# Mike NL, Question about sugars



## Julia37 (May 9, 2001)

Mike,Someone e-mailed me this question that I'd already wondered about. Are sugar intolerances like lactose and fructose the same mechanism as the immune system food intolerances? Or, can it be an enzyme deficiency in some and an immune system problem in others?


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## Mike NoLomotil (Jun 6, 2000)

Sensitivities of this type in the past were almost exclsuivley attributed to enzymatic and dysbiotic problems of breaking down complex sugars into simple sugars in the gut.But it has been observed for years, since I think the first primitive cytotoxic testing was done in the 50's and 60's that in some people an immunocyte response was reproducible as well.I do not have my references with me, but I do recall a study done not tooo long ago where it was discovered that antigenic properties are not limited to proteins as has been always assumed. I mean it has been understood that there were complex mechanisms whereby non-proteinacious materials could result in an end-stage cellular reaction, but this was not tantamount to carbs being directly antigenic. Yet seeming inexplicable cellular reactions to non-proteins could be observed.But unless my aged memory banks fail me, I recall reading a papaer regarding an antigenic carbohydrate structure which was recently demonstrated (I have the paper back home), thus opening another whole aspect of "immune response" to be investigated which was suspected, discounted, but now cannot be discounted.But regardless, there are mechanisms whereby a carbohydrate can result in release of proinflammtory mediators from circulating immuncyte types thus this has to be considered when assessing food hypersensitivities along with the other possible mechanisms.MNL


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## Julia37 (May 9, 2001)

Thanks Mike







When I have a fructose reaction it feels like 2 things are going on. I get a lot of acid pain, I suppose because my stomach is producing more in a futile attempt to digest the undigestible. Maybe it's also from inflammation.Then after I've had the pain for a while it moves *down* from my stomach to what I assume is the top part of my small intestine. This feels like inflammation, and when I had it real bad, before I knew what I know now, I described it this way to my GI. He said he couldn't account for it.Before I began getting treatment I would also have bad fatigue with this pain. I missed 6 days of work in one month.







Guess what I was eating during this time? Pizza! I thought it was healthy and was too tired to cook. I don't get these symptoms from lactose/dairy, instead I get the usual lactose intolerance symptoms of cramps, gas, and more frequent BMs.


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## bonniei (Jan 25, 2001)

So while end stage cellular reactions to carbohydrates can't be discounted would it be fair to say no studies have been done demonstrating that people who have fructose or lactose malbsorption problems also have these endstage cellular reactions?


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## Mike NoLomotil (Jun 6, 2000)

Hi BonnieThe technology to detect such reactions quantitatively did not exist prior to 1997, except in an earlier generation qualitative assay. So it is just in the last couple of years, as this new method of detecting these types of common-end point immunocyte reactions has been used daily to perform a growing number of individual assays, thus more and more individual data have been accumulated, that one could even have enough assays done and on hand to observe to be able to make any observations.These observations are among the many different observations that could indeed be targheted as indivisual investigations for eventual publication. But since the funding for investigations in this area of medicien is very very hard to come by, and this particualr aspect of food hypersensitivity reaction is but one of a large group of observeable reactions which have clinical siginificance as symptom generatros, that funding to perform further studies for publication when it is secured will have to be focused on something which is of immediate therapeutic benefit to a mass of people clinically, as opposed to an acadmic investigation.Unless of course at some point an institutio with captive funidng for such academic investigation and publication should take an interest...in which case that phenomenon could rise up to priority ladder.here is an abstract of just such an investigation by an immunology lab with the resources to investigate such intriguing obsrvations for the sole purpose of trying to understand them: __________________________________J Exp Med 1997 Sep 15;186(6):899-908Major Histocompatibility Complex-Independent Recognition of a Distinctive Pollen Antigen, Most Likely a Carbohydrate, by Human CD8+ Alpha/Beta T cells.Corinti S, De Palma RD, Fontana A, Gagliardi C, Pini C, Sallusto F.Laboratorio di Immunologia, Istituto Superiore di Sanita, I-00161 Roma, Italy.We have isolated CD8+ alpha/beta T cells from the blood of atopic and healthy individuals which recognize a nonpeptide antigen present in an allergenic extract from Parietaria judaica pollen. This antigen appears to be a carbohydrate because it is resistant to proteinase K and alkaline digestion, is hydrophilic, and is sensitive to trifluoromethane-sulphonic and periodic acids. In addition, on a reverse-phase high performance liquid chromatography column the antigen recognized by CD8(+) T cells separates in a fraction which contains >80% hexoses (glucose and galactose) and undetectable amounts of proteins. Presentation of this putative carbohydrate antigen (PjCHOAg) to CD8+ T cell clones is dependent on live antigen presenting cells (APCs) pulsed for >1 h at 37 degrees C, suggesting that the antigen has to be internalized and possibly processed. Indeed, fixed APCs or APCs pulsed at 15 degrees C were both unable to induce T cell response. Remarkably, PjCHOAg presentation is independent of the expression of classical major histocompatibility complex (MHC) molecules or CD1. CD8+ T cells stimulated by PjCHOAg-pulsed APCs undergo a sustained [Ca2+]i increase and downregulate their T cell antigen receptors (TCRs) in an antigen dose- and time-dependent fashion, similar to T cells stimulated by conventional ligands. Analysis of TCR Vbeta transcripts shows that six independent PjCHOAg-specific T cell clones carry the Vbeta8 segment with a conserved motif in the CDR3 region, indicating a structural requirement for recognition of this antigen. Finally, after activation, the CD8+ clones from the atopic patient express CD40L and produce high levels of interleukins 4 and 5, suggesting that the clones may have undergone a Th2-like polarization in vivo. These results reveal a new class of antigens which triggers T cells in an MHC-independent way, and these antigens appear to be carbohydrates. We suggest that this type of antigen may play a role in the immune response in vivo. _________________________________here is another, for example, observing the properties of some common preservatives and their ability to cause apoptosis...programmed cell death...on exposure, another form of ell response which reults in liberation of mediators as an end-point via a throuoghly different mechanism: ___________________________________Biochem Pharmacol 2002 Feb 1;63(3):437-53 In vitro induction of apoptosis vs. necrosis by widely used preservatives: 2-phenoxyethanol, a mixture of isothiazolinones, imidazolidinyl urea and 1,2-pentanediol.Anselmi C, Ettorre A, Andreassi M, Centini M, Neri P, Di Stefano A.Department of Pharmaceutical and Technological Science, University of Siena, via A. Moro, 53100, Siena, ItalyPreservatives are added to many final products, such as detergents, cosmetics, pharmaceuticals and vaccines. We conducted an in vitro investigation of the apoptosis- and necrosis-inducing potential of brief applications (10min) of four common preservatives: ethylene glycol monophenyl ether, 2-phenoxyethanol (EGPE), imidazolidinyl urea (IMU), a mixture of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one (CMI/MI), and 1,2-pentanediol, a "preservative-non-preservative" best known as pentylene glycol. Using HL60 cells, we monitored the kinetics of cell toxicity with the MTT test and analysed extranuclear end points of apoptosis, i.e. phosphatidylserine exposure and nuclear fragmentation. Preservative treatment resulted in a dose-dependent decrease of cell viability. The mode of cell death was dose-dependent: necrosis occurred at high concentrations while apoptosis, shown by DNA laddering, DNA sub-diploid peak and caspase-3 activation, occurred at lower concentrations 0-24hr after exposure to a single dose: CMI/MI induced apoptosis at low concentrations (0.001-0.01%) and necrosis at high concentrations (0.5-0.1%); IMU and EGPE required higher concentrations to induce apoptosis (IMU 0.01-0.1% and EGPE 0.01-0.5%) or necrosis (IMU 0.5-1% and EGPE only at 1%). PG induced apoptosis only at 5%. Externalization of PS, a hallmark of apoptosis, occurred early in HL60 treated with low concentrations of CMI/MI and EGPE and was concomitant with the subdiploid peak in HL60 treated with PG. However, it did not occur in HL60 treated with IMU. In conclusion, at appropriate concentrations, each of the four preservatives modulates the apoptotic machinery by a caspase-dependent mechanism. Thus, apoptosis could be a good parameter to evaluate the cytoxicity of these chemical compounds. ____________________________________The possibilities for investigation and publication of the array of possible immunocyte responses to substaces from chemicals to foods is almost incomprehensible due to the complexity of function of the immune system and its interraction with the intenrla dn extranl environment.Hence the need for and development of a common end point in vitro assay, for purposes of establishing some basis for clinical therapies realted to reducing exposure to potentially immuno-active substances. The MRT assay used as a tool for LEAP thus is a step in the right direction towards making clinical assessments of aberrant or non-aberrant resposnes of the general immune system to variosu exposures. As with any new thing, time + useage = more and more data = more understanding.teh dysfunctional processing of various carbohydrate structures can be linked to simple maldigestion due to enzyme deficiency or dysbiosis, to inflammatory destruction of the mucosal surface of the intestinal tract, and to non-allergic immunocyte responses...one, two or all of the above can occur simultaneously. No one has yet combined the methodologies for isolating each mecaghnisms into an integrated investigation to see to what degeree each is comorbid and how tor ecognize the relative contribution of each mechanism, and in who...Eat well. Think Well. be well.MNL


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## bonniei (Jan 25, 2001)

Ah! The invaraiable, inevitable funding problem. Too bad universities can't get more excited by this research and take a greater interest in it...


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## Mike NoLomotil (Jun 6, 2000)

Indeed it is....seeking funding these days in the private "entrepreneurial" sector is like asking the Roman Empire for tax relief







It's kind of funny. We have gotten way more interest from major medical universities/medical center groups in just the last month in the other technology we have recently gotten the rights to...which one would think is way weirder: low frequency pulsed electromagnetic therapy for accelerated bone healing, wound healing, soft tissue healing, and peripheral vascular insufficiency. Some major centers are already working on it with some "small" devices, some of which are already well enough established to be seeing use in the USA for "local trauma". BUT we have a "device" which places the whole body in the correctly pulsed and "gaussed" therapeutic field. (3) major Univerisities practially fell over their own feet with interest, so therapy can be administered passively during sleep freeing the waking hours to oursuits other than sittiing there with an electrogizmo wrape daround yer leg or arm or neck etc. And use on other body parts which canot presently be treated with existing devices. [This is NOT the essentially useless little lagnets one straps on for $19.95....this is a very specific and well researched form of pulsed ELECTROmagnetic fiedl therapy in wide use ine Europe and parts further east).But food and chemical sensnsitivity or DM for IBS, etc?







And the venture capital sector?







If I have to give one more presentation which ends with "sure you can x bazillion $$$$ as soon as you: (then the list of what you need the money for is read back to you as what you have to get finished before you get the money)I am going to blow my brains out.(figuratively speaking of course)Then ya get bombarded by people who do not know anything about how things work at all in the real world with "if it really did what all those patients and you say it did you would just automoatically be swamped with money and published all over the place..."







Hint: Bonnie, never invent anytjing that can help masses of people unless you are on the staff of a university or large medical center that is in the system, OR you are already independently wealthy and thus can afford to expend every penney you ever earned so that you can then spend the rest of yout life making it back.








(Or be "in good" with Lakshmi)Eat well. Think well. Be well.MNL


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## bonniei (Jan 25, 2001)

> quote:Or be "in good" with Lakshmi


LOL. I think that is your only hope. Maybe I should get you a statue of Lakshmi instead of Krishna


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## Julia37 (May 9, 2001)

Many many years ago I tore the front ligament in my left ankle and went to a chiropractor for treatment. He used an ultrasound device that I think is the same type of thing as your electro-magnetic device, Mike. He said it assisted healing of soft tissue. Then he would adjust it to make sure the bones were lined up right.I might be limping if it wasn't for him.


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## bonniei (Jan 25, 2001)

Don't know quite what to make of electromagnetic therapy, leave alone someone obtaining funding for it!


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## Mike NoLomotil (Jun 6, 2000)

_________________________________________"Maybe I should get you a statue of Lakshmi instead of Krishna " __________________________________________No way! I want out of this cycle, not bound to it by materiality. As a reward material wealth is actually counerproductive. No, you did just fine. _________________________________________"Don't know quite what to make of electromagnetic therapy, leave alone someone obtaining funding for it" _________________________________________Ah, clarify...don't visualize low frequency pulsed electromagnetic field therapy as having anything remotely to do with the relatively useless "strap on a magnet" junk you see sold all over the place.A lot of research has gone into the use of electromagnetic fields (electromagnet...passing the electric current through wires to create an electromagnetic field, where you can adjust the strength from very very tiny to very powerful). So you can vary the strength of the magnetic field a body part is exposed to and then you pulse it at various frequencies and you can adjust the duration of exposure.At some frequencies and strengths which are specific, electromagnetic fields have been shown to be BAD as they can impair the bodies abilities, for example, to isolate and kill carcinogenic cells...cancer cells. So you want to keep the body AWAY from that kind of EMF.Then there are field strengths and pulse frequencies which do nothing. THEN there is a very specific range of frequencies and field strength that has been proven to increase bone regrowth after a bone break, hasten blood flow into damaged tissue for wound repair enhancement, and even hasten the regeneration of some types of nerves. This is so advanced in some countries in Europe that it is allopathic medicine, and specific devices are also available here and there that are being studied and used clinically for very specific applications like the ones I described. This is being done in some major medical centers and universities in the USA now.These devices are sometimes a hassle to use as the patient has to have the device "attached" to them...and while they are undergoing treatment they are not able to move about etc. Think of having to go sit and get dialysis every day, for example. It is wonderful science for the patient but is restrictive to the part of the day that matters. When you are awake!So what if you could simply lie down in bed and go to sleep and get the treatment for your trauma or disorder while you were asleep? Just be warm and comfy or roll around and do whatever you do in bed and/or while sleeping and get your treatment then?Much better eh? In a nutshell this is what I am talking about. The device has alrady been in trial use with a major NFL teams players (look where I live and guess who LOL) for over a year with astounding trauma-recovery results, as well as with the top NCAA collegiate football program in the USA. How do you think their kicker who tore up his knee in camp ended up starting and playing all season, right up to capturing the championship, he queried rhetorically....A major well-designed and controlled study on the use of this thing on treating peripheral vascular insufficiency is also beginning July 1, and (3) major medical universities are exceedingly interested in getting some of them in for their patients to sleep in who now are using the other methods.There is also a center getting interesting results with urinary incontinence as well with LFPEMF, but with very awkward to use devices. Anyway the thing is, the mechanisms are built into a custom built great big bed that 300+ pound football players are sleeping in. It is going to market commercially starting no later than August 1 to the professional sports market (NFL) first, and NCAA collegiate sector as well coinciding with the beginnig of NFL training camps...when on come the broken bones the connective tissue and soft tissue trauma and multi-million dollar careers and team Super Bowl hopes are suddenly in jeopardy when a key player goes down for 4 months!In some cases we can cut that by 50%-90% (recovery time). And every user recovers much mre quickly after each game. Some players who after 8-9 years were functionally in the twilight of their careers...not playing every down..sitting out...not working out for days after a game as they were in too much pain...wearing braces on evry joint...suddenly have been rejuvenated, healed, returned to the starting lineup...in short: damn impressive in the eyes of trainers and doctors who do this for a living (try to but the mangled player back on the field since under the cap they cannot afford to replace him when he goes down).It is very cool. By the end of last year many of the Dolphins were walking wounded, and several would have been OUT for good "well into the season" if not for the use of this "bed". In fact we just installed one into the home of one of the Oakland Raiders a couple days ago and are lining up the staff to start making demos to all the NFL teams by August. This is being done in cooperation with and with the endorsement of the head trainers of the Dolphins, the Hurricanes, and several Dolphins players whose careers were literally saved last year by this gizmo...patents of course being filed as we speak.







Meeting doctors in Europe and seeing their work has again allowed the discovery of something useful to bring to the USA. It is now being manufactured effective 6/1/02 in a factory in Miami.And that, my friend, is the short version. Onward to Atlanta. CU tomorrow.MNLMNL


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## bonniei (Jan 25, 2001)

"Want out of this cycle-not bound to it by materiality." Got you! Will stick with Krishna.This electromagnetic therapy sounds cool. NFL players using it and all. Incredible! Perhaps it got funded because it is already widely accepted in Europe.


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## Mike NoLomotil (Jun 6, 2000)

Alot of research has been done on it everywhere from Russia to Japan to the U.K. to Timbuktu, using $$$ from teaching hospitals & universities to private healthcare providers, devices have been in commercial use, etc. It is something that has all the documentation done already but simply has not been brought to the USA in this form...pure luck I guess







Actually having professional connections in the European healthcare community afford us visison of a lot of things that would not otherwsie be seen here...some really great and some really "out there like Pluto". This one is one that was clearly a winner from the first look.MNLHot 'Lanta Mobile Unit


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## kel1059 (Feb 28, 2003)

----" Sensitivities of this type in the past were almost exclsuivley attributed to enzymatic and dysbiotic problems of breaking down complex sugars into simple sugars in the gut.But it has been observed for years, since I think the first primitive cytotoxic testing was done in the 50's and 60's that in some people an immunocyte response was reproducible as well." quote:-------------------------------------------------------------------------------- Fructose malabsorption doesn't have anything to do with immune reactions. --------------------------------------------------------------------------------my only question to you bonniei is --are you so absolutely 100% positive of this statement that you would stake your life on it?at first glance, one can look at your statement and boldly proclaim that a "fructose PROBLEM" has ABSOLUTELY nothing to do with an immune reaction.however, i am not entirely convinced. i believe that given the extreme complexity of the human body and the highly interdependant nature of the immune system with the digestive system --that it would be foolish to state with 100% conviction that a carbohydrate problem can not possibly --somehow-- involve the immune system to SOME extent in SOME people.there is evidence beyond what MNL posted on that thread. i am too lazy to build a case for it because i am only interested in exposing eric's bad information.**********************************************also, i was surprised to see him touting electromagnetic devices as contributing to human healing. using an electrical apparatus may seem 'shocking' to some but I know that this is the wave of the future.the old "let's design a drug that locks on to this receptor" -- is in my opinion turning out to be a bust as far as curing chronic illnesses.energy is the fundamental nature of the body.


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## kel1059 (Feb 28, 2003)

yet another brought back from the dead.


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## bonniei (Jan 25, 2001)

Yes I am 100% positive that carbohydrate malabsorption and the resulting symptoms of gas and diarrhea have nothing toi doo with immune reactions. Because I just have to be fructose free for one day and I see the results immediately. With immune reactions it would take a while for the body to get desensitized


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## Julia37 (May 9, 2001)

Well, well well. I go away for a while - got bored, Mike's forgotten me and there's not much activity here - and when I come back one of our old threads has been resurrected.I remember back when we were discussing this before I noticed my fructose symptoms and Bonnie's differ. I believe this is because my immune system engages to cause pain and inflammation, while hers doesn't - hers is more like lactose intolerance, except it's fructose. So she's right about her particular case.


> quote:however, i am not entirely convinced. i believe that given the extreme complexity of the human body and the highly interdependant nature of the immune system with the digestive system --that it would be foolish to state with 100% conviction that a carbohydrate problem can not possibly --somehow-- involve the immune system to SOME extent in SOME people.


I agree completely with you on this, and you are showing yourself to be smarter than most of the doctors and other "experts" I've met or seen quoted.This reminds me of the soy allergy "expert" infamy - the so-called allergy "experts" were saying it was "impossible" to be allergic to soy oil because it has no proteins.But gee, most of us get symptoms from all soy products, including the oil... What about that, Mr. Expert? And our lives would be so much easier if we didn't!They were saying that about soy lecithin also and I came across an abstract showing allergic reactions to lecithin and posted it somewhere around here...The moral of this story is, never trust an expert. Think for yourself.Food sensitivity is in the beginning stages of being studied and understood. All each of us can do at this point is figure out what's going on in our own bodies - it's way too soon to say any one thing is true of everyone.


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## Mike NoLomotil (Jun 6, 2000)

Never ever plan to just pass-through without comment. There is always some kind of controversy her in this community over food sensitivity, intolerance, maldisgestion, malabsorption, allergy, and the never ending lack of understanding of same, oft poluted by the opinions of those who have no basis upon which to construct an opinion which approximates facts.Oh, ALL discussion boards are like that.







Sorry!PSNothing here is directed to anyone in this discussion...but some of the information that is conveyed to earnest people in this discussion trying to understand this physiology is coming from sources inadequately versed in the subject. If there seem to be any barbs they are directed there, not at any present company. Better make that clear so no one thinks "Is he being crabby at ME?" Nichts!Having been gone from here for at least 6 months due to the extreme "total immersion" in the field required to rollout IBS Disease Management to physicians in several states, I can report that this also involves having spent another 6 months totally immersed in everything that has ever been published in any country by anyone who has done any kind of investigation at all which could in any way be related to the so called Irritable Bowel Syndrome.Plus we have been doing a little preliminary work on how well plasma cytokine levels correspond to positive and negative LEAP (MRT) assays, clinical symptoms, and in vitro assessment vs clinical response. Very exciting stuff coming out of that.We are now preparing to conduct a type of study which has never before been done , although some similar stuff was done in the 1990ï¿½s in Sweden using in vivo methods. In vitro methods and the findings on IBS and Migraine patients have been astonishingly consistent with what we knew they would be.This has all been required in preparation for submitting to an IRB in St. Louis the protocol for a multicenter controlled clinical trial of the DM program we have developed in cooperation with physicians who arrange from gastroenterologists from major centers to immunologists, allergists, and primary care providers.Having been in the total-immersion mode this long with these people and the literature, I can quite assure you that there are very very few authorities who have grasped the entire picture of so called IBS, in spite of the fact that there is way more information about the disease out there than anyone could rightfully imagine...and on every aspect of symptoms which are clinically interpreted to mean the imaginary functional disease of IBS.It is no functional disease. This is now a fact. It will probably take 5 years for even a modest number of the practitioners of the healing arts to assimilate this fact, and accept and embrace it. This is because of the dogma that has been established...it dies a hard death. There is SO MUICH DOGMA and so much WRONG information based on speculation which morphed to fact and now has been disproven...but it has been done "over there" in a vacuum from what someone else has discovered "over there" in another vacuum it is amazing that anyone actually has any of the facts about this non-functional "functional disease" straight at all.The best way to help correct this situation is not to spend endless hours debating the undebatable where it will not make any difference to the masses anyway, bit to bear-down on the hard work of developing and funding study designs whose results will be irrefutable, and which will lay to rest the dogma of the past once and for all.But I saw this thread passing through and so I thought I would add 2 cents to it for whatever anyone thinks it is worth.Let's be frank (yes I know I am Mike but let me be frank just for a minute). Carbohydrate malabsorptiosn is a misnomer, as the malabsorption term is descriptive of but one aspect of the entire process of digestion and absorption of carbohydrates for use by the body. The malabsorption is a symptom of an underlying problem, so it is a malapropism. The problem is not the malabsorption, it is for lack of a better word "maldigestion" that is the problem!Some people diagnosed with so called IBS show one kind of ï¿½carbï¿½ maldigestion, which is different than that shown by some others with so called IBS.People with chronic constipation who seem to have trouble procoessing carbs have apparently a different type of problem than the people with chronic diarrheic episodes who have trouble digesting carbs. It is not clear why yet as most studies have been observations from LBT teststing...who blows methane and who blows hydrogen on challenge. Why there are differentiable populations is not known except symptomologically. Remember some people donï¿½t seem to have much problem with carb digestion at all yet they have the ï¿½symptom setï¿½ of IBS . One thing is certain, C people do not have any inflammatory reactions occurring which can be reliably detected either in any portion of the whole GI tract or systemically (with the exception of some constipated people who have a lot of abdominal pain as well..ï¿½FAPï¿½). There is a population which shows this. The diarrheics all have abnormal inflammatory reactions in various places in the gut, starting with the jejunum and duodenum where the digestive and immune systems work together to examine all the stuff you eat or drink to separate safe from not safe. There are signs of chronic inflammatory changes and immunologic activation (if you do the exam of biopsies the right way now) all the way down to the distal colon. In each area what is found is a little different. I will forego the intricate descriptions of the different types of cellular changes observed by various investigations, as you donï¿½t ned to get into that right here to understand the facts.Now the people who show inflammatory changes who had some form or another of enteritis before they developed IBS symptoms occurred have distinct inflammatory changes from those who developed IBS (d) symptoms but have no history of a clearly precipitating or precursor event.Amongst BOTH POPULATIONS are a subpopulation of people who, besides having inflammatory changes which can be provoked and aggravated by direct food or additive challenge which results in the release of cytokines and other proinflammatory and proalgesic mediators in the gut and systemically (which they ALL SUFFER FROM), are people who also comorbidly suffer from difficulties processing carbohydrates.From the collective research so far, no one can tell in these patients which is the chicken and which is the egg (as follows) only that they are closely related.Some people develop inflammatory changes first, followed by onset of IBS symptoms which can be linked to aberrant immune responses to food antigens in the gut and they never had food allergy and still don't. It is a malfunction of adaptive immunity. Some of these people start to show symptoms not only of food and chemical sensitivity, but also difficulty in digesting complex carbs of various kinds and to varying degrees. In these people, it appears that the alterations in the environment of the gut lumen, mucosa, and gut wall which occur as a consequence of the chronic release of mediators can and does disrupt proper digestion...and disrupts the normal balance between the flora critical to proper digestion and the gut immune functions ability to properly differentiate safe from not safe.On the flip side are people who appear to suffer alterations to the flora as the primary insult, through one means or another ranging from broad spectrum antibiotics to enteritis or both, and then begin to have difficulty properly digesting carbs...get gassy bloated pain...and then later develop inflammatory changes characteristic of abnormal immune activation. This may be due to the fact it is now more clearly understood that antigenicity of food is not limited to proteins but certain "carbohydrate structures" are antigenic as well...and the gut is structured to process carbs a certain way and recognize them accordingly. Screw that up and you may be presenting something that no longer is recognized as benign, if not in the mucosa it may also occur systemically (altered permeability or even active transport of macromolecules which form immune complexes not normally seen by the adaptive immune system...ooops).It is very very very difficult for any of us, up to and including our best medical minds, to conclude anything factual with reliability by observing externally what appear to be cause-effect relationships between diet and symptoms when it comes to bowel dysfunction. The cause-effect relationships we can see and document are often misleading and lead to false assumptions and erroneous conclusions and beliefs. Tis is a big part of the problem with IBS dx and tx. Many of the indirect tests as well sometimes add more confusion than clarification if you simply look at what the results are actually telling you...period...versus what we believe they are saying which in fact they never said we just inferred, assumed, or concluded based on our belief systems or what some supposed ï¿½opinion leaderï¿½ suggests. Remember that is why a person is an ï¿½opinion leaderï¿½. They deal in Opinion. What we need are ï¿½FACT LEADERSï¿½. Too much IBS dx and TX is all based on ï¿½consensus opinionï¿½ï¿½which is by nature a transient and nebulous substance, subject to change at any moment, as well as the composition of the particular group which has formed and is promulgating the consensus in question.This is symptomatic of why, still, with all the evidence that has been published, there are still so many erroneous beliefs when it comes to people who suffer from GI and systemic symptoms which are commonly diagnosed as IBS. Pseudofacts that IBS is believed and assumed to be associated with no identifiable pathology, when in actuality if you look at the gut and the rest of the body the right way the evidence is irrefutably there.By definition functional means "no evidence of physical cause".Well when it comes to people with IBS, at least the large population (2/3) who suffer some diarrheic component to their alleged IBS symptoms, there seem to be very very few if any at all who do not have identifiable abnormalities. It is a disease which is characterized by many things, including distinct signs of low-order inflammatory changes. Therefore by definition these people do not have a functional disease, any more than asthmatics do.What they end up being called in the final analysis, the final ï¿½consensusï¿½, who knows? This is a transition period, and early in the period at that, as the information is not widely disseminated enough.The ones who are most puzzling are those people who at present are categorized as IBS with 'C' or c-types or whatever term du jour is used.THESE people got some problems for which there is still very very little clear cut evidence of the physiologic basis...only the signs and symptoms and events and characteristics of those events are studied and are becoming clearly delineated.So when if comes to the debates over so called carb malabsorption, well, in a way everyone has something right to say, one piece of the puzzle we can observe, but no one understands the whole problem yet as it is clearly not a single event or a single sequence or etiologyï¿½and its in a place that is damn hard to crawl into and take apeek!So anything more that is said which concludes otherwise has to be taken with a grain of salt...er, fructose?Anyway...back to fixating on reality a while longer. Stay tuned if anyone lives in the St. Louis area...your chance at free treatment for research purposes is soon at hand. Gimme dat blood, though.







Eat well, Think Well and you Will Be Well.MNL


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## bonniei (Jan 25, 2001)

Hey mike, nice to see you around







kel and I were talking about fructose malabsorption the one caused by the lack of Glut-5 transporter, the one caught by the breath hydrogen testI agreee there are cases of maldigestion brought about by inflammartory reactions and bad flora.kel pasted something from another thread here and i perhaps responded in a way which was not very clear about the context


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## Julia37 (May 9, 2001)

Mike, it's nice to see another of your technical posts. Like I don't have enough to read already!







I have the opposite effect with carbs as the one you discussed - if I don't eat enough of them I get spasms in my stomach. (and probably lower down if I let it get that far). I've always been this way and I find it necessary to eat a certain amount of bread, rice and pasta every day.I've talked to several other people over the years who appear to be the same, but apparently not everyone is - I don't know if this carb effect indicates anything, but I thought it might interest you.Needless to say, I'm *not* on the low-carb diet!














Julia


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## fleure (Dec 26, 2003)

MikeI saw an abstract on PubMed (jan 2004) "Alternative Approach to IBS and Migraine is winning over providers" claiming to pinpoint specific cases of food intolerance and create an individualized program for eliminating symptoms. Is this the LEAP program? fleure


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## Julia37 (May 9, 2001)

Fleure,I know Mike is busy and may not be here to answer your question, so I will.If this is the same article that appeared in the Jan. 2004 Disease Managment Advisor, it is the LEAP program.Details are at www.nowleap.comCheers,Julia


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