Irritable Bowel Syndrome
Most
of the patients I see with irritable bowel syndrome will
complain of a mixture of the following complaints:
-
Constipation, Diarrhea, or episodes of
both constipation and diarrhea
-
Abdominal Bloating
-
Abdominal pain (sometimes severe)
-
Foul wind, Bad breath,
-
Offensive and / or foul-smelling stools,
reactions to foods ranging from tiredness to pain to
sweating to brain fog etc. etc.
Can anything be done apart from "more
fiber, relax more and have an occasional yogurt" Do
anything really work for Irritable Bowel Syndrome?
Usually it is possible to obtain significant relief
from the symptoms of irritable bowel syndrome.
We use a clinical approach combining laboratory
investigation with treatment of low-grade gut infections.
We usually use Doctors Data Laboratory in the US for stool
culture and examination. This information is usually
extremely useful even in those patients who have
previously had extensive investigation including
colonoscopy etc.
It is also important to identify any food intolerances.
Some patients will be greatly helped by gastric acid
and/or pancreatic type enzyme supplementation.
It is my experience that most patients can be
significantly helped by a mixed nutritional and medical
approach.
Please see the section below on Leaky Gut
Syndrome. This may help explain the tiredness from which
many Irritable Bowel patients suffer from.
Important Medical Advice
If you notice a change in bowel habit or
rectal bleeding it is important that you discuss these
complaints with your doctor. This is especially important
in people aged over 40 years.
If you are going to come and see us…
It is important that life-threatening
disease such as bowel cancer has been ruled out by your
doctor.
The diagnostic criteria for Irritable
Bowel Syndrome include :
-
3+ months of continuous or recurrent
abdominal pain or discomfort
-
Discomfort is relieved with a bowel
movement and
-
Change in either the frequency or the
consistency of the stool.
The connection between irritable bowel syndrome and
tiredness/fatigue.
How can a gut infection affect a patient's overall
sense of well-being?
Certain areas of bodily function come up
again and again in medical problem lists taken from
chronic fatigue syndrome patients.
Very often patients are informed (erroneously, in my
opinion) that there is no connection between their fatigue
and their abdominal symptoms despite the fact that the
patient may have quite severe abdominal disturbance.
In my clinical experience many patients with chronic
(i.e. long-standing) medical conditions, may have
low-grade gut infections making a large 'contribution' to
their lack of well-being. Very frequently normalizing
gastrointestinal function makes a huge contribution to the
patient's overall sense of well being.
How can this happen?
The Bowel contains a lot of immune system
tissue. Additionally the bowel should function competently
as a barrier between the potentially toxic fecal matter
contained in the bowel and the bloodstream forming a
reliable separation between the two.
A brief explanation of 'leaky gut
syndrome'
The bowel wall contains a large amount of immune or
lymphoid tissue.
It is thin -just the thickness of an upper eyelid -
however it needs to form a competent barrier between the
essentially toxic fecal matter, which it contains, and the
blood/circulatory system.
The bowel has its own blood return system -called the
portal venous system- which is a subdivision of the blood
and circulatory system. Blood coming from the portal
(bowel) circulatory system to rejoin the main circulatory
system has to pass through the liver filtration system
before doing so.
The lumen (hollow) of the bowel contains partly
digested food, bacteria, bacterial toxins, moulds or
fungi, fungal / myco toxins, enzymes, the bugs that did
not get washed off the lettuce with that quick wash you
gave it(!)
The average healthy bowel contains a
greater number of bacteria than the number of cells in the
human body.
It is critical for several reasons to maintain the
correct bacterial balance in our gut. An unhealthy gut may
mean a poorly functioning immune system with recurrent
coughs, colds, flu etc.
If the gut wall is inflamed and 'leaky' and is not
functioning properly as a barrier, toxic products and
half-digested materials will get across the gut wall into
the blood stream. This frequently makes people feel quite
unwell.
This means that proteins are not broken down properly
into their constituent amino acids resulting in larger
protein particles, called peptides (a particle composed of
several amino acids) passing across the gut wall into the
blood stream causing immune system problems and possibly
also contributing to joint pains and various forms of
arthritis.
There has been much research in the role of bowel
bacterial infections in both rheumatoid arthritis and
ankylosing spondylitis and he has identified certain
species of proteus and also klebsiella as potential
troublemakers.
The Liver and irritable bowel syndrome
connection.
The Liver has an important role in
detoxifying materials after they enter the bloodstream.
Any toxins getting into the blood stream should be
detoxified by the liver before they are allowed out of the
gut blood circulation, into what is called the 'Systemic
Circulation' (the heart, great vessels, brain, etc.).
Relatively frequently the liver may be 'overloaded' by
gut toxins or it may be sluggish for other reasons and
find it difficult to cope with its work of detoxification.
Consequently patients may feel somewhat weak and
fuzzy-headed. Sluggish liver detoxification also
contributes to chemical sensitivity. As one patient told
me "I constantly feel as if I'm on the morning after the
night before - except there was no night before. I
constantly feel fuzzy-headed, as if I had a skinful last
night, except that I didn't".
What kinds of troublesome low-grade gut
infections are there?
Gut infections may be fungal, bacterial or possibly
worm-like.
At the moment conventional medicine is working hard to
develop more sensitive means of diagnosing gut infection
and advances have been made, especially in terms of
diagnosing bacterial gut infection using the Hydrogen
Breath Test, but there is still a long way to go in terms
of developing reliable investigations that are both
relative and specific.
What happens if liver detox pathways are
not running efficiently?
Almost everyone I see has had liver function tests,
checked by either family doctor or consultant. These will
usually have been totally satisfactory. This is important
in that it excludes any serious or life-threatening liver
disease.
However, the liver may be somewhat sluggish in its
normal work of breaking down toxins/old red blood
cells/old hormone molecules that are past their sell-by
date.
As a result of sluggish liver
detoxification people may notice food sensitivities and
sensitivities to perfumes, inhalants, alcohol, chemicals
and also processed foods.
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