Pathophysiology Of Irritable Bowel Syndrome
Recent research suggests that IBS has a multifactorial etiology that includes alterations in gut motility, small-bowel bacterial overgrowth, microscopic inflammation, and visceral hypersensitivity. Some of these postulated components of IBS pathophysiology may potentially lend themselves to probiotic therapeutic benefits.
Looking To The Future
You can permanently cure IBS by addressing the underlying cause. Here at PrimeHealth, our patients prove this is true.
10-year IBS patients have come through our door. Nothing worked for them. Then, we identified the root cause and prescribed a relatively short-term treatment for that issue. Within a few months, this 10-year affliction that mainstream doctors couldnt fix had disappeared.
If you live in the greater Denver area, to learn about our science-based approach to treating IBS. Or schedule a free phone consultation with us today from anywhere in the world!
Medically reviewed by Soyona Rafatjah, MD. on August 15, 2020
Screening Of Probiotic Bacteria
The researchers screened more than 20 different probiotic species for their ability to tighten the TJ barrier.
They tested the bacteria in cultures of a human cell line called Caco-2, which scientists often use to model the intestinal epithelium.
Only LA1 caused a rapid, strong tightening of the TJ barrier.
The bacteria appeared to achieve this by activating a protein in the membrane of the cells, called a Toll-like receptor.
Toll-like receptors , part of the bodys immune defenses, recognize patterns on the surface of microbes.
Similar to ringing an intruder alarm, when the bacterium bound to the receptors, it triggered a train of events inside the cells that tightened the TJ barrier.
To test whether LA1 would have the same effect in a live animal, the researchers administered it orally to mice.
LA1 rapidly enhanced the TJ barrier in the animals, which then protected them against chemically induced colitis.
The bacterium also promoted healing of the intestinal barrier in mice with colitis.
In mice, the same Toll-like receptors mediated these enhancements of the TJ barrier.
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How To Cure Irritable Bowel Syndrome In A Few Days
Welcome to the First House Call with Dr. Hyman!
So many times, I get asked health questionsin my newsletters, on Facebook, on Twitter, by my patients, or when I give lectures.
Thats why Ive created House Call with Dr. Hyman. Its a Q& A with me once a week. Im inviting you to send your questions, to share your thoughts, to ask me whatever you want about your health issues and concerns, and Ill try to answer them.
Ill do it from the perspective of functional medicine, which is a whole new framework of thinking about solving the puzzle of chronic disease. It is the science of creating health.
And Ill provide tools, suggestions, and plans to help you take back your health.
Lets get started!
Welcome to my weekly house callyour chance to ask me your questions.
How To Cure Irritable Bowel Syndrome in a Few Days
This weeks question is, I have irritable bowel syndrome. What do I do about it? What causes it? How do I fix my leaky gut? Do I take drugs?
Irritable bowel syndrome is a huge problem that affects almost 50 million Americans or almost one of every six people.
Its one of the most common reasons for visits to the doctor, and yet, most doctors have no clue how to treat it or whats really causing it.
Thats where functional medicine comes in.
Functional medicine is a not a new treatment or test or modality. Its a whole new way of thinking about solving the puzzle of chronic symptoms and diseases.
So, what is irritable bowel syndrome, or IBS, anyway?
Action items
Most Common Side Effects
In clinical studies, the most common side effects with XIFAXAN for IBS-D were:
- Nausea
- An increase in liver enzymes
Constipation was observed in only 0.5% of XIFAXAN patients.
Nausea was observed in 3% of patients taking XIFAXAN vs 2% taking placebo. Liver enzymes increase observed in 2% of patients taking XIFAXAN vs 1% taking placebo.
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Why Do Doctors Say Ibs Has No Cure
Conventional medicine does not know how to classify or discuss diseases that can start from completely separate causes. Because the exact same IBS symptoms can be triggered by a dozen different root causes, there is not one single treatment for IBS there are a dozen.
With a dozen IBS treatments that work in different IBS patients, conventional doctors say there is no cure.
Its the same with hypothyroidism, which can be triggered by several different underlying causes. Since there are multiple treatments for hypothoyroid patients with the same diagnosis, conventional doctors say there is no cure for hypothyroidism.
Study Shows That Targeted Antibiotics Lead To Prolonged Improvement In Ibs Symptoms
New Treatment Could Benefit Many Suffering from Irritable Bowel Syndrome
Los Angeles – Oct. 17, 2006 – Researchers at Cedars-Sinai Medical Center have found that a nonabsorbable antibiotic one that stays in the gut can be an effective long-term treatment for irritable bowel syndrome , a disease affecting more than 20 percent of Americans.
The study, which appears in the October 17 issue of the Annals of Internal Medicine, is the first to demonstrate benefits from antibiotic use even after the course of treatment has ended, supporting previously published research that identified small intestine bacterial overgrowth as a cause of the disease.
The randomized, double-blind, placebo-controlled study involved 87 participants, all of whom met specific multinational guidelines for diagnosis of IBS. They received 400 mg of the antibiotic rifaximin three times a day for 10 days or a placebo. Participants completed an extensive symptom questionnaire at the start of the study and then weekly for 10 weeks following treatment.
The questionnaire measured the severity of nine symptoms . Patients were also asked to provide a percent global improvement from 0 to 100 percent in their overall IBS symptoms.
Researchers found that the rifaximin not only led to significant improvement in global IBS symptoms during the 10 days it was administered, but also that the benefit continued for the 10 weeks of follow up when no antibiotic was given, showing sustained benefit.
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Imbalance In Gut Flora
A healthy balance of gut bacteria is critical to overall health and wellbeing. Our good gut bacteria probiotics- play a central role in digestion, nutrient absorption, immune function, and even cognition.
When the healthy balance of probiotic bacteria in the gut is disrupted, it leaves opportunity for potentially harmful bacteria, viruses and fungi to grow. This leads to inflammation in the intestines, changes in the mucous layer that lines our intestines and can even damage the intestinal wall. Clinical studies have established a strong link between IBS and a reduction in the diversity and amount of good bacteria in the gut. One study found that major functional dysbiosis was observed in constipated-irritable bowel syndrome gut microbiota. Another study observed both changes in the gut flora as well as increased intestinal permeability and activation of the immune system.
Rifaximin For Ibs: Second Opinion
In an editorial published with the study results, Jan Tack, MD, PhD, a professor of medicine at University Hospital of the University of Leuven in Belgium, writes that “The TARGET studies have some attractive findings,” including the sustained benefits and short treatment course.
It also seems to relieve the bloating, which he calls one of the most challenging symptoms.
But he has some caveats — calling for more studies before the drug is widely used.
In an email interview, he says his main concern is antibiotic resistance — so far not shown to be a problem in research studies — and that the study follow-up needs to be longer.
“This issue is relatively easy to address with a longer-term follow-up study or a retreatment trial,” he tells WebMD.
For now, he suggests that the antibiotic be reserved for those patients in whom overgrowth of the small intestine bacteria has been confirmed, or to limit treatment to a single cycle for those not responding to other medications.
Tack has severed as a scientific adviser to companies evaluating IBS drugs.
Another doctor, Christine Frissora, MD, an associate professor of medicine at Weill Cornell Medical College of Cornell University, says the results ”show promise.”
She was not involved in the studies but has been prescribing rifaximin for IBS patients with the non-constipation form âoff-label.â Off-label refers to uses that have not been approved by the FDA.
Pimentel says he is studying those patients now.
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How To Cure Ibs Permanently In 5 Steps
Irritable bowel syndrome is a common disorder of the large intestine. IBS causes stomach pain and irregular bowel movements.
Many experts consider IBS to be incurable. But here at PrimeHealth, we personally walk with and help patients reverse their IBS permanently.
Symptoms of irritable bowel syndrome include:
- Bloating
There are 4 types of IBS:
Is IBS a lifelong condition? Many gastroenterologists claim that IBS is a lifelong condition. Other doctors do not agree, though. Cutting-edge research is revealing that IBS can be cured for many patients.
Keep reading to learn about:
- How your gut microbiome affects IBS
- Functional IBS treatments
- How to cure IBS permanently in 5 steps
Diarrhea Compared To37% Placebo
Target 1 & 2 Study Design: Two identical, randomized, phase 3 trials conducted over a 3-month period. A total of 1258 patients meeting Rome II criteria for IBS received XIFAXAN 550 mg 3 times a day or placebo for 14 days. Primary endpoint was adequate relief of IBS signs and symptoms for at least 2 of 4 weeks during the month following 14 days of treatment. Adequate relief was defined as a response of yes to the weekly Subject Global Assessment question: In regards to your IBS symptoms, compared to the way you felt before you started study medication, have you, in the past 7 days, had adequate relief of your IBS symptoms? .Primary endpoint: 41% of patients in the XIFAXAN 550 mg group, 31% of TARGET 1 placebo group and 32% of TARGET 2 placebo group experienced adequate relief of IBS signs and symptoms. Composite endpoint was defined as 30% decrease from baseline in abdominal pain with a weekly average stool consistency score of < 4 for 2 weeks during the month following 2 weeks of treatment.
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Irritable Bowel Syndrome: New Antibiotic May Help Ibs
ByJim Spalding | Submitted On January 11, 2011
Irritable Bowel Syndrome – In the News: Antibiotic Show Promise For Bowel Ailment. Should You Use It Or Seek Alternative Treatment
In an article released by the Associated Press on January 7, 2012, we learn of an antibiotic being that has been considered for use in Irritable Bowel Syndrome . The antibiotic is rifaximin and the question is: should you use it if you have irritable bowel syndrome? Let’s look at the pros and cons of using this as well as an alternative way to treat IBS.
What causes IBS? Before now conventional medical opinion in the United States was that IBS is caused by due to the inability of the muscles of the organs of the gastrointestinal tract or the nerves controlling these organs to function normally. A leading researcher in the development of this new antibiotic suggests that the actual cause of the condition is being addressed with the antibiotic. An overgrowth of abnormal bacteria is cited as being the root of the problem. As a natural healer I have understood that an abnormal growth of micro-organisms in the gut can certainly play a huge part in IBS.
Wash one cup of wheat Soak it in 3 cups of water for 8 hours. Drink the water. Make 2 more batches of Rejuvelac without rinsing the seed in between. Drink them. Repeat as needed.
I pray that this information will help you make a wise choice about how to help yourself if you or your loved one is a sufferer of Irritable Bowel Syndrome.
After Just Two Weeks Of Treatment Relief Lasted For Up To 6 Months*
*In a clinical trial: range of 6 to 24 weeks average of 10 weeks of relief from abdominal pain and diarrhea. You can be retreated up to 2 times if symptoms return.
Target 3 Study Design: XIFAXAN was evaluated in 2438 IBS-D patients. 44% experienced relief from a course of treatment. Relief was defined as experiencing a 30% improvement from baseline in the weekly average abdominal pain score and a 50% reduction in the number of days in a week with a daily stool consistency of Bristol Stool Scale type 6 or 7 for 2 weeks during the month following 2 weeks of treatment. If patients experienced a recurrence of either of their symptoms for 3 weeks of a rolling 4-week period, they were then randomized to receive a repeat treatment with either XIFAXAN or placebo. The primary endpoint was the proportion of patients who experienced relief in both symptoms during the 4 weeks following repeat treatment.
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Inflammation May Play A Role In Irritable Bowel Syndrome
May 21, 2010
Dear Mayo Clinic:
I’ve read that persistent low-grade inflammation is present in some people with irritable bowel syndrome, and a few studies have reported on the potential benefits of medications that may target this aspect of IBS. Are these medications available to IBS patients? If not, is there a chance they will become available?
Answer:
Researchers have investigated the role that inflammation plays in irritable bowel syndrome . Studies have suggested that inflammation caused by an infection may trigger IBS symptoms and certain people who have IBS may have some ongoing inflammation. But research examining the effectiveness of anti-inflammatory medications in controlling IBS symptoms hasn’t shown any benefit. As a result, anti-inflammatory drugs are not generally used to treat IBS.
IBS is a disorder that affects the large intestine and is characterized by symptoms such as diarrhea, abdominal pain, cramps, gas, bloating and constipation.
The intestinal walls are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food through the intestinal tract. In some cases of IBS, these contractions are stronger and last longer than normal. Food is forced through the intestines too quickly, causing gas, bloating and diarrhea . In other cases, the opposite occurs. Food moves through the intestinal tract too slowly, and stools become hard and dry . Some people with IBS have a combination of both.
Effect Of Metabolic Products Of Probiotics And The Microbiota On Epithelial Barrier Function
Probiotic-derived metabolic products have been shown to enhance barrier function in a number of cases. Culture supernatants of Saccharomyces boulardii, but not Saccharomyces cerevisiae, were shown to significantly improve the capacity of epithelial cells for wound healing and migration in vitro and in vivo via the activation of 21-integrin collagen receptors .
Probiotic-derived polyphosphate is capable of protecting mice against DSS-induced colitis, acting on the integrinp38 mitogen-activated protein kinase pathway and suppressing oxidant-induced intestinal permeability by preventing F-actin and E-cadherin degradation . In another study, the authors identified the p40 molecule, produced and secreted by LGG, as the main mediator for ameliorating DSS and oxazolone-induced inflammation, through its binding to the epidermal growth factor receptor . Activation of the EGFR by p40 was sufficient to reduce cytokine-induced IEC apoptosis in vitro and ex vivo. Further, the authors succeeded in administering the p40 molecule specifically in the colon, where once again they observed a subsequent activation of the EGFR. Strikingly, in that study administration of p40 was able to both prevent and cure DSS-induced colitis , an effect that has never been observed before for live probiotic strains, as most might exert strain-specific preventive actions but are of little help once inflammation is manifested .
Luis A. Castagnini, … Mark A. Gilger, in, 2018
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Rifaximin Background And Mechanism Of Action
Rifaximin is a semisynthetic antibiotic that has an extra pyridoimidazole ring, making it a type of poorly water-soluble and minimally absorbed rifamycin. It has in vitro activity against enteric gram-negative bacteria, including enteric pathogens.32 It is most effective against the bacteria in the small intestine due to the higher concentration of bile in this region of the GI tract than in the colon.33,34 These properties make it effective for the treatment of IBS-D due to its postulated cause of gut bacterial overgrowth.35,36
Small intestinal bacterial overgrowth is a mixed syndrome characterized by a change in the quantity or quality of bacteria in the small intestine. It is generally defined as the presence of 105 bacteria/mL of upper GI aspiration.37 However, this definition is generally relaxed for the consideration of SIBO in IBS studies.38 Several studies have shown a definite relationship between IBS and SIBO. According to an article by Ghoshal,37 in the 11 studies they reviewed, the frequency of SIBO varied from 4% to 78% among patients with IBS and from 1% to 40% among controls. In IBS, it not only increased the number of bacteria in the gut but also the bacterial composition that is implicated in the disease.39
Supplements And Medications For Ibs Relief
Medications typically arent the first line of treatment for IBS, but they may be helpful for people with moderate to severe symptoms who have tried different dietary strategies without success.
Depending on your symptoms, your doctor may prescribe one or more of the following:
Fiber supplements If increasing fiber in your diet isnt effective, you can take a variety of supplements containing different forms of fiber. This is particularly geared toward people who experience constipation.
Laxatives If fiber supplements dont effectively relieve constipation, the next step is often to try a drug that stimulates bowel movements.
Smooth muscle relaxants These drugs can help with intestinal cramping, abdominal pain, and bouts of diarrhea. In some cases, though, they may cause constipation.
Antidiarrheal drugs If you experience frequent diarrhea, it may help to take a drug, such as Imodium , that slows down the movement of contents through your intestine or improves the consistency of your stools.
Antidepressants Even if you dont experience depression but especially if you do your doctor may prescribe certain categories of antidepressants to reduce pain or diarrhea by acting on your nervous system. People without depression are usually given a low dose of these drugs.
Pain relievers Certain drugs that act on the brains pain sensory mechanisms can help ease severe abdominal pain or bloating.
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