Posts Tagged ‘Symptoms’

 

John Libonati

New IBS Guidelines Include Screening for Celiac Disease

December 20th, 2008 by John Libonati


New guidelines for the treatment of IBS published by the American College of Gastroenterology include screening for celiac disease…

New IBS Guidelines Offer Treatment Ideas

American College of Gastroenterology Updates Recommendations for Irritable Bowel Syndrome
By Bill Hendrick

WebMD Health NewsReviewed by Louise Chang, MDDec. 19, 2008 — New guidelines have been issued by the nation’s gastroenterologists that are aimed at easing the abdominal pain, diarrhea, and other symptoms of irritable bowel syndrome (IBS), which afflicts millions of Americans.

The guidelines, issued by the American College of Gastroenterology, also offer hope to patients who’ve struggled with the condition and found satisfactory treatments lacking.

IBS is diagnosed in people whose symptoms include abdominal pain, bloating, gas, diarrhea, and constipation, or a combination of these symptoms. Though sometimes confused with inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, IBS is a separate condition.

IBS care uses up more than $20 billion a year in direct and indirect expenditures, according to William Chey, MD, professor of medicine and director of the Gastrointestinal Physiology Laboratory at the University of Michigan Health System. He developed the guidelines in conjunction with Philip Schoenfeld, MD.

“The last time the American College of Gastroenterology published guidelines for the management of IBS was in 2002, and the College recognized that in the span of five to six years there has been a remarkable explosion in knowledge that’s become available that’s helped us to understand the cause and management of IBS,” Chey says in a news release.

Tests and Treatments for IBS
According to the new guidelines:

Patients with symptoms typical for IBS — and without alarm features like rectal bleeding, low blood count due to iron deficiency, weight loss, or a family history of colon cancer, IBD, or celiac disease — do not need extensive testing before being diagnosed.

IBS patients with diarrhea, or a combination of constipation and diarrhea, should be screened with blood tests for celiac disease, a disorder in which patients can’t tolerate the gluten protein found in wheat or other grains.

When IBS patients have alarm features or are over 50 years old, they should have further tests (such as colonoscopy) to rule out other bowel disease such as IBD and colon cancer.
IBS patients and their doctors should consider treatments involving antidepressants, which have been shown to offer relief.

The drug Amitiza helps with women who have IBS with constipation; the non-absorbable antibiotic rifaximin can ease IBS and bloating as a short-term treatment. And Lotronex, a drug that affects serotonin receptors, can be considered for patients with severe IBS with diarrhea.

Certain anti-spasm treatments may offer short-term help with abdominal pain from IBS. These include hyoscine, cimetropium, and peppermint oil.

A probiotic called Bifidobacteria may help some IBS patients.

According to the guidelines, women are twice as likely as men to suffer from IBS, which often begins in young adulthood. Gastroenterologists have found that dietary changes have proved helpful, including the addition of dietary fiber supplements such as psyllium.

Chey says IBS can be managed in most patients with counseling, dietary and lifestyle interventions, and use of both over-the-counter and prescription medications.

The guidelines suggest many treatments might be tried, though the authors concede no single magical answer has yet been found to eliminate symptoms in IBS patients. But the guidelines offer hope for people with IBS that their doctors can try a number of methods to reduce discomfort, and that some of the steps that can be taken seem to work.

ARTICLE SOURCE: http://www.webmd.com:80/ibs/news/20081219/new-ibs-guidelines-offer-treatment-ideas


We have some very important information to share with you today.

While we were at Columbia University’s Topics in Gastroenterology, Dr. Steven Lobritto talked about cirrhosis of the liver and how he has actually seen people who were on the liver transplant list heal enough to be taken off once they started a gluten-free diet.

According to our new book, “Recognizing Celiac Disease”, 3.4% of people with non-alcoholic fatty liver disease have SILENT Celiac Disease. Most patients DO NOT have gastrointestinal symptoms.

Non-alcoholic fatty liver is a non-inflammatory hepatic (liver) disorder characterized by degenerative changes in the liver secondary to excessive accumulation of lipid in hepatocytes.

The good news is that studies showed liver enzymes normalize after 6 months on a gluten-free diet.

If you have patients or family members with non-alcoholic fatty liver (cirrhosis), who are not diagnosed with celiac disease, give them this information so they can get tested.

Related medical studies are referenced in “Recognizing Celiac Disease.” www.recognizingceliacdisease.com.

Celiac disease is a multi-system, hereditary, chronic, auto-immune disease estimated to affect 1% of the human population (3 million in the US) that is caused by the ingestion of wheat, barley, rye and oats. It is treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can result in complete recovery.  

John Libonati

Yes, You Can Die From Celiac Disease

March 10th, 2008 by John Libonati

You can definitely die from celiac disease, in a variety of ways:

1. Dehydration – Extreme damage to the intestinal lining can lead to death through dehydration.  In this case, the lining that is supposed to hold water in your body no longer functions.  The gut actually pulls water from your body.

2. Malignancies – Malabsorption of nutrients or consistent damage to cellular structures leads to cancers: lymphoma, leukemia, intestinal, esophageal, etc.

3. Pregnancy complications – Nutrient deficiencies can lead to cardiomyopathy in the mother or birth defects in the fetus from folic acid deficiency, protein deficiency, etc.

4. Immunodeficiency – A weakened immune system can allow common illnesses to become deadly – the flu for example.  Other illnesses normally fought off, are not.

5. Autoimmune diseases – Celiac disease, if not diagnosed and treated early, causes the body to react to other things in the body.  As the body tries to unsuccessfully attack and remove gluten (because the person keeps eating it), the immune system stays on a heightened alert and starts attacking other things.

6. Malnutrition – Any health problem that comes from malnutrition of any one or more nutrient that can lead to death can be caused by celiac disease.

Here are just 6 examples of how celiac disease can kill you.  It is a deadly serious condition caused by eating what is essentially a poison to susceptible people – people with celiac disease.

The gluten-free diet is the elimination of gluten from the diet.  That is only the first step.  The next step is determining any health problems that have arisen and treating them.  The final step is ongoing identification of health problems that arise in the future to determine how to treat yourself.

-John Libonati

John Libonati is Vice President and co-Founder of Gluten Free Works, Inc. He can be reached at john.libonati@glutenfreeworks.com.

Acid reflux affects millions of people every day.

Heartburn is the major symptom of acid in the esophagus, characterized by burning discomfort behind the breastbone (sternum). Findings in gastro-esophageal reflux disease (GERD)  include esophagitis (reflux esophagitis) — inflammatory changes in the esophageal lining (mucosa) —, strictures, difficulty swallowing (dysphagia), and chronic chest pain. Patients may have only one of those symptoms. Typical GERD symptoms include cough, hoarseness, voice changes, chronic ear ache, burning chest pains, nausea or sinusitis. GERD complications include stricture formation, Barrett’s esophagus, esophageal spasms, esophageal ulcers, and possibly even lead to esophageal cancer, especially in adults over 60 years old.

Occasional heartburn is common but does not necessarily mean one has GERD. Patients with heartburn symptoms more than once a week are at risk of developing GERD. A hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for developing GERD.

Here is some interesting information about acid reflux drugs. In 2006, over 100 million prescriptions for proton pump inhibitors (acid reflux drugs) were filled at a cost of $13.6 billion.  It is true that acid reflux drugs definitely help in the short term.  They reduce acid.

Unfortunately, the more powerful acid blockers (omeprazole, esomeprezole) can interfere with calcium adsorption and can aggravate preexisting hypocalcaemia and hypomagnesemia which are more common in celiac disease. [1]

They can also cause problems for people with cirrhosis. Use of proton pump inhibitors (PPIs) in patients with cirrhosis was associated with a risk of spontaneous bacterial peritonitis and Clostridium difficile-associated disease, according to two retrospective studies. [2]

Finally, long term use can also lead to Vitamin B12 deficiency. Vitamin B12 deficiency is already a common deficiency among people with celiac disease. The medications work by blocking acid secretion from the parietal cells of the stomach, but these cells also make a substance called intrinsic factor, which is critical for vitamin B12 absorption. Because proton-pump inhibitors such as Prilosec also reduce intrinsic factor secretion, long-term use can lead to a vitamin B12 deficiency. [3] 

Vitamin B12 deficiency is serious because it can lead to neurologic disorders. The neurologic symptoms of vitamin B12 deficiency include numbness and tingling of the arms and, more commonly, the legs, difficulty walking, memory loss, disorientation, and dementia with or without mood changes. Although the progression of neurologic complications is generally gradual, such symptoms are not always reversible with treatment of vitamin B12 deficiency, especially if they have been present for a long time. [4]  

Here are some things what work well for acid reflux and won’t destroy your health:

Dietary Changes:

1) Maintain a 100% strict gluten-free diet.  The immune reaction to gluten starts in the mouth and works all the way through the gastrointestinal tract, so avoid it. 

2) Doctors also now suggest that heartburn sufferers keep a daily food diary, so they are better able to see what food triggers are present in their day-to-day life. Once a list of common triggers have been found, begin eliminating foods one by one. Common heartburn triggers include chocolate, fried and fatty foods, and spices.  [5]

3) While suffering heartburn, you’re advised to refrain from consuming alcohol, caffeine, over-the-counter pain relievers, and other stimulants, which change the acidity of the stomach, and irritate the lining of the stomach further. [5]

4) Decrease sugar intake.  Sugar causes acid reflux in some individuals. [5]5) Increase fiber. Consuming more fiber nutrient foods is another natural way to alleviate future suffering. Bulk foods help to absorb excess acid and gas, and allow your body to rid itself of toxins more quickly. For those who respond poorly to high fiber vegetables, fiber pills and beverages are an easy alternative. [5]

6) Drink more water. The more water you drink, the less likely you are to suffer the pains of heartburn. Drinking at least 8-glasses of water each day will rid the body of toxins and allow your body to expel acid naturally.

Remedies:

Here are some quick home remedies that can help. 

1) Baking soda – take a 1/2 teaspoon of baking soda and mix with 4 oz. of water.  Drink it.  Baking soda is a base and counteracts the acid almost immediately.  It also has another benefit in that it cuts the reaction of the gluten proteins that cause the reflux in the first place. (If you accidentally ingested gluten.) It works quickly and is about as cheap a remedy as you’ll find.

2) Alka Seltzer Gold – this is gluten-free and works quickly. 

3) Apple cider vinegar – this remedy was suggested Alisa Weeks,  a member of the Knoxville Celiac Support Group. “We use the apple cider vinegar with great success. We take about a teaspoonful with some juice.”

4) Food enzymes – which help to speed the digestive process often eliminate heartburn altogether. Papaya enzymes are sold in chewable capsule form, and are taken immediately following a meal with a full glass of water. Both ginger and digestive enzymes are not medically proven to help with symptoms. [5]

Sources:

[1] Robb-Nicholson C (2007). “By the way, doctor. I heard that taking a proton-pump inhibitor could cause hip fractures. I’ve been taking 20 mg of Prilosec every day for a year. Should I be concerned?”. Harvard women’s health watch 14 (7): 8. PMID 17396273.

[2] Bajaj JS, et al “Proton Pump Inhibitor Use is Associated with a High Risk of Spontaneous Bacterial Peritonitis” Abstract 740 presented Nov. 4.

[3] http://www.everydayhealth.com/publicsite/index.aspx?puid=f0ed5fe5-034e-4196-997b-f976c293a99c&p=1

[4] http://lpi.oregonstate.edu/infocenter/vitamins/vitaminB12/

[5] http://heartburn.about.com/gi/dynamic/offsite.htm?zi=1/XJ/Ya&sdn=heartburn&cdn=health&tm=12&gps=89_111_1020_570&f=00&su=p284.8.150.ip_&tt=14&bt=0&bts=0&zu=http%3A//nhnh.essortment.com/heartburnhomer_rwel.htm