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Making Sense of IBS, IBD, and Leaky Gut
BY BARRY W. RITZ, BS By now, we've all heard that intestinal health is the foundation of overall well being. That fact is clear. The intestinal lining is responsible for absorbing nutrients from the foods that we eat and serves as our most important immune barrier, protecting us from potential allergens in undigested foods, as well as microbiological and chemical threats. But sorting through the terminology and the countless catalog pages and store aisles of intestinal health products and digestive aids can be confusing and overwhelming. We're not all gastroenterologists (gut doctors), but it seems a discussion is in order on irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), as well as the concept of leaky gut and how to best support intestinal health in these conditions or in a preventive manner. Irritable bowel syndrome is a disorder of intestinal function that affects 1 in 5—or 55 million— Americans during their lifetimes. Of the estimated 18.5 million current sufferers, 67 percent are women. The condition occurs in the small intestine, colon, or both. It can be characterized by abdominal discomfort, pain, bloating, mucus in the stool, and irregular bowel habits. IBS is typically a gut motility problem, resulting in constipation, diarrhea, or an alteration between these two extremes. It may also involve low-grade inflammation that is not detected in evaluations, but plagues the patient (termed sub-clinical inflammation). The cause of IBS is not well understood, and IBS is something of a catch-all term. While not considered the cause, stress may exacerbate existing irritable bowel symptoms. Traditional GI tests are necessary to rule out diseases such as cancer, ulcerative colitis, or Crohn's, but diagnosis of IBS is based entirely on symptoms. Lotronex®, a serotonin receptor medication and the first FDA-approved drug for the treatment of multiple symptoms of IBS, was released in February, 2000. While many people with diarrhea-predominant IBS found relief with the product, severe complications led to its withdrawal by November, 2000. As of mid-2002, 84 cases of ischemic colitis, 113 cases of severe constipation, 89 hospitalizations, 45 surgeries, and four deaths had been tied to the use of the drug. However, due in part to pressure from IBS sufferers who benefited from the drug, it was re-released in June, 2002, with strong restrictions on use. Another medication, Zelnorm™, was approved by the FDA in July, 2002, for the treatment of multiple symptoms of IBS, but only for short-term use in women whose primary complaint is constipation. Inflammatory bowel disease is a chronic inflammatory condition divided into two types depending on the location of the inflammation. Ulcerative colitis affects the colon, but just the lining. Crohn's disease can affect all layers of the intestine and even the entire length of the GI tract from mouth to anus. Again, the cause of IBD is not entirely understood, but autoimmune conditions and allergies, lack of blood supply to the area, abnormal bacterial overgrowth (often related to the overuse of antibiotics), and heredity all seem to play a role. Current medical therapy consists of anti-inflammatory drugs such as corticosteroids (Prednisone), Azulfidine, or mesalamine, and immunosuppressives like 6-mercaptopurine, Imuran, methotrexate, or cyclosporine. All of these medications have been shown to be effective, but long-term use is often complicated by serious side effects. Leaky gut syndrome is a surprisingly common problem with widespread effects and is not limited to a diagnosis of IBS or IBD. An understanding of leaky gut helps clarify how intestinal integrity relates to overall health. Food allergens and toxins that leak through an inflamed or damaged intestinal lining are carried by the blood to the liver and eventually affect systems throughout the body by aggravating inflammation in the joints, expressing toxins in skin disorders, triggering food sensitivities, and causing "brain fog" or hyperactivity. Managing leaky gut is preventive medicine at its finest. Reducing the toxic load on the liver and body can prevent illness or improve its outcome. Leaky gut can be caused by any number of different conditions that cause inflammation or damage to the intestinal lining, including infection, trauma (burns or surgery), and the use or overuse of many medications, like NSAIDs (ibuprofen). Chemotherapy or radiation therapy patients and those with HIV also cope with the effects leaky gut. Leaky gut is associated with a wide range of general symptoms, such as fatigue, fevers of unknown origin, abdominal pain, bloating, diarrhea, feelings of toxicity, memory problems, difficulty concentrating, and poor tolerance to exercise, and can cause: LEAKY GUT MAY CAUSE....
NUTRIENTS THAT HEAL THE GUT In addition to removing food and chemical allergens from our diets and environment, as well as reducing stress that might trigger intestinal distress (there are a variety of mind-body techniques), there are a number of nutrients and supplements that can help heal the irritable, inflamed, or leaky gut:
Optimal Digestion, Edited by Trent W. Nichols, MD, and Nancy Faass, MSW, MPH Proper Nutrition, Inc. www.propernutrition.com 800-555-8868 www.ibsgroup.org www.ccfa.org www.fda.gov |
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