Abdominal pain

Gut Feeling

The next time you’re at the store or in a theater or any crowded
place, look around you and consider this: About one out of every
five people may be having abdominal pain.

More specifically, about 20 percent of the population experiences
irritable bowel syndrome (IBS), with irritating symptoms such as
diarrhea, constipation, gas and bloating.

Hopefully you aren’t one of those one-in-five. But if you are (or
know someone who is), then you’ll be interested to know that a
long-time researcher of IBS believes that the last symptom on that
list – bloating – may be the key to understanding one of the
primary causes of IBS, which could lead to more effective
treatment.

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Uncomfortable expanding
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Without knowing anything else about it, when you see the term
“bacterial overgrowth,” you know that something not very good is
afoot.

Henry C. Lin, M.D., is a gastrointestinal specialist and an associate
professor of medicine at the University of Southern California. For
well over a decade, Dr. Lin has devoted his research efforts to
finding a single factor that might tie together the symptoms of IBS.
He now believes that bacterial overgrowth may be that factor. And
the key is bloating.

Over the years, Dr. Lin noted that almost all of the IBS patients he
treated reported post-meal bloating. This prompted him to focus
his research on gas caused by gut bacteria that ferments food in the
intestinal tract. Bacteria perform useful functions in the large
intestine, but Dr. Lin suspected that the bacteria might be
migrating to the small intestine, triggering gas, bloating and flu-
like symptoms that often accompany IBS.

After a breath-test study indicated that a large majority of IBS
patients experienced small intestinal bacterial overgrowth (SIBO),
an antibiotic trial helped confirm the results. In that trial, IBS
patients received either an antibiotic or placebo. About 75 percent
of the subjects who successfully eliminated SIBO with antibiotics
reported a significant improvement in IBS symptoms.

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Good guys vs. bad guys
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The use of antibiotics in Dr. Lin’s study may have been helpful in
demonstrating how bacteria play an important role in prompting
IBS symptoms, but that doesn’t necessarily mean that the best
course of treatment is antibiotics (which are already over-
prescribed, making some of them ineffective against certain
bacteria).

I asked HSI Panelist Allan Spreen, M.D., to take a look at Dr.
Lin’s study. He told me he wasn’t aware of the theory that
connected bacteria to IBS, but found it to be reasonable. In an e-
mail he wrote: “I do feel there’s something to the research; I just
hope it doesn’t mean a quickie, antibiotic-related ‘cure’ is coming.
Antibiotics, of course, might help to immediately lower the ‘bad
guy’ bacteria count, and therefore help a person feel better, while
simultaneously killing ‘good guys’ and causing more trouble down
the road.”

In several e-Alerts, Dr. Spreen has written about the necessity of
probiotic organisms. In a healthy individual, these beneficial
bacteria inhabit the digestive tract in massive numbers, crowding
out harmful bacteria, aiding digestion, and supporting immune
function. This healthy “gut flora” produces valuable nutrients
(including certain B vitamins and omega-3 fatty acids), digestive
enzymes like lactase, and immune chemicals that fight harmful
bacteria and even cancer cells.

But this critical ecosystem is fragile and easily disturbed. For
instance, poor nutrition, steroid drugs, chemotherapy and some
types of antibiotics can completely kill off the beneficial bacteria
in the gut. And when the number or activity level of your good
bacteria drops too low, it opens the door for harmful bacteria to
proliferate, allowing the opportunity for diseases such as IBS to
develop.

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Striking the balance
————————————————————I asked Dr. Spreen if Dr. Lin’s research might indicate that
probiotic supplements would be a good treatment for IBS, and he
replied, “I absolutely would be giving probiotics for such a
problem, along with any agents that might assist strengthening the
intestinal wall, such as FOS (fructo-oligo-saccharides), which
helps the ‘good’ bugs to reestablish, aloe juice, which has a long
history of calming bowel problems, essential fatty acids, and
digestive enzymes (which are usually underproduced in such
situations).”

Just one question: Fructo-oligo-WHAT? This was a new one to
me. But a little research revealed that FOS is simply a natural fruit
and vegetable fiber that promotes the growth of beneficial bacteria.

Meanwhile, sufficient amounts of intestinal flora can be
maintained through dietary sources such as cultured products
(yogurt and kefir), and lignans (flaxseed, carrots, spinach,
cauliflower, broccoli, millet and buckwheat). But while the
digestive tract can be “re-colonized” by introducing enough good
bacteria to overpower the bad bacteria, dietary sources alone can’t
provide organisms in the vast numbers required to correct a serious
imbalance. For this, a high-potency probiotic nutritional
supplement is necessary.

But one word of caution: Bacterial imbalances in the intestine
should not be taken lightly. So talk to your doctor or a health care
professional before using a probiotic supplement to address IBS or
any other chronic digestive problems.

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and another thing

“Good riddance to a bad drug.”

That was one prominent researcher’s reaction when Vioxx was
taken off the market last month. But now millions of Vioxx users
are wondering where to turn for alternatives.

In several HSI Members Alerts and e-Alerts we’ve examined
glucosamine; a widely used natural treatment for arthritis. In an e-
Alert I sent you last year, I told you about a 12-week University of
Western Australia study of 50 subjects with osteoarthritis. Ninety
percent of the group that used glucosamine reported relief, while
only 17 in the placebo group showed improvement.

These are encouraging results, but an HSI member named Pat has a
question about a potential side effect. Pat writes: “I am a 60-ish
year old woman who has type II diabetes and osteoarthritis
especially in my knees. There are a lot of products out there that
claim to help the joints, however, most contain glucosamine
sulfate. Now, there are some reports that glucosamine is a sugar
and aggravates blood sugar levels. OK! What do we do?”

Good question, Pat. Glucosamine is an amino sugar, and some
studies suggest that it may interfere with the regulation of blood
sugar levels, and could also play a role in insulin resistance. In two
major studies, however, subjects showed little or no change in
blood sugar levels.

So while there is a basis for concern, researchers advise
glucosamine users who have diabetes to make more frequent
checks of their blood sugar levels. And without question, Pat and
others who are in a similar situation should consult their doctor or
health care provider before using glucosamine.

And one more note: glucosamine is frequently extracted from
shimp, crab and lobster shells, so some individuals who are allergic
to shellfish may have an adverse reaction. This is not always the
case, but if you have that particular allergy, you should carefully
watch for signs of a poor response when beginning a regimen of
glucosamine supplements.

To Your Good Health,

Jenny Thompson
Health Sciences Institute

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Sources:
“Small Intestinal Bacterial Overgrowth: A Framework for
Understanding Irritable Bowel Syndrome” Journal of the American
Medical Association, Vol. 292, No. 7, 8/18/04, jama.ama-assn.org
“Bacteria May Be the Cause of IBS” Alicia Di Rado, University of
Southern California press release, 8/25/04, usc.edu

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