Wednesday, May 2, 2012

Origin of IBS: The bacteria theory

Although there is no general agreement in the scientific community regarding what causes IBS, it is interesting to notice that a theory comes back very often. You can find it in old books, some very recent discoveries support it, but until now there hasn't been any definitive proof of it. Still, to my mind this is the most probable origin of IBS. A review of what we know about bacteria infections possibly causing IBS,  and why a cure already exists if this theory holds.

Bacteria could cause IBS

Where did this idea come from? First of all, it is not new. It is as old as the invention of the term "IBS". If you are a regular reader of this blog, you already know that this is the theory beyond Elaine Gottshall's Breaking the vicious cycle. This led her to try the specific carbohydrate diet, which is now well known amongst IBS and other intestinal diseases sufferers.
The theory is as follows:
  1. Our modern diet contains lots of complex sugars (also known as carbohydrates: (disaccharides and polysaccharides)
  2. These types of food are hard to digest, especially in certain situations, due to illness or stress, or food intolerances.
  3. When the carbohydrate is not correctly digested, it stays in the tract, becoming food for bad bacteria.
  4. Being well nourished, the bacteria flourish.
  5. Bacteria overgrowth follows.
  6. The presence of harmful bacteria causes injuries and mucus in the digestive tract. 
  7. The digestive tract being inured, it becomes less efficient, therefore carbohydrates become even more difficult to digest. Go back to 2.
It is also very interesting to notice that lots of known bacteria infections show similar symptoms with IBS. Small intestinal bacterial overgrowth, or SIBO (basically, bacteria that should stay in your large intestine go down in your small intestine), is a well documented condition where bacteria in the lower bowel cause chronic diarrhea. Intestinal yeast infection does the same.

The SIBO theory

A few years back, a study shattered the IBS world: it claimed that Irritable Bowel Syndrome patients were almost always positive to the SIBO test. So could IBS simply be misdiagnosed SIBO for most of us? It is true that there is a striking similarity of symptoms for these two conditions. After publication, known medicaments for SIBO were tried on IBS sufferers, and among them. Rifaximin had quite a good success rate. This study reports an 84% improvement rate for IBS sufferers.

The results of the original study could not be reproduced. But there is still compelling evidence that a huge portion of IBS  sufferers actually have SIBO. Your doctor can give you a test if you want to.

Unfortunately, treatment of SIBO or IBS with antibiotics like Rifaximin is not always successful: symptoms often come back after a few months, and the bacteria becomes resistant with time. I am however convinced that one can treat SIBO like IBS using the same principle. I will explain it at the end of the article.

The MAP bacteria theory

 Lately, a new theory has emerged, and I have to say it is incredibly promising.

The Mycobacterium avium subspecies paratuberculosis is a bacteria that is well known to affect cattle. The infected animals then suffer from Johne's disease. Now, guess where this bacteria installs itself, and what the symptoms are? The small intestine, and diarrhea. Sounds familiar?
Going from infected cattle to human is quite easy: meat, cheese, milk, are all possible infection sources. MAP infection is wide spread in cattle, and this bacteria is known to be resistant to common antibiotics, so it is very possible that lots of people actually have some in their body.
Now, is there a link between digestive disorders and the MAP bacteria? Recent studies show incredible results. This study analyzed five Chrohn's patients, and found the five of them had a MAP infection! Of course there are not enough samples to draw a definitive conclusion. This other study states that MAP infection was detected in 75% of IBS patients and 87% of Chrohn's patients.

These numbers are way too big to be a coincidence. The question that remains is: Is MAP infection the cause of many IBS and Chrohn's, or do these diseases ease the development of MAP infection? The truth has to be one of both.

One could argue that the level of MAP infection should reach 100% if it were to be the origin of IBS. My opinion is that IBS is actually a collection of unidentified diseases. If you think about how it is diagnosed: doctors basically test everything they can think of, and if they find nothing, they say it is IBS. So IBS should actually be called Unidentified Bowel Disease!
These recent discoveries could mean that we identified the origin of approximately 75% of IBS conditions. This would be a huge breakthrough.

I heard about this MAP bacteria theory by reading an E-Book. David, its author, now has a blog where he discusses all the evidence pointing to MAP infection regarding  IBS and Chrohn's. If you are interested in the subject, I recommend it:

You can also download the e-book here:
You need to register first.

David claims it is possible to get rid of these conditions with three ingredients:
_ A low-carb diet, to make the bacteria starve
_ Coconut oil, which contains lauric acid, known to kill MAP
_ Calcium before meals, which prevents MAP to spread more

Now, these are interesting. I already talked about my incredible results with the low-carb diet, but the other two are already well known helpers for IBS.

What it means for us IBS sufferers 

It is funny to notice that this theory has been around for ages, and yet never totally confirmed. Still, recent studies show that the very first assumption may be the right one.
How can we use these discoveries to our advantage? Well, bacteria feeds on carbohydrates, so a logical conclusion would be to limit them. For that, two diets exist: the specific carbohydrate diet(SCD) and the low-carb diet.
Several believers of the SCD claim to have cured themselves of IBS. Doctor Lutz, who wrote life without bread, claims he can cure 80% of Chrohn's diseases and most of chronic diarrhea/constipation using a low-carb diet.
So if you haven't already, please give those a three-weeks try. Here's some help to get started.

3 commentaires:

Anonymous said...

A nice post. The problem is thinking that there is only 1 cause of IBS. There are many different things that cause IBS, from bacterial overgrowth, imbalance, and infection to parasites, celiac disease, other food allergies, hormonal issues, and others. The IBS Treatment Center in Seattle WA has a great website and has treated thousands of patients from around the world. The difference between them and most other clinics is they test for a wide range of the things that can cause IBS. Imagine that - testing.

Guillaume said...

you're quite right, there probably are many causes of IBS. the interesting thing about this one is that studies show that lots (approx. 75%) of IBS sufferers are concerned by bacterial overgrowth.

Morlais Davies said...

I'd agree, we test many clients suffering from IBS and many show great improvement once we identify the food type, or food types (often its a combination) thats sparks off the bodies intolerance.

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