Saturday, August 21, 2004

Irritable Bowel, Chronic Fatigue, and Fibromyalgia

http://jama.ama-assn.org/cgi/content/short/292/7/852

A clinical review in JAMA discusses a new theory into the misunderstood diseases of Irritable Bowel, Chronic Fatigue, and Fibromyalgia. It also suggests how these three disorders may be connected. Irritable bowel disease can present with many different symptoms. However, bloating after eating a meal is the most common symptom. Researchers discovered that the increased gas had less to do with an intolerance to any particular kind of food and more to do with bacterial overgrown in the small intestine. Bacteria do serve a critical role in the colon or large intestine. However, the small intestine between the stomach and the colon in healthy people is a mostly sterile environment. This is achieved by the acidity of the stomach which kills most bacteria which enters in the upper GI tract. On the other end a special valve at the insertion of the small intestine to the large intestine called the iliocecal valve prevents bacteria in the colon from ascending up and overgrown in the small intestine. Well, in the case of irritable bowel that is just what happens. The symptoms of bloating come from certain disaccharide like sorbitol, lactose, lactulose, and fructose found in certain foods which are not absorbed entirely in the upper small intestine, reach the bacteria in the lower small intestine and cause the bacteria to grow and produce gas. The small bowel gets distended due to the gas causing pain and bloating. The iliocecal valve keeps the gas bottled up in small intestine from being released into the colon and then expelled as flatus. Glucose and sucrose are easily absorbed in the upper small bowel and do not cause bacterial overgrown, gas production, bloating, and abdominal pain.

So, what about the constipation, diarrhea, or a combination of the two which are common symptoms in irritable bowel. Well, these symptoms are due to what kinds of bacteria are growing in the small intestine and what gases they produce. Methane gas causes decreased paristalsis and constipation. Other gases include hydrogen, and hydrogen sulfide. Diarrhea is related to toxins released by certain bacterias which stimulate the small intestine to secrete water. In the colon, a variety of bacteria are found that all compete with one another so no one kind overgrows the others. In the small intestine it is common for one or two specific bacterial species to overgrow and cause the symptoms of irritable bowel.

So, what about fibromyalgia and chronic fatigue syndrome. It's no revelation that these mysterious disorders seem to run together. Well, researchers have discovered that fibromyalgia and chronic fatigue may be caused by the same small intestine bacterial overgrown as irritable bowel. Turns out there is a great new test to diagnose irritable bowel. Symptomatic patients can be given a dose of oral lactulose and then a breathalizer test can be taken measuring for increased methane, hydrogen, and hydrogen sulfide production. Well, it turns out that patients with irritable bowel symptoms have higher gas production than healthy individual. What was even a greater surprise was that almost 100% of individuals suffering from fibromyalgia and chronic fatigue symptoms also had positive lactulose challenge, breathalizer tests. This means that having fibromyalgia and chronic fatigue could be linked to bacterial overgrown and irritable bowel (chronic fatigue can be associated with post mononucleosis as well as other potential chronic infectious, genetic, and environmental diseases and exposures).

However, not all individuals with irritable bowel have fibromyalgia. This is due to the kind of bacteria that is overgrown in the small bowel and the individual's immune reponse to the specific bacterial strain. According to the article, bacteria as well as signs of inflammation where found in neighboring lymph nodes adjacent to the small intestine in suffers of fibromyalgia and chronic fatigue. The subsequent inflammatory reaction to the bacteria results in the characteristic body aches, pains, malaise, and fatigue.

So, what to do about it. Well no official studies have been perfomed. But the review article suggests several ideas. While symptoms persist, an irritable bowel sufferer should temporarily avoid foods that contain complex disaccharide such as lactose (dairy products), sorbitol (apple juice), and even fructose (fruit) in some cases. Suffers will need to learn which foods cause bloating, constipation, and diarrhea. Temporarily eliminating these from the diet will stop feeding the bacteria in the lower small intestine and prevent the bacterial overgrown and gas production.

Another idea it to replace bad bacteria with good bacteria. Since, bacterial overgrown is believed to be due to one or two offending stains of bacteria, adding good bacteria to the mix could help control bacterial overgrown by increasing the competition for food between good and bad bacteria. Yogurt and Cranberry juice have not been shown effective in helping to alleviate symptoms of irritable bowel due to active yogurt culture and antibiotic properties in the later. This is probably because these also contain lactose and fructose which exacerbate the condition. Several prescription and nonprescription products which contain milk bacteria (Lactobacillis acidophilis) or other mixed strains of bacteria (probiotics) may be helpful (Culturel, Bifidobacterium bifidus, fecal probiotics). Probiotic therapies have proven successful in the treatment of inflammatory bowel (Crohns disease, Ulcerative colitis, Clostridium difficile colitis, recurrent diarrhea, rota virus?).

Finally, 14 day treatment with the antibiotic Flagyl (metronitazole) is also effective at treating irritable bowel. However, doctors feel uneasy about relying on antibiotic treatment due to possible emergence of resistant basteria strains.

2 comments:

  1. A clinical review in JAMA discusses a new theory into the misunderstood diseases of Irritable Bowel, Chronic Fatigue, and Fibromyalgia. It also suggests how these three disorders may be connected. Irritable bowel disease can present with many different symptoms. However, bloating after eating a meal is the most common symptom. Researchers discovered that the increased gas had less to do with an intolerance to any particular kind of food and more to do with bacterial overgrown in the small intestine. Bacteria do serve a critical role in the colon or large intestine. However, the small intestine between the stomach and the colon in healthy people is a mostly sterile environment. This is achieved by the acidity of the stomach which kills most bacteria which enters in the upper GI tract. On the other end a special valve at the insertion of the small intestine to the large intestine called the iliocecal valve prevents bacteria in the colon from ascending up and overgrown in the small intestine. Well, in the case of irritable bowel that is just what happens. The symptoms of bloating come from certain disaccharide like sorbitol, lactose, lactulose, and fructose found in certain foods which are not absorbed entirely in the upper small intestine, reach the bacteria in the lower small intestine and cause the bacteria to grow and produce gas. The small bowel gets distended due to the gas causing pain and bloating. The iliocecal valve keeps the gas bottled up in small intestine from being released into the colon and then expelled as flatus. Glucose and sucrose are easily absorbed in the upper small bowel and do not cause bacterial overgrown, gas production, bloating, and abdominal pain.

    So, what about the constipation, diarrhea, or a combination of the two which are common symptoms in irritable bowel. Well, these symptoms are due to what kinds of bacteria are growing in the small intestine and what gases they produce. Methane gas causes decreased paristalsis and constipation. Other gases include hydrogen, and hydrogen sulfide. Diarrhea is related to toxins released by certain bacterias which stimulate the small intestine to secrete water. In the colon, a variety of bacteria are found that all compete with one another so no one kind overgrows the others. In the small intestine it is common for one or two specific bacterial species to overgrow and cause the symptoms of irritable bowel.

    So, what about fibromyalgia and chronic fatigue syndrome. It's no revelation that these mysterious disorders seem to run together. Well, researchers have discovered that fibromyalgia and chronic fatigue may be caused by the same small intestine bacterial overgrown as irritable bowel. Turns out there is a great new test to diagnose irritable bowel. Symptomatic patients can be given a dose of oral lactulose and then a breathalizer test can be taken measuring for increased methane, hydrogen, and hydrogen sulfide production. Well, it turns out that patients with irritable bowel symptoms have higher gas production than healthy individual. What was even a greater surprise was that almost 100% of individuals suffering from fibromyalgia and chronic fatigue symptoms also had positive lactulose challenge, breathalizer tests. This means that having fibromyalgia and chronic fatigue could be linked to bacterial overgrown and irritable bowel (chronic fatigue can be associated with post mononucleosis as well as other potential chronic infectious, genetic, and environmental diseases and exposures).

    However, not all individuals with irritable bowel have fibromyalgia. This is due to the kind of bacteria that is overgrown in the small bowel and the individual's immune reponse to the specific bacterial strain. According to the article, bacteria as well as signs of inflammation where found in neighboring lymph nodes adjacent to the small intestine in suffers of fibromyalgia and chronic fatigue. The subsequent inflammatory reaction to the bacteria results in the characteristic body aches, pains, malaise, and fatigue.

    So, what to do about it. Well no official studies have been perfomed. But the review article suggests several ideas. While symptoms persist, an irritable bowel sufferer should temporarily avoid foods that contain complex disaccharide such as lactose (dairy products), sorbitol (apple juice), and even fructose (fruit) in some cases. Suffers will need to learn which foods cause bloating, constipation, and diarrhea. Temporarily eliminating these from the diet will stop feeding the bacteria in the lower small intestine and prevent the bacterial overgrown and gas production.

    Another idea it to replace bad bacteria with good bacteria. Since, bacterial overgrown is believed to be due to one or two offending stains of bacteria, adding good bacteria to the mix could help control bacterial overgrown by increasing the competition for food between good and bad bacteria. Yogurt and Cranberry juice have not been shown effective in helping to alleviate symptoms of irritable bowel due to active yogurt culture and antibiotic properties in the later. This is probably because these also contain lactose and fructose which exacerbate the condition. Several prescription and nonprescription products which contain milk bacteria (Lactobacillis acidophilis) or other mixed strains of bacteria (probiotics) may be helpful (Culturel, Bifidobacterium bifidus, fecal probiotics). Probiotic therapies have proven successful in the treatment of inflammatory bowel (Crohns disease, Ulcerative colitis, Clostridium difficile colitis, recurrent diarrhea, rota virus?).

    Finally, 14 day treatment with the antibiotic Flagyl (metronitazole) is also effective at treating irritable bowel. However, doctors feel uneasy about relying on antibiotic treatment due to possible emergence of resistant basteria strains.

    ReplyDelete
  2. Anonymous2:58 PM

    I just want to give additional helpful information for all fibromyalgia sufferers.

    Fibromyalgia is a condition where you feel chronic pain in certain parts of your body; it is a muscular pain especially around the joints. There can also be centralized pain felt in the spinal chord, brain, neck shoulders etc. People with fibromyalgia generally complain of pain in the joints, but it actually is the muscles and the tendons around it that cause the pain, it can be excruciating sometimes and can be a continuous throbbing pain. People suffering from Fibromyalgia also show symptoms of depression, sleeplessness, irritable bowel syndrome, stress and many others, which are caused due to the pain.

    Rid Fibromyalgia provides a simple process to helps you eliminate all your symptoms of fibromyalgia and enjoy living your life again. This will provides us the best and most effective solutions on how to rid ourselves from pain.

    The Rid Fibromyalgia provides an eBook entitled “Heal the Body” that will teach you the best diet that will allow you to eat your way to wellness, it will also document which vitamins and supplements will target and reverse the illness, how to achieve pain relief through acupuncture, what exercises are safe and will work, and what type of medications may make you sicker, and what will work. This eBook takes a step by step approach in showing you how to rid yourself of the pain naturally so that you can take back your life.

    We must know the symptoms of this illness. For us to know what would be the approach we will going to apply. Here's Signs and Symptoms of Fibromyalgia and steps to treat it naturally.

    We must also be responsible and aware to the things to gain and cope up with this kind of illness. Eating nutritious food with regular exercise would be result to a better life. Here's Basic Tips in Coping Fibromyalgia.

    If we say Fibromyalgia Diet, there is no specific recommended diet for fibromyalgia. But a healthy diet rich in vitamins and minerals can certainly help in coping with the illness. Magnesium rich vegetables are recommended for patient's suffering from fibromyalgia. Here's some information for you to help in Fibromyalgia Diet.

    We must also think that vitamins are important for Fibromyalgia sufferers. This will give us additional energy and strength to kept a healthy living. But of course, you must be aware that not all vitamins are effective or directly gives you a good result. Find the best vitamins that would easily give a good response if your taking it. The best thing is your healed and keep your body healthy as possible. Here's The Benefit of Vitamins for us to know why vitamins are important for fibromyalgia sufferers.

    Also feel free to view this video Fibromyalgia Help. It really gives good information for those who have Fibromyalgia and encourage not to give up because in every pain your getting through has a good solution in the end.

    Here's Rid Fibromyalgia, For free info and helpful articles on fighting fibromyalgia.

    ReplyDelete