Irritable Bowel Syndrome (IBS) And Elimination Diets

August 17, 2010 in IBS by ibs_guru

Foods may cause irritable bowel syndrome (IBS) symptoms: In the U.K., most doctors have been, and continue to be, skeptical that foods cause symptoms of (IBS) and elim­ination of specific foods can improve these symptoms.

This is despite almost 70% of people dia­gnosed as having IBS reporting symptoms related to specific foods. There is accu­mu­lating evidence, though still cri­ticized because of lim­it­ations of studies that make it dif­ficult to prove, that specific foods may be the cause of symptoms in many people labeled as having IBS.

Food intol­erance testing and elim­ination diet based on IgG anti­bodies may be bene­ficial: Atkinson et.al. (Gut, 2004) ran­domized people to either an elim­ination diet based on elevated IgG antibody levels (YorkTest Labor­atories) for specific foods or a sham diet. Those who avoided specific foods based on their IgG antibody tests had improvement in IBS symptoms (10–26% reduction) and global rating of quality of life sig­ni­ficantly improved. Re-​​introducing foods for which they tested positive resulted in worsening. Zar et.al. (Am J Gastro, 2005) reported sig­ni­ficant improvement of IBS symptoms such as pain, bloating, and alter­ations in bowel habits based on six month elim­ination of elevated food-​​specific IgG4 anti­bodies in 25 people.

Irritable bowel syndrome (IBS) is very commonly dia­gnosed in adults: No dia­gnostic tests can confirm IBS. It is a dia­gnosis of exclusion. It is a syndrome, that is, a col­lection of symptoms that cannot be explained by other diseases res­ulting in the dia­gnosis of IBS. Common missed dia­gnoses that are blamed on IBS include lactose intol­erance, Celiac disease, gluten sens­itivity or gluten intol­erance, colitis, Crohn’s disease, parasite infections such as giardia, bac­terial over­growth in the intestine or alter­ations in gut bacteria levels and types (dys­biosis), food allergies, food intol­erance, and food hypersensitivity.

Celiac disease, colitis and Crohn’s disease should be excluded before dia­gnosing IBS: Celiac disease, colitis and Crohn’s disease can be dia­gnosed or excluded by blood tests, stool tests, and biopsies of the intestine. Food allergy, intol­erance and sens­itivity are not only more dif­ficult to confirm or exclude but fre­quently missed because of lim­it­ations of blood tests, stool tests, allergy skin tests and biopsies. Adverse food reactions have to be con­sidered as a potential cause of the symptoms attributed to IBS.

There are common foods that cause adverse food reactions: Common foods reported by IBS suf­ferers, whose symptoms improve with elim­ination, are wheat, barley, and rye (gluten); dairy including cow’s milk protein (casein) and/​or lactose (milk sugar); the legumes (peanut) and soy; yeast used to bake or brew foods; corn; shellfish and fish; nuts (almond, Brazil nut, cashew, and walnut); fruits (apple, orange, and strawberry); vegetables (celery, cabbage, and lettuce); the meats (pork, beef, and chicken); and night­shades (potato and tomato).

Indi­vidual specific and food-​​specific elim­ination diets are based on a variety of tests and a food-​​symptom diet diary: Elim­ination diets based on the common foods causing allergic reactions and non-​​allergic food reactions have been used for quite some time and are often pre­scribed with or without a food symptom diet diary. Inter­estingly, to my knowledge, no one has looked at approaching these people and their adverse food reactions indi­vidually, based on tests for Celiac disease, gluten intol­erance or sens­itivity (elevated blood gliadin IgA or IgG anti­bodies and/​or stool gliadin IgA antibody without dia­gnostic blood tests or biopsy for Celiac), casein intol­erance (stool IgA anti-​​casein antibody or blood IgG antibody), oral allergy syndrome (OAS) history and thorough food allergy testing (skin prick testing, IgE RAST or CAP RAST tests, intradermal skin testing or patch skin testing).

Specific food elim­ination diet trials based on such information (see the table at www.thefooddoc.com) has been helpful in my experience. Food-​​pollen cross reaction in OAS is well doc­u­mented. A diet symptom diary combined with specific food elim­ination based on results of food allergy tests, food intol­erance of food sens­itivity tests, and known pollen allergies should be con­sidered as a possible approach to elim­ination diet. This should not exclude eval­uation for and treatment of estab­lished Celiac disease, lactose intol­erance, dys­biosis, colitis or Crohn’s disease.

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This article was ori­ginally pub­lished on www.HypnotherapyClinic.info by Con­sultant Clinical Hyp­no­therapist & Pys­cho­therapist Noel Bradford

As a pro­fes­sional therapist Noel help people with everything that you would expect including giving up smoking, con­trolling their weight, dealing with fears and phobias. However his services go far beyond this and encompass things that affect everyone at some time in their life, such as depression, anxiety, panic attacks, stress, and low self esteem.

He  also has detailed spe­cialist training in several areas including but not limitted to Irrittable Bowel Syndrome and Pyscho­sexual matters that affect men such as Errectile Dys­function and Pre­mature Ejac­u­lation as well as those affecting women such as Hyper Desire Disorder, Vaginisums, and Dys­pareunia.

Ori­ginally posted 2010-​​02-​​15 17:30:06.

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