questions

Valorie

I will post some more on this, but skip the LEAP tetsting and try to find another dietian.

Valorie

Sorry to hear you have both. The reason in IBS foods can effect a person almost right after eating is because IBSers have an altered gastro colonic response.

This is more about the amount of calories in a meal as well as the amount of fats, which trigger the responce. This is about "THE act of eating itself" and not particular foods themselves.

Postprandial symptoms are a common feature in patients with irritable bowel syndrome (IBS). In one study, one half of patients presenting with IBS reported symptom occurrence or exacerbation following a meal. (1) This effect of meals on gastrointestinal symptoms has been attributed to an increased colonic contractile response to meals in IBS patients. This colonic response has several components.

The first and most rapid component occurs within a few minutes of distension of the stomach by the meal and is mediated by gastric mechanoreceptors that evoke colonic contraction through a vagally mediated afferent pathway.

A second phase, mediated by chemo-receptors in the small intestine, results in colonic contraction that may last up to two hours after meal ingestion. (2) Prolonged manometry (3) and barostat studies (4) demonstrated that the increase in colonic motility after meals was almost immediate, and subsequently we and others reported that patients with diarrhoea and urgency predominant IBS experienced these symptoms in association with repetitive high amplitude propagated contractions that induce mass movements in the colon. (5,6)

The third phase of the colonic contraction after the meal results from ileal stimulation by chyme and has been documented best in animals as it occurs 2-6 hours post-meal ingestion, (7) a time when humans are often ingesting another meal and stimulating the first two components!

The first two phases of the colonic response to food involve serotonergic pathways: thus, antagonism of the serotonin (5-hydroxytroyptamine (5-[HT.sub.3])) receptor reduces both components of the colonic response to meal ingestion. (8)

In this issue of Gut, Houghton and colleagues (9) provide further support for the role of serotonin in mediating this response [see page 663]. They report increased postprandial serotonin levels in patients with diarrhoea predominant IBS and meal related symptoms; serotonin levels were higher than those of patients with IBS without meal related symptoms. There were also higher fasting levels of serotonin in IBS patients compared with controls..."

http://www.accessmylibrary.com/comsite5/bi...d=0286-23195846


Part of this process is from an alter gastro colonic responce

""The gastrocolic reflex, a partly neurogenic process, refers to an increase in colonic motility induced by feeding. Postprandial deviations from the normal motility patterns lead to altered bowel habits. For example, a spastic colon (eg, diarrhea-predominant IBS [D-IBS]) is characterized by an exaggerated motility response to food intake. This exaggerated postprandial response also occurs in response to intraluminal distention or to an injection of cholecystokinin (CCK -- a hormone released in the duodenum) in patients with IBS."

I highly recommend this which has graphics as well.

http://www.helpforibs.com/footer/gastrocolic.asp


This food info might help

http://www.ibshealth.com/ibsfoods.htm

Yeast in not involved in the pathophysiology of IBS.

Since I have suffered for thirty eight of IBS I wonder what role foods play in IBS. So I asked Dr Douglas Drossman at the UNC Center for Functional GI and Motility disorders and here was his response. This is not a substitute for seeking medical advise from your doctor on any specific conditions you may have, but for educational purposes only.

Dr. Drossman is a Co-director of the Center and Professor of Medicine and Psychiatry at UNC-CH. He established a program of research in functional gastrointestinal disorders at UNC more than 15 years ago and has published more than 250 books, articles, and abstracts relating to epidemiology, psychosocial and quality of life assessment, design of treatment trials, and outcomes research in gastrointestinal disorders.


Dr Drossman's comments on foods for IBS Health.

Shawn,
To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Furthermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse.

However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature.

The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.
Doug

http://www.ibshealth.com/ibsfoods2.htm

I would find a new dietian.

Leap I believe is basically a "scam." I spent years going over the leap program and information with one of the people that started it and IBS is NOT caused by foods, which is what they basically promote. I can go into more details if you want on it. Its also pretty expensive.

something to note.

Fungus is in the gut to PROTECT you from pathogens. When there is a REAL overgrowth it can be detected and treated and is a serious issue that can in some cases lead to death.

Its not the cause of IBD conditions or IBS.

Carbs and sugars can negatively effect the gut for other reasons.

There are fungus meds if that is a real issue and there are real ways to diagnose it.

There is also a ton of bad information on the internet about it all and people are making a ton of money promoting BAD information.

It's Not All In Your Head: Understanding Irritable Bowel Syndrome

http://www.researchchannel.org/prog/displayevent.aspx?rid=26275&fid=1698 

you have to select quicktime or windows media.

 

 

 

Just wondering...what is your background in the study of mycology?