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What is the difference between IBS & IBD?
IBS - Irritable Bowel Syndrome and IBD - Inflammatory Bowel Disease, are two conditions of the intestinal tract. They share some common symptoms such as pain and discomfort, urgency and bloating, and alteration of bowel habits. While IBS is usually characterized as a functional disease or syndrome with a diagnosis made on a cluster of symptoms in the absence of notable structural abnormalities, IBD is a very similar disorder, but does differ in that it is a collection of disorders characterized by chronic mucosal and/or inflammation of the intestines.
IBD is typically separated into two different diseases - Crohn's Disease and Ulcerative Colitis. IBD is characterized by inflammation or ulceration, i.e. "organic" changes in the small and/or large intestines, which are not associated with IBS.
Crohn's Disease is characterized by inflammation involving all layers of the bowel wall in any part of the gastro-intestinal tract. The most common sites include the small intestine, colon, and stomach. Abdominal pain is common and may be mistaken for acute appendicitis. Stools are often non-bloody. The distal colon is not involved. Weight loss and fever are common. Occasionally, an inflamed tender loop of small bowel may be felt on a physical examination.
Ulcerative Colitis is characterized by chronic inflammation of the colon and does not involve the small intestine. Typically, the inflammatory process begins at the rectum and spreads. Common sites of involvement include the rectum & recto-sigmoid area. The rectum is almost always involved and continuous biopsies reveal superficial inflammation.
In Crohn's Disease there is an increased expression of THl cells whereas with Ulcerative Colitis an atypical Th2 response is present. Current medical therapies that target IBD go after various drugs to help decrease inflammation, although it remains unclear as to the triggering factor initiating the inflammatory response.
It has been suggested that psycho-social and physical stressors may lead to the development of IBS. Psychological and alternative medicine therapies have been studied in patients with IBS. Drosman and Colleges recorded the result of a large and successful multi-center, randomized trial comparing cognitive therapy with education.
In a group with moderate to severe functional bowel disorder. Investigators randomized 215 patients, to either Cognitive Behavior therapy or education. The Cognitive Behavior therapy was significantly more effective than education, with a response rate of 70% compared to 37% respectively.
This application is relevant for children with diseases such as autism or other disease where children are known to have gastro-intestinal disturbances. These results were significant and were confirmed through protocol analysis. The authors concluded that 12 week Cognitive Behavioral therapy was more effective than education, regardless of symptoms or severity. It has also been demonstrated that alterations in the gut immune system are also present in IBS. There is an increase in mast cells in the Ileum and colonic mucosa.
A build-up of toxic material in the GI tract as a result of both IBS and IBD can be potentially dangerous. The effects range from neurological impairment to altered immune and gene function. Additionally, there may be a cross-over role with gut-related adult diseases. The preventive administration of probiotics prevent any recycling of the toxic substances or at least minimize it. As the probiotics contact and process the various substances, undoubtedly some mutations occurs. Therefore, a constant replenishment of probiotics is important. Probiotics provide a unique method of detoxification of the gut both during and after healing.
Not only can the probiotics assist with clearance of foreign matter, but they also aid in a number of other important processes such as re-establishing a correct bacterial population ratio between the various parts of the GI tract.
Probiotics may beneficially affect both IBS & IBD in the following ways:
Guts and Glory Program reviewed
Jule Klotter reviews Restoring Your Digestive Health by Jordan S. Rubin, NMD & Joseph Brasco, MD in last month's Townsend Letter News. She explains how, except for the common cold, digestive problems drive people to the doctor more than any other ailment. Jordan S. Rubin & Joseph Brasco both believe that the cause of digestive disorders and their cure lie in the foods people eat. Their book Restoring Your Digestive Health draws on personal & clinical experience.
Jule Klotter explains how Jordan Rubin developed Crohn's Disease at age 19, the summer after his freshman year of college. His weight plunged from a normal of 175-80 pounds down to 120. X-rays showed inflammation in his small and large intestines. Since conventional medicine offered control of symptoms but no cure, Rubin turned to alternative medicine, seeking help from 70 health practitioners in seven countries and 300 different 'miracle' products without success. He did find some relief with the low-carbohydrate diet outlined in Elaine Gottschall's book Breaking the Vicious Cycle, but it wasn't until a nutritionist taught him what and how to eat that he saw a lasting improvement. By changing his eating patterns and supplementing with homeostatic soil-based organisms that were discovered and developed by Peter W. Daubner, PhD, Rubin was able to stop taking all the medications and regained his health.
Similar to the diet that the nutritionist had advised Rubin to follow, the Guts and Glory Program, outlined in Restoring Your Digestive Health, avoids modern processed foods and emphasizes meat from organically-raised, grass-fed animals; raw, fermented goat's milk in the form of kefir or yogurt; vegetables; fruits; and certain fats like goat butter, coconut oil/butter, olive oil, and flax seed oil. Rubin & Brasco also encourage readers to consume fermented vegetables and fruits, because of the lactobacilli they contain, and easily-digested, nutrient-rich homemade stocks and broths.
Restoring Your Digestive Health explains the reasons for these food choices in detail. "If this book had a mantra," Rubin & Brasco write, "it would be this: Decrease the total amount of carbohydrates you eat and be selective about the quality of the carbohydrates you eat." Carbohydrates are especially difficult for people with digestive problems to break down. Because of this, some undigested carbohydrates end up feeding harmful bacteria in the small intestine. These bacteria damage the intestinal wall and further impair digestion.
She explains how the 'The Guts and Glory Program' is divided into three phases. The first phase, during which `Brasco Broth' is eaten throughout the day with the recipe included, is designed to rest the bowel and encourage the repair of the bowel lining. It also reduces inflammation, rehydrates the body, and reduces the total microflora. When improvement is noticed (usually 7-14 days, or sooner), the second phase begins. During this phase, which also lasts 7-14 days, fermented goat dairy products and more steamed vegetables are added to the diet. Additional probiotic supplements help reinoculation of the gut with friendly bacteria, lowering colonic pH and improving nutrient absorption. The third phase, which is long-term, seeks to restore and maintain health. It draws more attention to the consumption of healthy fats and the quality and quantity of carbohydrates. Rubin & Brasco use the three phases as blueprints for creating treatment plans for over 20 gastrointestinal disorders, ranging from hemorrhoids and ulcers to constipation and Crohn's Disease. In addition, Restoring Your Digestive Health contains 7 nutrient- or probiotic-rich recipes and some lifestyle recommendations that benefit digestive health.
Dr. Brasco writes, "100% of my patients would get better by changing their diet. However, only 3 - 4 out of 10 patients agree to change it." Jordan Rubin compares his recovery from Crohn's disease to an athlete training for the Olympics: "It takes that kind of commitment to get well from a chronic or degenerative disease." Jule Klotter says that Restoring Your Digestive Health does not offer a `miracle' supplement or pill. The book outlines a program that requires effort and commitment and she says that even people who don't want to follow the Guts and Glory Program can learn ways to enhance their digestive health from this book.
What time of day is best to exercise?
According to Michael O'Shea, writer for San Diego Union Tribune, the late afternoon hours, between 2 p.m. and 4 p.m., are most favorable for working out. He says that studies show that body temperature reaches its peak at this time and is one to two degrees higher than in the morning. The afternoon is prime time for physical activity because a higher temperature creates optimal conditions for exercise. According to the American Council on Exercise, your muscles are warmer and more flexible, perceived exertion is low, reaction time is quicker, strength is at its height, and resting heart rate and blood pressure are at low.
One potential downside to end of-day workouts is that most folks tend to be distracted by family and work and are apt to follow their routine irregularly. Some exercisers may even find it hard to get to sleep if they engage in physical activity too late in the day. So, if you normally work out at sunrise, don't rush to rearrange your schedule. It's more important to find a time of day when you can exercise consistently. If that happens to be in the morning, spend a few extra minutes warming up to elevate your body temperature.
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