# IBS or Herxheimer Reaction



## Corydalis (Apr 27, 2013)

Could we be experianceing Herxheimer Reactons? Could some or all of our IBS symptoms be herxheimer in nature?

If feels to me like my bouts have cycles, and I wonder if it is possible that these bouts corraspond with something I do seasonally that causes a "die off" and I am herxing?

Please share you're thoughts. Do you seem to have more symptoms in a certain season? Spring or fall? Do trips to places where the weather is different trigger you?

http://biovedawellness.com/2010/02/the-herxheimer-reaction-feeling-worse-before-feeling-better/


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## Kathleen M. (Nov 16, 1999)

I don't think you would have a situation causing bacterial die off in numbers enough to be that toxic day after day, year after year.

Now some bacteria in the colon can be more or less pro-inflammatory so more or less irritating/soothing, but that isn't a herx reaction.

Seasonally I tend to think more of an allergic reaction (either pollen or something you eat that comes in season).


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## Corydalis (Apr 27, 2013)

Kathleen M., thank you so much for your reply, and I agree with you that certainly we have dietary changes along with seasonal ones, especially here in the north! I was also thinking along the lines of mould in a seasonal setting, for instance now after all the snow melts and before the spring rains come or grass grows, there are white sheets that almost look like cobwebs on the grass, it is apparently some kind of mould. And there are indeed pollens already too.

But my thought came with also, that come spring we start to go outside and get some pretty good doses of sunshine (vitamin D) which may give our immune the extra kick it could need to do some internal house cleaning so speak.

Also thinking about suppliments like oregano and garlic, and foods like pizza (with oregano and garlic) and garlic foods (which tend to be big IBS triggers for some) having anti bacterial qualities, in theory, could someone who is consuming these foods or supplements on a regular basis be getting herx reactions, and not reactions to the food itself? Caraway and allspice are also mentioned, I am sure there are many more.

I found these two links, please have a look at them and share your thoughts with me.

This link talks about the antibacterial effects of oregano, garlic and allspice : http://www.wellnessresources.com/studies/oregano_and_food_poisoning/

This link talks about caraway, garlic and oregano having antimicrobial effects against moulds: http://www.doiserbia.nb.rs/img/doi/1450-7188/2009/1450-71880940009D.pdf


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## Kathleen M. (Nov 16, 1999)

I'm not sure how much they work after digestion and absorption. Works outside the body is not the same as the colon.

Garlic has fodmaps in it and that is more likely why garlic is a problem.

And the herx reaction usually is a lot more than "just" IBS symptoms like

"flu-like symptoms including headache, joint and muscle pain, body aches, sore throat, general malaise, sweating, chills, nausea or other symptoms."

And not all bacteria release the endotoxins that the bacteria that initially were what got the reaction described do.


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## Corydalis (Apr 27, 2013)

Kathleen M., what are your thoughts on SIBO? I recently read an article that it is thought that 50% or more of IBS sufferers likely have SIBO. I also read that during treatment for SIBO, especailly a dietary one, die off is likely to occur. The bacteria thought to be responsible for SIBO is thought to be a friendly bateriea that would not be releasing endotoxins, yet the die off if the numbers are great enough can still cause a herx from what I am understanding.

I DO have all most all fo the symptoms you speak of, chills, fatigue, nausia, aches and pains, and sometime head ache, with these bouts.

I wonder if so much of our food these days is contaminated with these diffent kinds of bacteria, that can cuase the symptoms we contiue to share, how will we ever feel better? Some of these bacteria are getting stronger and stronger because of antibiotics and the poisons used on crops, that they get to such a mutated state our bodies no longer have the immune system or acid strength needed to kill them before they set up shop in our internal world.

found a good link on bacteria too if anyone wants to check it out: http://www.medic8.com/healthguide/food-poisoning/bacterial-food-poisoning.html


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## Kathleen M. (Nov 16, 1999)

Depends on what part of the scientific process they were looking at. In a preliminary study that was set up to find SIBO in IBSers (actually started with people suspected to have SIBO then screened those people for IBS symptoms) it was like 80%, but other people tend to find more around 5-10%.

So it really depends on do you look at all people with IBS or do your pre-select for those likely to have SIBO first.

I think the question with your theory is why isn't every human having these huge herx reactions and severe IBS all the time if that is stuff in every person's diet.

I do think bacteria have a role to play but it really isn't as simple as I think your theory would make it. For most people, IMO, it will be which set of normal colon bacteria their diet causes them to have and how much that particular subset of normal bacteria which have a normal range of interactions with the gut happen to increase or decrease the symptoms cause by problems in the host. I think without host damage the bacteria don't really matter much. I don't think 100% of the blame will be that you have X bacteria in there or occasionally something you eat has a mild effect on some bacteria (and most of the antibacterial effects have never really been demonstrated that much in humans, usually it is they do it in a test tube or on a food surface, that is very different than having an effect at the amount you can actually eat and survive and after it has been digested and absorbed away from where the bacteria are).

If you are having all those flu like symptoms and fevers and all that you have something other than IBS going on. Those are not IBS symptoms. I just don't know that you can assume that something that effects a few bacteria in a test tube is having the exact same effect as a potent antibiotic that is demonstrated to actually kill off a large percentage of bacteria in a human being.


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## Corydalis (Apr 27, 2013)

Kathleen M., Thank for your thoughts, I appreciate you responding, and you raised some excellent points! It is so hard to know where to go with treatment, as this site attests too, everyone is asking everyone else for help, tips, experiences and comparisons with everything from BM to diet. We probably don't all have the same thing, many here have not been clinically diagnosed with anything, IBS, SIBO or LG, but even those of us who have, may not have necessarily gotten the right diagnosis. What you say is good, how do we know first of all and then where do we go from there.

I guess I got caught up in all of the food related topics regarding SIBO and IBS, in how sensitive some seem to be to even minute quantities of their trigger foods. It seems plausible that some die off could be causing discomfort to some.

When I was diagnosed with IBS, the GI doc tried to explain to me all the possible reasons why I was in pain, one was that some people have more nerve sensitivity than others, a small bubble of gas that moves through one person unnoticed, could potentially cause me a very uncomfortable episode. The nerves in some people are hyper sensitive to BM, gas, stress and anxiety, so again it seems plausible that some people may feel even smaller die offs while others may not miss a step.

I have questioned whether my diagnosis was correct or not, but over the years I continue to have these bouts, so it's all I have. I have C and I bloat terribly after many meals, it's very uncomfortable.

Recently I had a neighbor tell me about the Wheat Belly book and going gluten free, both seem to be a popular topic on this site, along with SIBO, the SCD diet and the FODMAP. I don't know where to turn for help, I certainly can't do them all at once!

I will take what you had to say about my symptoms to thought however; as you seem to feel that I may not have IBS after all.

My brother in law has Chronic Lymes disease that is where I learned about herxheimers reaction. What he has is a spirochaete however, so his die offs are very hard. He has had die offs from oregano oil supplements. He also has to be careful of wheat and sugars, because spirochaetes thrive on those too.

I wish that I were onto something with my idea, it may be a lot easier to treat people if that were the case, but unfortunately it still has science quite busy, and sufferers full of questions.

Best wishes,


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## Kathleen M. (Nov 16, 1999)

I don't think that extreme reactions to small amounts of food really points directly at bacteria, or bacterial die off.

It is a matter of how things effect other things. I can't see how a small amount of food that might kill of a very tiny percentage of bacteria=huge reaction. Even if you could only kill bacteria capable of releasing the toxins involved.

I think the small amounts of food = huge reaction usually does not even point to bacteria making gas and the gas making symptoms. Because you can only make a couple of molecules of gas per molecule of food that can be fermented.

For people with true huge reactions to very tiny traces of food that points to the immune system responding to the food, not the bacteria in your gut.

See the problem with "it is the nerves" so it must be the die offs...the gas isn't from the die off. The gas is from happy healthy bacteria digesting carbs. Endotoxins that cause the herx reaction are not gases. IBSers do seem to be sensitive to normal levels of gas, and may sense as pain the normal functioning of the gut. It is like the barrier that is supposed to keep that all unconcious and unfelt has some holes in it and so too much sensation comes through and the brain tends to translate any unexpected signal it isn't supposed to be conciously aware of as pain.

Like I said the bacteria may play a role, but I don't think the work in the way you seem to think they do. Generall all the diets you mentioned tend to reduce the amount of food the bacteria have to ferment. Again the happy healthy growing bacteria, not the ones that just died and are leaking their insides out.

Low fodmap is probably the one I'd start with, as it is most designed for IBS and gas issues.


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## Corydalis (Apr 27, 2013)

Kathleen M.,thank you for your informative response, and for explaining some good details, perhaps others reading our posts who may have the same misconceptions as myself will find help and information here too.

I am losely on the FODMAP right now, it's making me a bit owly but I have not had as much gas. I am keeping my food selection small, timid to try new things. Energy is low and some sweating throughout the day too.

All I can do it commit to a plan, fallow it through, journal well and hope for the best!

Thank you for you time!


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## Dianaearnshaw (Feb 22, 2013)

Well, here's my two penn'orth for what it's worth!

I agree with Kathleen to a point. Or at least I agree with with her bottom lines generally but differ a bit in the causes.

Apart from nutrition, I have also been studying (not formally) evolution. It has taken me a while to bring together these two elements to understand what's going on. I have read many things that have motivated me - most of them one liners! It was in a Prof. Richard Dawkins (famous evolutionary biologist here but you may not know him there) book that I read "*when nature finds a satisfactory way of doing something, it is replicated across all life*" or words to that effect.

Think of a plant grown in stony soil with semi-light and given little water. What happens? It dies - the bacteria, viruses, yeasts and fungi that are everywhere, will feed on it until it succumbs as it has no ability to fight back. We are no different. You made a very important point Corydalis - the sun. Those of us that live in the northern hemisphere (and the further north, the worse the situation) get barely adequate sunlight due to the sun's UVB rays being very short. Vitamin D is elusive! But when the sun is overhead (your shadow shorter than you are tall) we need to take it like medicine. I know supplements are available but I suspect they have limited use in someone with a gut problem - they may not be absorbed. Vitamin D is needed for everything.

When I plan treatment fo someone, I think about the "light, soil, moisture and microbes." The fact is, that in a healthy organism, whether it is a human being, bird, worm or yeast, if you give them what is needed for healthy life, they will thrive and be able to shake off less-than-optimal conditions (as long as this is not sustained) and illnesses. The balance of life is preserved.

I agree with Kathleen that eating small amounts of something seen as beneficial is unlikely to have any impact - especially when eaten with something that harmful microbes thrive on - like pizza! These foods can be useful as regular additions to the diet to maintain health.

My belief is that we are generally less healthy than we were years ago because we are filling our stomachs and feeding the pathogenic microbes, rather than nourishing ourselves: we cover ourselves with sunscreen before venturing out in the sun: and we are constantly bombarded by drugs that alter the natural balance of gut microbes - antibiotics, the pill, other hormones and lots more.

Getting back to the original question! - the die-off reaction is most unpleasant but has to be borne if recovery is the aim. As I said in my other contribution it is when you've had a couple of days without food (if you've had flu or something) or had a couple of days of being low carb for whatever reason, that you migh start up this die-off reaction but that will stop when you eat as you were before.

As Kathleen rightly said, you may have something else going on Corydalis. Maybe you need to check with your doc.

Hope this is helpful!


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## Corydalis (Apr 27, 2013)

Diana, how wonderful of you to write such a long and informational reply! So very much appreciated! I have been to yourgoodhealth site and want to try the sauerkraut, I have some canned that my husband and I made, I like it very much, but I hate how it smells the whole house up! But if it makes me feel better, I will get right too it!

I have appreciated both of your educated replies to my plight, as I may indeed not have IBS, or I do along with something else.

I went to docs several times for my pains as a young woman, and eventually after pooing black poo for over a week, and having severe abdominal pains, I got to see a Gastro Intestinal doc, who as far as I know, tested me to everything under the sun. I had both an upper and lower endoscopy, with biopsy, my poo was tested for parasites and worms, he ruled out gluten (tho' I am not sure how-) and with my symptoms, nausea, chills, hives, abdominal pain, bloating, fatigue, he did not know what to tell me when he couldn't find anything. He hesitantly diagnosed me with IBS-C. He tried Prilosec and some kind of antispasmodic, neither of which helped. He suggested I go to an allergist, or try a very low dose of antidepressants.

Since, I have continued to have the bouts on and off (tho' thankfully I have not had the black poo issue again) sometimes not for months at a time.

I have suspected deficiencies, like iron, one of the Bs, or some hormonal imbalance. I may have Endometriosis, unconfirmed, but I fit most all the symptoms&#8230;But my iron always checks out, my thyroid checks out, my liver and kidneys, blood pressure and cholesterol all good, Calcium, potassium and sodium, all good.

I know-or hope the IBS world of knowledge has grown quite a bit since I saw GI doc, (13 years ago?) so if you gals have any ideas, if you think it does not sound like IBS to you, does it sound like an allergic reaction? Leaky gut? I really hate to go back to the doc for this again, I would like to try something, anything, but so far all I have had is the IBS diagnosis to go off from&#8230;I am open to a new suggestions&#8230;Could all my issues just be gas with the nerve sensitivity thing?

Thank you both again for kindly responding to my posts, when there must be SO many! When everyone just wants to feel a little better having someone read and answer is that needed support.


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## Dianaearnshaw (Feb 22, 2013)

Hi Corydalis,

My own view is that all gut problems can be put under the same umbrella. The wrong diet or excessive meds will result in gut dysbiosis - hence IBS, Crohn's disease, celiac disease, ulcerative colitis and cancer.


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## Dr. Dani (Jan 18, 2013)

Hi there, I agree with Kathleen, fever and chills are not a normal part of IBS and you should be checked for autoimmune things going on too. Because IBS symptoms are very nonspecific and it's a diagnosis of exclusion, all other things need to be ruled out first. That being said, autoimmmune diseases and IBS share a common feature: both are heavily influenced and even started due to the effects of stress on the body and there is a strong inflammatory component to both. I've seen complete remissions with diseases like rheumatoid arthritis for example, in my own patient, after getting on an anti-inflammatory diet, and most importantly starting a daily mindbody practice to decrease whole body inflammation and restore health to the brain-gut-immune axis Starting with a simple meditation or breathing practice just 15 minutes a day is great way to start, and it shoud help your symptoms if you do it every day



Kathleen M. said:


> Depends on what part of the scientific process they were looking at. In a preliminary study that was set up to find SIBO in IBSers (actually started with people suspected to have SIBO then screened those people for IBS symptoms) it was like 80%, but other people tend to find more around 5-10%.
> 
> So it really depends on do you look at all people with IBS or do your pre-select for those likely to have SIBO first.
> 
> ...


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## Corydalis (Apr 27, 2013)

Thank you so much Dr. Dani! Your post was so welcome! I was just posting with another here about meditation! You have made good witness that I really need to get back to that. I use to do yoga some, and it did help too, but then a ton of stressful stuff happened, after that I gained a little weight and it was harder to do, and with time I just didn't get back to it. I felt like taking the time out for it felt a little selfish maybe, that I should be doing other things that need getting done, or keeping up with others, but if I can be better for myself I can be better for them too right?

Thank you for also confirming with the girls here that I should consider that I may something else going on. It will help me a lot, I can broaden my scope and try some other metheds that are not just IBS related and hopefully land on something that really helps.

Coping with stress and anxious nerves is a big one for me. But also am intriqued with the gut and serotonin theories making news as well! Some foods may really help for what they can do for us mood wise in a given day.

Best wishes


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