Information on Gut Issues

 IBS

Around one in seven people experiences the unpleasant symptoms of irritable bowel syndrome (IBS), which include abdominal pain, mucus in the stools, and alternating diarrhoea and constipation. Other terms for irritable bowel syndrome include ‘spastic colon’ and ‘irritable colon’. It seems that people with IBS have sensitive bowels that are easily ‘upset’. More women than men are prone to IBS, and symptoms tend to first occur in early adulthood. The cause is unknown, but environmental factors – such as changes of routine, emotional stress, infection and diet – can trigger an attack. Irritable bowel syndrome doesn’t cause lasting damage, and doesn’t contribute to the development of serious bowel conditions, such as cancer or colitis.

Symptoms of IBS
Some of the more common signs of irritable bowel syndrome include:
* Abdominal pain or cramping that is often relieved by passing wind or faeces
* Alternating diarrhoea and constipation
* A sensation that the bowels are not fully emptied after passing a motion
* Abdominal bloating
* Mucus present in the stools
* Nausea
* Loss of appetite
* Other types of indigestion, such as heartburn.
None of these symptoms are exclusive to IBS. In particular, it would be unusual for IBS to produce these symptoms, for the first time, after the age of 40.

Two main IBS categories
Irritable bowel syndrome can be subdivided into two major categories, including:
* Constipation-predominant – the person tends to alternate constipation with normal stools. Symptoms of abdominal cramping or aching are commonly triggered by eating.
* Diarrhoea-predominant – the person tends to experience diarrhoea first thing in the morning or after eating. The need to go to the toilet is typically urgent, and cannot be delayed. Incontinence may be a problem.

Click HERE to view a video by the Mayo Clinic on IBS.
Crohn’s Disease 

Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract which can affect any part of the gut, from the mouth to the anus, but commonly affects the small and large intestine. It is one of the group of inflammatory bowel diseases (IBD).
The cause is unknown.
– Smokers are at an increased risk of developing Crohn’s disease.
– IBD runs in families. Crohn’s disease and ulcerative colitis are both associated with certain genetic diseases.

Crohn’s disease differs from ulcerative colitis because it causes inflammation deeper within the intestinal wall. Crohn’s disease usually occurs in the small intestine, but it can also occur in the mouth, esophagus, stomach, duodenum, large intestine, appendix, and anus. Ulcerative colitis affects only the colon.

Because IBD is inflammatory, it increases the risk of colon cancer due to the constant inflammation and healing process.

Symptoms
Chronic inflammation results in pain, diarrhoea and weight loss, as well as other symptoms. Symptoms and signs vary according to the site of involvement and how much of the gut is involved.
If the small bowel is involved, patients may get abdominal pain after meals, diarrhoea and weight loss. With large bowel involvement, diarrhoea and rectal bleeding is common.
Symptoms in Crohn’s disease may begin insidiously and the diagnosis is often delayed. Systemic features are common (fever, weight loss, etc) and perianal disease (fissures, fistulae and abscesses) is a frequent early clue to the diagnosis.
Anaemia may also be diagnosed because of Crohn’s disease.

Diagnosis
The diagnosis is made by a combination of x-rays, endoscopy, colonoscopy and biopsies. Exclusion of infective causes of diarrhoes and bleeding is important and hence stool culture and examination may also be performed. A full blood count may also be done to see if the patient is anaemic because of low iron, folate or vitamin B12, plus to look for an increased white cell count, elevated platelets and a high ESR (which may indicate that an inflammatory process is occurring).

Celiac 

Celiac disease is an inherited, autoimmune disease. The lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.

The intestines contain projections (called villi) that absorb nutrients. In undiagnosed or untreated celiac disease, these villi become flattened, and the ability to absorb nutrients properly is altered. As a result, several other organ systems may also be affected. The disease can develop at any point in life, from infancy to late adulthood.

Causes, Incidence, and Risk Factors  
The exact cause of celiac disease is unknown. Once thought rare, celiac disease has recently been estimated to affect 1 of every 133 Americans. However, only a small fraction of people living with celiac disease in the United States have been diagnosed at this time.

Those with a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and those of European ancestry. Women are affected more commonly than men.
There are numerous diseases and conditions associated with celiac disease, including:
•    Anemia
•    Lactose Intolerance
•    Dermatitis herpetiformis (a burning, itching, blistering rash), and other skin disorders
•    Type 1 diabeties
•    Thyroid disease
•    Down syndrome
•    Unexplained infertility
•    Miscarriage
•    Osteoporosis or osteopenia
•    Certain types of intestinal cancer
•    Neurological conditions
•    Autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus

The symptoms of celiac disease can vary significantly from person to person. Symptoms may be intestinal or seemingly non-intestinal in nature. This variability is part of the reason the diagnosis is frequently delayed. For example, one person may have constipation, a second may have diarrhea, and a third may have no irregularity in stools.

A partial listing of gastrointestinal symptoms:
•    Abdominal Pain
•    Abdominal distention, bloating, gas, indigestion
•    Constipation
•    Decreased appetite (may also be increased or unchanged)
•    Diarrhea, chronic or occasional
•    Lactose intolerance (common upon diagnosis, usually goes away following treatment)
•    Nausea and vomiting
•    Stools that float, are foul smelling, bloody, or “fatty”
•    Unexplained weight loss  (although people can be overweight or of normal weight upon diagnosis)

 

Colitis 

Colitis and the SCD

Colitis (also called ulcerative colitis) is an acute or chronic inflammation of the membrane lining the colon-your large intestine or bowel. Colitis causes inflammation and sores, called ulcers, in the top layers of the lining of the large intestine. Ulcerative colitis rarely affects the small intestine except for the lower section, called the ileum.

The inflammation makes the colon empty frequently, causing diarrhea. Ulcers form in places where the inflammation has killed colon lining cells. The ulcers bleed and produce pus and mucus. You may have abdominal pain, diarrhea, rectal bleeding, painful spasms (tenesmus), lack of appetite, fever, and fatigue.

* Ulcerative colitis is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the intestines.

Ulcerative colitis can be difficult to diagnose because its symptoms are similar to other intestinal disorders such as irritable bowel syndrome and to another type of IBD called Crohn disease (also called Crohn’s disease).

Another confusing condition called irritable bowel syndrome is not like either ulcerative colitis or Crohn disease. Irritable bowel syndrome is a common disorder of the intestine that leads to cramps, excessive production of gas, bloating, and changes in bowel habits.

 

Diverticulitis 

Diverticulitis and the SCD

Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis.

When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.

Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. This excess pressure might cause the weak spots in the colon to bulge out and become diverticula.
Diverticulitis occurs when diverticula become infected or inflamed. Doctors are not certain what causes the infection. It may begin when stool or bacteria are caught in the diverticula. An attack of diverticulitis can develop suddenly and without warning.

The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications.

To diagnose diverticular disease, the doctor asks about medical history, does a physical exam, and may perform one or more diagnostic tests. Because most people do not have symptoms, diverticulosis is often found through tests ordered for another ailment.

When taking a medical history, the doctor may ask about bowel habits, symptoms, pain, diet, and medications. The physical exam usually involves a digital rectal exam. To perform this test, the doctor inserts a gloved, lubricated finger into the rectum to detect tenderness, blockage, or blood. The doctor may check stool for signs of bleeding and test blood for signs of infection. The doctor may also order x rays or other tests.
Autism and SCD 

This article was taken from Breaking The Vicious Cycle with permission of the author Pam Ferro President of the Gottschall Center for Autism in Massachusetts.
Pamela Ferro, a registered nurse in private practice in Massachusetts, specializes in the treatment of children diagnosed with Autisim Spectrum Disorder (ASD). She is also the aren’t of a child with autism. In treating over 300 children with ASD, she reports that at least 90% of these children present severe gastrointestinal problems that were unrecognized and, therefore, untreated. Her clinical experience shows that many fo the behavioral symptoms associated with autism can be traced to an injured intestine. The Specific Carbohydrate Diet addresses the vicious cycle of malabsorption, maldigestion, inflammation, and food allergies seen in children with autism. Once healthy digestion begins, many children with autism demonstrate remarkable improvements in bowel function, language eye contact, self-stimulatory behavior, anxiety, and mood. Ms. Ferro has developed a modified version of the Specific Carbohydrate Diet that eliminates the use of dairy for three to six months. As the child’s behavior becomes stabilized, parents can slowly reintroduce dairy and evaluate whether or not it can be tolerated.

Note: The Specific Carbohydrate Diet was designed to treat bowel disorders and not specifically for ASD. Dairy is allowed on the Specific Carbohydrate Diet in the form of butter, certain cheeses and homemade yogurt. It not only adds variety to the diet, but homemade yogurt provides one of the best vehicles to introduce healthy bacteria into the bowel.

The Specific Carboydrate Diet has entered the world of autism through “the back door” – the intestinal tract. And what may have first appeared to be ‘the back door,” via the digestive system, is rapidly becoming one of the most scientifically researched areas in determining what may be one of the underlying causes of many autism spectrum disorder. Because the Specific Carbohydrate Diet’s goal is to heal the intestinal tract and to rid it of bacterial and fungal overgrowth, it is proving to be a very successful dietary intervention in treating many autistic children and leading them back to a life of normalcy.

When implementing the Specific Carbohydrate Diet, it is important to remember that during the first week to ten days, profound changes are occurring in the digestive tract: the hundreds of different families of microorganisms are changing their metabolic functions due to the lack of nutrients to which they have been accustomed and of which they are now being deprived.  Some children may do well even during the first week.  But others will go through a period of adjustment which some refer to as “detoxification.” It will be helpful during this period to find support from the many other parents who have been through this change.  Going to the websites (listed in our links section) can give you this support.

It is especially important that you read the information on these websites relating to the introduction of dairy products. A decision can then be made if the Specific Carbohydrate Diet should be implemented with or without dairy.

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