Irritable Bowel Syndrome Message Boards

For quite some time now they have been studying the gut flora of IBsers. Candida has already been ruled out.

They are studying the gut lining with very powerful electron microscopes at the cellular level.

""Gut Bacteria and Irritable Bowel Syndrome
By: Eamonn, M. M. Quigley M.D., Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland

Bacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These "normal" bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the flora and its host, and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article presents a discussion of the possible role of bacteria in IBS and various treatment approaches."

Do bacteria play a role in IBS?

The possibility that gut bacteria could have a role Irritable Bowel Syndrome (IBS) may surprize some; there is indeed, now quite substantial evidence to support the idea that distrubances in the bacteria that populate the intestines may have a role in at least some patients with IBS. What is this evidence? It can be summarized as follows:

1. surveys which found that antibiotic use, well known to distrub flora, may predispose individuals to IBS.

2. The observation that some individuals may develop IBS suddenly, and for the first time, following an episode of stomach or intestinal infection (gatroenteritis) caused by a bacterial infection. (This is called Post Infectious IBS but here the intial infection resolves and there are structural cell changes)

3. recent evidence that a very low level of inflammation may be present in the bowel wall of some IBS patients, a degree of inflammation that could well have resulted from abnormal interactions with bacteria in the gut. (this is not overt inflammation but also specific cells and inflammatory mediators) Stress can also influence this process and has been shown to be connected as well.)

4. The Suggestion that IBS maybe Associated with the abnormal presents, , in the small intestines, of types and numbers; a condition termed small bacterial overgrowth (SIBO)> (This is a seperate condition and is not panning out as a cause)

5. Accumaliting evidence to indicate that altering the bacteria in the gut, by antibiotics or probiotics, may improve symptoms in IBS.

For some time, various studies have suggested the presence of changes in the kind of colonic flora in IBS patients. The most consistent finding is a relative decrease in the population of one species of 'good' bacteria, bifidobacteria.

However, the methods employed in these studies have been subject to question and other studies have not always reproduced these finding. Nevertheless, these changes in the flora, maybe primary or secondary, could lead to the increase of bacterial species that produce more gas and other products of their metabolism. These could CONTRIBUTE to symptoms such as gas, bloating and diarrhea."

"We still don't know the exact role bacteria has in IBS. More research is needed."

This was from 92
"Postgrad Med J. 1992 Jun;68(800):453-4. Related Articles, Links

Comment in:
Postgrad Med J. 1993 Jan;69(807):80.

The role of faecal Candida albicans in the pathogenesis of food-intolerant irritable bowel syndrome.

Middleton SJ, Coley A, Hunter JO.

Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.

Candida albicans was sought in stool samples from 38 patients with irritable bowel syndrome and 20 healthy controls. In only three patients with irritable bowel syndrome was C. albicans discovered and these patients had either recently received antibiotics or the stool sample had been delayed more than 24 hours in transit. C. albicans was isolated from none of the control stool samples. We conclude that C. albicans is not involved in the aetiology of the irritable bowel syndrome.

PMID: 1437926 "

This position is shared by both the american and Australasian Society of Clinical Immunology.

"The Australasian Society of Clinical Immunology and Allergy has issued this paper on Allergy testing and treatments."

ASCIA Position Statement:
Unorthodox Techniques for the Diagnosis and Treatment of Allergy, Asthma and Immune Disorders
Dr Raymond J. Mullins on behalf of the Education Committee, ASCIA October 2004

"INAPPROPRIATE TESTING

Chronic Candidiasis
Use: Treatment of a variety of ailments including allergy, irritable bowel, food allergy and intolerance, autoimmunity, arthritis and psychological conditions.
Method: This approach is based on the concept that imbalance of gut flora results in overgrowth of Candida albicans within the gut. Release of fungal toxins results in a variety of symptoms including fatigue, arthritis, irritable bowel, food intolerance as well as psychological symptoms. These toxins weaken the immune system, predisposing to further symptoms from ingested foods and toxins. Treatment centres on dietary supplements, administration of antifungal drugs such as nystatin, and restriction of "Candida friendly" foods such as those containing sugars, yeast or molds.
Evidence: Candida is a normal gut organism, and immune responses (antibodies, cell mediated responses) to this organism are both expected and observed in healthy controls as well as those allegedly suffering from this condition. There is no evidence of overgrowth of Candida or altered immune responses to this organism in patients complaining of this syndrome. There is neither a scientific rationale nor published evidence that elimination of Candida with diets or anti-fungal therapy is useful for management."

http://www.allergy.org.au/pospapers/unorthodox.htm

It has been twenty years since Dr Crook first speculated on "Candida over growth syndrome" and here were are twenty years later with less proof then when they started. The postion paper above is from 2007 and the americans have the same postions as well as the mycology (fungus) experts I posted above and gastroenterologists and neurogastroenterologists.

This goes over real candida conditions.

http://www.cdc.gov/nczved/dfbmd/disease_listing/candidiasis_gi.html

These are Mycology experts.

Chronic Candidiasis

Overview

It has been proposed that the asymptomatic colonization with Candida might be associated with a variety of symptoms and cause a "Candida Hypersensitivity Syndrome" [599] This concept was popularized by William Crook, MD in his book The Yeast Connection [491]. Previously, C.O. Truss, a physician from Birmingham, Alabama had proposed the existence of such a malady [2257, 2259]. Other names that have been given to this presumed condition include:
Candida-Related Complex
Polysystemic Candidiasis
Chronic Candidiasis (This term should not be confused with Chronic Mucocutaneous Candidiasis)
The syndrome is theoretically due to an overgrowth of Candida albicans in the gastrointestinal tract or in association with mucous membranes. The syndrome is said to occur in connection with some or all of the following risk factors:
Use of broad spectrum antibiotics
Use of oral contraceptives
Ingestion of diets rich in yeast-containing foods or readily utilizable carbohydrates.
Pregnancy
Tremendous attention by public media and health magazines has created a large body of uncritical publications on this topic [399, 486, 490, 2046, 2256, 2257, 2258, 2259, 2459]. There are no rigorous data to support these concepts. The whole idea is based on historical controls and no working definition has been ever assessed [220]. Although brief communications by the proponents have appeared in major journals [483, 484, 485, 487, 488, 489, 492], the actual studies performed by these physicians do not appear to have been subjected to peer review. The American Academy of Allergy and Immunology published a position paper in 1986 stating that the concept was "speculative and unproven" [84]. Later, a carefully designed study on the topic by Dismukes et al. demonstrated that the condition does not appear to be reproducible or verifiable [599].

Clinical Manifestations

There is a broad range of symptoms that have been associated with this syndrome. They can be classified in the following groups, although it is not clear how many or which of them are required to make a diagnosis nor is there scientific data linking these multiple clinical manifestations with Candida albicans overgrowth [220, 262]:
Vaginal. Recurrent episodes of Candida vaginitis associated with the classic symptoms of pruritus, burning and abnormal discharge.
Gastrointestinal. Heartburn, bloating, diarrhea or constipation.
Respiratory allergy. Rhinitis, sneezing and/or wheezing.
Central nervous system. Anxiety, depression, memory deficits and/or loss of ability to concentrate.
Menstrual abnormalities. Severe premenstrual tension and/or menstrual irregularities.
Other Systemic Symptoms. Fatigue, headache and/or irritability.
Specific Diagnostic Strategies

The proponents of the existence of this syndrome base their diagnosis on the clinical picture previously discussed [490, 491, 2459]. There is no laboratory test that allows a clear identification of patients affected with this presumed disorder. Actually, "no clear definition of the disease has ever been advanced" [220]. Considering these facts, it is impossible to set criteria to establish and identify patients affected with this supposed disease.

From a practical viewpoint, we recommend that all women with recurrent vaginitis be carefully evaluated for possible causative factors. Patients with more general complaints should receive a general physical examination. A CBC, general serum chemistries (including liver enzymes), and thyroid studies should be checked to eliminate the possibility of an anemia, subclinical hepatitis, and so forth. Finally, Renfro et al. reported that approximately two-thirds of patients with chronic fatigue had an underlying psychiatric diagnosis [1893].

Treatment

Proponents of this syndrome have recommended such therapies as:
Long-term therapy with antifungal agents at increasing doses until resolution of symptoms. Oral and usually vaginal nystatin are recommended. Other azoles, such as ketoconazole have been also used [262].
Diet modification including restriction of sugar and other simple carbohydrates [487].
Candida allergy shots [220].
Avoidance of mouldy environments [220].
The value of these therapies is unknown. Dismukes et al. conducted a prospective double-blind study to assess the impact of antifungal therapy on this condition [599]. This study compared oral and vaginal nystatin with placebo in 42 premenopausal women with the presumed diagnosis of chronic candidiasis. The remarkable finding of this study was that nystatin did not "reduce systemic or psychological symptoms more than placebo did "[599]. One of the major proponents of the syndrome, Doctor William Crook criticized the study by saying that nystatin is no more than one of the components of the "comprehensive and multimodal therapy" required for this condition [487]. The same author agreed on the urgent need for more scientific studies on the topic. However, a recently done and detailed Medline search on the topic yielded only the data that we have discussed.

Chronic Candidiasis FAQ

We often receive inquiries about the diagnosis and treatment of chronic candidiasis. Here is our FAQ list:
How can I decide if I have chronic candidiasis? Answer: We don't know. The syndrome has never been clearly defined and a workable diagnostic approach has never been put forth. While we have no doubt that there are individuals who suffer from some (or all) of the symptoms listed above, we are not aware of any testing procedure that can link these symptoms to a candidal infection.

My doctor cultured Candida from my stool. What does this mean? Answer: Candida spp. are frequent asymptomatic colonizers of the skin and bowel. Such cultures are of little significance unless you are critically ill in an ICU or are receiving cancer chemotherapy.

I took _______ (name of drug) or I altered my diet to include (or exclude) _______ (name of food) and now I feel better. Doesn't that mean I have (had) chronic candidiasis? Answer: The most common form of this question is "I took fluconazole and now I feel better--does this mean I had chronic candidiasis?" While we're glad you feel better, response to fluconazole is not a diagnostic tool. The various antifungal drugs have effects that go beyond the fungi (for example, fluconazole interacts with the enzyme systems of people, not just of fungi) and many diseases have a natural course of progression and regression. Similar concepts apply to changes in diet. If something makes you feel better, we're delighted for you. We just don't know what it means.

I still really think I might have chronic candidiasis. What should I do? Answer: At the risk of being repetitive, we'll say it again: We don't know of any useful approaches to diagnosing or treating chronic candidiasis. You should see a competent physician and be checked for the things that we do know how to diagnose (see discussion above). If these tests are negative, then we have nothing too specific to offer other than sympathy. We are not denying your symptoms. Rather, we honestly don't know what to do about them. If you can identify something that makes you feel better, then we'll cheer for you!

Is "yeast" the same as Candida? Answer: The term "yeast" is relatively imprecise. Medical mycologists use this term to describe fungi that reproduce predominantly by budding or fission. There are many genera of fungi that fit in this category. Beer and bread makers use the term to refer to Saccharomyces cerevisiae. Doctors sometimes use the term "yeast infection" to refer to Candida spp. and its diseases. For example, yeast vaginitis is the colloquial phrase for candidal vaginitis.

http://www.doctorfungus.org/mycoses/human/candida/Chronic_Candidiasis.htm

--------------------
My website on IBS is www.ibshealth.com

Print Remind Me Notify Moderator