# Treatment Protocol - The 4 R's - Remove, Replace, Reinoculate adn Repair



## karoe (Sep 22, 1999)

I know this post is long, but I think it's very good information and it took me a while to put it together. It includes an excerpt from Dr. Galland's monograph, an appendix called the 4R Program (Remove, Replace, Reinoculate and Repair). This is important information about the critical activity of bacteria which produce short chain fatty acids from indigestible starches in the large intestine. Making sure that this process is working seems basic to good health and to ending digestive problems&#8230;.it appears to be important that the right starches are eaten or all the expensive probiotics in the world aren't going to make a lasting improvement&#8230;. My take on this, anyway. I found Dr. Leo Galland's website (http://www.mdheal.org/) one day while I was doing a search on Metagenics, a company that makes supplements. I spent a lot of time reading his articles and looking at his slide presentations. He is very generous with his material. A lot of the stuff on his site has to do with gastrointestinal health and its connection to chronic disease. (not just IBS, Chrons, IBD) Recently (6/08) I found his monograph "Gastrointestinal Dysregulation: Connections to Chronic Disease" on the Integrative Medicine site, and I purchased it. (119 pages, softbound, $60) It is meant for physicians, but I read it and got a lot out of it. I think this approach was preferable to a phone consultation with him ($400 for 30 min). I am working with Dr. Galland's recommendations for probiotics (and pre-biotics), because that is where I am with my healing journey. I 'only' have IBS. I did a 2-week Elemental Diet (using AbsorbPlus) for two weeks in the Spring, and now I am able to eat fruit (& got rid of lots of gas). I have had good but unfortunately temporary results from various probiotic sources, including raw milk (which I still cosume, a glass at bedtime), and I can't take large quanities of the Natren products without getting constipated, so I thought I would do more research and try other probiotics. I am currently taking one capsule of Natren's Bifido factor and one capsule of the Megadopholis in the am on an empty stomach and again just before bed with the raw milk. I feel better than I have in several years, but I have to be very careful about what I eat, and I continue to have extreme fatigue and gut pain every afternoon from about 2-6. I am often having a formed stool, finally, and I'm grateful and very excited about that. I take no other supplements at this time, but eat lots of whole fresh food (org.meats, vegetables, no sugar or simple carbs-- over 3 years now) and drink triple-filtered water to the exclusion of all other beverages.The information on providing a substrate, or prebiotic, in the form of vegetable or fruit fiber that is digested by gut bacteria in the large intestine is something I wish I'd found out about before now. I feel that I might have been able to get the probiotics to "implant" after the Elemental Diet, had I thought earlier about the substrate issue. I am actively eating foods that will be a good substrate. Again, I am now able to eat apples, after the elemental diet experience, and this helps (pectin).Next up I will be adding fermented foods to my diet, as it seems more logical to me than popping capsules over the long term. Here is a long interesting quote from the monograph. I don't know which to try first, as the research makes them all sound great (!).[brackets are mine]From the Appendix -- 4R Program (Remove, Replace, Reinoculate, Repair)"'Reinoculate' is the third step in the 4R gastrointestinal support program Reinoculate refers to the reintroduction of desirable bacteria, or "probiotics," into the intestine to reestablish micro flora balance. Bacterial balance in the intestine is critical for proper intestinal permeability. Over 400 different species of microorganisms reside in the human gastrointestinal tract and the overall balance of these organisms can profoundly influence gut ecology and health.Probiotics serve a variety of functions in the gastrointestinal tract. Perhaps the most important function of probiotics is antagonistic activity toward pathogens, which they perform in a variety of complimentary ways. First, probiotics assist in colonization resistance-- the ability of normal flora to protect against the unwanted establishment of pathogens. Second, probiotics may produce various antimicrobial substances. For instance, lactobacillus casei GG has been shown to produce substances inhibitory toward a broad spectrum of gram-positive and gram-negative pathogens. Competition for nutrients is a third mechanism. By competing for available nutrient substrate, beneficial bacteria can inhibit the growth of other less favorable flora. Competitive inhibition for bacteria adhesion sites is a fourth mechanism of probiotics. For instance, lactobacillus acidophilus inhibits the adhesion of several enteric pathogens to human intestinal cells. A final mechanism involves systemic host response. For instance, L. casei GG may decrease the likelihood that pathogens will develop resistance against probiotic agents. Thus, probiotics may be viewed as a vehicle to neutralize on inhibit pathogen activities, or increase or stimulate host immune stimulant activities to the intestinal tract, or both.A variety of supplemental sources may be considered helpful in reinoculation. These include cultured and fermented foods containing live bacteria, refrigerated liquid supplements containing live bacteria, or freeze-dried bacteria packaged in powder, tablet, or capsule form. Frequently supplemented species include Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus thermophilus, Lactobacillus sporogenes, Lactobaccillus casei GG, Lactobacillus NCFM, Saccharomyces boulardii, Bifobacterium bifidus, Bifidobacterium longum, Bifidobacterium breve.In addition to directly reintroducing the bacteria, the reinoculate step may also involve indirectly bolstering the healthy microflora with prebiotics, which selectively promote beneficial synergistic flora without silmultaneously supporting pathogenic bacterial growth. When prebiotics are included in the diet, increased levels of fecal fermentation and intraluminal concentrations of SCFAs [short chain fatty acids], such as proprionate, acetate, and butyrate, are produced from fermentation of the fibers by the colonic microflora. SCFAs are thought to supply up to 70% of the energy used by colonic epithelial cells; therefore, prebiotics support improved intestinal integrity and promote intestinal cell regeneration. Prebiotics include fructans [jerusalem artichokes, chicory root, belgian endive are rich sources, supplements are made out of the chicory root], inulin [asparagus, artichoke, onion, banana, chicory root] and fructooligo- saccharides [jicama, jerusalem artichoke], arabinogalactans [radishes, leek seeds, reiki, mushroom. Food sources are said to provide minimum amounts. Supplements are made of the wood of the larch tree. Should we really be eating that?] and some soy fibers. The incorporation of soluble fiber [pectin as in apples, oatmeal (not instant) numerous supplements exist for this ] another important nutrient substrate for probiotics, may also help the reinoculation process."From Gastrointestinal Dysregulation: Connections to Chronic Disease, a monograph, 2008, available from the Institute for Functional Medicinewww.functionalmedicine.orgauthor: Leo Galland, M.D. with Helen LaffertyAdapted from Lukaczer D. The "4R Program" in Jones DS, ed. Textbook of Functional Medicine, Gig Harbor, WA: The Institute for Functional Medicine


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## overitnow (Nov 25, 2001)

karoe said:


> Supplements are made of the wood of the larch tree. Should we really be eating that?]


Lots of good info in here. I just wanted to comment on this, in particular. I do not have info on the larch tree; but the first source of the class of nutrients called flavonoids, that I have found so useful in treating my IBS, came from pine bark. I would be willing to bet small money that larch has similar constituents. Before the "quake" took down the site, there was a posting on flavonoids from info provided by Patman75 and myself. One of the bits of science he had dug up is that, as the flavonoids essentially contain the plants biological defense system, by ingesting them you add those defenses to those which we, as a species, have also developed. In this particular reference, they have been found to help kill off the pathogenic bacteria while leaving the health giving ones in place. From what he had found, flavonoid supplementation helps probiotics with their work, and may be one reason why I have had the recovery that I have enjoyed for so long. Since my relief comes from a blend of grape seed and skin along with other constituents, rather than a tree bark, it should be easier to locate. Cheers,Mark


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## Patman75 (Mar 9, 2008)

My nutritionist put me on a 4R program. It was most helpful in getting my health back on track.Great Artical.


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## IanRamsay (Nov 23, 2008)

hi MarkBirch sap also contains flavenoids as does elm bark (the inner bark) and ceder bark (inner bark) i have been tapping birch trees in the spring for years to get a good supply of teh sap to last out the year. be aware though, pine bark, ceder bark and elm bark all taste totally awfull, its like eating saw dust with superglue and emulsion paint. (I have tried them all in every way imaginable). karoe:hi mate. specific strain probiotics are the reason i am in remission. the body is a funny place to live, and just like the real world there are undesirables that must be dealt with! i believe that just 1 gram positive bacterial group that is lacking in the gut can cause all sorts of problems, so all you need to do is top up the one that is lacking. the problem is finding the one that is lacking! its a long process. i have after several years of trying them one at a time. its been extremely expensive, very frustrating but hell it was worth every penny, and worth every day i have spent the last 12 years researching probiotics.Mark:im currently toying with the idea of probiotics with flavenoids to make a super suppliment. (A bit like superman with an uzi) what do you recon? im thinking about calling it flavenotics! (I copyrighted the name thismorning)cheersIan


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## overitnow (Nov 25, 2001)

IanRamsay said:


> Mark:im currently toying with the idea of probiotics with flavenoids to make a super suppliment. (A bit like superman with an uzi) what do you recon? im thinking about calling it flavenotics! (I copyrighted the name thismorning)cheersIan


That could actually be very useful, especially given all of the conditions that that could touch. There are absorbency issues involved in actually getting good in vivo results; but, given your persistence with all of those probiotic strains, go for it.Mark


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## IanRamsay (Nov 23, 2008)

hi markvery true, the preperation formula for correct absorption is something that i have hit a brick wall with so far. i think it is the GSE that is causing the problem, not the extract but the extrapolation process that is used leaves a minute chemical residue that seems to be a protein HT blocker. ill get there in the end.cheersian(I am the only guine pig, so ill let you know how i get on!)


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## karoe (Sep 22, 1999)

Love to hear more from anyone who's tried the 4R program or anything like it. Patman, can you give more details or tell me where you may have posted this information? Thanks, that's useful to all of us who are exploring this.


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## Patman75 (Mar 9, 2008)

My nutritionist put me on her version of a 4R program. I found this link that describes it. The link is has an overall summary of IBD but at the bottom of page one it discusses a 4R program. It says for Chrons but I did it for ulcerative colitis. This is not the exact program that I did but the theory and what is describes are very close to what I did.http://www.lef.org/protocols/gastrointesti..._disease_01.htmThe 4-R Program for Crohn's DiseaseThe following steps are recommended to help patients with Crohn's disease first reduce their symptoms and then begin long-term repair of the damage caused by their disease: *	Remove. Remove all suspicious foods from the patient's diet that precipitate inflammation. The following are the most likely to be troublesome: dairy, eggs, nuts, fruit, tomatoes, corn, wheat (or gluten), and red meat. All refined carbohydrates should be removed. All fats except for essential fatty acids should be eliminated, because hard or trans fats are detrimental to people with Crohn's disease (Heckers H et al 1988; Lorenz-Meyer H et al 1996). Products such as Vivonex®, UltraMaintain®, or UltraClear® can be used at the outset. UltraClear® is preferable because it contains sufficient fiber to maintain regular bowel evacuation. Removal of gastrointestinal parasites, undesirable bacteria, or fungal elements is important. *For me I removed, caffeine, all processed sugars, Gluten, starches, dairy. I went on the Candida diet to get the yeast under control. I also took an all natural antifungal-anitbacterial supplement.*	Replace. The diets of most patients who have inflammatory bowel disease are nutritionally imbalanced. Replacement of vital nutrients consists of a good multivitamin, together with minerals that are lacking. The vitamins that most patients with inflammatory bowel disease lack are the B-complex vitamins such as folic acid and vitamin B6, and particularly vitamin B12 (Rogler G et al 2004). Iron and calcium deficiencies are frequently found in patients with Crohn's disease (Capurso G et al 2002; Lomer MC et al 2004; Siffledeen JS et al 2003), as well as deficiencies in zinc, protein, vitamin D, and folic acid (Rath HC et al 1998; Siffledeen JS et al 2003). Patients with Crohn's disease are usually under increased oxidative stress and have lower levels of antioxidant vitamins. Supplementation with vitamins C and E reduces oxidative stress (Aghdassi E et al 2003). Long-term use of corticosteroids warrants the inclusion of supplemental calcium and vitamin D to prevent corticosteroid-induced osteoporosis. *I added a high quality multi-vitamin. My Antifungal-antibacteria supplement also had antioxidants. My diet was very nutritious with no processed foods. Everything was made from scratch. I also took/take Omega 3 fish oil.*	Reinoculate. A normal healthy intestine contains 5 to 7 pounds of friendly bacteria, the good bacteria that are responsible for manufacturing some vitamins and cell food in the intestine. In a diseased intestine, these bacteria are not present in adequate amounts or are absent, having been replaced by pathogenic organisms or yeast overgrowth. Reinoculation consists of taking mixtures of the friendly bacteria Lactobacillus acidophilus and Lactobacillus bulgaricus along with fructose oligosaccharides to promote continued repopulation with these beneficial bacteria (Fedorak RN et al 2004). Inhibition of pathogens by lactobacilli follows the lowering of pH through liberation of acids, resulting in an antimicrobial action. Stool samples provide information regarding these overgrowth factors, pH, and the balance of fatty acids. *I took a probiotic supplement and a HCL-digestive enzyme to fix all the damage I did with antacids and Pepto-Bismol .*	Repair. Frequently the lining of the small intestine becomes permeable, allowing antigens and other incompletely digested products to pass through the bowel wall. Repair of the protective layer consists of adding nutrients such as pantothenic acid (vitamin B5), zinc (Cario E et al 2000; Kapp A et al 1991; Weimann BI et al 1999), fructose oligosaccharides, and vitamin C to build up the integrity of the intestinal wall itself. *I also took a supplement that was designed to repair the intestines.2 weeks on the 4R program I went from 3-6 urgent loose BM's every morning to 1-2 solid formed BM no urgency. My Ecezma disappeared I did this for 3 months. After that I only took the multivitamin and fish oils. I stayed on the no processed foods, no caffeine, no gluten, no added sugar diet. Best 7 months of my life since my first UC flair. I tried to add some things back into my diet 2 months ago and it did not go over very well. I have made a few changes and they appear to be working. I don't want to jinx them yet.That's about it. Let me know if you have any other questions.Pat


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## karoe (Sep 22, 1999)

Pat:Wow, you made a rapid recovery with some basic changes! I'm still struggling with IBS that became unmanageable and incompatible with a normal life in 1999. Doing better, but it's still a huge burden.BIG QUESTION: What about the substrate of undigestible fiber you are supposed to be eating to support the probiotics??????? That is the whole point of my post, maybe I didn't emphasize it enough. Here is a link to a naturopath's site where he has reproduced a long article on Inulin. It has great information, but beware, when you get to the end you can see that it was written for the food processing industry. I personally wouldn't take a supplement to provide the fiber, for me, the right food is the way to go. In reading this, consider that our ancestors at lots of leaves and tubers, in other words our systems evolved that way. With the modern diet as poor as it is, you can see how the intestine gets off track. Following this, I will also post a recipe I developed to provide the fructan/inulin containing vegetables in a tasty gratin. http://members.shaw.ca/duncancrow/inulin_review.html


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## IanRamsay (Nov 23, 2008)

hiAlthough prebiotics may help some people, they also hamper others. through all of my research over the last 12 years i have found that pre biotics will only benifit a certain number of strains of gram positive bacteria and in some instances actually slows the rate of probiotic take up. it is dependant on the strain of probiotic, the method of production and the method of delivery and storage that define the role of pre biotics. the timing between taking pro and pre biotics is fairly important too.Ian


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## karoe (Sep 22, 1999)

*Good Breakfast Recipe* *Gratin of Jerusalem Artichoke, Belgian Endive and Onion*(sources of fructans and inulin) The intense flavor of this gratin develops overnight. Great for folks who don't like the taste of eggs.Peel, then shred in food processor (or coarsely chop by hand):2 medium organic onions2 small or 1 large Belgian Endive4-5 golf ball sized Jerusalem Artichokes (sunchokes)Melt 4 or so tablespoons of butter (from pastured cows) in a large fry panGrease an 8 x 8 square glass pyrex baking dish, set asideSaute (medium) all the vegetables just until the onion becomes transparent. They will wilt, so don't worry about the large volume. (Don't brown the veggies or your gratin will be a very unappetizing color*) Salt & pepper to tasteWhile vegetables are cooking, prepare 7 organic eggs by beating them for a minute with a mixer on high, and add 1 tsp of ground nutmeg (optional) Fold in by hand snipped fresh dill (optional) Salt and pepper to taste.Preheat oven to 350 degrees.Empty the cooked vegetables out onto a dinner plate to cool for 15 min. (Don't put hot vegetables into the baking dish as they will melt the butter in it and your gratin will stick to the pan*) When vegetables are cooled, arrange them in the baking dish. They should come at least halfway up the sides. Pour on the eggs. Bake until all the wetness dissapears from the top and the gratin is golden brown, about 30-35 min.Cool, cover and refigerate. Next day, cut into four servings. Reheats in microwave nicely. (do not expect to eat it right out of the oven. The great taste develops overnight*)*mistakes I have actually madeTips:•	Will taste better if you use organic onions•	Choose J. Artichokes that are firm, rounder and moist•	If you can't get good butter, use coconut oil•	Try to eat a quarter of the gratin, for a good quantity of vegetables. •	You could add feta cheese and omit part of the salt, but really the onions take care of the flavor!


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## karoe (Sep 22, 1999)

Ian, I've read that prebiotic supplements can actually be detrimental as they feed bad bacteria. That's why I choose the dietary approach. These types of undigestible starches can cause gas in some people until their system gets used to it, so it's important to start slow. I've had good experience with 1/2 cup of oatmeal 3X per week (soluble fibre, NOT resistant starch, they are different) and an organic apple every day (pectin, also not a resisant starch). I am now moving toward including the vegetables.From what I've read you need over 4 grams per day to make a difference; some studies used 15 grams per day. I have seen amounts like 245 MILLI-grams (!) included with probiotics...that would be too little to do anything, it's just a marketing pitch. It is estimated that back in the days of hunting and gathering, over 30 gm per day was eaten per person, from root vegetables and leaves. A Jerusalem artichoke has, on average 18 grams per 100 grams of the vegetable. Only Chicory root has a higher amount; I am consuming belgian endive which is said to be the leaf of this root but I can't be sure of the inulin content. The root is the main source of inulin for industrial processing.


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## overitnow (Nov 25, 2001)

I have a friend who shares, with me, a family history of heart attacks. We are both concerned about our heart health; but he insists on treating his condition with diet alone while I try to blend that with a couple of supplements that are designed to lower those risks. There will be no way of knowing whether either of our outcomes would be different if we reversed those approaches; but he refuses to even look at the science behind this. Given that death or an attenuated vitality may be this outcome, I choose to throw everything I can at this. It just seems rational to me. Everybody gets to choose how they want to pursue their health goals, there is no right or wrong, here. Still, given our conditions, expediency and speed may have some value. I no longer have D; but my stools still tend towards long and soft with my unenhanced, omnivorian diet alone. If I use my fibre powder (with it's 12 gr of total fibre and pre and probiotics in those small, dismissed quantities), in a couple of days--about the time it now takes for my food to pass through me--, my stools become firmer, shorter, and leave less mess behind. If I eat a half cup serving of All Bran _every day_ (with it's 12 gr of total fibre and no pre or probiotics), _it makes no difference to my output_! I don't know why this happens; but I sure know what I will continue to use. When I tried, back in the 90s and unscientifically, to identify and eliminate my triggers, they kept changing on me. I eliminated milk products and replaced them with soy. Then I eliminated wheat products and replaced them with spelt and quinoise. Then I eliminated the nightshades, distilled vinegars, and fungi. Then I eliminated meat and added more soy to my diet. Organics were difficult to find in those days; but we bought what we could find and afford. No supplements: no improvement. In fact, it just kept getting worse. 10 and a half years ago I began supplementing and I have been in full recovery for over 9 years. When I looked at page 2 of the reference Patman left above on this thread re IBD and supplementary support , I find that I am using many/most of the suggested nutrients, although some, like L glutamine and inulin, are in quantities only large enough to insure proper absorption of the accompanying nutrients, along with a large dose of antioxidants and circulatory support from the flavonoids. Now this could be a coincidence; but I don't believe in coincidences, just cause and effect. If I had to get all of that dietarily, I would not know where to start. I know that we have evolved from a species that was hunters and gatherers--and if you are a First Nation in the Americas or parts of the Pacific Rim, not that long ago--but many of those examples of early, pre-agricultural, man may not have lived as long as we currently do. I am in my middle 60s and would like to live actively for the next 15-20 years. I am also lazy and have no desire to spend these last years looking on my own for the best sources of nutrients, when there are fully trained scientists already dedicated to doing that. ("Not," in my best Seinfeldian way, "that there is anything wrong with that.") I do salute you for the research and the changes you have made and bringing these results forward, especially given our preference for the quick and dirty solution. Still, I would never turn my back on the advances that have been made in nutritional science, and I think the length and quality of my recovery points to the value in that choice.Cheers,Mark


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## Rick_from_IBS-Life (Nov 23, 2008)

Hey mark, I rekon you are on to something there with your flavenotics idea! - catchy name - whatever the science!Rick


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## karoe (Sep 22, 1999)

Mark:Thanks for your excellent, thoughtful post. I agree, nobody knows what this IBS stuff really is (altho some on this board seem to think they do







) so we each follow what appears to work and be logical to us as individuals. Yes, *do it with real food is my mantra, because I'm sure that it's all the psuedo-food items from the food and drug industries that I ingested my whole life that's at the root of my problems!!* I do the cave man, or hunter gatherer diet. Meat and vegetables. Small amt of complex carbs. HOWEVER!! Please note how FAST I asked you the question about how you resolved your fatigue! I am willing to supplement (I take fish oil! and probiotics!) if I can investigate the product and see if it makes sense to me. I tell you, if I could get rid of this fatigue, I'd be almost there. I will get back to that, but for the moment I am really going great guns on the probiotic diversification and the non digestible starch substrate, and I'd like to stick with it.


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## karoe (Sep 22, 1999)

Quick update, I just ran across this thread again. I had a DNA/PCR stool profile test done in early February. I am happy to say that my short chain fatty acid profile was fine! The negative findings were overpopulation of good bacteria, presence of parasite (Ascaris L) and evidence of fat malabsorption. I'm working on getting rid of the parasite first. By the way, I found this doctor via the website of the Institute for Functional Medicine. The test is by a company called Metametrix and you can read about it on their website.I would like to comment on how I feel but I think it may be premature. I took the drug for the worm about ten days ago and it's been up and down, I need to watch this over a few more weeks and the second dose of medication is tomorrow.


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## karoe (Sep 22, 1999)

Update on treatment of Ascaris:I took Albenza on Feb 9 and again on Feb 23. I had some mornings when I felt really very well. Euphoric. But it was up and down.I never saw any actual worms pass.The weekend of Feb 29-March 2 I noted a substantial change in bowel habits for the better. Once a day in the morning, less gas overall, formed stool with uniform texture and uniform dark color. Just a few days when there was more than one bowel motion in a day. I am cautiously optimistic. On the other hand, this has not done anything for my afternoon fatigue. I will be addressing that soon with the doc; preliminarly tests of cortisol, dhea and thyroid are ALL LOW. Just goes to show, the IBS thingy is not one problem, it's several at the same time......for some of us anyway.Fingers crossed. Imagine all that distress, all those years, and four pills kill the problem. Wow. I hope.


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## karoe (Sep 22, 1999)

Really quick update........I STILL feel better. One bowel motion in the morning. Dark color and uniform texture. A few slip ups like when I ate too much fresh pineapple, but after two days back to "New Normal" Fingers still crossed.


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## overitnow (Nov 25, 2001)

I missed your earlier posts on the worms. Isn't that a wonderful outcome? Consider my emotional fingers crossed, as well.Stay well.Mark


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## karoe (Sep 22, 1999)

Another really quick update...a year later and I do feel better. Still have to stay on the straight and and narrow with foods, but bowel function is more predictable. My second diagnosis from the Functional Medicine Doc is Adrenal Fatigue and boy does that ever fit. Watch YouTube videos on it if you have fatigue and you can't figure out what it is. I am treating that with vitamins, supplements, adaptogens and sleep. I am feeling better, and yes it is related to the gut.


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## Moises (May 20, 2000)

karoe,That's great that your IBS is under control. Regarding fatigue, have you tried vitamin D?


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## karoe (Sep 22, 1999)

Moises, thanks for your note. I always enjoy your posts. I have been taking 4000 IU of Vit D for almost a year now.


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## karoe (Sep 22, 1999)

Another short update. About a week ago I had severe cramping for half an hour and then realized I had to get to the bathroom. This NEVER happens to me, I'm one those who has to wait around, crouch, drink tea, go thru a whole routine to have a BM. This reminded me of prior episodes of food poisoning. I searched my memory but could not think of anything I'd eaten that was in the least suspect in the past 3 days. I felt better instantly, and I have kept feeling better over the past few days. I am going to go on the hopeful assumption that after 2 years of probiotics and eating proper substrates ie. apples., I think the good guys may have won over the bad guys, and the bad guys just got abruptly excreted. This experience also reminded me of doing the elemental diet, when on two occasions I had to rush to the bathroom with liquid stools, and felt much better afterward. I do believe that 2 week diet helped me kill something (s). Subsequent to the diet, I was able to tolerate apples, which I think has been a very important part of my healing.Of course this joy is preliminary, but these events and the way I feel are really very extraordinary for me so it may just be something. The improvements seem to come a bit at a time.







I have very little gas and what gas I have has an extremely mild odor. That's new. If this seems to be sustained, I will post the history in a new thread.


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## karoe (Sep 22, 1999)

Yet another update. About 14 months after my first DNA/PCR test for digestive function, I repeated the test to see how things looked and to make sure the parasite (ASCARIS) was gone. Digestive function looked real good (test for stuff like fat in stool, etc.) and lo and behold 2 new parasites were discovered, and ascaris was gone. I have H Pylori (the thing that causes ulcers) and D Fragilis ( a common bug but can be tough to get rid of, traditionally not even treated because it's said not to cause symptoms). I couldn't see why the test did not pick these up the last time. My doc called and the company gave her lots of information (based on their experience with thousands of patients) and said they had lowered the level at which the test picks up the presence of the parasites, or if you will, increased the sensitivity. Satisfied with this explanation, I will be taking the antibiotic protocol over the Memorial DAy weekend...well, starting it, anyway.


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## IBD/IBS Author (May 24, 2007)

Hi Karoe,Fab news! I'm keeping a little log of what I'm currently doing over on the IBD forum - I have UC and IBS. But just had to comment here as you are going down a similar path that I'm doing. And you are correct in that it isn't just one thing that gets affected. In addition to the UC and IBS, my nutrition/ayurvedic/enzyme guy and I have been and will be working on my malabsorption, low adrenals, low thyroid, low immune system, and leaky gut issues. I've been working with him about 3 months now and have seen more positive changes in that time frame than during the past 12 years. I like him best because he doesn't discount Western medicine but rather works with both Western and Eastern and uses the most advanced technology that he can get his hands on to help diagnose all the issues.Keep up the great work. So glad to hear of someone else who's finding that postiive path toward good health. Cheers,Elizabeth


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## karoe (Sep 22, 1999)

I rejoice at the prospect of feeling better, but I am mightily annoyed at the fact that I visited many docs and none thought to do these simple tests: Ascaris, h pylori, D Fragilis. Nobody should be labeled with IBS until all bugs are found and eradicated. This seems so simple, and this misery has gone on now for 13 years. Unbelievable. And now I have to pay for docs and meds and supplements outside my health plan to get well. Mind boggling!


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## overitnow (Nov 25, 2001)

karoe said:


> And now I have to pay for docs and meds and supplements outside my health plan to get well. Mind boggling!


I know, I know. Don't hold your breath. All I want is an acknowledgement from Canada's Medicare for all of the money I have saved the taxpayers by supplementing myself rather than constantly visiting the doctors. Rather than that, you just get dismissed as one of those health fanatics using "natural" treatments, even here. (Hey! You know that arsenic is all natural...)Be well, be happy. There is not a better thing you can spend your money on.Glad to hear you are feeling so much better.Mark


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## karoe (Sep 22, 1999)

I'll make a quick update here....having much success. After eradicating 3 pests from my system, 2009-2010, and getting good regular once a day bowel function, my doctor has done the following: given me bioidentical hormones, which helps a bit and shown me how to take magnesium. I take capsules to counteract constipation (!! that's what happened after all the bowel issues subsided-- very slow transit time) and to treat insomnia. In 2 1/2 weeks I was a new person with and added bonus being that some restless leg symptoms ceased. That confirms my suspicion that I was magnesium deficient. The really big news is that the doctor suspected mold biotoxin illness as the cause of my fatigue. I had the tests and had my house inspected. I did have high numbers for the inflammation markers (but Lyme disease was ruled out, thank God) and my house did not have any real bad molds. I started a medication called cholestyramine which binds toxins to bile and then they can be excreted. After only 3 doses, one of my afternoon naps is now a thing of the past. I will post a summary when the treatment is all done. Every day I feel better-- mood, clearer thinking etc. Read about mold by googling "Ritchie Shoemaker" he's the guru of this diagnosis. All best wishes.


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