http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=8249972 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16410032&query_hl=7&itool=pubmed_docsum http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12738465&query_hl=7&itool=pubmed_DocSum http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=15932370 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16836942&query_hl=9&itool=pubmed_docsum 1: Curr Gastroenterol Rep. 2006 Aug;8(4):305-11. Links Bacteria and irritable bowel syndrome: the evidence for small intestinal bacterial overgrowth. * Lee HR, * Pimentel M. GI Motility Laboratory, Cedars-Sinai Medical Center, 8730 Alden Drive, 2nd floor, Los Angeles, CA 90048, USA. Irritable bowel syndrome (IBS) is a complex, yet common diagnosis in gastroenterology. Recent data suggest the increasing importance of bacteria in the pathophysiology of IBS. Some studies have shown that IBS can be precipitated by an acute case of gastroenteritis. These pathogenic organisms may contribute to long-term gut dysfunction. In another line of effort, a growing body of evidence links IBS to the presence of excessive bacteria in the small bowel, called bacterial overgrowth. Although the means by which this is determined have been indirect, studies demonstrating the benefit of unabsorbed antibiotics suggest that reduction in gut flora is important. Further work has also examined bacterial overgrowth in the context of the various symptoms of patients with IBS. These symptom complexes include constipation, diarrhea, and alternating forms of the condition. Although this idea seems initially counterintuitive, it has been demonstrated that the fermentation of methane in the gut is associated with and can result in the slowing of intestinal transit, resulting in constipation. In this review, these topics are discussed and outlined. PMID: 16836942 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15294487&query_hl=5&itool=pubmed_docsum 1: Asia Pac J Clin Nutr. 2004;13(Suppl):S24-5. Links Intestinal microflora: negotiating health outcomes with the warring community within us. * Chin J. Immunology & Microbiology, Elizabeth Macarthur Agricultural Institute, NSW Agriculture, Camden, NSW 2570, Australia. Digestion of food and absorption of nutrients constitutes the primary role of the gastrointestinal tract (GIT) of mammals. An extremely large surface area created by the complex involution of crypts and villi, and lined with epithelial cells has evolved to facilitate these functions. Some of the 400 species of micro-organisms in the GIT that are adherent, have exploited and adapted to particular microniches in different compartments of this vast intestinal real estate while the rest abound as free living entities sequestered in mucus or complexed with digesta in the lumen. Whether localised or in transit, these bacteria are continuously competing for survival1. The ability to persist and propagate or be ultimately eliminated, is dependent to a large extent upon the armoury of each combatant. Susceptibility or immunity of each strain to the arsenal of bacteriocins or quorum sensing factors produced by another constitutes a community at war. While only a thin layer of epithelial cells known as enterocytes separates the host from the warring factions, they must form an effective barrier against incursions and introgressions by intestinal microflora. Erosion of this barrier integrity by stress, inflammation or disease would lead to translocation of bacteria into the blood stream. If pathogenic, the host would die from septicaemia unless the micro-organisms are eliminated by the immune system. For this reason, the bulk of cells aligned behind the layer of intestinal epithelial cells are immune cells that include lymphocytes, monocytes, macrophages, polymorphonuclear leukocytes and dendritic cells. These immune cells form a nexus of innate and acquired immune capability that constitutes a formidable barrier against intending or inadvertent translocators. Immune responses are not initiated only when barrier integrity is compromised. TOLL receptors on the lumenal surface of basolateral enterocytes can signal the presence of "dangerous" or pathogenic microbes and therefore arm the immune system. Alternatively, danger signals including soluble molecules that transgress enterocytes despite a tight barrier junction, can be detected by TOLL receptors on macrophages and dendritic cells. Signalling provides the main pathway of immune activation when the barrier integrity is intact and is the main mechanism for countering a suppressed or tolerized default intestinal immune response. Suppression of immune responsiveness is mandated in the GIT to prevent undesirable responses against dietary antigens that can lead to allergic disorders like food intolerance. The GIT has evolved its own hazard analysis and critical control points (HACCP) to balance reactivity with tolerance and this balance can be manipulated by diet, using nutraceutical supplements. Indeed, nutritional strategies can be used to derive health outcomes by manipulating warfare between bacteria and bacteria, as well as preparing defence of the host against intruders. A mouse model of inflammatory bowel disease initiated by the enterocyte denuding agent dextran sodium sulphate (DSS) was used to explore the intimate tripartite relationship between the host, intestinal bacteria and diet. In this model, DSS reproducibly initiates an inflammatory response in the colon. It is believed that barrier integrity, once compromised by DSS, facilitates an inflammatory response against harmful enteric bacteria populations. Use of antibiotics that target these bacteria significantly reduces the severity of inflammatory pathology. Following the same principle, modulation of the good-bad bacteria balance by administration of probiotic bacteria also significantly reduced the inflammatory response associated with DSS treatment. Another example of dietary manipulation of gut microflora was provided by a series of studies designed to examine the benefits of low glycemic index diets normally recommended for diabetics. In these studies, rats fed a LGI starch supplement for 10 weeks, developed colon pathology associated with an increase in haemolytic bacteria. These animals were also immunologicallyologically less responsiveness than controls not fed the supplement. Shifts in the population dynamics of enteric bacteria can also be modulated by supplements containing decoctions of various mushroom or herbal extracts. Some of these supplements possessed statin-like properties and were capable of changing recipient responses to immunological challenge. With the advent of sensitive molecular tools such as PCR (Polymerase Chain Reaction) and t-RFLP (terminal-Restricition Fragment Length Polymorphism), both cultivable and non-culturable bacteria populations can be analysed. At the same time, the development of microarrays including PAM (Patterned Antibody Microarrays), will permit accurate dissection of the immune response to dietary change or supplementation. Armed with these tools, it is now timely to critically re-address the role of diets and dietary supplements in generating desirable health outcomes that are no longer delimited by our perception of the foods we ingest as simply being nutritional. PMID: 15294487 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8249972&query_hl=8 1: Am J Gastroenterol. 1993 Dec;88(12):2044-50. Related Articles, Links Sugar malabsorption in functional bowel disease: clinical implications. Fernandez-Banares F, Esteve-Pardo M, de Leon R, Humbert P, Cabre E, Llovet JM, Gassull MA. Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. OBJECTIVE: To investigate the relationship of sugar malabsorption to the development of clinical symptoms in functional bowel disease. METHODS: Twenty-five consecutive outpatients [five men, 20 women; mean age 38.7 +/- 2.6 (SEM) yr] with functional bowel disease and symptoms suggestive of carbohydrate malabsorption were studied. Twelve healthy subjects [six men, six women; mean age 35.7 +/- 3.7 (SEM) yr] acted as the control group. Sugar malabsorption was assessed by breath-hydrogen test after an oral load of various solutions containing lactose (50 g), fructose (25 g), sorbitol (5 g), fructose plus sorbitol (25 + 5 g), and sucrose (50 g). The severity of symptoms developing after sugar challenge was studied. In addition, the effect on clinical symptoms of a diet free of the offending sugars, compared to a low-fat diet, was assessed. RESULTS: Frequency of sugar malabsorption was high in both patients and controls, with malabsorption of at least one sugar in more than 90% of the subjects. Median symptom scores after both lactose [median 6; interquartile (IQ) range 3-7] and fructose plus sorbitol (median 2; IQ range 0-4) malabsorption were significantly higher than after sucrose load (median 1; IQ range 0-1.5) in functional bowel disease patients (p = 0.001 and p = 0.007, respectively). However, there were no differences in healthy controls. In addition, symptoms score after both lactose and fructose plus sorbitol malabsorption was significantly higher in patients than in control subjects (p = 0.02 and p = 0.008, respectively). On the other hand, H2 production capacity, as measured following lactulose load, was significantly higher in patients than in controls. The clinical symptoms improved in 40% of the evaluated patients after restriction of the offending sugars. CONCLUSIONS: These results suggest that sugar malabsorption may be implicated in the development of abdominal distress in at least a subset of patients with functional bowel disease. PMID: 8249972 [PubMed - indexed for MEDLINE ---------------------------------------------------------------- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10979349&query_hl=8 1: Isr Med Assoc J. 2000 Aug;2(8):583-7. Related Articles, Links Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints. Goldstein R, Braverman D, Stankiewicz H. Gastroenterology Institute, Shaare Zedek Medical Center, Jerusalem, Israel. BACKGROUND: Carbohydrate malabsorption of lactose, fructose and sorbitol has already been described in normal volunteers and in patients with functional bowel complaints including irritable bowel syndrome. Elimination of the offending sugar(s) should result in clinical improvement. OBJECTIVE: To examine the importance of carbohydrate malabsorption in outpatients previously diagnosed as having functional bowel disorders, and to estimate the degree of clinical improvement following dietary restriction of the malabsorbed sugar(s). METHODS: A cohort of 239 patients defined as functional bowel complaints was divided into a group of 94 patients who met the Rome criteria for irritable bowel syndrome and a second group of 145 patients who did not fulfill these criteria and were defined as functional complaints. Lactose (18 g), fructose (25 g) and a mixture of fructose (25 g) plus sorbitol (5 g) solutions were administered at weekly intervals. End-expiratory hydrogen and methane breath samples were collected at 30 minute intervals for 4 hours. Incomplete absorption was defined as an increment in breath hydrogen of at least 20 ppm, or its equivalent in methane of at least 5 ppm. All patients received a diet without the offending sugar(s) for one month. RESULTS: Only 7% of patients with IBS and 8% of patients with FC absorbed all three sugars normally. The frequency of isolated lactose malabsorption was 16% and 12% respectively. The association of lactose and fructose-sorbitol malabsorption occurred in 61% of both patient groups. The frequency of sugar malabsorption among patients in both groups was 78% for lactose malabsorption (IBS 82%, FC 75%), 44% for fructose malabsorption and 73% for fructose-sorbitol malabsorption (IBS 70%, FC 75%). A marked improvement occurred in 56% of IBS and 60% of FC patients following dietary restriction. The number of symptoms decreased significantly in both groups (P < 0.01) and correlated with the improvement index (IBS P < 0.05, FC P < 0.025). CONCLUSIONS: Combined sugar malabsorption patterns are common in functional bowel disorders and may contribute to symptomatology in most patients. Dietary restriction of the offending sugar(s) should be implemented before the institution of drug therapy. PMID: 10979349 [PubMed - indexed for MEDLINE] ======================================================================= http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11458611&query_hl=8 1: Rev Prat. 2001 May 15;51(9):969-72. Related Articles, Links [Specific carbohydrate malabsorption] [Article in French] Nancey S, Flourie B. Service d'hepato-gastro-enterologie Centre hospitalier Lyon-Sud 69495 Pierre-Benite. Specific malabsorption of carbohydrate is related to the lack or decrease in enzymatic activity needed for its hydrolysis; seldom, it is related to the lack or overloading in transport mechanism of monosaccharide. Ingestion of unabsorbed carbohydrate may induce digestive symptoms due to its colonic fermentation (borborygmus, bloating, pain, and flatus) or its osmotic activity (diarrhoea). In a patient consuming at least a bowl of milk per day and suffering of functional digestive symptoms, intolerance to lactose must be ruled out because its treatment is easy and efficient, i.e. to put fermented dairy products in place of milk. Publication Types: * Review * Review, Tutorial PMID: 11458611 [PubMed - indexed for MEDLINE] ====================================================================== http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3969931&query_hl=5 1: Am J Clin Nutr. 1985 Feb;41(2):228-34. Related Articles, Links Tolerance to glucose polymers in malnourished infants with diarrhea and disaccharide intolerance. Fagundes-Neto U, Viaro T, Lifshitz F. The response of infants with diarrhea and lactose intolerance to feedings containing soy protein and sucrose (Sobee), and/or to a carbohydrate free formula (RCF), to which glucose polymers (GP) were added, was assessed in twenty patients. They all were less than ten months of age and had varying degrees of malnutrition. Eleven had acute diarrhea and nine had chronic diarrhea. None of them had classical enteropathogenic strains and parasites in the stools. All had lactose intolerance when feedings were begun with cow's milk formula and some also had sucrose intolerance when fed sucrose containing soy formulas. They had persistent loose stools and excreted feces with an acid pH and with carbohydrates, thus they were given dietary treatment with RCF with GP. There were 9 patients with acute diarrhea and lactose intolerance (1 of them also had sucrose intolerance), who improved on RCF with GP feedings; but 2 patients (lactose and sucrose intolerant) failed to respond to this diet. There were six patients with chronic diarrhea and lactose intolerance (four of them also had sucrose intolerance), who improved on RCF with GP formula, but there were three patients who failed on this treatment. These data show that some infants with diarrhea, malnutrition, and lactose-sucrose intolerance may also develop intolerance to GP and require further dietary management with glucose as the source of carbohydrate in the diet. PMID: 3969931 [PubMed - indexed for MEDLINE] ================================================================================= ======================================================================== 00000000000000000000000000000000000000000000000000000000000000000000000 The JAMA article states that Methane gas slows the digestive process and causes Constipation. It also states that the methane gas is produced by gut microorganisms that are a result of undigested starches. Here are other research articles that prove to us that undigested starches cause IBS. Here is how to connect the dots between these research articles: Research paper #5 proves that Methane gas is an indication that a person has Constipation. Where does the methane gas come from? From intestinal bacteria! (Research paper #4) How do you increase these intestinal bacteria? Research paper # 1 proves that carbohydrates that are not digested feed the bacteria Research paper #2 and #3 also prove that gut bugs are responsible for GI problems: When antibiotics killed the gut bugs it resulted in the elimination of the symptoms of irritable bowel syndrome in many of the subjects. (Long term antibiotic treatment may result in gut bugs that are resistant to the antibiotic; so this should not be a permanent solution.) Research paper #1 proves that bacterial fermentation is caused by unabsorped starches. Half of the volunteers were fed starches together with an inhibitor that would make them unable to absorb the starches. The volunteers that were unable to digest their starches showed signs of having carbohydrate fermentation in the colon. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3053313&query_hl=11 1: Gastroenterology. 1988 Dec;95(6):1549-55. Related Articles, Links Effect of starch malabsorption on colonic function and metabolism in humans. Scheppach W, Fabian C, Ahrens F, Spengler M, Kasper H. Department of Medicine, Wuerzburg University, Federal Republic of Germany. To study the impact of starch on colonic function and metabolism, 12 healthy volunteers consumed a controlled diet rich in starch for two 4-wk periods. In one of the study periods they received the glucosidase inhibitor acarbose (BAY g 5421) and placebo in the other. Stool wet weight increased by 68%, stool dry weight by 57%, fecal water content by 73%, and the mean transit time by 30% on acarbose. Breath hydrogen was significantly higher on acarbose, indicating stimulated carbohydrate fermentation in the colon. Fecal bacterial mass (+78%), total stool nitrogen (+53%), bacterial nitrogen (+200%), and stool fat (+56%) were higher in the acarbose than in the control period. The stimulation of fermentation in the human large intestine may be important in colonic and possibly other diseases. Publication Types: * Clinical Trial * Controlled Clinical Trial PMID: 3053313 [PubMed - indexed for MEDLINE] Research paper #2 and #3 prove that gut bugs are responsible for GI problems: Small intestinal bacterial overgrowth is associated with irritable bowel syndrome. Eradication of the overgrowth with antibiotics eliminated the irritable bowel syndrome of many of the subjects." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=7766746&dopt=Abstract 1: Aliment Pharmacol Ther. 1995 Feb;9(1):63-8. Related Articles, Links The effect of oral vancomycin on chronic idiopathic constipation. Celik AF, Tomlin J, Read NW. Gastrointestinal Motility Unit, University of Sheffield, UK. BACKGROUND: A case study reporting the efficacy of oral vancomycin in a patient with chronic idiopathic constipation prompted this prospective trial of oral vancomycin in eight female patients (aged 21-61 years) with severe constipation resistant to the action of dietary fibre. METHODS: The trial was divided into two consecutive 14-day periods. During the first period, each patient was given ispaghula, 3.5 g twice a day, and during the subsequent period they took 250 mg vancomycin t.d.s. per os, as well as the fibre supplement. During both periods they collected stools and recorded daily bowel symptoms (stool frequency, straining, stool consistency, subjective stool volume) in a diary. At the end of each period whole gut transit time and the breath hydrogen response to a standard meal, giving oro-caecal transit time, were measured along with gastrointestinal symptoms which were assessed on visual analogue scales. RESULTS: Vancomycin caused a significant improvement in stool frequency, consistency, ease of defecation and the amount of stool patients felt they produced (all P < 0.05), but objective measures of daily stool weight and whole gut or oro-caecal transit time were not significantly different. Basal breath hydrogen levels were higher after vancomycin treatment in seven out of eight patients. One patient experienced a complete remission of symptoms when she took vancomycin and remains in remission after 14 months. This patient showed no levation in basal breath hydrogen level. CONCLUSION: Although this study does not support the use of vancomycin for most patients with constipation, the results suggest that modification of the intraluminal flora may be of value in the treatment of the occasional case of idiopathic constipation. Publication Types: * Clinical Trial * Controlled Clinical Trial PMID: 7766746 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=11151884&dopt=Abstract 1: Am J Gastroenterol. 2000 Dec;95(12):3503-6. Related Articles, Links Comment in: * Am J Gastroenterol. 2001 Aug;96(8):2505-6. * Am J Gastroenterol. 2001 Aug;96(8):2506-8. * Am J Gastroenterol. 2001 Jul;96(7):2281-2. * Am J Gastroenterol. 2001 Nov;96(11):3204-5. * Am J Gastroenterol. 2003 Nov;98(11):2572; author reply 2573-4. Click here to read Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Pimentel M, Chow EJ, Lin HC. Department of Medicine, Cedars-Sinai Medical Center, CSMC Burns & Allen Research Institute, and School of Medicine, University of California, Los Angeles, 90048, USA. OBJECTIVES: Irritable bowel syndrome is the most common gastrointestinal diagnosis. The symptoms of irritable bowel syndrome are similar to those of small intestinal bacterial overgrowth. The purpose of this study was to test whether overgrowth is associated with irritable bowel syndrome and whether treatment of overgrowth reduces their intestinal complaints. METHODS: Two hundred two subjects in a prospective database of subjects referred from the community undergoing a lactulose hydrogen breath test for assessment of overgrowth were Rome I criteria positive for irritable bowel syndrome. They were treated with open label antibiotics after positive breath test. Subjects returning for follow-up breath test to confirm eradication of overgrowth were also assessed. Subjects with inflammatory bowel disease, abdominal surgery, or subjects demonstrating rapid transit were excluded. Baseline and after treatment symptoms were rated on visual analog scales for bloating, diarrhea, abdominal pain, defecation relief, mucous, sensation of incomplete evacuation, straining, and urgency. Subjects were blinded to their breath test results until completion of the questionnaire. RESULTS: Of 202 irritable bowel syndrome patients, 157 (78%) had overgrowth. Of these, 47 had follow-up testing. Twenty-five of 47 follow-up subjects had eradication of small intestinal bacterial overgrowth. Comparison of those that eradicated to those that failed to eradicate revealed an improvement in irritable bowel syndrome symptoms with diarrhea and abdominal pain being statistically significant after Bonferroni correction (p < 0.05). Furthermore, 48% of eradicated subjects no longer met Rome criteria (chi2 = 12.0, p < 0.001). No difference was seen if eradication was not successful. CONCLUSIONS: Small intestinal bacterial overgrowth is associated with irritable bowel syndrome. Eradication of the overgrowth eliminates irritable bowel syndrome by study criteria in 48% of subjects. PMID: 11151884 [PubMed - indexed for MEDLINE] ======================================================================= Research paper #4 states that " Intestinal bacteria form two gases, hydrogen (H2) and methane (CH4)" Forget the rest of the article,it is not relevant to our discussion. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12197533&query_hl=26 1: Life Sci Space Res. 1969;7:102-9. Related Articles, Links Intestinal hydrogen and methane of men fed space diet. Calloway DH, Murphy EL. University of California, Berkeley, USA. Intestinal bacteria form two gases, hydrogen (H2) and methane (CH4), that could constitute a fire hazard in a closed chamber. So H2 and CH4 pass from the anus but these gases are also transported by the blood to the lungs and removed to the atmosphere. Several factors affect gas formation: 1) amount and kind of fermentable substrate; 2) abundance, types, and location of microflora; and 3) psychic and somatic conditions that affect the gut. We evaluated the first factor by studying men fed different diets and have also recorded influences of uncontrollable factors. One group of 6 men ate Gemini-type diet (S) and another received a bland formula (F), for 42 days. Breath and rectal gases were analyzed during the first and final weeks. Flatus gases varied widely within dietary groups but much more gas was generated with diet S than with F. In the first 12-hour collection, subjects fed S passed 3 to 209 ml (ATAP) of rectal H2 (avg 52) and 24 to 156 ml (avg 69) from the lungs (assuming normal pulmonary ventilation). With F, these values were 0 to 3 ml (avg 1) and 6 to 36 ml (avg 20). Subjects were calmer during the second test. Gas production was lower with S than initially; F values were unchanged. Methane differed idiosyncratically, presumably due to differences in flora. Computed from 12-hour values, maximum potential daily H2 and CH4 are per man: for S, 730 ml and 382 ml; for F, 80 and 222 ml. Volumes would be larger at reduced spacecraft and suit pressures. PMID: 12197533 [PubMed - indexed for MEDLINE] ======================================================================== Research paper #5 In conclusion, a methane positive breath test is associated with constipation as a symptom. 1: Dig Dis Sci. 2003 Jan;48(1):86-92. Related Articles, Links Click here to read Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y. GI Motility Program, Bums and Allen Research Center, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. It has recently been determined that there is an increased prevalence of bacterial overgrowth in IBS. Since there are two gases (hydrogen and methane) measured on lactulose breath testing, we evaluated whether the different gas patterns on lactulose breath testing coincide with diarrhea and constipation symptoms in IBS and IBD. Consecutive patients referred to the gastrointestinal motility program at Cedars-Sinai Medical Center for lactulose breath testing were given a questionnaire to evaluate their gastrointestinal symptoms. Symptoms were graded on a scale of 0-5. Upon completion of the breath test, the results were divided into normal, hydrogen only, hydrogen and methane, and methane only positive breath tests. A comparison of all subjects and IBS subjects was undertaken to evaluate diarrhea and constipation with regards to the presence or absence of methane. This was further contrasted to Crohn's and ulcerative colitis (UC) patients in the database. After exclusion criteria, 551 subjects from the database were available for comparison. Of the 551 subjects (P < 0.05, one-way ANOVA) and in a subgroup of 296 IBS subjects (P < 0.05, one-way ANOVA), there was a significant association between the severity of reported constipation and the presence of methane. The opposite was true for diarrhea (P < 0.001). If a breath test was methane positive, this was 100% associated with constipation predominant IBS. Furthermore, IBS had a greater prevalence of methane production than Crohn's or UC. In fact, methane was almost nonexistent in the predominantly diarrheal conditions of Crohn's and UC. In conclusion, a methane positive breath test is associated with constipation as a symptom. PMID: 12645795 [PubMed - indexed for MEDLINE] ======================================================================== Quick summary: Research paper #1 proves that bacterial fermentation is caused by unabsorped starches. Half of the volunteers were fed starches together with an inhibitor that would make them unable to absorb the starches. The volunteers that were unable to digest their starches showed signs of having carbohydrate fermentation in the colon. Research paper #2 and #3 prove that gut bugs are responsible for GI problems: Small intestinal bacterial overgrowth is associated with irritable bowel syndrome. Eradication of the overgrowth with antibiotics eliminated the irritable bowel syndrome of many of the subjects." Research paper #4 states that " Intestinal bacteria form two gases, hydrogen (H2) and methane (CH4)" Research paper #5 In conclusion, a methane positive breath test is associated with constipation as a symptom. Research articles about SCD and D #1 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=5094255&query_hl=1 J Pediatr. 1971 Oct;79(4):612-7. Related Articles, Links The response of infants to carbohydrate oral loads after recovery from diarrhea. Lifshitz F, Coello-Ramirez P, Contreras-Gutierrez ML. PIP: A clinical study was carried out to assess the response of 46 infants to oral loads of carbohydrates after recovery from severe diarrhea. The response was measured by the increases in blood reducing sugars and by the variations in the stool pattern following administration of oral carbohydrates. Disaccharide oral loads were used in the test. During the acute stage of the illness, 38 of the 46 patients had exhibited intolerance to carbohydrates, as evidenced by the excretion of acid stools and/or stools with a greater than .25% carbohydrate content. Prompt improvement from diarrhea was induced by elimination of all lactose, disaccharides, and other carbohydrates from the diet. None of the infants had monosaccharide intolerance during the acute diarrheal stage. The carbohydrate oral loads were administered within 1 week after recovery and serially thereafter. Responses to sucrose and lactose loads were related to the degree of intolerance exhibited during the illness. In infants with diarrhea, the impaired carbohydrate metabolism is temporary. Oral feedings may be administered after cessation of profuse diarrhea and vomiting and after replacement of water and electrolytes. Patients should be back on a milk formula within 3-4 months, depending on the degree of carbohydrate intolerance exhibited during the illness. PMID: 5094255 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3969931&query_hl=5 1: Am J Clin Nutr. 1985 Feb;41(2):228-34. Related Articles, Links Tolerance to glucose polymers in malnourished infants with diarrhea and disaccharide intolerance. Fagundes-Neto U, Viaro T, Lifshitz F. The response of infants with diarrhea and lactose intolerance to feedings containing soy protein and sucrose (Sobee), and/or to a carbohydrate free formula (RCF), to which glucose polymers (GP) were added, was assessed in twenty patients. They all were less than ten months of age and had varying degrees of malnutrition. Eleven had acute diarrhea and nine had chronic diarrhea. None of them had classical enteropathogenic strains and parasites in the stools. All had lactose intolerance when feedings were begun with cow's milk formula and some also had sucrose intolerance when fed sucrose containing soy formulas. They had persistent loose stools and excreted feces with an acid pH and with carbohydrates, thus they were given dietary treatment with RCF with GP. There were 9 patients with acute diarrhea and lactose intolerance (1 of them also had sucrose intolerance), who improved on RCF with GP feedings; but 2 patients (lactose and sucrose intolerant) failed to respond to this diet. There were six patients with chronic diarrhea and lactose intolerance (four of them also had sucrose intolerance), who improved on RCF with GP formula, but there were three patients who failed on this treatment. These data show that some infants with diarrhea, malnutrition, and lactose-sucrose intolerance may also develop intolerance to GP and require further dietary management with glucose as the source of carbohydrate in the diet. PMID: 3969931 [PubMed - indexed for MEDLINE] ------------------------------------------------------------------ http://jama.ama-assn.org/cgi/content/full/292/7/852 Here is the way to convince relatives on the scientific merit of SCD. The American Medical Association is the official organization for doctors in the USA. It publishes a prestigious journal for medical research:the Journal of the American Medical Association. An article was published in that journal by Dr Henry Lin,faculty member at USC. That article vindicates Elaine and SCD!! It explains the following points: * Gut microrganisms are the cause of IBS. *Starches that were not well digested produce the gut microrganisms. *Gut microrganisms emit endotoxins that disturb the brain. There is even more.... It is very important to go to the 90+ references and read their summary by clicking on the links. It is great to read and see that the ideas of SCD are backed by medical evidence. If your local doctor does not know about it,you can now prove that it is due to ignorance and negligence.LOL Here is a link to it from a SCD website http://www.geocities.com/scd_post/jama.html PLEASE try to access it from the original website. The pictures have not yet been loaded and it is more impressive to read it in its official site. http://jama.ama-assn.org/cgi/content/full/292/7/852 The writing is very hard to understand. My husband got discouraged when he started reading it,but I encouraged him to continue and he was able to get important points from it. The article convinced him that Elaine's work is scientific. Mimi http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15861016&query_hl=14&itool=pubmed_DocSum 1: J Pediatr Gastroenterol Nutr. 2005 May;40(5):561-5.Click here to read Links Malabsorption of carbohydrates and depression in children and adolescents. * Varea V, * de Carpi JM, * Puig C, * Alda JA, * Camacho E, * Ormazabal A, * Artuch R, * Gomez L. Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Deu, Barcelona, Spain. varea@hsjdbcn.org BACKGROUND: Previous studies have shown an association between sugar malabsorption and depressive symptoms in adult women. Incompletely absorbed sugars may form nonabsorbable complexes with tryptophan, an amino acid precursor of serotonin, decreasing its availability. As serotonin is the most important neurotransmitter involved in depressive disorders, its depletion could lead to the onset of depression. METHODS: The authors' aim was to study the possible association between malabsorption of sugars (lactose and fructose) and depressive symptoms in adolescent patients of Spanish origin. The authors studied two groups of patients. Group G included 14 patients previously diagnosed with sugar intolerance. In these, the authors assessed depressive symptoms. Group P consisted of seven patients suffering from major depression. In these, the authors performed functional sugar absorption tests. The authors studied the metabolic pathway of tryptophan in both groups. RESULTS: In the group with sugar malabsorption, there was a 28.5% prevalence of depressive symptoms that was higher than expected in our population. In the group with depression, the authors found a higher than expected prevalence of sugar intolerance (71.42% versus 15% in controls). CONCLUSIONS: The unexpected prevalences obtained for the groups studied suggest that there may be an association between sugar intolerance and depressive symptoms during adolescence. PMID: 15861016 [PubMed - indexed for MEDLINE] Related Links * Sugar malabsorption in functional bowel disease: clinical implications. [Am J Gastroenterol. 1993] PMID: 8249972 * Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints. [Isr Med Assoc J. 2000] PMID: 10979349 * Carbohydrate malabsorption in black and Hispanic dialysis patients. [Am J Gastroenterol. 1986] PMID: 3740026 * Fructose and sorbitol malabsorption in ambulatory patients with functional dyspepsia: comparison with lactose maldigestion/malabsorption. [Dig Dis Sci. 1997] PMID: 9440643 * Fructose malabsorption is associated with decreased plasma tryptophan. [Scand J Gastroenterol. 2001] PMID: 11336160 * See all Related Articles... Display Show