Clinical Nutrition: Irritable bowel syndrome

Clinical Nutrition: Irritable bowel syndrome

Irritable bowel syndrome is a common and chronic disorder. It is estimated that 10-20% of the adult population is afflicted with it in some form and degree. It is probable that the percentage is much higher, since for many the symptoms are mild and go untreated. Proper diagnosis and treatment are important because continued irritation of the bowel may lead to diverticulosis, ulceration of the bowel, and colectomy. About 23,000 colostomies are inserted in this country annually.

The decreased absorption of food associated with an irritable bowel may lead to weakness, anemia, and malnutrition as well as being productive of associated conditions like gallstones, kidney stones and arthritis.

It has long been suspected that the condition is caused by infection or parasitic infestation. This is because the symptoms presented include flatulence, cramping, rectal itching and diarrhea or thin, ribbon-like stools. This concept is reinforced by the fact that sulfa drugs, which inhibit bacterial growth, lessen the severity or even prevent attacks of colitis. However, stool cultures taken on colitis patients invariably report "no pathologic organisms."

Only the normal bacterial flora of the bowel are found. But, remember that inhibiting bacterial growth is helpful. Here is why.

Suspected cause and correction

Normal bacterial flora will ferment sugars not completely digested and absorbed. This results in the production of an enormous amount of gas. Carbon dioxide, hydrogen, and methane gases as well as lactic and acetic acids are formed. This distends the abdomen and causes flatulence.

The carbon dioxide is absorbed into the blood and exhaled through the lungs. The hydrogen and methane are not readily absorbed into the blood and are expelled rectally. The acids imitate the bowel and produce an inflammatory response which will produce copious amounts of mucous or bleeding if mucous production is inadequate.

Patients with active symptoms are asked to avoid the foods listed below and to supplement the diet with a source of plant enzymes directed at simple carbohydrates. Remember, an intolerance to any of these sugars reduces tolerance to the others. Those with active lactose intolerance will be sucrose intolerant as well. Gluten intolerant patients are made worse by lactose and fructose, and we all suffer to some extent from so- called sugar substitutes being fermented because the body cannot digest them.

Foods to avoid

Fructose-containing foods:

Orange juice and sweet fruits (oranges, apples, pears, grapes, bananas, pineapples, melons, etc.) -- honey -- waffle syrup.

Corn sweeteners as found in soda pop, pastry, candy, cereals, coffee creamers, salad dressings, sweet pickles, ice cream, and ham.

Sorbitol and mannitol foods:

Sugarless chewing gum -- sugarless (diabetic) foods -- tooth paste -- breath mints.

Other foods:

Wheat bran, beans, sweet corn, chili powder, pepper, hot spices.

Lactose-containing foods:

Milk (white and chocolate) -- ice cream -- whey.

This list can be intimidating. Most people will look at it and say "but, you haven't left me anything I CAN eat." Fortunately, that is not true. But it does take some getting used to.

One very important point needs to be stressed here. No one is completely intolerant of these foods and no one can eat all they want. What is important is to relieve the symptoms of carbohydrate intolerance to find the major offender in each person's diet -- and reduce that to an acceptable level.

Permitted foods

All vegetables except sweet corn and dried beans -- tomatoes and avocados are recommended. Corn and rice cereals are preferred.

Cheese, butter, meat, fish and poultry.

Remember, even if purchased gluten-free, bread still contains white sugar and should be avoided.

Recently, the consumer market has been flooded with lactose- digesting enzyme products. They often suggest that now at last you, too, can enjoy all the ice cream and dairy products you want. This is simply not true, for the reasons I have given.They will help, but because they address only lactose they do not solve the whole problem.

A few years ago, another product announced that it should be taken by people who have problems with beans. It works, but it doesn't come close to addressing the entire problem.

There is another point you should be aware of. Most enzymes are expensive and some enzymes are very expensive. Most of the products available over-the-counter and through multi-level companies must be, of necessity, low potency to provide a large profit margin.

There are new professional products available for professionals that address the entire problem.

The Chiropractic Journal.

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By Howard F. Loomis

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