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Inflammatory Bowel Disease (IBD)

What is Inflammatory Bowel Disease (IBD)?

Inflammatory Bowel Disease (IBD) is a prevalent cause of chronic illness in a large number of people. It can present itself in two different forms:

Although both Crohn's Disease and Ulcerative Colitis can appear clinically very similar:

  • Ulcerative Colitis primarily involves inflammation of the colon and rectum, as opposed to the upper GI tract.
  • Crohn's Disease, on the other hand, impacts a greater area of the upper intestinal digestive tract, and is thus more likely to trigger malabsorption, along with chronic vitamin and nutrient deficiencies.

Probiotics and Inflammatory Bowel Disease (IBD)

Dr Richard Fedorak MD of University of Alberta advocates the use of probiotics in IBD. At a symposium during Digestive Disease Week he spoke about the 3 components of Inflammatory Bowel Disease:

  • an antigen, that is, a bacterium or bacterial product that passes through the epithelium
  • defects in permeability of the epithelium, possibly because of genetic susceptiblity to these defects, allowing the anitgen into the intestine
  • a dysregulated immune response that occurs in response to the antigen, also genetically controlled

Dr Fedorak explains how different strains of probiotics have different effects. They differ in how well the adhere to epithelium, how well they fight bacteria and how they regulate the immune system. Lactobacilli are able to survive the Upper GI tract much better thatn bifido bacteria, but bifido bacteria are better at destoying pathogenic bacteria.

He goes on to explain the mechanism for probiotics in IBD. "Bacteria adhere to the lining of the colon - like icing on a cake. Probiotics are able to negotiate through this layer of bacteria and layer themselves against the epithelium surface. They prevent bacteria for adhering to or crossing the epithelium."

UCLA's CURE Digestive Diseases Research Center reports that when assessing 443 IBS referrals, 66% of IBS patients reported gas as a symptom, and 60% reported bloating-type symptoms as "the most bothersome".

VSL#3 has been successfully used in the Dietary Management of Bloating In an 8-week double-blind placebo-controlled trial in 25 diarrhea-predominant IBS patients VSL#3 was helpful in the dietary management of IBS with bloating. (mean change:-13.7 points; 95%CI -25, -2; P=.05). 46% of VSL#3 patients reported satisfactory relief of bloating for 4 weeks on study vs 33% in the placebo group (P=.27)

VSL#3 has also been used in the Dietary Management of Flatulence (gas) In an 8-week double-blind placebo-controlled trial in 48 IBS patients VSL#3 was helpful in the dietary management of IBS with flatulence (VAS score at 8 weeks: 29.7 vs 39.5, P=0.01).

Additional positive results were noted in randomized, double-blind placebo-controlled 2003 trial. Kim et al. reported a reduction in the urgency in diarrhea-predominant IBS patients involved in the trial. The fecal urgency score showed a trend toward reduction in the VSL#3 group (mean change: -8 points; 95%CI -15, -2; P=.056).

A very important fact to note - No side effects were reported in either of the randomized, double-blind placebo-controlled trials of VSL#3.

VSL#3 Junior, watermelon flavored sachets, are now available for children.

Extensive studies on VSL#3, Culturelle and OMX Probiotic indicate their effective use and benefit to reduce Inflammatory Bowel Disease. Therapeutic, loading doses are usually necessary to see results.

Symptoms of Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) is characterized by chronic intestinal inflammation resulting in symptoms of:

  • diarrhea,
  • bleeding,
  • abdominal pain,
  • fever,
  • joint pain, and
  • weight loss.

These symptoms may be mild or severe. It may gradually develop from an initial minor discomfort, or else may present suddenly with acute intensity.

Increasing evidence point to an important role for inflammatory cytokines (i.e. messengere compounds) for the pathogenesis of Crohn's Disease. One such cytokine, tumor necrosis factor alpha (TNF-alpha) plays a key role.

One study showed that the release of TNF-alpha by inflamed Crohn's Disease tissues can be significantly reduced by Lactobacillus casei or Lactobacillus bulgaricus supplements.

Comparison of Ulcerative Colitis and Crohn's Disease

Feature

Ulcerative Colitis

Crohn's Disease

Distribution Diffuse, distal predominance Segmental or diffuse, often
proximal predominance
Rectum Always involved Often spared
Microscopic Distribution Diffuse Often focal
Depth of Inflammation Mucosal Transmural
Sinus Tracts and Fistulae Absent Often present
Strictures Absent Often present
Granulomas Absent Often present

Inflammatory Bowel Disease (IBD) is believed to develop as a "gut" reaction to intestinal dysbiosis --chronic imbalances in the microbial flora that set off a chain of pathogenic events.

A damaged intestinal mucosa triggers and perpetuates Iinflammatory Bowel Disease (IBD) by allowing a steady stream of antigens and toxins to continually confront the immune system.

A simple stool test is able to confirm the presence of Inflammatory Bowel Disease. See Great Smokies CDSA and Parasitology 2.0

Causes of Inflammatory Bowel Disease (IBD)

Bacteria and VIruses

Infectious causes for Inflammatory Bowel Disease (IBD) generally have a more acute onset and run a shorter course than other forms of Inflammatory Bowel Disease (IBD). Bacterial organisms that can produce Inflammatory Bowel Disease IBD include Shigella, Salmonella, Campylobacter, and some E. coli. Bacteria are a common cause of acute colitis. Viral causes include Norwalk-like virus and rotavirus (small bowel) as well as cytomegalovirus (CMV) and herpes simplex virus in immune compromised people. Other causes include chlamydial infection and amebiasis.

Clostridium Difficile

Antibiotic-associated Inflammatory Bowel Disease (IBD) can occur from therapy with broad spectrum antibiotics leading to overgrowth of Clostridium difficile or other organisms such as Candida. This produces a toxin that causes damage to the mucosal lining of the digestive tract. Dr Ohhira OMX probiotics is resistant to Clostridium Difficile.

Imbalances of Essential Fatty Acids

Because certain infectious organisms produce symptoms very similar to Inflammatory Bowel Disease (IBD), testing for other possible causes, like parasites, is strongly recommended. Many Inflammatory Bowel Disease (IBD) symptoms produced by chronic inflammatory immune response may be significantly reduced by addressing imbalances of essential fatty acids. Levels of zinc, iron, copper and other crucial minerals are often deficient in patients suffering from Inflammatory Bowel Disease (IBD).

Allergic Immune Reactions to Food Particles

Allergic immune reactions to food particles may play an important role in the development of Inflammatory Bowel Disease (IBD) symptoms. Low levels of important amino acids can cause aggravated inflammatory responses. Inflammatory Bowel Disease (IBD) is also associated with malabsorption of nutrients. Patients with Inflammatory Bowel Disease (IBD) have a higher risk of developing osteoporosis.

Evaluation of Inflammatory Bowel Disease IBD

Great Smokies Diagnostic Labs offers assessments that specifically target the physiological mechanisms associated with Inflammatory Bowel Disease (IBD), allowing for a more precise treatment strategy to help prevent development and halt progression of the disease. The CDSA 2.0 test gives you insight into your digestive function and gut microbial ecology.

This easy-to-administer home stool test offers a noninvasive differential diagnosis between Inflammatory Bowel Disease (Crohn's Disease and Ulcerative Colitis) and Irritable Bowel Syndrome (IBS), expanded bacteria, yeast and parasite detection, a reliable assessment of exocrine pancreatic function, and a noninvasive risk assessment for colorectal cancer. If bacteria, yeast or parasites are detected, they may be grown out to establish which natural products will inhibit their growth.


Recent research conducted by Dr. Marcel A. Behr, of the Research Institute of the MUHC and McGill University, has provided new insight into the curious mutation of NOD2 gene, a mutation that is found in 25% of Crohn's disease patients. It is not precisely known how this mutation influences the disease.