Irritable Bowel Syndrome Relief

This Recent Editorial in the BMJ (June 30) looked at Lactose intolerance, that I thought would be beneficial to us all.

Lactose intolerance Is common and can be diagnosed clinically and treated with simple dietary measures ^.

Lactose intolerance occurs in about 25% of people in Europe; 50-80% of people of Hispanic origin, people from south India, black people, and Ashkenazi Jews; and almost 100% of people in Asia and American Indians.¹ Lactose is a disaccharide sugar that is found exclusively in mammalian milk and is digested by the enzyme lactase in the mucosal brush border of the intestine. Reduced intestinal lactase results in malabsorption of lactose. The unabsorbed lactose is metabolised by colonic bacteria to produce gas and short chain fatty acids, causing the clinical syndrome of abdominal cramps, bloating, diarrhoea, and flatulence. Lactose malabsorption does not always cause lactose intolerance; symptoms depend on the amount and rate of lactose reaching the colon, and the amount and type of colonic flora. 

Source: BMJ 2007:334:1331-1332

Shinjini Bhatnagar, pediatric gastroenterologist and senior research scientist¹, Rakesh Aggarwal, professor²  Comments to: shinjini.bhatnagar@gmail.com

Since everyone’s Irritable Bowel Syndrome is different, what works for me might not work for you. But being healthy is a way of life.

IBS Trigger Foods

• Beans
• Sorbitol
• Carbonated drinks - increases bloating and gas
• High sugar levels, causes diarrhoea
• Caffeine and unfortunately
• Chocolate

Tolerated Foods

• Vegetables, eaten cooked not raw
• Fruits should be ripe - such as peeled apples, ripe bananas, grapefruits, nectarines and peaches.

What Causes your Irritable Bowel Syndrome (IBS) to flare?

• Stress
• Eating Certain Foods
• Travel
• All of the Above

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Smoking: Nicotine on the gastric mucosa.

Nicotine is a naturally occurring substance in tobacco that has a complex effect on many organs and systems in the body.
Pharmacologically, Smoking cigarettes results in a fast absorption of nicotine and subsequent distribution over all tissues. Stimulation of peripheral nicotinic receptors leads to increased catecholamines and noradrenaline, resulting in vasoconstriction, tachycardia and an increased myocardial contraction.

After smoking rectal blood flow diminishes, whereas both gastric acid secretion and motility are enhanced.

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Diagnostic criteria
In 1978, Manning et al. described several abdominal symptoms that were more likely to be present in the irritable bowel syndrome than in organic abdominal disease.

While, In 1988, the Rome I criteria were established by a multinational committee of specialists, which further refined the Manning Criteria.

In 1998, the Rome Working Team proposed changes to the definition and diagnostic criteria for IBS to reflect new research data, and to improve clarity. These criteria have evolved, as the Rome Process has integrated fresh evidence and new conceptual approaches to the condition.

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