Imagine having a condition with symptoms so severe that you can't leave the house, yet your doctor calls it a "functional," or "psychosomatic," disease -- meaning that it's all in your head.
Frustrating? Absolutely.
But it's a very real problem for the 60 million people -- that's 20 percent of Americans -- who have irritable bowel syndrome (IBS). These people are plagued by uncomfortable and often disabling symptoms like bloating, cramps, diarrhea, constipation, and pain.
I have lots of patients with IBS, some of whom have suffered for decades without relief. Their previous doctors couldn't find the cause of the illness, so they were told to just get more fiber or take Metamucil, or were prescribed sedatives, anti-spasm drugs, or antidepressants.
That is NOT the answer. I've found a better way. And in today’s blog I am going to share 5 steps you can take right now to cure IBS without drugs.
But first I want to tell you about a patient of mine ...
Alexis and Her Lifelong Irritable Bowel
At age 45, Alexis had suffered from IBS for 33 years -- almost all of her life! Her major symptom was sudden, painful, cramping diarrhea. She was doing the best she could to prevent it. She didn't consume dairy, didn't drink or smoke, and took Citracel every day. Yet nothing helped.
She would go to the bathroom 4 to 5 times before she even left the house in the morning. And she couldn't go out of the house at all without knowing where all the closest bathrooms would be in case she had what she called "s--- attacks."
That wasn't Alexis' only problem ... She also felt full and bloated after every meal, which starchy foods made worse.
An upper endoscopy had shown that she had gastritis, or inflammation of the stomach, and she had taken many antibiotics over the years. She also had severe premenstrual syndrome (PMS), with irregular periods, breast tenderness, sugar cravings, headaches, and agitation.
She also had unusual symptoms like rectal itching (often a clue to yeast infections or food allergies). And she was tired all the time.
Alexis tried to eat healthy, but her diet was less than ideal. She had a bran muffin and coffee in the morning and a salad for lunch. But her "drug of choice" was sugar -- in the form of cakes, ice cream, Jell-O, diet sodas, and other junk food. Not surprisingly, she was also about 20 pounds overweight.
To help Alexis, all I really did was identify and treat the UNDERLYING CAUSES of her digestive problems! To understand how I did that, you first have to understand a little bit about how the gut works.
How Gut Imbalances Can Lead to IBS
Imagine a tennis court. That is the surface area of your small intestine, where food is absorbed. Your small intestine is also the site of about 60 percent of your immune system. And this sophisticated system gut-immune system is just one-cell layer away from a toxic sewer -- all of the bacteria in your gut.
If that lining breaks down -- from stress, too many antibiotics or anti-inflammatory drugs, intestinal infections, a low-fiber, high-sugar diet, alcohol, and more -- look out! Your immune system will suffer and you can develop all sorts of digestive problems -- including IBS.
Let's talk a little more about all that bacteria. You've got about 3 pounds of it -- 500 species -- in your gut. In fact, there is more bacterial DNA in your body than there is human DNA! Among all that gut bacteria, there are good guys, bad guys, and VERY bad guys.
If the bad guys take over -- or if they move into areas that they shouldn't (like the small intestine which is normally sterile) -- they can start fermenting the food you digest, particularly sugar or starchy foods.
This is called small bowel bacterial overgrowth -- and it's a major cause of IBS.
The major symptom it causes is bloating, or a feeling of fullness after meals. What causes this bloating? The overproduction of gas by the bacteria as they have lunch on your lunch!
Small bowel bacterial overgrowth can be diagnosed by a breath test, which measures gas production by the bacteria, or by a urine test that measures the byproducts of the bacteria after they are absorbed into your system.
Bacterial overgrowth is a real syndrome and was recently described in a review paper published in the Journal of the American Medical Association. The condition can be treated. In fact, a major paper was recently published in the Annals of Internal Medicine that showed using a non-absorbed antibiotic called rifaximin for 10 days resulted in a dramatic improvement in bloating and overall symptoms of IBS by clearing out the overgrowth of bacteria.
That's great news for many IBS patients. But, unfortunately, not all patients with the same diagnosis are created equal. There's more than one factor that leads to IBS. Another major cause of IBS is food sensitivities.
A landmark paper, was recently published in the prestigious British medical journal Gut that found eliminating foods identified through delayed food allergy testing (IgG antibodies) resulted in dramatic improvements in IBS symptoms. Another article, an editorial in the American Journal of Gastroenterology, stated clearly that we must respect and recognize the role of food allergies and inflammation in IBS.
So the research tells us that these are the two main causes of irritable bowel -- food allergies and overgrowth of bacteria in the small intestine -- but there may be others, including a lack of digestive enzymes, parasites living in the gut, zinc or magnesium deficiency, and more.
And this is precisely why it is so critically important to personalize treatment based on the unique circumstances that exist for each person who suffers from IBS -- the solution is most certainly not a one-size-fits-all one. But solutions can be found if we look carefully at the underlying causes and treat them.
Which leads me back to Alexis ...
How I Helped Alexis Heal from IBS
I prescribed Alexis a non-absorbed antibiotic, an antifungal drug for her yeast problem, and had her eliminate the foods to which she was allergic. I believe in treatment that addresses the underlying cause of the problem. If there is a bacterial or yeast infection, then medications are often the best treatments. The key is to effectively treat the cause. If medications do that, then I use them.
Then I gave her supplements of healthy bacteria to normalize her gut and zinc to help with her digestive enzymes (chronic diarrhea can result in zinc deficiency).
I also gave her extra fiber to feed the healthy bacteria, fish oil to reduce gut inflammation, a multivitamin, and herbs to balance her hormones (which are greatly affected by abnormal bacteria).
What happened then may shock some, but I wasn’t surprised. It is the same result I have seen in patient after patient when the principles of functional medicine are applied ...
Alexis came back to see me two months later, and she was a different person. Not only did she lose 20 pounds, she had not had a "s---- attack" and was having normal bowel habits for the first time in 33 years! She also had more energy, and her PMS vanished.
She looked and felt 10 years younger and was free of the suffering she had endured for over three decades.
Do you suffer like Alexis did? It doesn't have to be that way. We have the understanding and tools to deal with this chronic problem and the suffering it causes one in five people. There is no need to wait for any more studies. I have been treating IBS in my practice for over 10 years with dramatic success.
In fact, just recently, one of my patients told me that, for the first time in his life, he didn't have any more stomach pains or digestive problems. He had previously been so bad that he had to have a phone installed in his bathroom!
To take advantage of these discoveries today, simply follow these five steps.
5 Steps to Curing IBS
1. Get tested. Try to get a test for IgG food allergies (see Immunolabs for more information on this testing) and eliminate the foods that test positive for 12 weeks.
2. Test yourself. If you can't afford the test mentioned above, then just eliminate the most common food allergens for 12 weeks -- that's dairy, gluten, yeast, eggs, corn, soy, and peanuts. And then reintroduce them to see if they cause symptoms. This is an effective way to isolate the foods that may be causing you problems.
3. Get rid of the unwanted visitors in your small bowel. Ask your doctor to prescribe rifaximin (Xifaxin) and take two 200 mg tablets 3 times a day for 7 to 10 days. This is often the best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome.
4. Repopulate your digestive tract with good bacteria. I don't usually recommend brands, but when it comes to probiotics the quality varies so much that I suggest taking two specific brands. Take one packet of VSL3 or other high potency probiotic twice a day for 1 to 2 months. This probiotic has over 450 billion organisms per packet. I also recommend a probiotic called S. boulardii take two capsules twice a day for 2 months. This is a special probiotic that helps to further normalize gut function.
5. Read more about the condition and your options. My favorite book on this subject is Digestive Wellness by Elizabeth Lipski.
By taking these steps and seeking out the underlying causes of IBS, you can dramatically improve your health and overcome your digestive disorder.
Rifaximin is a semisynthetic, rifamycin-based non-systemic antibiotic, meaning that very little of the drug will pass the gastrointestinal wall into the circulation as is common for other types of orally administered antibiotics. It is used in the treatment of traveler's diarrhea and hepatic encephalopathy, for which it received orphan drug status from the U.S. Food and Drug Administration in 1998.
Uses
Rifaximin is licensed by the U.S. Food and Drug Administration to treat traveler's diarrhea caused by E. coli.[1] Clinical trials have shown that rifaximin is highly effective at preventing and treating traveler's diarrhea among travelers to Mexico, with few side effects and low risk of developing antibiotic resistance.[2] [3] It is not effective against Campylobacter jejuni, and there is no evidence of efficacy against Shigella or Salmonella species.
It may be efficacious in relieving chronic functional symptoms of bloating and flatulence that are common in irritable bowel syndrome.[4] There was recently a pilot-study done on the efficacy of rifaximin as a means of treatment for Rosacea, according to the study, induced by the co-presence of small intestinal bacterial overgrowth.[5]
In the United States, rifaximin has orphan drug status for the treatment of hepatic encephalopathy.[6] Although high-quality evidence is still lacking, rifaximin appears to be as effective as or more effective than other available treatments for hepatic encephalopathy (such as lactulose), is better tolerated, and may work faster.[7]
[edit] Availability
Rifaximin is currently sold in the U.S. under the brand name Xifaxan by Salix Pharmaceuticals. It is also sold in Europe under the names Spiraxin, Zaxine, Normix, Rifacol and Colidur and in India under the name RIXMIN (Sold by Cipla, cost 9.90/capsule).
References
1. ^ Xifaxan label informationPDF Retrieved November 15, 2008.
2.
3. ^ DuPont, H (2007). "Therapy for and Prevention of Traveler's Diarrhea". Clinical Infectious Diseases 45 (45 (Suppl 1)): S78–S84. doi:10.1086/518155. PMID 17582576.
4.
5. ^ Ruiz J, Mensa L, Pons MJ, Vila J, Gascon J (May 2008). "Development of Escherichia coli rifaximin-resistant mutants: frequency of selection and stability". The Journal of antimicrobial chemotherapy 61 (5): 1016–9. doi:10.1093/jac/dkn078. PMID 18325895. http://jac.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18325895.
6.
7. ^ Sharara A, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, ElHajj I. (2006). "A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence". Am J Gastroenterol 101 (2): 326. doi:10.1111/j.1572-0241.2006.00458.x. PMID 16454838.
8.
9. ^ Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi A, Savarino V.
10.
11. ^ Wolf, David C. (2007-01-09). "Hepatic Encephalopathy". eMedicine. WebMD. http://www.emedicine.com/med/TOPIC3185.HTM. Retrieved 2007-02-15.
12.
13. ^ Lawrence KR, Klee JA (2008). "Rifaximin for the treatment of hepatic encephalopathy". Pharmacotherapy 28 (8): 1019–32. doi:10.1592/phco.28.8.1019. PMID 18657018. Free full text with registration at Medscape.
14.
I'm already two years into avoiding it, which I'm pretty sure is the only thing the doctors will say. Or am I missing the point here? 
