Q:For some time now I have suffered from digestive problems. The doctors tell me I have "irritable bowel" and have prescribed imodium. My condition is getting worse and I am now seriously underweight. I feel there has to be a cause of my problem and that taking medication is no answer in the long term. I am writing to you to ask your help on a number of points.
Could your medical team please tell me something about imodium? Is it a drug which should be prescribed long term?In Vol 2 No 9 of WDDTY you had an article, "Gut Reactions", in which reference was made to research being done in Cambridge on the relationship between food intolerance and bowel flora. Has this research been written up anywhere and if so, could you give me the reference?
Could you recommend any other reading which might help me throw some light on my condition? J. W., Bradford........
A:"Irritable bowel syndrome" is a catch all phrase used by most doctors when they basically don't know what the problem is. Also referred to as "spastic colon" , it's mainly characterized by aches or pains, gas,
flatulence, distension and general disquiet in the abdomen, as well as a disturbance of bowel habits, with diarrhoea or constipation. In other words, things just aren't right down there.
But each condition could result from one or more of a number of causes. Top of the list is food allergy or intolerance; the work we cited from Cambridge, performed by Dr. John Hunter, has shown allergies to a number of foods as responsible. The biggest offender was wheat, followed by corn, dairy products, coffee, tea and citrus fruits, in that order.
But food allergy is by no means the entire story. You could have a candida overgrowth, which would be causing your body not to tolerate certain foods, as could an overgrowth of other bacteria in the bowels. Extra tea, coffee or alcohol could upset your gut, or you could be allergic to milk and milk products. Finally, we're also finding that parasites like giardia lamblia or worms produce symptoms that mirror those of IBS a very common occurrence in the US and the UK.
Dr Stephen Davies has also seen increasing numbers of cases of IBS caused by the recent bran craze in people who could be marginally wheat intolerant. He's also discovered a high incidence of people with hypochlorhydria (low stomach acid). When food is not properly broken down in the stomach, the bowel cannot digest it. Treatment is by a short course of pancreatic enzymes.
Finally, repeated courses of antibiotics can disturb the millions of bacteria and other organisms that perform all manner of functions in the bowel, causing symptoms of IBS.
We spoke to Dr Keith Mumby about your letter, and he said the following:
"Imodium, while not as dangerous as many other drugs, simply covers up the real problem, which in most cases is a biochemical one. In some cases, it is psychological, the result of anxiety, obsession or tension. But in my experience, that occurs in a very small percentage of IBS cases, and not 95 per cent, as many doctors believe.
If you would like to embark on a self help programme, I suggest that you do the following, in this order:
1)Begin a sensible exclusion diet to isolate a possible food allergy.
2)If that doesn't cure the problem, consider candida overgrowth as a possible source of your problem (See WDDTY Vol 2 Nos 6 and 11).
3)Consider whether parasites are the cause (which we will be covering in a forthcoming issue of WDDTY). If so, find an enlightened doctor who will put you on a therapeutic trial of Flagyl(metronidazole) which kills a wide range of intestinal parasites like giardia. If you feel spectacularly better after the trial, it's very likely that a parasite is behind your difficulties.
4) If you're still not better, find a clinical ecologist with experience in this area who may be able to find the root cause and treat it."