# Food Intolerance: Dietary Treatments in Functional Bowel Disorders.



## eric (Jul 8, 1999)

FYICurr Treat Options Gastroenterol. 2003 Aug;6):339-345. Food Intolerance: Dietary Treatments in Functional Bowel Disorders.O'Sullivan M, O'Morain C.Department of Gastroenterology, Adelaide & Meath Hospital, Trinity College, Tallaght, Dublin 24, Ireland. maria.osullivan###amnch.ieCurrently, there is little convincing scientific evidence from well-designed trials to support the role of dietary modification or exclusions in irritable bowel syndrome IBS. Similarly, there is an absence of conclusive data linking any dietary components directly to the pathogenesis of IBS. The role of diet, as a single modality, is unlikely to play a major role in treating IBS. Dietary modifications should be viewed as a valuable part of a multicomponent management approach in combination with other strategies such as lifestyle, behavioral, and pharmacologic therapy.PMID: 12846943


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## Mike NoLomotil (Jun 6, 2000)

LOL"Currently, there is little convincing scientific evidence from well-designed trials to support the role of dietary modification or exclusions in irritable bowel syndrome IBS. Similarly, there is an absence of conclusive data linking any dietary components directly to the pathogenesis of IBS. The role of diet, as a single modality, is unlikely to play a major role in treating IBS." Go away a few days and ya miss more dogma-perpetuation again, which works against actually helping sick people with IBS get well. Lets see what we can do to help set the record straight a bit.First, especially immunologists and allergists who conduct actual study in vivo on this subject will reply that claims such as this are often made in the literature, by physicians, therapists and lay people alike who simply are not familiar enough with the subject. Or have not been exposed to or practiced any effective methods, therefor if it is not in their personal realm of experience it does not exist.That does not make such assertion fact, regardless of who asserts it. This assertion indeed is merely dogma, and innacurate at that. But selective thinkers will seek that which perpetuates and validates their selective thinking by identifying with others who do the same. Its an old humanm story, and medicine is not different than any other field.On the other hand this part IS factual:"Dietary modifications should be viewed as a valuable part of a multicomponent management approach in combination with other strategies such as lifestyle, behavioral, and pharmacologic therapy."This is why any integrated Disease Management Program of competence will include those elements listed (dietary therapy, psychologic modlaities as indicated, and pharmacotherapy as indicated).In fact I know of very few people, if any, who are advocates of single modality therapy among those who are competent at the modlaities of isolating food allergy and food sensitivity one from another in the managment of IBS, or any other condition for that matter where symptomology can be elicited by staple food ingestion.Some more useful information for the diarrheic IBS sufferer than this Part A "counterprodctive dogma" can be found here...among other places http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=4;t=000616 IBS: A DOCTORS PLAN FOR CHRONIC DIGESTIVE TROUBLESBy Gerard Guillory, M.D.; Vanessa Ameen, M.D.; Paul Donovan, M.D.; Jack Martin, Ph.D. http://www.amazon.com/exec/obidos/ASIN/088...3369143-6824157 ï¿½FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENTï¿½, Professor Jonathan Brostoff , M.D.. Allergy, Immunology and Environmental Medicine, Kingsï¿½ College, London http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 FOOD ALLERGY AND INTOLERANCE, Professor Jonathan Brostoff, MD, Stephen Challacombe, MD (NEW 2002) http://www.amazon.com/exec/obidos/ASIN/070...product-details and http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=1;t=033795 andSLIDE SHOWORAL TOLERANCEUNIVERSITY OF SUNDERLAND, U.K. http://www.sunderland.ac.uk/~hs0acu/lec01.ppt Loss of Oral Tolerance and the cascade of mediator release which leads to symptoms is not only becoming better understood by those who choose to understand it, it has led to mcuh more effective dietary protocols which allow patient specificity, thus succcess that indeed has been absent in the past.The alleged paucity of information is simply that..alleged...not to mention that the coming year will find outcome related investigative reports on disease management of IBS patients via oligoantigenic dietary therapy currently under way becoming public. This will go a long way towards dispelling old dogma like this.Meanwhile, fortunately, there are many physicians who have moved beyond such dogma and their patients are all the beter off for it!







MNL


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## Mike NoLomotil (Jun 6, 2000)

another thread on topic http://www.ibsgroup.org/cgi-local/ubbcgi/u...t=034049#000008 MNL


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## Mike NoLomotil (Jun 6, 2000)

Also interesting as over 10 YEARS ago the British Royal Society of Medicine published a position on the matter which refelected a different conclusion from findings that had already been published at THAT time.In fact they bemoan the lack of an effective tool for isolating food intolerance reactions in the conditions cited, as of 1992.That "technology problem" has been alleviated, at least. __________________________________________Journal of the Royal Society of Medicine 1992 Sep;85(9):560-4Food ï¿½Allergyï¿½--Fact or Fiction: a Review.Finn R.Royal Liverpool Hospital.Food sensitivity is a common condition presenting with various clinical syndromes including Migraine, Urticaria, Gluten Enteropathy, Crohn's disease and Irritable Bowel Syndrome. It is a heterogeneous condition affecting different organ systems and is also aetiologically diverse with subgroups due to allergy, pharmacological reactions, enzyme deficiencies and psychological causes. Clinical acceptance of food sensitivity has been delayed by the use of dubious diagnostic techniques by a minority of practitioners and the lack of laboratory diagnostic tests, but several double blind studies have now fully validated the existence of food sensitivity syndromes. More widespread recognition of food sensitivity would be cost effective for the National Health Service.Publication Types: ï¿½	Review ï¿½	Review, Tutorial _____________________________MNL


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## flux (Dec 13, 1998)

> quote:Unfortunately, MNLs comments seem more designed to prevent any dissenting views.


Agreed.


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## lflower (Jun 23, 2003)

Wow. Thanks Mikenolomotil. That was a very interesting read. It sums it all up in a nutshell. I'm curious though, what is your profession? Thanks Eric for starting it and getting MNL going!


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## bonniei (Jan 25, 2001)

> quote:Unfortunately, MNLs comments seem more designed to prevent any dissenting views.


I don't agree. I think every time eric posts that it is stress which is the trigger and food intolerance which is voodoo, Mike NL feels a responsibility to post that food intolerance is atleast vaguely connected to IBS. While I cannot comment on LEAP tests I think people who claim that food intolerance is all hog wasjh are doing the members a big disservice. Valuable info like carbo exclusion does help with gas and hence other IBS related info gets lost- the carbo exclusion idea I got from flux BTW which I have refined to fructose and wheat


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## eric (Jul 8, 1999)

Bonnie, please don't put words in my mouth about food intolerences they are very real conditions!Stress/aniety/emotions and foods are *triggers* to IBS.The bowel reacts to *all* stimulis from all of the above.


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## kel1059 (Feb 28, 2003)

I have to agree with bonniei. In my opinion, eric hurts people when he states that "food' is not "IBS".Also, the doctor who wrote the abstract that eric posted is a visiting professor at UNC with Dr drossman. This automatically sends up red flags for me. this tells me that she was only invited because she had already expressed her incorrect dogma.Foods play a strong role in my symptoms. In fact, prior to the discovery of Ibsacol, food elimination was my chief weapon that i used to control my symptoms. However, it is really starting to look like my underlying problem is a highly dysfunctional immune system. how did it get that way? 1. genetics 2. fungus/ yeast overgrowth /hypersensitivity 3. triggered by overconsumption of wheat, milk (wheat has been implicated in a number of immune system problems) 4. intestinal dysbiosis as a result of poor diet, too much sugar 5. essential fatty acid deficiencies or disorders 6. extreme stress due to inefficient or faulty catecholamine production 7. (fill in the blank)It is possible that any number of factors has brought the house crashing down.MNL does an incredible job of presenting an extremely valuable part of the IBS - "syndrome" as it relates to food intolerance. One must never forget that IBS is nothing more than a collection of symptoms with no known --exact-- cause.His information has been unbelievably valuable. In fact it was some of his comments on Ibsacol that guided my decision to make the investment. *....and that particular decision is probably the most important thing that i may have ever done to alleviate my symptoms. I am actually experiencing normalcy in my bowels for the first time in 20 years.*


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## bonniei (Jan 25, 2001)

eric, I apologize if I have put words in your mouth. Can exclusion diets of foods other than fat be successful? What is your opinion on the carbo exclusion diet? What is your solution for gas? Let's have it straight from the horse's mouth and I'll quote this thread forever!


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## kel1059 (Feb 28, 2003)

i remember what things used to be like for me when i was still eating wheat. UNBELIEVABLE!!!!The pain and the cramping was beyond belief. then there was the bloat (or it may have been trapped gas) i don't know.i am convinced that it is downright hurtful to post information that is counter to the food intolerance view. i don't want anyone to suffer the way i suffered due to wheat.


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## bonniei (Jan 25, 2001)

Well eric- you haven't commented-case closed!. It does show your true opinion of food I think. All this talk about food being a trigger and not a cause is just hog wash to hide your true feelings


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## eric (Jul 8, 1999)

Bonniei, food is a trigger not the cause of IBS!!! http://www.ibshealth.com/ibsfoodsinfo.htm


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## bonniei (Jan 25, 2001)

Hey eric my friend!


> quote: Can exclusion diets of foods other than fat be successful? What is your opinion on the carbo exclusion diet? What is your solution for gas? Let's have it straight from the horse's mouth and I'll quote this thread forever!


eric your response?


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## bonniei (Jan 25, 2001)

In addition to my last post who cares if food is a trigger and not a cause. Eliminating some food can eliminate IBS!


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## Kathleen M. (Nov 16, 1999)

No eliminating some food does not eliminate IBS.Avoiding foods that trigger your IBS may keep you from having symptoms, but you still have IBS.For some people food is the major trigger, but it isn't that the food "caused" the IBS in that if that person never ever ate X or Y they never ever would have had IBS to start with sort of Food "causes" IBS.Food didn't cause the underlying problem of the IBS, but certain foods may in some individuals trigger symptoms.Some people are triggered by other things. Stress, weather, internal signals (like wake up colon or Hey colon I just ate).So for some people the symptoms are EXACTLY the same regardless of which foods they ate, but OTHERS find that if I avoid X I don't get Y symptom.I don't understand why you are being so aggressive to eric about this??? Or what you do not understand.It is like allergies. Cats didn't make me allergic, my GENES did. Cats are not the cause of my allergies, but they are a trigger for my symptoms.Avoiding cats limits my symptoms (but they are not my only trigger by any means) but avoiding cats doesn't "cure" the allergies, it just eliminates the sneezing.Now the "allergy shots" I do may infact eliminate the allergies because they change the underlying problem with the immune system and can make me permanantly tolerant of cats so they never bother me again. But avoiding the cats doesn't eliminate the allergy to them.EVERYONE agrees that some people can limit some or all symptoms when they avoid food, but food isn't the cause. Some people only have problems with some foods when the IBS is flared up for OTHER reasons. AND some people get OVERLY focused on avoiding foods to get rid of symptoms and get neurotic enough about their food-phobias that they damage themselves with unhealthy diets. So focusing too much on "food as the CAUSE of IBS" can make some people do things that are very damaging when they should be focusing on some other trigger, or using a treatment that would eliminate the reactions which may or may not be associated with food.Many who have "eliminated" their IBS with CBT or hypnotherapy or medications find that foods that triggered their IBS NO LONGER do that, they can eat them FREELY...so do you thing FOOD CAUSED THEIR IBS???? Something else caused the IBS and food is just the "trigger".Is that ANY clearer, my dear??K.<who could eliminate IBS symptoms when it was bad by never eating any food or drinking any fluids ever again, but the treatment would eventually be fatal>


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## bonniei (Jan 25, 2001)

i know the difference bettwenn triger and cause, kmottus dear, but I wanted to know if eric knew the difference, LOL. All he says is food is a trifger and not a cause and posts studies which say exclusion diets don't work. It is very confusing to a newcomer. People come to the board looking for help and they get misled by eric that eliminating some foods won't help their IBS.So kmottus let me ask you a question. Has CBT cured you of your IBS or just your symptoms. And were you glad you came to know that CBT was an option?BTW I am not being aggressive to eric because if you note I did call him my friend. OK maybe slightly aggressive because he didn't answer my question which I have posted twice already. I hope if he doesn't answer the question again you will let me off the hook. It is so bugging when eric tries to pose as an authority when he indeed doesn't have the answers to many questions.


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## eric (Jul 8, 1999)

I am a busy person right now for one, two when I look at the posts and the attitudes I tend to think, let them figure it out as why help when someone is bitching at me and it really concerns me when words are put in my mouth or I am called names or some are extremely hostile to me. We have all been talking about this for years now and its not understood well because instead of focusing and talking about it, there is just distraction, you ask me questions I answer and then you argue.You have never once understood what I am saying about foods or even bothered to research what I have posted all along on them.If you knew what I was talking about with foods and d you would have to understand why serotonin is majorally implicated in IBS. *So, I ask you a question why is serotonin majorally implicated in the pathophysiology in IBS?* And what does that have to do with d predominate IBS? Because when you learn all that we can talk, otherwise its just getting pointless. Until you learn that for yourself's it will all never be clear what I am saying and how important it all is.Please answer the above question!!!People should understand the role of foods as triggers in IBS, it is majorally important!!!


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## bonniei (Jan 25, 2001)

You see! He didn't answer my question again! so let this be a notice to all about why I feel aggressive to eric. I will quote this thread for ever more. Thanks eric! You have made my day!


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## eric (Jul 8, 1999)

Bonniei, I answered your question right here where I have food information and IBS? http://www.ibshealth.com/ibsfoodsinfo.htm You haven't answered my question?I also posted this numerous times from my website here.""However, it is important to separate factors that worsen IBS e.g., foods as above, stress, hormonal changes, etc. from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, though it can make it worse, foods must be understood as aggravating rather than etiological in nature. "Written for me because I went out and kindly asked one of the leading experts in the field IBS and Fucntional disorders. http://www.ibshealth.com/ibsfoodsinfo.htm


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## Kathleen M. (Nov 16, 1999)

As for exclusion diets they don't work for ALL IBSers because food is not the "cause" or the "trigger" for symptoms in most people.I think the CBT I did pretty much "cured" my IBS. The things that trigger my symptoms (walking more than 15 steps in a row, picking up anything at all that weights more than a pound or two and EVERY Single meal no matter what it was, even large volumes of water and nothing else) no longer trigger symptoms in me.It didn't completely "cure" me because I still have some low level abdominal ache, and occasionally (although not always clear what triggers it now) get a bit spasmy, but my symptoms really do not currently rise to the level of having IBS, really. With my current symptoms I would not be accepted into any of the IBS clinical trials because I don't have enough symptoms often enough to really meet the criteria usually used.CBT got to the "Enteric Nervous System" which seems to according to most of the researchers in the field be where the "cause" or "defect" that causes IBS is. Treatments aimed at the ENS and fixing what is wrong there often eliminate triggers.I think it is important that people KNOW that elimination diets do not fix many people with IBS. Because I have seen WAY too many people over the years who are totally convinced that the ONE AND ONLY thing that causes their IBS is diet and if they can just find the right one and have the "guts" {pun intended} to stick it out for enough decades they will be cured. There are plenty of alt. med types who will insist that diet is the ONLY factor at all in IBS and people do need to know that this is not true.K.


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## bonniei (Jan 25, 2001)

I missed that link. Thanks for putting it up, eric.I do not say that food is a cause of IBS. Serotonin is majorally, as you put it, implicated in IBS because of the brain gut axis connection. But just like antidepressants don't cure depression, just treat the symptoms, serotonin would play the same role in IBS.


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## bonniei (Jan 25, 2001)

kmottus, actually you and I are not good candidates to talk about a particular treatment curing or even eliminating symptoms. Both of us take meds which might influence these symptoms. I believe you take/took Buspar and now Prozac?But my point is if something is going to help IBS why not post it and not have it argued about. If eric feels serotonin helps he is free to podst it but if I post about fructose helping and he posts an old study about it not helping, even though Dr Drossman feels it helps, he is responsible for his words and has to bear the consequences of them affecting others. As an e.g see http://www.ibsgroup.org/ubb/ultimatebb.php...t=033847#000000


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## Kathleen M. (Nov 16, 1999)

You should read an article that was out last summer (If I recall correctly) in Discover magazine about some of the issues of what some of the antidepressants do.There may be more than "just" treating symptoms in the changes that may occur in the brain. They make nerves grow and all sort of interesting things and some suspect that why it takes weeks to feel better is that the drug doesn't directly treat the symptoms, but some of what it does to the brain structure reverses what being depressed does to your brain structure. If it was directly attacking sympotms it would be more likely to work from day one rather than only working after the brain changes start being apparent.But you are right for the most part treating IBS with serotonin-effecting drugs tends to only treat things for as long as you take them. However at least some of the studies on things like CBT and Hypnotherapy (the CBT study I did had a one year follow up, but that part of the study hasn't been published yet as I think some people are still in the follow up period, or just finishing that now) show that often the benefits remain after the treatment phase is over. So one is no longer actively doing the therapy, yet the IBS doesn't come back. So that is closer to a "cure" than most things. Basically it is getting the body to re-regulate the nervous system so it doesn't freak any more sort of thing.I did my CBT in 1998 and it hasn't come back like it was even after all this time. Now there isn't anyway to know if I am just one of those where it woulda gone away on it's own anyway, which is why they did a big study, but assuming it was the treatment, things actually got better during the one year follow up period and typically have gotten better in each of the following years as well.


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## eric (Jul 8, 1999)

What's important also is the role serotonin play's in motility and function of the digestive tract and contractions in IBS at the gut level, which isvery important in connection with d predominate IBSers and what it means in regards to foods you eat? Its not even just about the foods you eat, but also even how big the meal is Itself and the ACT OF EATING ITSELF.Also since foods are not the only player in IBS triggers and its important to recgonize there are many triggers not just foods and foods should not be the only focus on symptoms and this is a more holistic approach and less focused on one specific trigger, foods, or stress.Also gas transit can even be altered just by sitting all day at your computer and lack of excersise and movement which effects colon health. So even with that is not always about foods. The sole focus on only foods is unhealthy in regards to IBS treatment, its major to recognize there role however and just as important the the role of hormones anxeity/stress/emotions, even the weather all as triggers in IBS and to manage accordingly all these issues including your diet and figure out comorbid foods issues as well such as fructose and lactose intolerences or if you have celiac or for many other reasons including very importantly malnutrition from not eating right itself which effects how the digestive system works in and of itself regardless of IBS.Parasympathetic and sympathetic nervous sytem responces also are a part of and act on digestion function and also plays roles in IBS and eating.


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## Kathleen M. (Nov 16, 1999)

Buspar keeps the low level abdominal pain completely gone. Even when I do not take it the pain/bowel symptoms are not at a level that I really could be diagnosed with IBS (the stool is totally normal now).Prozac is for migraines and that is VERY recent.I am about as close to cured as one can be even though for 100% complete remission it takes VERY LOW levels of medication. The Buspar is at about 1/2 the dose usually used for IBS, and I can go without it, except I am doing some heavy abdominal work with my T'ai Chi and it bothers me a bit too much when I go without it.The Prozac hasn't made any difference in the last of the IBS symptoms, if anything it seems to make the Buspar a little less effective, but even with no meds if my symptoms were at 10 before that are at 0.25 now, a DRAMATIC improvement.Really I couldn't walk to the curb without doubling over in pain before, I couldn't eat ANYTHING without have a BM and doubling over in pain, I couldn't carry or lift ANYTHING without doubling over in pain and a full dose of Buspar and constant use of antispasmodics make my symptoms go from a 10 without treatment to maybe a 8 with the treatment. Enought that I could do somethings, but still bad enough that I couldn't really do the field work I do.If going from an 8 with lots of meds to a 0.05 when on low doses of some meds and about 0.25 without meds isn't impressive enough for you, I don't know what is.I don't know why I am feeling like I have to defend my progress like this in response to you, but I do. I feel like you think I am lying about being in almost total remission...sighK.


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## bonniei (Jan 25, 2001)

No I don't think you are lying but I know how dramatically meds have affected me and serotonin has helped a lot of people so it is not impossible that meds have brought about the dramatic change of symptoms. Of course I am not asware of what kind or dose of meds you took prior to CBT and after. I sometimes wonder if I was off fructose and wheat and went off meds whether I would have IBS problems. It is my own doubts about myself.Did you ever manage to get the CBT protocols used in that study? I am curious about CBT. I would love to find out more about it. Perhaps I should go to the CBT forum


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## Kathleen M. (Nov 16, 1999)

Unfortunately that is a journal that I can't get full access to on-line through the library, so I will have to go back there, probably to get the refs, or wait for it to show up on ISI database, which lists the references...It wasn't there a couple of days ago...let me see if it is there now....nope not up on ISI, yet..it can take awhile, but it lists all the refs nice and handy-like...so I will have to traipse back to the scary library (they are remodeling and you gotta walk though the destruction zone to get to anything (hopefully soon it will look more like construction)K


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## Kathleen M. (Nov 16, 1999)

This book title looks kinda familiar that it might be one of the refs they had..Cognitive-Behavioral Treatment of Irritable Bowel Syndrome: The Brain-Gut Connectionby Zindel Segal (Author), Brenda Toner (Author), Shelagh Emmott (Author), David Myran (Author), Zindel V. Segal, Brenda B. Toner But it lists 1999 as a copyright and I thought the ref was 200* but I just did a brief glance....it will take a trip across the street to get the real info.


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## bonniei (Jan 25, 2001)

Be safe!


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## Kathleen M. (Nov 16, 1999)

This one is the right year and the amazon.com link from the Books above gives what I think is the right yearIrritable Bowel Syndrome: Psychosocial Assessment and Treatmentby Edward B. Blanchard The review mentioned giving detailed treatment info.K.


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## bonniei (Jan 25, 2001)

Thanks k!


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## kel1059 (Feb 28, 2003)

Fixing the immune system (as referenced by kmottus with respect to allergy shots) is sort of like what i am doing with Ibsacol. It seems to be doing exactly as advertised. therefore one could say that the immune system is at the root of my problems.however, not so fast. I am not entirely convinced that the immune system is responsible for the entire mess. In other words, I don't think a genetically inferior immune system can be 100% to blame (although it could be).i think that environmental factors play a strong role. I think that certain foods such as wheat and dairy can cause profound changes in a person's body at the immune level. I also think that microorganisms and heavy metals can also alter the immune response and eventually weaken it or cause it to go into a state of dysfunction.therefore, the people who say that "food does not cause IBS" need to be very careful. How do they know what the EXACT role of food is for different people??????One person may have no problems at all with food. But another person may have a condition which would never manifest itself if not for daily eaing of wheat.HOW DO YOU KNOW??? you really don't know, and that is because IBS is still an "unexplained" syndrome. Therefore, anything is possible. Some things are more likely than others of course.*****************I am just very glad that I seem to be getting to the root cause of my problem --- dysfunctional immune system. Now, my next project is to see if the mercury chelation will improve my nervous symptoms.


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## kel1059 (Feb 28, 2003)

You see--eric, you need to be careful when you make blanket statements.throughout the ages, the men of science have repeatedly been proven wrong by a newer generation of scientists. each generation has the advantage of greater technology which results in a deeper understanding.So, to think that you know what the causes or triggers are concerning IBS -- is jumping the gun.In the future, our doctors will split IBS people up into multiple groups --each having a different name and the treatments will vary.One group of people will be a group called the "the milk protein/ corn protein/ wheat gluten screwed up my immune system subtype".In other words, our future doctors have clearly identified a group of people whose symptoms and ILLNESS is brought on by a specific protein.**********************************************by the way, concerning celiac disease, does a person say that the celiac patient has symptoms caused by wheat and therefore wheat is a trigger??????????? (i.e. genetics is the cause and wheat is the trigger)ordoes someone say that wheat is the reason behind the whole mess?????(i.e., wheat is the cause because it is a wheaty/genetic thing)


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## lflower (Jun 23, 2003)

Does anyone know what MikeNoLomotil does for a living? He sounds like he's Dr. MikeNoLomotil when he talks about "Grand Rounds". I havn't heard that term used since I worked at a hospital as a respiratory therapist 20 years ago. He hasn't answered my question about what he does and I hope I'm not being too nosy. I'm not trying to hit on him... really!!


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## Kathleen M. (Nov 16, 1999)

Celiac is pretty analogous to allergies.Wheat triggers the symptoms.Eating wheat didn't cause you to become Celiac, but your genetic predisposition combined with something in the environment got the disease started, so is the "cause".Wheat (well actually gluten because with celiac there are OTHER grains that are part of the problems as well not just wheat) triggers symptoms when it is consumed, and since we have no other way to block the symptoms triggered by gluten avoiding it is the only treatment.Theoretically it might be possible to treat with something that specifically blocks the anti-gluten antibodies then someone with celiac could eat gluten without having a problem.Presumably people have always had a risk of becoming a celiac, even before people ate much in the way of gluten-containing grains, it just wouldn't matter if you were or not if you don't have it in the diet.It isn't like people started eating wheat and it changed us so now some of us become celiacs...That Candida paper and Celiac (read the whole thing, don't know if you saw my analysis of the paper or not) basically did the usual sort of what may be the cause of these sorts of immune problems. The immune system gets exposed to something that it is SUPPOSED to react agains. This something looks a lot like something it shouldn't react to. In some people with the right genetic background the antibodies they make in response to something the should fight off cross react with something else (basically the lock and key in some people will fit more than one thing). So now the body fights against something that is normally harmless.It isn't the gluten that makes the symptoms, but the misguided attack on it by the immune system. The Immune system causes lots of damage and havoc when it attacks anything it believes is an invader, whether the thing is really harmless or deadly. Much of what makes us feel sick when we are sick is what the immune system does to us (friendly fire) not what the microbe is doing to us.K.


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## kel1059 (Feb 28, 2003)

> quote: It isn't like people started eating wheat and it changed us so now some of us become


There are a few doctors who think that this indeed may be happening. Maybe not specifically with celiac disease but the doctor who wrote the "No Grain Diet" thinks that wheat might be the causative agent in some of the rise in autoimmune disorders that seem to be escalating. There is no question that genetics plays a very strong role but I think it is unwise to overlook foods especially in this day and age of selective breeding, genetic engineering, and repeated overconsumption of the same foods every day.Some animals can thrive off of just about anything -- rats and raccoons come to mind. But other animals fare poorly on diets that are not in alignment with their natural diet.Eric, the point I am trying to make is that you can't say that something is definitely not the cause of IBS. The biggest reason is that there appears to be multiple causes. Is there anyone out there who thinks that there is one single cause????As of today based on my extreme success with immunomodulation (things may change), I am almost certain that my IBS is due to immune dysfunction of some sort or another. However, I do not think that explains everyone's problem. When I said that food was causing my problems, I was correct and I was incorrect. Certain foods would cause a severe magnification of my symptoms. However, there was no diet or group of foods that allowed me to be normal like I am today. (but I was a severe case) Therefore, in my case, it came down to a dysfunctional immune system. The future will tell as to whether or not I will be able to eat wheat, dairy, corn..... again. I think that if fat is a non-factor in a person's IBS (such as in my case), but certain protein foods are a factor --then, possibly the immune system is involved.


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## Kathleen M. (Nov 16, 1999)

> quote: Eric, the point I am trying to make is that you can't say that something is definitely not the cause of IBS. The biggest reason is that there appears to be multiple causes. Is there anyone out there who thinks that there is one single cause????


Um...most of the experts who do the whole being on the Rome committee kinda seem to be MUCH MUCH more narrow on the potential number of causes than most of the alt. med community....But whadda they know??




























Right???K.PS.Let me go get you a very recent abstract I read to day and post it. Be back soon.


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## Kathleen M. (Nov 16, 1999)

Curr Gastroenterol Rep. 2003 Aug;5(4):331-6. Current insights into the pathophysiology of irritable bowel syndrome.Schwetz I, Bradesi S, Mayer EA.Center of Neurovisceral Sciences and Women's Health, CURE: Digestive Diseases Research Center, David Geffen School of Medicine at UCLA, VAGLAHS, Bldg. 115, Room 223, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. emayer###ucla.eduRecent reports have emphasized the possible role of mucosal immune activation and inflammation in neuropathic changes in the pathophysiology of irritable bowel syndrome (IBS). However, novel findings using functional brain imaging techniques have underlined the importance of altered perception of visceral stimuli to symptom generation in IBS. These new developments have rekindled an old debate on peripheral versus central mechanisms in the pathophysiology of IBS. In this review we discuss the latest findings in light of these two concepts. In addition, we provide evidence for the hypothesis that, in the absence of alterations in endogenous pain modulation systems and changes in visceral perception, chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a cardinal IBS symptom.Basically they look at is the nerves in the gut or the nerves in the head that underpin the whole IBS and without one of those defects not much else alone explains the pain that is a required symptom of IBS as it is currently described by most of the experts.But if you wanna do the any and all symptoms of anything are part of IBS thing that tends to muddy up the waters a lot.K.


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## Kathleen M. (Nov 16, 1999)

How this integrates into your immunomodulation works for me thing is kinda thusly.If you didn't have the underlying problem in the nervous system the immune stuff going on wouldn't cause you symptoms. However if you have the underlying problems in the nervous system (cause)the immune stuff may be a trigger for symptoms.So reducing the trigger may reduce symptoms, but may not get rid of the underlying cause.A lot of the "if we didn't eat it 1.2 million years ago" it is the cause of all modern illness arguements so far haven't really impressed me. But then I don't know that we completely understand what our first human ancestors actually ate and I believe some of the "deteriorating health" thing is the reliance on too few foods much more than which few foods you eat. But that is me. I think all meat, or all grain or all fruit etc diets are all going to be found to be a problem, and more of the autoimmune stuff seems to be more of a which normally harmless bacteria/virus twigs off a person with a genetic predisposition but that is me. K.


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## kel1059 (Feb 28, 2003)

This gives me a lot to think about. I would have to say that based on multiple drugs that I have used to control nervous/brain function --and none helped my IBS-- that the problem is centered on immune dysfunction.I have also noticed that certain allergy medications have improved my nervous symptoms (but they make me tired). Therefore, that seems to be another link to the idea that the immune system may be the responsible party in all of this. However, the nervous system may indeed also have some strong input in all this. The future will tell. One other factor, my nervous symptoms quiet down on dry, warm days or when the temperature is below freezing. Once again this points to the immune system (probably atypical mold allergy).Concerning pain and brain imaging, that is a tricky one. I always had pain except if I did not eat and my bowels were empty. I never had a balloon up me so I can't answer that one. ----- i am thinking that rheumatoid arthritis may be a close cousin to my subtype of IBS. I don't think anyone has implicated the nervous system in this disease and yet these patients also exhibit different brain imaging scans. I am wondering if chronic pain may be a reason as to why the brain might be processing the pain in different regions.Once again, I started to fall into the trap of "what is true for me is true for others". Therefore, it is entirely possible that brain scans could differentiate people --and point to a clear nervous connection in some subtypes. Since I never had a scan I can not comment and guessing is pointless.


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## kel1059 (Feb 28, 2003)

I think that in the future when brain imaging becomes more common they will have more data on patients such as pre-IBS scans and post-IBS scans and "brain scans after 15 years of IBS".If the brain imaging is always the same regardless of the stage the patient is in then it is more likely that the brain and nervous system is faulty. However, other possibilities would still exist.


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## kel1059 (Feb 28, 2003)

The more I think about it, the more i think that it is too difficult to tell what causes what. Only guesses can be made by me. I think it is a given that the nervous system affects the immune system and vice versa. I also think that a poorly functioning digestive system will affect the nervous and immune system.Typical and atypical allergies will affect all 3 systems. i believe that certain organisms will affect these systems. --and I am currently investigating whether removal of mercury will take a load off of my 3 systems.I think that everyone would benefit from a multimodal strategy that seeks to optimize all 3 systems.However, based on endless prior treatment strategies which included CBT and hypnotherapy, probiotics (helped with Diarrhea), diet (helped greatly but far from the cure), herbal (helps with gas and odor), colonics (very temporary relief), medication (very little help) ---- I would have to conclude that in my particular case it is due to immune dysfunction. This is because of the extreme and sudden total shift in the way my bowels have been normalized upon 2 trials of Ibsacol.I am wondering if it is possible that ibsacol could have changed my brain and that is why my bowels and my LUNGS are functioning correctly for the first time in a couple of decades. (my lungs were a problem 15 years before IBS --the IBS gradually appeared)I am thinking that Ibsacol may have changed my entire immune system for the better and this may have had profound changes on my hypothalamus and pituitary gland and other parts of the brain. I won't know for a long time as to how my overall brain and nervous system responds. But despite the fact that I still have complaints, I already feel much better overall. I think that mercury chelation is responsible for quite a bit of my misery right now --chelation days are definitely worse.We have all seen studies that show how ess fatty acids can improve brain function and even correct or improve mental conditions. I am thinking that ess fatty acids are too weak to make a big change but it is possible that Ibsacol has the power to make the necessary change regarding some types of mental illness.


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## eric (Jul 8, 1999)

Curr Gastroenterol Rep. 2003 Aug;5 4:331-6. Current insights into the pathophysiology of irritable bowel syndrome.Schwetz I, Bradesi S, Mayer EA.Center of Neurovisceral Sciences and Women's Health, CURE: Digestive Diseases Research Center, David Geffen School of Medicine at UCLA, VAGLAHS, Bldg. 115, Room 223, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. emayer###ucla.eduRecent reports have emphasized the possible role of mucosal immune activation and inflammation in neuropathic changes in the pathophysiology of irritable bowel syndrome IBS. However, novel findings using functional brain imaging techniques have underlined the importance of altered perception of visceral stimuli to symptom generation in IBS. These new developments have rekindled an old debate on peripheral versus central mechanisms in the pathophysiology of IBS. In this review we discuss the latest findings in light of these two concepts. In addition, we provide evidence for the hypothesis that, in the absence of alterations in endogenous pain modulation systems and changes in visceral perception, chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a cardinal IBS symptom.


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## echris (Jul 19, 2000)

Gosh. I missed Mike's diatribe and Eric scientific rantings. Like two ships passing in the night.I was diagnosed with Celiac Disease about 1 1/2 years ago, went on the Gluten free/lactose free diet. The diarrhea stopped. I have now gained back over 20 of the 25 pounds that I lost. My life is getting back to normal. LEAP did not help me. I still look at the diet printouts once in a while, but it certainly wasn't worth the amount of money that I paid for it.Hope that you guys have a pleasant summer.


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## Kathleen M. (Nov 16, 1999)

Most allergy medications are anti-histamines.Histamine is used by the GI tract, the Nervous System and the Immune System.Part of what makes you sleepy with anti-histamines is that if they get in the brain they shut down the "stay awake" signal that is histamine mediated. Most of the "non-drowsy" antihistamines are ones that do not get into the brain as well.The tricyclic antidepressants generally are also dandy antihistamines (which is why they make many people drowsy when they start on them).H1 receptors (Histamine Receptor #1) is the main one involved in allergic responses in the respiratory tract/skin.H2 receptors are mostly in the stomach and deal with acid production.I assume the mast cells that do the "flush flush the bad wrong bug outta here" are H1 mediated, mostly.H3 has been implicated in migraines, but the last I heard this was still in the "maybe we can make a drug" area of research, but I haven't checked on that lately.H1 and H2 receptors are not always installed according to the manual and sometimes H2 blockers (acid reduction meds like tagamet and Zantac) will help with allergy symptoms, so it isn't as all or one as it at first appears.K.


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## kel1059 (Feb 28, 2003)

Yes but if I am much better during the dead of winter as opposed to allergy season then that tells me that the immune system dysfunction is the likely culprit. So if I take an antihistamine and it helps me then even if the effects are working on the nervous system it still tells me that the immune system is the starting point.I think the key piece of information is the ibsacol and how it has done such a remarkable job of normalizing my bowels. From my understanding, it accomplishes this by correcting the immune system -- specifically the prostaglandins and supposedly it reduces leukotriene release.Tranquilizers, anti-depressants, anti-cholinergics and all the others failed miserably. Yet, the immunomodulator is giving me relief.Anything is possible but I am betting that the immune system is the responsible party in all of this. However, I think it would be a mistake on my part to think that the nervous system is blameless. Possibly there is a mild genetic weakness that has affected both systems. It is difficult to tell what happened because I know that environmental issues played a large role.This is a big issue with me since there is no guarantee that Ibsacol will continue to work. I am baffled as to why there is not more research in this area. I am not sure that drugs are the answer though. It seems that drugs usually don't get to the root cause of the problem. Given a choice between drugs or Ibsacol, I would rather take Ibsacol because at least it is something that the body recognizes as natural (something that it can burn for fuel).The bigger question is why did all of this happen with my bowels. it was not a sudden thing like what some people experience. It was gradual and it seemed to gain momentum during my stages of very poor eating. This is why I think that wheat, dairy, sugar, wine, and anything with a high yeast content is what has led to my downfall. It is entirely likely that yeast/fungus hypersensitivity is a very large contributor to a dysfunctional immune system. It is beyond me as to why people can so readily dismiss this phenomena. After reading eric's abstract from the Mayo Clinic concerning "strange immune reactions" due to fungus in the sinuses, it makes perfectly good sense that this can be happening all over the body. The skin, vagina, lungs, now the sinuses -- why is it taking so long to recognize that it is most likely also happening in the bowels. I know it is not the only factor involved in immune dysfunction. However, since so many people continue to suffer from hopeless cases of IBS, yeast eradication/control seems like it would be an excellent part of a comprehensive program to try and regain control of the bowels. All it takes is a doctor like Dr Carol Jessop of California (she has helped the majority of her CFIDS patients with a prolonged antifungal program -- although even she admits that it is only a part of the problem) who knows what he or she is doing. It also requires extremely strong discipline, and possibly the person can get lucky like me with a product like Ibsacol. Maybe 20 to 40% of the IBS population could experience a strong response to a program of yeast eradication, heavy probiotic supplementation, removal of all offending foods, zero yeast-zero sugar diet, low carb diet for first 3 months then a gradual increase, glutamine supplementation, Ibsacol, and maybe a few other additions according to individual need.


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## kel1059 (Feb 28, 2003)

where did eric go?


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## Mike NoLomotil (Jun 6, 2000)

Hmm....interetsing since the success rate is over 85%....I just wonder when I hear from one of the 15% "why"EC....just because I forget your pt ID please email me so I can talk to your dietician if you were in Honmecare or to your doctior if you were on offcie-care and see what we can do to determine where the l;ack of relief comes from.If we did follow the protocol and instructions exactly and the symptoms did not improve, there has to be a reason as prophylaxis for the reactions (which are simply comorbid with your celiac problem) should have reduced your symptoms unless the celiac protocol was not correct or not implemented at the same time. Were you diganosed with celiac disease before or after going on the LEAP DM program?For example an active celiac will suffer worsened cell mediated food intoelrances due to the effects of the active inflammation upon the gut mucosa, end even eliminating the comorbid reactive foods may remain symptomatic due to the severity of the celiac-realted inflammation. And tests fro cell mediated reactions do not detect celiac disease...thats a separate problem as you know.On the flip side if the celiac is on their celiac protocol not only will their tolerance to other foods improve over time, but any LEAP protocol followed should be effective as long as their celiac protocol is also followed. But if it is not then the LEAP protocol will be farrrr less effective.I just need to have the case reviewed so we can see the issues. Anyway Either one will negate the benefits ofthe other esp when dealing with the pathology of celiac disease. Email me your ID and I will have my staff follow up with you and see what needs to be done to improve your results.MNLPS on another postNo time to go further today but such things must be kept in context"chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a cardinal IBS symptom."Except it is not the only symptom, and the nature and pattern of the pain experienced is variable...the quality nature frequency duration of one pts pain component may be quite different than another and the pain which accompanies the diarhea of the patient suffering loss of oral tolerance may differ from one who does not...for example many patients are diagnosed with IBS when their pain is not releived by defecation, as requiored by the Rome criteria...it goes on and on as does the defecation...over and over...uintil the patient is exhausted and a pile of chilly quivering flesh on the bathroom floor. This is characteristic of the subject who will test out with siginificant food intolerance reactions....it is difficult to gelan much about the entire symptom set from one postulate about one symptom in the seat when that symptom also has a wide range of character. Indeed localized chronic infllamtogenic processes are not the ONLY mechanism...it is though ONE mechanism...involved in these subjects symptoms.


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