reserve.
4. In a large skillet, heat ¼ cup of olive oil over medium heat. Add eggplant, sun dried tomatoes, and garlic. Cook until eggplant is soft, about 8-10 minutes.
5. Stir in red wine and cook for about 2-3 minutes, until alcohol evaporates. Remove skillet from heat and fold in the goat cheese, 1 tablespoon of basil, and reserved caramelized onions.
6. Flip over portobello mushrooms to rounded side down. Fill each mushroom with a heaping scoop of the eggplant mixture.
7. Sprinkle each mushroom cap with Parmesan cheese and bake for 20 minutes.Remove stuffed mushrooms from oven, sprinkle with remaining tablespoon of basil, and serve warm.

Yield: 4 servings

More About Food Allergies: IgE and IgG

The immune system functions like a sentinel standing guard against foreign invaders. In the case of an allergy, the invaders are called allergens. The primary weapon that it uses against invaders is the production of antibodies.

The antibodies cause reactions that result in the offending allergens being removed from the body. In many people, foods act as allergens rather than nutrition. This can result in the symptoms of IBS.

The immune system produces numerous kinds of antibodies, called immunoglobulins. IgE and IgG are acronyms for the two different kinds of antibodies produced by the immune system in allergic reactions to food. You might be asking why you need to know this. Conventional allergy testing looks for IgE reactions only.

These types of reactions typically occur immediately after contact with or ingestion of the allergen, and in some cases can cause serious, even fatal, health problems. Potential IgE reactions include swelling of the lips and tongue, hives, bloating, abdominal pain, or sudden diarrhea. These are the reactions that people usually think of when they hear the word allergy. However, IgE reactions can also lead to many other symptoms not traditionally recognized as being caused by food allergies.

The problem with this type of testing is that most food allergies are not IgE reactions, but are rather IgG reactions, which usually show up hours or even days after ingestion of the allergen. They are generally not nearly as dramatic as the more severe IgE reactions, and usually result in "mere" constipation, diarrhea, bloating, gas and abdominal pain. Both antibodies are important, and food allergy testing should include both or the cause of IBS may be missed.

For more information about this subject refer to The Irritable Bowel Syndrome Solution.
Image thanks to pennypinchingparent.com

Do You Really Need a Biopsy to Diagnose Celiac Disease?

Celiac disease is traditionally diagnosed with a positive biopsy of the small intestine. The biopsy will demonstrate damage to the intestine known as villous atrophy. Villi are small finger-like extensions of the lining of the intestine that are visible only under the microscope.

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

Biopsies are done in a hospital on an outpatient basis, but require strong medication due to the invasiveness of the procedure. An endoscopy is performed, which involves a tube being placed into the mouth, down the esophagus, and past the stomach. A tissue sample can then be taken from the small intestine.

Although the small intestine is extremely important to our health, in most cases the value of the biopsy in diagnosing celiac disease is highly questionable. About 98% of people with a gluten allergy or celiac disease can be diagnosed as being allergic to gluten with a blood tests alone.

There is no added benefit from performing the biopsy. The results of the biopsy do not change the form of treatment nor the outcome for the patient. Only if the blood tests are negative can a biopsy potentially provide useful additional information.

Image thanks to karlloren.com

Celiac and Gluten Intolerance Q&A

How Is Celiac Disease Different from a Gluten Intolerance? 


Although celiac disease is a gluten allergy, it is only one form of gluten allergy. Many react to gluten and may have elevated serum antigliadin antibodies, but they do not have damage to the small intestine. These people have a negative biopsy of the small intestine, as well as negative antiendomysial antibody and tissue transglutaminase tests. 



How Common Are Gluten Allergies? 


Although no studies have been done on the prevalence of gluten intolerance, the prevalence of gluten allergies is certainly higher than that of celiac disease alone. 

What symptoms may be caused by a gluten allergy?

• Abdominal Pain
• ADD/ADHD
• Anxiety
• Canker sores
• Constipation
• Diarrhea
• Fatigue
• Fibromyalgia
• Gas
• Headaches
• Heartburn
• Indigestion
• Infertility
• Iron deficient anemia
• Irritability
• Irritable bowel syndrome
• Joint Pain
• Osteoporosis
• Poor Growth
• Poor immune function (frequent illness)
• Sinusitis


What Is the Treatment for Celiac Disease and Gluten Intolerance?


The treatment is identical for both celiac disease and gluten intolerance and involves removing all sources of gluten from the diet. This means that a person with a gluten allergy should not eat bread products, pastas, or processed food of any kind that contains wheat, rye, or barley in any form. Individuals require special dietary counseling. Fortunately, many alternative sources for gluten free breads, pastas and other foods now exist and are easier than ever to find.

What Are the Results of Avoiding Gluten? 


If you are allergic to gluten, then the result of removing gluten from your diet is generally a reversal of your health problems. Symptoms very often resolve, some faster than others, and you gain a new definition of optimal health. 
Even celiac disease is reversed, usually resulting in complete recovery of the damage to the small intestine. 



What if Someone with a Gluten Allergy Chooses Not to Avoid Gluten?


Of course, they continue to suffer the symptoms that their gluten allergy is causing. However, the long term consequences are much more severe. People with celiac disease are known to be at higher risk for many conditions, including cancer of the digestive tract, thyroid problems, anemia, osteoporosis, and many autoimmune conditions.

If you or someone you know suffers from any of the symptoms listed above, be sure to be screened for food allergies via blood testing.

Information on testing for food allergies at IBS Treatment Center.
Image thanks to fresnodoula.wordpress

What is TSH?

Most physicians measure thyroid function by testing levels of TSH. TSH stands for Thyroid Stimulating Hormone.

Thyroid Stimulating Hormone is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. TSH levels are supposed to automatically increase to compensate for low thyroid hormone production. When this happens, TSH levels become abnormally high and indicate a hypothyroid condition.

Unfortunately, most physicians are using an outdated and unnecessarily wide reference range when determining normal TSH levels. You may actually be hypothyroid, but have been told by your physician that your thyroid level is normal.

A normal TSH level is between 0.3 and 2.5 as determined by the American Association of Clinical Endocrinologists. However, most physicians and labs are using a range of 0.30 to 5.00. Therefore your TSH level may increase to what appears to be a very normal looking 3.00, when you may in fact be quite hypothyroid.

Thyroid Antibodies/Hashimotos Thyroiditis

Many hypothyroid conditions are caused by an autoimmune condition that attacks the thyroid gland. There are two major thyroid antibodies, called thyroid peroxidase antibody and anti-thyroglobulin antibody. The presence of these antibodies can indicate an autoimmune condition called Hashimotos Thyroiditis. This condition can be present even if your TSH is normal, and it may affect your need for thyroid hormone.

Image thanks to merck

4 Common Misconceptions about Irritable Bowel Syndrome

IBS Misconception #1

The biggest misconception is that IBS (Irritable Bowel Syndrome) defines a specific medical condition. IBS is, by definition, just a group of symptoms affecting the digestive tract that haven’t been explained.

Unlike cancer, a stroke, or the flu, IBS is more of a starting point than a diagnosis, because it doesn’t provide any new information.

Once a person has the symptoms it is necessary to do additional testing to identify the cause of those symptoms - what you might call an actual diagnosis. And once you have an actual diagnosis, then you can treat whatever it is that causes the symptoms and usually stop them.

IBS Misconception #2

A second common misconception is that IBS is only caused by one thing. Nothing could be further from the truth.

The digestive tract is very complicated, but can only display a limited range of symptoms. There are many things that can cause constipation, diarrhea, abdominal pain, gas, bloating, etc. Any individual might have one or more of the causes at any one time.

There is a wide range of causes of IBS and manypatients have more than one cause, sometimes several causes, at the same time. For example, many patients have an allergy to a food, which causes them to have IBS symptoms. But not all IBS patients have food allergies.

Many patients have bacterial or microbial issues, for example, not enough of the needed digestive bacteria are living in their digestive tract. But not all IBS patients have bacterial issues. Some patients have food allergies, bacterial/microbial issues, and other factors. To correctly diagnose the cause of IBS symptoms it is necessary to test for a range of potential causes. If you don’t treat all of the conditions you have, your IBS probably won’t be resolved.

IBS Misconception #3

The third misconception is that there is a single treatment for IBS. This misunderstanding goes along with the previous misconception- that there is only one cause. The reason that there isn’t a single treatment for IBS is that there isn’t a single cause. If all IBS were caused by dairy allergies, treatment would be simple – don’t eat dairy products. But because there are many, sometimes overlapping causes, there will never be a single simple treatment for IBS symptoms.

IBS Misconception #4

Lastly, but perhaps the most common misconception is that IBS is caused by stress. If this were true the world would be full of IBS patients. We see patients all the time that have been told by their doctor that stress is the problem, but once we identify the cause and treat it, the symptoms are resolved.

What is even more interesting is that many patients report that while they had IBS symptoms they also had a heightened sense of anxiety, but that it went away when they treated their condition. That is not to say that stress can’t make IBS worse. Stress can affect the immune system and that can impact IBS symptoms. But stress is usually not the underlying cause of the symptoms.

More information on IBS at IBSTreatmentCenter.com
Image thanks to astrogle

HealthDay News: Some 'Gluten-Free' Beers Really Aren't

Thanks to HealthDay.com for this news about beers that may be claiming to be low gluten or gluten free, but still made from barley:

Critical Quotes:

"Beer is made using barley, which contains a form of gluten called hordein. However, some beer companies contend that the brewing process eliminates gluten or reduces it to very low levels, according to a release from the Journal of Proteome Research, where the new study appears."

"Eight brands labeled "gluten-free" did not contain hordein. However, the researchers were surprised to discover that two of the brands labeled "gluten-free" actually had about as much hordein as regular beer."

From HealthDay:

Regular beer and even some brands of beer labeled "low-gluten" contain high levels of gluten and could cause problems for people with celiac disease, a new study says.

Beer is made using barley, which contains a form of gluten called hordein. However, some beer companies contend that the brewing process eliminates gluten or reduces it to very low levels, according to a release from the Journal of Proteome Research, where the new study appears.

Because existing tests for detecting gluten in malted products are not very accurate, the research team developed a new test that's highly accurate for hordein.

They used this test to analyze 60 commercial beers and found that many of the regular brands contained significant levels of hordein.

Eight brands labeled "gluten-free" did not contain hordein. However, the researchers were surprised to discover that two of the brands labeled "gluten-free" actually had about as much hordein as regular beer.

People with celiac disease need to avoid gluten, a protein that triggers a reaction that damages the small intestine. Diarrhea, constipation, fatigue and abdominal pain are among the symptoms experienced by people with celiac disease when they consume foods and beverages with gluten.

The only treatment for people with celiac disease is to remain on a lifelong gluten-free diet.

Original source: Journal of Proteome Research, news release, Dec. 21, 2011
Image thanks to gayrva.com

Bacteria

The bacteria inside us form a teeming, busy ecosystem. Changing or harming one species will have repercussions on the other species and on the host itself.

While we are used to thinking of the earth's ecosystems in this way, it may seem strange that these same principles govern our internal environments. This environment is all too easily altered, especially in our world of antibiotics. And many people suffer from IBS due to a microbial imbalance in their digestive tract.

There are three major categories of bacteria:

1. Good bacteria, such as acidophilus and bifidobacterium;
2. Bad bacteria, too numerous to mention but rarely tested for in most clinics;
3. Ugly bacteria, so dangerous that you've probably heard about them before.

It's also important to know that yeast (Candida) and parasites can also be a significant cause of IBS symptoms like diarrhea, constipation, and abdominal pain.

A deficiency of good bacteria and/or the presence of bad and ugly bacteria, yeast (Candida) or parasites will cause a variety of digestive problems, including abdominal pain, diarrhea, constipation, and even nutritional deficiencies. There are tests to diagnose each of these problems. And once diagnosed, all these conditions are readily treatable.

Information on the detection and treatment of deficiencies in good bacteria, as well as the detection and treatment of unwanted bacteria, yeast (Candida) and parasites on the IBS Treatment Center website.

Bacteria image thanks to wikipedia

The Many Forms of Gluten Intolerance: Understanding Non-Celiac Forms of Gluten Intolerance

In our previous article (Understanding & Defining Celiac Disease), we discussed and defined celiac disease. In this piece we will discuss other forms of gluten intolerance that do not meet the definition of celiac disease.

Celiac Disease is a common problem, but gluten intolerance is far more common than celiac disease. There is a great deal of debate about how to define gluten intolerance and the relevance of forms of gluten intolerance that are not celiac disease. In this article I hope to clarify some of these issues and acknowledge the validity of all forms of gluten intolerance.

What do we mean by non-celiac forms of gluten intolerance?

As a reminder, gluten is a protein found in wheat, rye, spelt, kamut, barley and other grains. Many people find that they cannot tolerate gluten, but they do not test positive on any of the tests used to diagnose celiac disease. These tests include the biopsy of the small intestine, and the endomysial, reticulin, and tissue transglutaminase antibody tests. This is a common occurrence and one that I frequently see in my office.

Notice that I did not say that they do not test positive for gluten intolerance. In fact, most of these people do have test results that indicate that they are gluten intolerant, even though they do not test positive for celiac disease.

How do you test for other forms of gluten intolerance?

One test that I haven’t mentioned yet is the gliadin antibody test. This test is commonly run and is often positive when the others are negative. It is then usually ignored or the physician states that it is a false positive. It makes you wonder why it was run at all. But it is only a false positive if you want it to predict celiac disease. Gliadin antibodies are very poor predictors of celiac disease. However, they are positive for a reason. They indicate that the immune system has formed a reaction against gliadin, which is a fraction of gluten.

This is very important. Just because someone has an immune reaction to gluten does not mean that they will get celiac disease. Remember from the previous article, celiac disease is really another phrase for villous atrophy. So we can rewrite that sentence to say, “Just because someone has an immune reaction to gluten does not mean that they will get villous atrophy.” Villous atrophy is a result of the immune reaction to gluten. But it is only one possible result. It is a reaction to gluten that results in an autoimmune reaction to the lining of the digestive tract which results in villous atrophy.

I hope I didn’t get too wordy there. You may have to read that twice. What I really want to say is that celiac disease is just one type of gluten intolerance.

Are there other tests for gluten intolerance?

In my office I run a full panel of IgE and IgG antibodies for about 100 different foods and food components. I regularly see elevated antibodies to gluten, gliadin, wheat, barley, rye and spelt. These people usually do not have celiac disease, which I also rule-out. A positive test for any of these foods indicates that they have an immune reaction to those foods.

These patients invariably begin to feel better once they have eliminated these foods from their diet. They may have digestive symptoms such as constipation, diarrhea, IBS, gas, bloating, or heartburn, or they may have any number of other symptoms, such as fatigue, headaches, arthritis, chronic sinusitis, eczema, etc.

What if you haven’t run any blood tests, but know that you can’t eat gluten?

There are many people who discover through trial and error that eliminating gluten from their diet helps them to feel much better. These people often have not undergone any testing. And really, what is the point? You don’t need someone else to tell you that you feel better.

I always honor my patients’ right to know that they can’t eat gluten. Who am I to tell them otherwise? There usually isn’t any point in testing them, since any test for celiac disease or gluten intolerance will typically be negative once a person has stopped eating gluten for a while. And asking someone to eat gluten for at least a month so that I can verify their gluten intolerance seems illogical when you consider how ill that usually will make them feel.

The common treatment for everyone.

Whether you have celiac disease, are gluten intolerant, or just think that everyone on earth should avoid gluten (I don’t think this), then you are left with the same treatment plan, avoid gluten. Some people believe that celiac disease is a more severe form of gluten intolerance, but the evidence does not necessarily support this. Many celiacs are basically asymptomatic. And many non-celiac gluten intolerant individuals are very ill.

“Gluten intolerance” covers us all.

In the end, the words “gluten intolerance” cover anyone who can’t eat gluten, regardless of the reason.

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Image thanks to stonyfield.com

Understanding and Defining Celiac Disease

What is celiac disease?

You may have never heard of celiac disease, but it is actually a fairly common problem. In fact, 1 out of every 133 people has it. That is over 2 million people in this country. It is really more of an allergy than a disease, although it is typically called an intolerance to gluten.

What is gluten?

Gluten is a protein found in wheat, barley, rye, spelt, kamut, triticale, and couscous. People who have celiac disease cannot eat any foods made out of these flours. Gluten is the thing that makes bread, well, bread. It allows bread to rise and keeps it together with lots of nice little air pockets, making your bread light and spongy. Without gluten it is difficult to make bread that is not heavy and dense.

What are the symptoms of celiac disease?

The symptoms vary widely. Celiac disease is typically thought of as a condition that causes diarrhea, abdominal pain, gas and bloating. However, many people do not experience these symptoms at all. They may experience constipation, weight gain, fatigue, headaches, heartburn, skin problems such as eczema and acne, or any number of health problems.

What exactly happens to the body in celiac disease?

In people with celiac disease, eating gluten leads to damage of the small intestine. Damage is specifically done to the villi of the small intestine. Villi are tiny finger-like extensions of the surface of the intestinal tract. They can only be seen under a microscope. In celiac disease the villi are in essence worn down, or blunted. This is known as villous atrophy. It’s something like the difference between holding your hand open with your fingers out, and having your hand clenched into a fist. The fist represents the blunted villi.

Why does this happen?

In people with celiac disease, their immune system is triggered by gluten to not only attack gluten, but to attack their own intestinal tract. This leads to villous atrophy. It is not known exactly why this happens, but it appears to be a genetic response to gluten.

How is it diagnosed?

Celiac disease is diagnosed by measuring the damage to the small intestine. The presence of villous atrophy can be determined by a biopsy taken during an endoscopy (a procedure to scope your esophagus, stomach and the upper part of your small intestine) and seen under the microscope. The blood test for tissue transglutaminase antibodies has also been shown in scientific studies to be equally effective at determining whether or not there is villous atrophy.
Endomysial antibodies and reticulin antibodies are older blood tests that are not as reliable as the transglutaminase antibody, but if these tests are positive then they are also diagnostic for celiac disease.

What is the treatment for celiac disease?

The treatment for celiac disease is to stop eating gluten. That is easier said than done, but many thousands of people find that they are capable of completely removing gluten from their diet. Of course, it does take conscious effort. Gluten is found in almost all bread products, pastas, soy sauce, and many, many processed foods. However, there are many companies now producing gluten free alternatives, and more are coming out every month.

What is the long term outcome for people with celiac disease?

Fortunately, removing gluten from the diet usually reverses the damage that had already been caused. Significant improvement is usually noticed within weeks if not days, and continued improvement and healing may go on for 1-2 years.

Are there other forms of gluten intolerance?

Many people do not have celiac disease, but it is clear to them that eating gluten is making them sick. This is an important topic. Read more at Understanding Non-Celiac Forms of Gluten Intolerance.

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Image thanks to thehealingfrequency.com

Gluten Free Black-Bottom Cupcake Recipe

This week's recipe thanks to Jules Gluten Free. If you have a recipe that you would like to share, please send it to info@ibstreatmentcenter.com and we'll be sure to give you credit when sharing with our readers.

Ingredients

Filling:

• 8 ounces cream cheese, dairy or non-dairy (Tofutti® Better Than Cream Cheese)
• 1 egg or egg substitute (e.g. 1/4 cup firm silken tofu, blended with 1/2 tsp. gluten-free baking powder)
• 1/3 cup granulated cane sugar
• 1/8 tsp. salt
• 1/2 cup chocolate chips (Enjoy Life® Mini Chips)

Cupcakes

• 1 1/2 cups Jules Gluten Free™ All Purpose Flour
• 1/4 cup milk powder, dairy or non-dairy (Vance’s DariFree™), or almond meal
• 3/4 cup brown sugar
• 1/4 cup unsweetened cocoa powder (not Dutch processed)
• 1 tsp. gluten-free baking powder
• 1 tsp. baking soda
• 1/4 tsp. salt
• 1/2 cup milk, dairy or non-dairy (So Delicious® Coconut Milk Beverage)
• 1/2 cup water
• 1/3 cup vegetable or canola oil
• 1 Tbs. apple cider vinegar
• 1 tsp. pure vanilla extract

Directions

Preheat oven to 350° F (static) or 325° F (convection).

Line 24 muffin tins with cupcake papers or lightly coat with oil.

Beat cream cheese, egg (or egg substitute), sugar and salt in a medium-sized bowl until lighter and well-mixed. Stir in the chocolate chips, cover and refrigerate until finished mixing the cupcake batter.

Whisk together the Jules Gluten Free™ All Purpose Flour, milk powder, brown sugar, cocoa, baking powder, baking soda and salt. Slowly stir in the milk, water, oil, cider vinegar and vanilla, beating until totally smooth.

Spoon the chocolate batter into each muffin cup, filling only 1/3 full. Top with a spoonful of cold cream cheese mixture — it does not have to cover the top of the muffin cup completely, or cover each cup evenly.

Bake for 30-35 minutes, or until a toothpick inserted into the cupcakes comes out clean and the cream cheese topping is beginning to lightly brown. Remove to cool on a wire rack.

Yield: 22-24 cupcakes

Milk Allergy Q&A

What's a Dairy Allergy?


An allergy is an immune response that results in inflammation and tissue damage. Such a response to food can be exhibited in any part of the body, therefore it can cause a wide range of problems. Food allergies also interfere with nutrient absorption, resulting in conditions such as iron deficiency anemia, osteoporosis, and fatigue.

What Is Lactose Intolerance?

Lactose intolerance is an enzyme deficiency, not an allergy. However, lactose intolerance can be the result of a dairy allergy and the two are frequently confused.

What Causes a Milk Allergy?

Most likely it is a genetic condition. In the big picture, humans have only recently introduced cow’s milk into the diet, so it’s not surprising that the immune system doesn’t always recognize it as a friendly substance.

Why Is It so Difficult to Recognize One's Own Food Allergy?

This is a significant problem because of the difficulty in connecting your symptoms with your eating habits. Your symptoms probably vary in intensity or come and go. The trick is that allergy symptoms may show up hours or even a day later, after a food is well absorbed into your system. And if you stop to think about it, you probably eat dairy every day.

Even if you only eat something 2 or 3 times per week you can still have a significant allergic reaction to it.

Which Foods Are Dairy Foods?

Dairy includes all types of milk from a cow, all cheese, butter, half and half, yogurt, cottage cheese, ice cream and other obvious milk products. It also includes the proteins casein, whey, and lactalbumin, which are found in many processed foods. Low-fat and nonfat milk are just as allergenic as whole milk. And eggs don’t come from cows, so they’re not considered a dairy product.

How Do I Determine if I Have a Dairy Allergy?

The only sure way to determine if you have a milk allergy is to have your blood tested for antibodies to dairy. This is done with an ELISA Food Allergy Panel. If you suspect that you may have a dairy allergy, or you experience any of the symptoms listed earlier, email us at info@ibstreatmentcenter.com or call the office at 888-546-6283 to schedule an appointment.

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More information on dairy allergies and symptoms at CenterforFoodAllergies.com
Image thanks to indiatimes.com

Does food intolerance play a role in juvenile chronic arthritis?

This chronic arthritis case study comes from National Institutes of Health:

Sixty children with juvenile chronic arthritis (JCA) have been examined at the paediatric rheumatology out-patient clinic in Maastricht, of whom three ultimately appeared to have a food intolerance.

In one of these three patients, there appeared to be a relationship with joint complaints. In the course of the elimination/challenge tests which were conducted, severe painful swelling of the knee occurred rapidly after each challenge. Three challenges were carried out with the same result each time.

Since the symptoms did not disappear entirely following elimination of milk, it was concluded that milk intolerance in this case was an aggravating factor in a seronegative monoarticular JCA.

In the second and third patients, a strict diet had no positive effect on the joint problems. In conclusion, the existence of such a connection between food and chronic joint complaints has been made clear, it only plays a role in incidental cases.

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Source
National Institutes of Health
Department of Paediatrics and Rheumatology, Academic Hospital Maastricht, The Netherlands.
Schrander JJ, Marcelis C, de Vries MP, van Santen-Hoeufft HM.
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Image thanks to arthritis.org

The Role of the Immune System in the Digestive Tract

The huge surface area of your digestive tube must be protected against injury from bad bacteria, viruses, parasites, and other toxins that may get into the digestive system with food or by any number of other routes. The immune system is critically important in helping the intestines respond to these challenges.

Possibly the greatest challenge to the digestive tract's immune system is to correctly tell the difference between what is bad (such as viruses and bad bacteria) and what is good (such as nutrients and good bacteria).

Your immune system must determine whether or not to develop a tolerance to everything you put into your mouth. Whenever you try a new food, it must decide, "Do I like this or do I attack and kill it?"

You are always ingesting bacteria and other substances with your food, no matter how fresh and clean it is, so these must be screened out. While your immune system will "okay" most foods, genetic and other issues may affect its decision. Recent studies also suggest that your immune system's ability to develop correct tolerances depends a great deal on the balance of good bacteria inside your intestinal tract.

When you put something into your tube that the immune system doesn't like, it attacks by means of inflammation and excess mucus production.

If your immune system is continually bombarded with messages to attack, its reactions can have major consequences. Inflammation of the digestive tube can in turn lead to damage of the lining of this tube, often resulting in something called "leaky gut" or "gut hyperpermeability."

These two terms are simply descriptions of the damage to the digestive tract that is a result of something triggering an immune response.

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More information at IBSTreatmentCenter.com
Image thanks to wikipedia

Digestive Problems Can Run in the Family

Many patients describe having digestive problems similar to other members of their family. A patient recently expressed that her sister, mom, and even grandma all had digestive problems. So she assumed that her problem was genetic.

Fortunately, she didn’t assume that there was no hope for helping her. That is why she came to our clinic. But many people do not understand that just because a problem runs in the family, does not necessarily mean they have to suffer from it.

What do we mean by that?

In most cases these symptoms are caused by something external to the body. By this we mean caused by something in the environment, such as food, bacteria, or yeast.

Often the cause is a genetic problem, especially if a food allergy is the trigger. What we often do not realize is that the trigger can be avoided. We do not have to expose ourselves to the same foods as our relatives, but most of us do.

Most people also consume very few base foods, such as wheat, dairy, eggs, potatoes, sugar cane, and more. But we combine them in many different ways with many different flavorings and spices. Therefore family members generally eat the same kinds of foods, even when they do not live together.

If a food allergy is triggering a symptom, which it often is, then it should not be too surprising when other members of the family suffer from the same problem.

Fortunately, problems of this nature can usually be sorted out. Food allergies that cause digestive problems can be detected with the proper kind of blood testing. And with the proper education you can learn how to truly avoid that food and find suitable alternatives, which is often easier said than done.

Having other family members tested can then help them sort out their digestive problems. These test results usually prove to be very interesting.

Family members usually see a great deal of overlap in their results due to the strong genetic component of food allergies.

They can then also have improved health, with the added benefit being that you will likely have something in common when it comes to the foods you use to prepare dinner.

What is a Nickel Allergy?

No, it’s not being allergic to money. But as many of you know, some people are allergic to the metal nickel. This usually manifests as redness of the skin, which occurs when the skin comes in contact with nickel. This is what we might call a more classic allergic reaction, different from the hidden types of food allergies commonly discussed.

A nickel allergy is often discovered when exposure to an item of clothing or jewelry leads to a read rash. This may occur when a fastener made from nickel, such as the button on your pants, comes into contact with your belly and leads to a rash. Or when a piece of jewelry containing nickel, such as an earring, bracelet, watchband, etc. comes into contact with your skin and causes a rash.

These reactions are often readily apparent to the wearer and are called contact dermatitis. But nickel allergies can also trigger eczema on other areas of the skin.

What does all of this have to do with digestive problems?

Far more than you might imagine. The digestive tract is a highly specialized extension of your skin. It is a continuation of the epithelial tissue that surrounds the rest of your body.

Therefore, it should not be too surprising to realize that if something affects your skin, then it could also impact your digestive tract as well and cause abdominal pain, diarrhea, and other digestive problems. An astute reader recently wrote us and asked why we had never talked about this before. Frankly, it never occurred to us. But upon further investigation, it certainly makes sense.

How Your GI Tract Gets Exposed to Nickel

Some foods are particularly high in nickel. When you ingest them the lining of your digestive tract is exposed to nickel. And like your skin, it is possible that the nickel can trigger an inflammatory reaction, except within your digestive tract.

Not everyone who has a skin reaction to nickel will necessarily have a digestive problem from ingested nickel. Only people especially sensitive to nickel will notice this reaction, because the nickel is a not maintaining constant contact with the epithelial tissue at a high dose like is in the case of earrings or buttons on pants. But if you do have a skin reaction to nickel, it is certainly something important to consider.

Foods That Contain Nickel

Foods known to be high in nickel include chocolate (cocao), coffee, tea, nuts, soy beans and other legumes, and even oatmeal. Canned food is also often higher in nickel. But remember, just because you react to one or more of these foods does not necessarily mean that it is because of a nickel allergy. There are many other reasons that people can react to the foods listed above.

You may already know if you have a serious reaction to nickel due to a skin reaction, but in some cases your digestive reaction may not be that obvious. Conventional allergists offer a patch test that can help, but is far from perfect. And in some cases the only way to sort is out is to do a trial diet low in nickel. Unfortunately this is the only treatment as well, but it is possible to do. And if it isn’t solving your problem, then please come and see us. We’ll try to help you sort out the rest.

More information at IBS Treatment Center.

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Picarrelli, A, et. Al., Oral Mucosa Patch Test: A New Tool to Recognize and Study the Adverse Effects of Dietary Nickel Exposure. Biol Trace Elem Res. 2010 Mar 5. [Epub ahead of print]

Sharma AD. Relationship Between Nickel Allergy And Diet. Indian J Dermatol Venereol Leprol 2007;73:307-12
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Image thanks to hubpages.com

Food Allergy Case Study: Diet and disease symptoms in rheumatic diseases--results of a questionnaire based survey.

This study can also be viewed on the National Institutes of Health website.

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Experiences with food intake, diet manipulations and fast were registered in rheumatic patients.

The study was a questionnaire-based survey in which 742 patients participated. It comprised 290 patients with rheumatoid arthritis, 51 patients with juvenile rheumatoid arthritis, 87 patients with ankylosing spondylitis, 51 patients with psoriatic arthropathy, 65 patients with primary fibromyalgia and 34 patients with osteoarthritis.

One third of the patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthropathy reported aggravation of disease symptoms after intake of certain foods while 43% of the patients with juvenile rheumatoid arthritis and 42% of the patients with primary fibromyalgia stated the same.

Twenty-six percent of the patients with juvenile rheumatoid arthritis and 23% of the patients with rheumatoid arthritis, ankylosing spondylitis and primary fibromyalgia had previously tried certain diets in the attempt to alleviate disease symptoms, whereas 13% of the patients with psoriatic arthropathy and 10% with osteoarthritis had tried diet therapy.

Less pain and stiffness were reported by 46% of the patients and 36% reported reduced joint swelling. Similar beneficial effects of diet were also reported in other rheumatic disease groups.

Fifteen percent of the patients with rheumatoid arthritis and ankylosing spondylitis had been through a fasting period. Less pain and stiffness were reported by 2/3 of the patients in both groups and half of the patients in both groups reported a reduced number of swollen joints.

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Haugen M, Kjeldsen-Kragh J, Nordvåg BY, Førre O.

Source
Department of General Practice, University of Oslo, Norway.

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Image thanks to blog.itechtalk

Case Study: The canadian celiac health survey.

This case study available in full at NIH.gov:

The purpose of this study was to characterize the diagnostic process, frequency of associated disorders, family history, and impact of a gluten-free diet in individuals with celiac disease. All members of the Canadian Celiac Association (n=5240) were surveyed with a questionnaire. Respondents included 2681 adults with biopsy-proven celiac disease.

The mean age was 56 years. Most common presenting symptoms included abdominal pain (83%), diarrhea (76%), and weight loss (69%).

The mean delay in diagnosis was 11.7 years. Diagnoses made prior to celiac disease included anemia (40%), stress (31%), and irritable bowel syndrome (29%). Osteoporosis was common. Prior to diagnosis, 27% of respondents consulted three or more doctors about their symptoms.

Delays in diagnosis of celiac disease remain a problem. Associated medical conditions occur frequently. More accurate food labeling is needed. Improved awareness of celiac disease and greater use of serological screening tests may result in earlier diagnosis and reduced risk of associated conditions.

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Dig Dis Sci. 2007 Apr;52(4):1087-95. Epub 2007 Feb 22.

Cranney A, Zarkadas M, Graham ID, Butzner JD, Rashid M, Warren R, Molloy M,
Case S, Burrows V, Switzer C.

Department of Medicine, Ottawa Health Research Institute, University of Ottawa,
Ottawa, Ontario, and Queen's University, Kingston, Ontario, Canada.

PMID: 17318390 [PubMed - in process]

Understanding Parasites

It is often assumed that people living in the United States do not have parasites. For this reason, most people are not tested for parasites unless they have traveled to a tropical or third world country, or they have engaged in risky behavior, such as drinking from a stream.

Contrary to popular belief, it is not so unusual to find parasites in North Americans. However, you can’t find what you don’t look for. And since most people don’t get tested for parasites, most physicians therefore assume that parasites don’t exist here.

Complicating matters is that even if you have been tested for parasites, traditional stool testing is fairly ineffective at detecting most parasites.

Almost all testing for parasites involves a microscopic analysis of a stool sample. This means that a very small smear of a much larger stool sample is viewed under a microscope.

The parasite, or more likely the eggs from the parasite, must be present in that smear, and must be present in a significantly high amount to be found during the microscopic exam.

And the lab technician must be proficient at recognizing it when they see it.

Unfortunately, microscopic exams are notoriously unreliable for finding parasites. Although it’s been used for decades, microscopic examination is far from perfect.

Multiple stool samples are required in order to increase the reliability of the test, but parasites are still easy to miss. In fact, it can literally be like looking for a needle in a haystack, only now you have to use a microscope to examine the haystack.

Scientists have long known the ineffectiveness of stool testing for parasites, but recently it has been become more apparent with the development of DNA testing. DNA testing is now available to evaluate the contents of a stool sample, rather than relying on the imprecise method of a microscopic exam. And DNA testing has proven that it can literally find a needle in a haystack.

Since DNA parasite analysis became available just over a year ago, it has shown to be an extremely valuable tool for helping to identify parasite infections seen in patients at the IBS Treatment Center. As a matter of practice we have always tested patients for parasites, but prior to the availability of DNA parasite testing, parasites were rarely diagnosed. DNA testing is infinitely more sensitive in detecting parasites, and since the introduction of this type of testing, we have found parasites in far more people than we previously suspected could possibly have them.

Now we treat parasites at least once every two weeks or so, and not just the garden variety of parasites such as Giardia. Parasites come in a range of different types, such as amoebas (Giardia, B. hominis, D. fragilis, etc.), roundworms, tapeworms, threadworms, pinworms, flukes, and others. We have seen most of them several times, and each requires a different type of treatment. As a word of note, parasites generally require prescriptive medication for successful eradication.

Parasites can cause many different types of digestive problems, including gas, bloating, abdominal pain, diarrhea, and constipation. They are also capable of causing other types of health problems throughout the body.

You need not travel outside the United States to be exposed to a parasite or to contract a parasitic infection. We live in a very small world now where foods and other items are imported from countries near and far, and people from those countries often harvest foods in our own country. There is no guarantee that you are safe from parasites simply because you live in North America.

Please contact the IBS Treatment Center for more information about DNA parasite testing.

Image thanks to myvetachicago

Elimination Diets & IBS

Ideally, to create an optimal diet for Irritable Bowel Syndrome (IBS), all you'd have to do is avoid a certain food or food group to discover whether it was triggering your IBS.

Unfortunately this is easier said than done. It takes a great deal of time, persistence, and education to properly construct a diet that will adequately treat IBS. Proper lab testing can help you avoid all of this.

The purpose of an elimination diet is to identify whether or not specific food groups trigger your IBS symptoms. Essentially, during an elimination diet you stop eating the foods you normally eat until your symptoms improve.

If you feel better after you've eliminated a food or stopped eating altogether, then you might strongly suspect that your diet is involved. You may have gone on a fast or a cleansing diet, or simply avoided food for a day or two and discovered that your IBS was much better. Of course, eventually you have to eat, and the trick is figuring out exactly what you can eat.

If, when you reintroduce a food, your symptoms return, then it's likely that the food or one of its ingredients is an IBS trigger for you. It's sounds simple enough, but it can be a very slow process and very time consuming. And even after going through this process you may still not see a pattern or you may still be confused about which foods are causing your problems.

More information on why it's hard to detect your own food allergies.

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Image thanks to backtotheroots