Probiotics and herbs for Irritable Bowel Syndrome | Update

Category: Blog

Scientists say Probiotics have shown promise for treating patients with recurrent Clostridium difficile infections.

C. difficile is an opportunistic pathogen found in the intestines of approximately 3% of healthy adults and 40% of infants. The bacterium causes a spectrum of diseases in humans, ranging from mild to severe.

Studies have shown that this bacterium is responsible for

  • 10-25% of antibiotic-associated diarrhea cases,
  • 50-75% of antibiotic-associated colitis cases, and
  • 90-100% of antibiotic-associated pseudomembranous colitis, respectively.1

Irritable Bowel Syndrome – A natural treatment

Substantiated probiotic benefits include prevention of high cholesterol, management of constipation, reduction of recurrent urinary tract infections, improvement of irritable bowel syndrome symptoms, and reduction of antibiotics side effects in Helicobacter pylori eradication. Because probiotics are generally recognized as safe and can be removed with antimicrobial agents, their use should be considered in patients of all ages.2 

Can Irritable Bowel Syndrome (IBS) be treated with probiotics and herbal medicine

Doctors showed that against placebo a combination therapy with herbal medicine and probiotics appears to relieve overall Irritable Bowel Syndrome symptoms by increasing beneficial intestinal microbe counts.3

This is good news for people who suffer from  Irritable Bowel Syndrome and supports earlier cited research that says the non-pharmacological route may be best for some.

Recently doctors wrote of the benefits of probiotics in the gastrointestinal diseases : “The withdrawal, due to adverse events, of a number of pharmacological agents that were approved for the treatment of IBS has left a therapeutic vacuum for patients suffering from the disorder…Recent incremental advances suggest these areas are being addressed and that the future holds much promise for the use of lactic acid bacteria in the treatment of irritable bowel syndrome.4

A growing number of research supports that some probiotic strains may help to maintain health in older people.

Benefits include: establishment of

  • balanced intestinal microflora;
  • improving colonization resistance and or prevention of diarrhea;
  • reduction of fecal enzymes;
  • reduction of serum cholesterol;
  • reduction of potential mutagenes;
  • reduction of lactose intolerance;
  • synthesis of vitamins; predigestion of proteins.5

Prescription painkillers for Irritable Bowel Syndrome?

“In the current U.S. health care system, clinicians often lack the time, infrastructure, and incentives needed to provide integrative care to patients with chronic conditions, including IBS…Instead, very often physicians take the path of least resistance.

Narcotic prescriptions are a quick and easy way to get patients out of their office, even though the long term effects can be harmful.”6

“From 1997 to 2008 opioid prescriptions for chronic abdominal pain more than doubled,” desite the the fact that office visits to the doctor for abdominal pain decreased significantly over the same span.5 So less people were getting more narcotic pain medications. In fact the liklihood that a prescription pain killer would be prescribed for abdominal pain increased from 5% at the study’s start to 12% but 2008.

In 2010 the same researchers reported: “18 percent of IBS (Irritable Bowel Syndrome) patients surveyed reported they were currently using narcotics. These patients reported more abdominal pain, poorer health quality, more IBS-related limitations, more hospitalizations and surgeries, and that they were more likely to use antidepressants and antacid medications.” 7

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) refers to a bowel disorder characterized by abdominal pain and cramping, intestinal gas and bloating, as well as changes in bowel movements without a known reason. Diarrhea or constipation are primary symptoms – in some cases, these symptoms alternate, while in others one is more dominate. IBS is not the same as inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis.

Other symptoms include:

  • A change in bowel habits
  • Urgency for bowel movements
  • Feeling of incomplete evacuation (tenesmus)
  • Bloating
  • Abdominal distention

People with IBS, more commonly than others, have gastroesophageal reflux (GERD), symptoms relating to the genitourinary system (such as bladder or urinary tract infections), chronic fatigue syndrome, fibromyalgia, headache, backache and psychiatric symptoms such as depression and anxiety. Some studies indicate that up to 60% of persons with IBS also have a psychological disorder, typically anxiety or depression.

IBS may begin after an infection, use of an antibiotic, a stressful life event, or with advanced age without any other medical indicators.

IBS does not lead to more serious conditions in most patients, but is a source of chronic pain, fatigue, and other symptoms that can dramatically affect the quality of a patient’s life.

What are Options for Treatment?

The diagnosis of IBS is typically based on symptoms, alone, as there is no real test to confirm the condition … although it may be important to first rule out anatomical abnormalities. That’s why at the Magaziner Center for Wellness, we do functional tests versus anatomical tests – we look at how everything functions, rather than just looking at the upper or lower gastrointestinal tract which will typically appear normal in an IBS patient.

Because several conditions may present as IBS, including celiac disease, fructose malabsorption, mild infections, parasitic infections and several inflammatory bowel diseases, we look at food sensitivities, especially to dairy, wheat, corn and soy which are the most common. If a sensitivity or allergy is uncovered, we work with our patients to make necessary modifications to eliminate the trigger from his/her diet.

Overall, we help move all patients away from an inflammatory diet – one that may include fried foods, sugary carbohydrates, processed foods and artificial sweeteners – to a “Mediterranean” diet centered on healthy fats, lean proteins, fruits and vegetables. We also help patients eliminate the use of anti-inflammatory medications. This is important because repeated use of antibiotics can cause an imbalance of intestinal bacteria (also known as dysbiosis) and some, such as Naproxen, have been linked to the occurrence of “Leaky Gut Syndrome,” which is characterized by damage to the intestinal lining.

To determine if dysbiosis exists, we look at stool samples and the general health of the gastrointestinal tract. The stool tests also allow us to look at fatty acid metabolism, digestion and assimilation (absorption) and the specific bacteria that may be absent or present. When necessary, we utilize enzymes or probiotics to improve metabolism and overall intestinal health.

In summary, we treat using the Four Rs made famous by Jeffrey Bland, PhD:

Remove: We eliminate common pro-inflammatory foods and foods that may trigger food reactions, including grains containing gluten and dairy products and opt instead for a diet featuring rice-based products, legumes, fruits, vegetables, fish and poultry. The exposure to toxic chemicals and toxic metals such as mercury is also eliminated.

Replace: If it is determined that a patient cannot properly digest a normal meal without complaints of bloating, gas formation or reflux, we will recommend the use of digestive aids, such as digestive enzymes or hydrochloric acid, to be taken along with meals.

Re-inoculate: In order to improve intestinal immune function and thereby improve whole body function, we utilize probiotics, such as acidophilus and bifidus bacteria, that are normal inhabitants of a healthy intestinal tract.

Repair: After a time period deemed sufficient for each individual patient, we add additional nutrient supplements to promote proper repair of the intestinal lining. These supplements may include the amino acid L-glutamine, pantothenic acid, zinc citrate, omega 3 EPA/fish oil, and vitamin E as mixed tocopherols.

Questions ? email magazinercenter@gmail.com

Dr. Allan Magaziner & Dr. Scott Greenberg

1. Y. Y. Loong et al. A Review on the Effects of Probiotics and Antibiotics towards Clostridium difficile InfectionsPertanika Journal of Science and Technology, 21 (2): 293 – 302 (2013)

2.  Taibi A, Comelli EM. Practical approaches to probiotics use. Appl Physiol Nutr Metab. 2014 May 5:1-7. [Epub ahead of print]

3. Ko SJ, Han G, Kim SK,  Effect of korean herbal medicine combined with a probiotic mixture on diarrhea-dominant irritable bowel syndrome: a double-blind, randomized, placebo-controlled trial. Evid Based Complement Alternat Med. 2013;2013:824605. doi: 10.1155/2013/824605. Epub 2013 Dec 5.

4. Clarke G, Cryan JF, Dinan TG, Quigley EM. Review article: probiotics for the treatment of irritable bowel syndrome–focus on lactic acid bacteria. Aliment Pharmacol Ther. 2012 Feb;35(4):403-13. doi: 10.1111/j.1365-2036.2011.04965.x. Epub 2012 Jan 8.

5. Malaguarnera G, Leggio F, Vacante M, et al Probiotics in the gastrointestinal diseases of the elderly. J Nutr Health Aging. 2012 Apr;16(4):402-10.

6. University of North Carolina press release for findings presented at the May 3 (2010) annual Digestive Disease Week conference in New Orleans. http://www.med.unc.edu/www/newsarchive/2010/may/unc-study-patients-with-ibs-commonly-use-narcotics

7. Dorn SD, Meek PD, Shah ND.Increasing Frequency of Opioid Prescriptions for Chronic Abdominal Pain in US Outpatient Clinics. Clinical Gastroenterology and Hepatology. Volume 9, Issue 12 , Pages 1078-1085.e1 , December 2011

8. University of North Carolina press release for findings presented at the May 3 (2010) annual Digestive Disease Week conference in New Orleans.