As someone who has IBS and who has yet to be successful getting relief, in spite of eating a simple, strict version of Mary's Mini, am always looking for a solution. Just received this, and am interested in a discussion of the recommendations:
Dr. Gabe Mirkin's Fitness and Health e-Zine
June 10, 2012
New Treatment for Irritable Bowel Syndrome (IBS)
Doctors have finally shown that most cases of Irritable
Bowel Syndrome are caused by an overgrowth of bacteria in the
upper intestines (Digestive Diseases and Sciences May 11,
2012;57(5):1321-1329). IBS affects more than 30 million North
Americans. It is characterized by recurrent belly pain, bloating,
gas, and diarrhea or constipation or both. Earlier studies showed
that IBS can often be controlled by taking rifaximin, an antibiotic
that is not absorbed into the bloodstream.
In this new study, researchers passed tubes down the
esophagus and into the upper part of the small intestine (duodenum)
to collect cultures for bacteria. They found large amounts of
bacteria in the small intestines of the participants who had IBS.
The IBS sufferers were far more likely to have diabetes and/or
to take medication to shut off stomach acidity. Diabetes weakens
your immunity to make you more susceptible to all types of
infections, and the acid in your stomach helps protect you from
THE NORMAL INTESTINAL TRACT: When you eat, food passes
down your esophagus and into your stomach. Then it passes through
more than 20 feet of small intestine and five feet of large
intestine (colon). You absorb most of your food in your small
intestine and a lesser amount in your large intestine.
THE SMALL INTESTINE: In your small intestine, food is broken
down into carbohydrates, fats, and proteins. Then cells in your
small intestine produce thousands of chemicals called enzymes that
break down carbohydrates into sugars, proteins into amino acids,
and fats into fatty acids. Of all carbohydrates, your small
intestines allow only four simple sugars (glucose, fructose,
galactose and mannose) to be absorbed into your bloodstream.
Of all proteins, only single amino acids and chains of amino
acids can be absorbed. Of all fats, only fatty acids are
THE CAUSE OF GAS: Any carbohydrates that cannot be broken
down into one of the four single sugars are not absorbed in the
small intestine. Instead, they pass to your large intestine, where
bacteria ferment them. Fermentation produces gas, which is normal.
This fermentation is supposed to occur only in your large intestine.
BACTERIA IN YOUR INTESTINES: The large intestine is loaded
with bacteria, but the rest of your gastrointestinal tract has
relatively few bacteria. You are not supposed to have large amounts
of bacteria in your small intestine. When a person has bacteria in
the small intestine, unabsorbed carbohydrates are fermented there,
producing significant amounts of gas. This causes cramping and
burning because the gas stretches the small intestine. The gas
can also push the intestinal contents rapidly toward your large
intestine to cause diarrhea, and the carbohydrates fermented in your
upper intestinal tract can clump together to make you constipated.
TREATMENT BASED ON THIS NEW UNDERSTANDING OF IBS:
* Avoid foods with added sugars, sugared drinks, and foods made from
flour (bakery products and pastas) because these foods are the ones
that are most easily fermented by bacteria to cause intestinal gas.
* Eat a high fiber diet. Your diet should be loaded with raw or
lightly cooked vegetables, fruits, whole grains, beans, nuts and
seeds. These foods contain many natural antibiotics to limit
bacterial overgrowth in the small intestine. They also contain
plenty of soluble fiber that is fermented primarily in the colon,
and insoluble fiber that helps to prevent constipation.
* If you take medications to shut off stomach acid to treat
belching and burning, check with your doctor to see if you can
stop taking them. Stomach acid inhibits the growth of bacteria in
the upper intestinal tract. Shutting off stomach acid encourages
bacteria to grow in the small intestine.
* Ask your doctor if you would benefit from taking rifaximin 200mg
three times daily for three days, then a maintenance dose of 200
mg daily for several weeks. Rifaximin is an antibiotic that is
not absorbed into your bloodstream.
* Check for intestinal parasites. If you have them, your doctor
may prescribe paromomycin 500mgs three times a day and/or
doxycycline 100mgs twice a day for a week.
- Avoid other antibiotics, if possible, because they can change
your normal intestinal bacteria.