In my thirty years in medicine, I have never diagnosed anybody with “irritable bowel syndrome.”
Not that I didn't want to make the diagnosis. But it always seemed to be the last resort - if there wasn't a better explanation for the patient's symptoms. And there always was.
If my patients came with the label, I quietly looked for a more appropriate diagnosis, mostly some kind of food intolerance and/or infections. And if they came with any of the myriad of gastrointestinal complaints, they deserved a thorough workup.
Food allergies: Physicians differ between food allergies and food intolerance. For the patient the difference is minimal: The only action that will help is leaving out the offending food.
Allergies are mediated either through blood – then they show up in blood tests. Or they are cell-mediated, which means they can’t be detected by blood tests; skin prick test is the way to go then.
If you usually feel good (or even just better) in the morning before you eat, food problems are likely. – Floating stools point to a food culprit, too.
There are rare and dangerous diseases, therefore a doctor should eliminate serious diagnoses. But this is what you can do yourself:
• Write a food journal. Everything that goes into your mouth should go in here – including beverages, pills and chewing gum. A pattern might become clear once you regularly record everything.
• In my experience, these are the most common food offenders: dairy, soy, nuts, gluten, corn – especially HFCS (High Fructose Corn Syrup), nightshades (tomato, potato, eggplant, bell and hot peppers), citrus, seafood, lectins, food colorings, preservatives, flavor enhancers (like MSG), eggs, apples and other fruit, chocolate (though probably less common than people think – it usually are the non-cacao ingredients that cause trouble), yeast. And don’t forget: prescription medication! Recreational drugs.
• Read labels! Of course, foods without labels – like kale and carrots – are healthier anyway because only processed food is required to be labeled.
• Has anybody in your family a bowel disease? You might have the same.
• Jot down pains, headache, heartburn, stomach ache, bloating, diarrhea, constipation, blurred vision, slow urination, skin rashes, blocked nose or ears,
• Don’t eat after dinner – and don’t have dinner late. The sheer bulk in your stomach may create the discomfort; besides it prevents the cell repair that should be taking place nightly – but can’t happen when your body is busy digesting.
• Are you very thirsty – especially during and after a meal? That might be a sign of a food allergy. Don’t suppress your thirst – this is how your body gets rid of the offending food: by diluting it.
• If you suspect food allergies, leave out the whole list above plus whatever you suspect for a week. Then one by one, every few days reintroduce another food from the list. – Sometimes only repeated exposure shows the problem – that happens mostly with cell-mediated allergies.
• Blood-mediated allergies are the quick ones – that can bring you to the emergency room - like peanuts. Never try to force your body into accepting any food that it doesn’t want!
• Slow allergies make you sick over time – by the chronic inflammation in your body. That causes for instance cancer in the long run.
• Take a probiotics regularly. I personally like Primal Defense (this is not an endorsement – only an idea to start with. Begin with a small dose, slowly take more. If a probiotic does not agree with you, change the brand.
• Most people benefit from fish oil – to counteract the constant inflammation that comes with food allergies.
• Chew well.
• Eat vegetables, vegetables, vegetables. Not only are they good for you – they also seem to cause fewer allergies.
• Serious runners suffer from a curious disease called “runner’s diarrhea” (about fifty percent of them.
• Obesity might be a sign for food allergies: We tend to crave exactly the foods that are worst for us.
• And most importantly: Don’t eat it if it hurts you!
Unfortunately, you can even have a bowel disease without any gastrointestinal complaints: About fifty percent of gluten intolerance (celiac sprue) patients never notice anything wrong with their belly. But they might have joint or back pain, diabetes, autoimmune disease, mental fog, depression – and a host of other problems. Read More
Blog: On Health. On Writing. On Life. On Everything.
Ugly Reflux
August 21, 2010
Reflux is one of those ailments which keep people going to the doctor and take medication forever – and on the face of it, there’s no cure.
And, in the long run, it can be a dangerous disease. Longstanding erosion of the esophagus can lead to Barrett’s esophagus and even cancer.
Why are so many people with the diagnosis of reflux?
Reflux is, in most parts, another disease with owe to SAD – the Standard American Diet. People have intolerances to certain foods and allergies, and those keep the esophagus (and possibly the stomach and the whole gut) inflamed. Instead of eliminating the offending foods, the doctor prescribes Zantac or Tagamet or even one of the stronger proton inhibitors. And has gained a life-long patient.
In the long run, those stomach medications create new problems: Since they all reduce acidity, they also may hinder digestion, and further infections as the stomach acid is supposed to kill invading germs.
PPIs (proton pump inhibitors, drugs lik, Prilosec, Prevacid and Nexium), the strongest anti-heartburn medications can also be addictive, can trigger food allergies, and can weaken your bones.
Heartburn only comes in very rare cases from producing too much acidity for no good reason (that condition is called Zollinger-Ellison syndrome, and should be ruled out by your doctor if the burning goes on relentlessly, regardless what you do). Normally, your stomach reacts with acidity when you eat something wrong. Or if you just each too much, period. So, why fighting the acidity, if you can eliminate the underlying cause?
Sometimes physicians diagnose a “hiatal hernia” – a gap in the diaphragm that allows the stomach to come a bit into the chest area. No connection has been found between HH and reflux. It seems that many people have a hiatal hernia, for reasons unknown – or for carrying a paunch that pushes the organs up into the lung cavity; for instance, it is very well known, that heartburn is extremely common in highly pregnant women. Perhaps also lacking exercise makes the diaphragm go limp. Whatever it is, hiatal hernia does not cause reflux.
If you want to break that cycle – here is what you can do:
Find out what your body does not tolerate. It is not difficult. Write a food journal. The most common culprits are, in my experience,
• Gluten
• Dairy products
• Corn syrup (HFCS)
• Tomatoes (and the whole nightshade family actually – peppers, eggplants, potatoes, too).
• Chocolate could be the culprit.
• Or nuts.
• Harsh foods: alcohol, caffeine, citrus, and spicy foods.
• ANYTHING can lead to a reaction. And not only burning in your esophagus; bloating, cramps, diarrhea, constipation, joint pains, migraine headaches, and many more symptoms can stem from food intolerance.
• Certain medical drugs are the culprits – Fosomax, for instance, that is intended to make your bones stronger (I would not touch it because of its side-effects. Better food and more movement certainly gives you stronger bones without side-effects).
• Sometimes it is not the kind of food but how it is prepared: raw versus cooked. Usually, cooked is easier on the stomach.
• It might be the timing: Some people get away with a raw salad or an acidic fruit during the day, but not at night, as the last meal that lingers in their stomach.
• Or a whole food group: Many people do better without sugars and white starches and reduced whole grains.
• Basically, all junk foods and processed foods are under suspicion. They contain trans-fats and preservatives, coloring, stabilizers, flavorings that are alien to you body.
• Drink enough water - but not with meals or right afterward.
Of course, it is better, to not be indiscreet in the first place. But if you are looking for healing alternatives:
• Mastic gum is my favorite; it is an agent that covers the stomach and helps if you have been indiscreet, food-wise. Unfortunately, mastic is not cheap. An alternative, paid by insurance is Carafate, with a similar action.
• DGL licorice helps – it is a deglycyrrhized licorice that does not have the bumping effect on blood pressure. This comes also as a lozenge.
• Other herbs that soothe the stomach are chamomile tea, aloe vera juice (or eat directly from the plant – the jelly-like inside of the leaf; avoid the green outside leaf – it is a harsh laxative), slippery elm, plantain banana, calendula and marshmallow (the real herb – not the sweet candy!), cabbage juice, artichoke extract. But watch it: I, for instance, have a chamomile allergy; that would make the situation worse.
• It is always a good idea to start out with the Ayurvedic herb neem which kills all sorts of infections because, unbeknownst, germs can cause all the indigestion. Ask your doctor.
• In an acute attack, sleep with your upper body a bit elevated (turns the flux downward).
• Always chew your food well! Big chunks might lie in your stomach like stones.
• Help your whole digestive tract with probiotics.
• Eliminate stress – especially when you eat. Sit down for three meals a day – don’t gobble things down on the run!
This is what to avoid – besides hurting foods:
• Too big meals.
• Eating after dinner.
• Peppermint – as it has a relaxing effect on the sphincter that closes of the stomach.
A reminder: Before you embark on a natural healing course, it is a good idea to have endoscopy – because you don’t want to overlook anything serious. And make sure your doctor looked for an H. pylori infection. On the other hand, there is evidence, that a bit of H.pylori might be necessary for normal digestion – and triple antibiotic definitely could do some harm.
And then – just to confuse things: Elderly people often have too low stomach acidity, and if they are taking medications that lower it even more, one can imagine that this will lead to problems. There is a supplement for this condition: betaine HCl. And some patients with can be helped with digestive enzyme – a whole new topic. Read More