# ACG CONFERENCE: LEAP PROGRAM Releives Symptoms Of Diarrehic Predominant IBS



## Mike NoLomotil (Jun 6, 2000)

Excerpted from:ï¿½Use of The LEAP Mediator Release Test To Identify Non-IgE Mediated Immunologic Food Reactions That Trigger Diarrhea Predominant IBS Symptoms Results in Marked Improvement of Symptomsï¿½; 69th Annual Scientific Meeting and Postgraduate Course, American College of Gastroenterology, November, 2004.Fred H. Williams, M.D.; Dept. of Gastroenterology, St. John's Mercy Medical CenterSt. Louis. Missouriï¿½The study consisted of ten patients who referred to a community-based GI practice for (D-IBS). They were evaluated for causes of their symptoms as deemed appropriate by the Gastroenterologist. Typically, they were treated with standard therapy such as anti-spasmodic, and anti-diarrheal medications." "Patients who were non-responders to standard therapy and who met Rome II criteria for D-IBS were offered enrollment in the LEAP MRT dietary modification program.ï¿½ï¿½ï¿½Prior to beginning the diet and at each follow up visit, patients were asked to rate symptoms in the following general categories on a scale of 0-4 with 4 being the most severe: constitutional, psychological, HEENT, skin, cardiopulmonary, musculoskeletal, genitourinary, weight management, and gastrointestinal. Specifically, they were asked to rate the following GI symptoms: heartburn, cramping, diarrhea, constipation, bloating, gas, nausea, vomiting, and painful elimination. The data presented for each patient is that of their initial visit before starting the LEAP MRT dietary modification program and their most recent visit. ï¿½ï¿½Prior to starting the Program, patients had a mean gastrointestinal score of 26 (range 13- 42). At the last time point available, this had decreased to a mean of 6 (range 3- 16).ï¿½ï¿½Prior to starting the LEAP Program, patients had a mean ï¿½globalï¿½ score of 57 (range 38 - 83) on a self-reporting symptom survey which takes into account both GI and non-GI symptomology commonly seen in IBS-D subjects. At the last time point available, this had decreased to a mean of 19 (range 7-32).ï¿½ï¿½We report on ten patients with D-IBS who were refractory to standard therapy. They were placed on the LEAP- MRT Dietary Modification Program and had a marked improvement in their GI and systemic symptoms. We believe that this study supports the hypothesis that a substantial portion of D-IBS symptoms are due loss of oral tolerance to typically benign oral antigens, with subsequent development of non-IgE mediated delayed hypersensitivity reactionsï¿½ which result in release of various pro-inflammatory mediators which lead to the typical GI and systemic symptoms associated with D-IBS. Elimination of these offending nutritional antigens from the diet, by the LEAP method, results in substantial improvement in D-IBS symptoms.ï¿½ SUPPLEMENTAL REPORT ALSO PRESENTED on NEW FINDINGS: D-IBS patients plasma cytokine levels were compared to plasma cytokine levels of normal non-IBS controls by Signet Diagnostic Labortaory. D-IBS patients showed substantial elevated plasma levels of specific proinflammatory cytokines compared to asymptomatic controls.Open challenge trial of MRT-test-positive D-IBS patients plasma while asymptomatic while on the LEAP Program showed minimal plasma levels of (17) known cytokines in interlekins. With 17 hours post-oral challenge with MRT-test positivie foods (off LEAP Diet) plasma levels of numerous inflammatory cytkines became gorssly elevated and IBS-D symptoms appeared. Remobvel of the reactive foods cause cutokine levels to drop and symptoms to disappear with 72 hours of return to LEAP diet.This data represent a great step forward in undertanding the role of loss of oral tolerance to benign antigens, inflammatory changes in the gut of IBS-DS patients, and the origin of symptomology as well as prophyoactic treatment with LEAP.________________________Reprints of full reports available by conctacting Signet Diagnostics1-888-NOW LEAPoeleap###leapallergy.comMike NL


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## overitnow (Nov 25, 2001)

Nice to see you here, again. Also nice to see the results. (You, once, helped find some studies re grape seed for me. I am happy to report that I am now over 5 years w/o symptoms.)Cheers,Mark


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## Poor Boy (Feb 13, 2003)

Yeah Mike and Mark now were looking at some good ideas....I am on this type of elimination diet thing now.....I had the Great Plains lab do some work for me.....helped me identify the dysbiotic flora ......now its the foods that turn on the antigen process.....keeping my fingers crossed....I just can't figure out why so many on this board are against this therapy.....LAter Guys


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## Mike NoLomotil (Jun 6, 2000)

That which we do not understand we resist. Sometimes it is also NIH Syndrome- Not Invented Here Syndrome. it is human nature that once a person sets themslves up as an "authority figure" and establishes their position on something, there is this aspect of human natre whihc makes it difficult for some to alter or expand or modify their position. I think that trait is a 3 letter word.It is easier to do a Rumplestilskin than to do the necessary work to learn a new subject. Espceially if you look at the kind of stuff you have to study and study and study to even begin to comprehend the immunologic process of oral tolerance and how it is compromised in D-IBS patients (and several other conditions). If you do not do that, the whole role of food and chemical sensitivities as they relate to IBS-D symptomology eludes even the finest minds.The brilliance of immunologists like Brandtzaeg is astonishing. http://www.annalsnyas.org/cgi/reprint/964/1/13.pdf Current Understanding of Gastrointestinal Immunoregulation and Its Relation to Food Allergy PER BRANDTZAEG Laboratory for Immunohistochemistry and Immunopathology (LIIPAT), Institute of Pathology, University of Oslo, Rikshospitalet, N-0027 Oslo, Norway Ann. N.Y. Acad. Sci. 964: 13-45 (2002). MNL


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## skinny (Jul 27, 2002)

Hey Mike, good to see you back in action.







Too bad eric left this board.







I'm curious on the LEAP program. That's one thing I haven't looked into deeply. Since we live in the same city maybe we can have lunch sometime? I'm busy with other things right now, but I'm looking to expand my knowledge of IBS.skinny


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## Mike NoLomotil (Jun 6, 2000)

Hey SkinnyBeen in the final stages of post-hurricane reconstruction on my house and lost track of your emails.Bounce me back sometime...almost done with the heavy lifting.MNL


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