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Minimizing The Risk of Childhood Food Allergies

Dr. Eric Viegas, ND

Ottawa Holistic Wellness Centre

www.medicineismusic.ca

food allergies child peanut

Q: As a parent of a young child, what steps can I take to reduce the risk of childhood food allergies?

A:

  • Fish Oil consumption during pregnancy may cut the risk of childhood allergies by 30% (1). Researchers in London compiled data from women consuming a daily fish oil capsule from the 20th week of pregnancy until the first 3-4 months of breastfeeding. The consumption of fish oil cut the risk of childhood egg allergy by 30% (1).

 

fish oil food allergies child

 

  • Probiotics: eczema risk was cut by 22% in a group of mothers consuming a daily probiotic supplement between 36-38 weeks of pregnancy and the first 3-6 months of breastfeeding (1). However, probiotic supplementation did not appear to reduce the risk of childhood dairy allergy (1).

 

soap baby food allergies bath

 

  • Hygiene: Avoid overuse of “baby wipes” and make sure that soap is completely washed off of your baby’s skin. A recent study using mice suggests that disruption of our skin’s top lipid (fat) layer by soaps and allergens can contribute to the development of food allergies in young children with altered genetic mutations in their skin (2). Mice with genetic mutations in their skin barrier that were exposed to common food allergens (eg. peanuts) to their skin over 2 weeks were then fed these allergens by mouth. The mice developed allergic reactions in the intestines, on the exposed skin sites, and suffered anaphylaxis. More research is needed in this area to further clarify how these mechanisms affect humans. Unfortunately, skin barrier mutations are not visible in children until later in life, so minimizing your child’s exposure to harsh chemicals and allergens that may disrupt their skin barrier is a factor in reducing the risk of developing childhood food allergies.

 

 

Always consult with your doctor before beginning any new supplement or medication. For more information on the prevention and treatment of childhood allergies, consult with your local naturopathic doctor and/or functional medicine practitioner.

 

References:

 

  1. Garcia-Larsen V, Ierodiakonou D, Jarrold K, Cunha S, Chivinge J, et al. (2018) Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLOS Medicine 15(2): e1002507. https://doi.org/10.1371/journal.pmed.1002507.
  2. Matthew T. Walker, Jeremy E. Green, Ryan P. Ferrie, Ashley M. Queener, Mark H. Kaplan, Joan M. Cook-Mills. Mechanism for initiation of food allergy: dependence on skin barrier mutations and environmental allergen costimulation. Journal of Allergy and Clinical Immunology, 2018, ISSN 0091-6749, https://doi.org/10.1016/j.jaci.2018.02.003.

10 Common Childhood Rashes and What You Should Know About Them

Dr. Eric Viegas, ND

rash child ottawa naturopath

There are many different types of rashes that children and their parents will encounter throughout their lives.

The following is a list of common rashes, their causes and symptoms, a description of their appearance, and what you can do about them.

 

 

  • Contact Dermatitis

 

Many causes including certain foods, body products, latex, jewelry and poison ivy.

 

Most incidents of contact dermatitis are mild, start around 48 hours after skin exposure, and resolve when the specific substance is prevented from contacting the skin. A mild reaction will usually result in small red bumps, while a more serious reaction can result in swelling and blisters.

 

  • Measles

 

A red, but not itchy, viral rash that is located over most of the child’s body. Children will usually complain of common cold symptoms: fever, sneezing, irritated throat, coughing, swollen glands, red eyes, and loss of appetite. Although preventable with the MMR (measles, mumps, rubella) vaccine, those who choose to forego immunization are at a higher risk of infection. If you believe your child has been infected with measles, please seek medical care immediately.

 

 

  • Scarlet Fever

 

Most common in children ages 2-10 (but infection can occur at any age). A scarlet fever rash is coarse to the touch, and red. It typically presents on the torso first, then spreads to other areas of the body over the course of a couple of days.

 

Children will typically present with a high fever followed by the rash 24 hours later.

Other symptoms include sore throat, difficulty swallowing, and white or yellow spots at the back of the throat; all related to a strep throat infection. If you suspect that your child has scarlet fever, seek medical attention immediately.

 

 

  • Chickenpox

 

Caused by the varicella zoster virus, this is a contagious and very itchy rash that affects the whole body. It may appear as red spots and/or blisters (pox). Each chickenpox red spot has a life cycle of 1-2 days; blistering, bursting, drying out, and crusting. New spots will appear daily for up to one week. This infection will stay dormant in nerves, and may result in an outbreak of shingles later in life.

 

An easy way to combat the itchiness of chickenpox is an oatmeal bath:

  • Using a mesh bag or cheesecloth, add 1 cup of uncooked oats and tie off one end.
  • Secure the oatmeal bag under your tub’s faucet and run under warm water, periodically squeezing the bag as the tub fills.
  • Once the bath is full, you can remove the bag from the faucet, letting it float in the bathwater. Continue to periodically squeeze the bag into the water.
  • Submerge affected areas in the bath for 20 mins.
  • You can also add calendula and lavender flowers to help soothe irritated skin.

 

 

  • Roseola

 

Appears around 3 days after a high fever caused by the roseola virus. This infection is usually mild, starting with a sudden high fever for 2-3 days and developing into a pink rash appearing on the torso, neck and arms once the fever begins to drop. Some children may experience seizures due to the sudden intensity of the fever, and the rash will last 1-2 days. This rash typically affects children aged 6 months to 2 years. Seek medical care if you suspect your child has roseola.

 

 

  • Fifth Disease

 

A “slapped cheek” facial rash that also has a lacy appearance on the torso, arms, legs, and buttocks.

This rash will follow sudden flu-like symptoms (fever, fatigue, aches, etc.), and children are most contagious 7 days before the onset of the rash.

 

Once the rash has appeared, children are no longer contagious. Hot temperatures and sunlight exposure may cause the rash to wax and wane over several weeks.

 

While the infection is mild for children, developing fetuses are at an increased risk when exposed to fifth disease. If you are pregnant and develop some of the signs and symptoms of fifth disease, seek medical attention immediately.

 

 

  • Heat Rash

 

Can happen to any baby exposed to hot weather or dressed too warmly. The rash looks like red or pink dots on the child’s head, neck, and/or shoulders.

Make sure your child is dressed lightly on hot days, covering their head and limbs, and do your best to avoid prolonged sun exposure.

 

 

  • Cradle Cap

 

Oily, yellow, scaly and/or crusting rash on a baby’s scalp. This rash is common and treatable, and its presence certainly does not mean parents are not caring for their baby.

Home treatment for cradle cap:

  • An hour before shampooing, rub your baby’s scalp with baby oil, or vaseline to help lift and loosen the crusts/ scales.
  • Wet your baby’s scalp then gently scrub the scalp with a soft-bristle brush (eg. a soft toothbrush or a fine-toothed comb) for a few minutes to remove the scales.
  • Wash the scalp with baby shampoo, rinse well, and gently towel dry.

 

 

  • Lyme Disease

 

Can be caused by bacteria that are carried by ticks. A Bullseye red rash at the site of the bite will expand, followed by flu-like symptoms, joint pain, and neurological problems.

 

In the case of lyme disease, see a doctor immediately.

 

 

  • Diaper Rash

 

Can be caused by urine/stool bacteria, moisture, heat, friction, or chemicals in a baby’s diaper. The rash has a red (may also appear burned/scalded) appearance, and affects the thighs, buttocks, genitals, or abdomen.

Sometimes, a yeast infection may be responsible for the rash, so always check with your doctor before using any medicated ointments for your child.

 

As with any skin issue, it is best to see your doctor when a rash presents so that you can get an accurate diagnosis and timely treatment. Some rashes require immediate antibiotics, while others tend to resolve on their own. I hope this quick guide to rashes will help ease the stress around skin issues for you and your children.

Bolster Your Immune System for The Holiday Season

Q&A: How Will My Immune System Survive The Holidays?

 

With winter and family holidays fast approaching, I am constantly asked about what can be done to bolster the immune system and reduce stress. Here are some easy tips to get you through the rest of the year.

 

Q: I’m travelling a lot over the holidays, what can I do to boost my immune system?

 

A: A recent study used elderberry to prevent the onset of influenza during air travel. The study looked at 600-900 mg of elderberry extract containing 90-135mg of anthocyanins. Study participants took 2 capsules per day for 10 days before air travel. Two to four days before departure, the dosage was increased to 3 capsules per day, until 4 days after arrival at their destination (1).

immune system dr. eric viegas

Anthocyanins belong to the flavonoid group of phytochemicals; commonly found in teas, wine, fruits, vegetables, nuts, olive oil, and cocoa. They add vibrant color to these foods, along with a potent antioxidant capacity. Recent research into the human effects of anthocyanins has revealed their ability to strengthen blood vessels, balance the immune system, and combat inflammation (2,3).

 

Of the 312 participants taking the elderberry extract, 29 developed a cold. The group taking the placebo treatment had greater symptom severity and over twice the duration of illness compared to the elderberry group.

 

For more information on how you can best avoid the cold and flu this year, click here

Q: I’ve heard sugar can compromise my immune system. What lifestyle behaviours can help me with my sweet tooth?

 

A: Sugar is a contributing factor when dealing with illness over the holidays. Try structuring your meals with a low carbohydrate content, and increase your consumption of proteins from meat and vegetable sources. Some good vegan sources of protein include pumpkin seeds, lentils, black beans, almonds, and tempeh.

healty immune system dr. eric viegas

Munching on high protein snacks will help to keep your blood sugar stable, increase feelings of fullness, and make it less likely for you to grab extra holiday treats.

 

Q:What about stress and my immune system? My family drives me crazy over the holidays, and I know I’m going to get sick because of the added stress…

 

A: Stress is an inevitable part of everyone’s lives. Unfortunately, you can’t pick your family, but you can build your resilience to the added stress that comes with holiday get togethers.

 

Daily yoga is an excellent way to tone your nervous system and help you keep a cool head when dealing with added stress.

healthy immune system dr. eric viegas

A recent systematic review of 11 studies found that yoga enhanced the production of the body’s own antioxidants vitamin C and glutathione in healthy, diabetic, prediabetic, hypertensive, and renal disease patients. As a result, there was a significant reduction of oxidative stress after a session of yoga (4).

 

The great thing about yoga is that you don’t need to go to a class to reap the health benefits. A quick search of youtube will get thousands of results for many different types of yoga; one for every person’s unique needs.

 

Have a safe and happy holiday!

 

References:

 

  1. Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travelers: a randomized, double-blind placebo-controlled clinical trial. Nutrients. 2016;8(4):182.
  2. Lila, Mary Ann. “Anthocyanins and Human Health: An In Vitro Investigative Approach.” Journal of Biomedicine and Biotechnology 2004.5 (2004): 306–313. PMC. Web. 2 Nov. 2017.
  3. Youdim K, Martin A, Joseph J. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. 2000;29(1):51–60.
  4. Pal, R. & Gupta, N. (2017). Yogic practices on oxidative stress and of antioxidant level: a systematic review of randomized controlled trials. Journal of Complementary and Integrative Medicine, 0(0), pp. -. Retrieved 2 Nov. 2017, from doi:10.1515/jcim-2017-0079.

Eczema FAQs & How Naturopathic Medicine can help

eczema dr eric viegas

Dr. Eric Viegas, ND

 

Why do I have Eczema?

  • Partly due to genetics, immune dysregulation causing allergic inflammation, and environmental factors.
  • If you have a family history of eczema you are more likely to develop it. Environmental factors like bacterial (staphylococcus aureus) colonization of damaged skin, and chronic phthalate exposure (found in textiles, food products, and plastics) contribute to inflammation and immune dysregulation.
  • There is some evidence that the presence of helicobacter pylori, a bacteria commonly known for causing stomach ulcers, can also contribute to immune dysregulation and inflammation of the skin barrier.
  • Food triggers are also an important contributor to eczema. Increased intestinal permeability contributes to allergen sensitization, so chances are good that your digestive system needs some help. A naturopathic doctor can work with you to establish which foods may be contributing to your eczema.
  • If you have endocrine problems like thyroid disease it is best to take your medication and be well managed, as worsening hypothyroidism may also worsen the severity of your eczema.

 

What is the best treatment for Eczema?

  • A combination of dietary management, skin care, and stress management will help to control the chronic symptoms of eczema and address the underlying causes.

 

Can diet affect Eczema?

  • Eggs, wheat, dairy, soy, peanuts, tomatoes, and artificial colours & preservatives have been implicated as triggers in a large percentage of eczema cases. Elimination of these offending foods has been shown to restore normal intestinal function and reduce the progression of new food allergies. Avoidance of these foods may be continued for up to one year to achieve the best results.
  • There is also a growing body of evidence to support histamine intolerance in the development and severity of eczema. In histamine intolerance, ingestion of histamine-rich foods (think red wine, aged cheeses, cured meats) overwhelms your gut’s ability to breakdown this inflammatory molecule. Overtime, more systemic signs of histamine intolerance (rashes, heart palpitations, irritable bowel syndrome, and allergies) develop.
  • Eating more fatty fish (eg. salmon, herring) in pregnancy, lactation, infancy and childhood has shown protective effects against eczema in epidemiologic studies.

 

What lifestyle behaviours can help with my eczema?

  • First, stop scratching. Scratching will break the skin barrier and allow for bacterial colonization.
  • In terms of keeping clean, baths are more beneficial than showers as long as you remember to “soak and smear”; bathe, pat yourself dry, and then apply a very generous amount of moisturizer to the skin. For added benefit, soak oatmeal in a clean cloth bag in your bath to soothe your skin.
  • People suffering from the itchiness of eczema tend to have more anxiety, and feel more stressed out. Finding an outlet for your stress and keeping your anxiety at a manageable level will help to benefit your outlook and the severity of your eczema. A naturopathic doctor has many tools to address high stress and anxiety.

 

What are natural topical remedies for Eczema?

  • Seabuckthorn oil, castor oil, olive oil, coconut oil, calendula oil, chickweed cream, and moisturizers containing beeswax can all help to moisturize the skin and maintain its barrier. It is also important to use a mild pH-neutral soap free of any perfumes or fragrances to avoid any unwanted skin irritation.

 

What Supplements are good for Eczema?

  • Daily fish oil supplementation and use of the probiotic strains lactobacillus acidophilus and bifidobacterium bifidum are two supplements with good evidence for use in eczema.
  • However, you should always consult your doctor before starting any new medication or supplement. A naturopathic doctor will take a thorough health history to determine any other health concerns that should be addressed along with your skin health and come up with a comprehensive treatment plan. It is not uncommon for people with eczema to also experience digestive issues, allergic rhinitis (seasonal allergies), and asthma.

 

References:

 

Kido M., Tanaka J., Aoki N., et al: Helicobacter pylori promotes the production of thymic stromal lymphopoietin by gastric epithelial cells and induces dendritic cell-mediated inflammatory Th2 responses. Infect Immun 2010 Jan; 78: pp. 108-114

 

Elias P.M., and Schmuth M.: Abnormal skin barrier in the etiopathogenesis of atopic dermatitis. Curr Opin Allergy Clin Immunol 2009 Oct; 9: pp. 437-446

 

de Maat-Bleeker F., and Bruijnzeel-Koomen C.: Food allergy in adults with atopic dermatitis. Monogr Allergy 1996; 32: pp. 157-163

 

Agata H., Kondo N., Fukutomi O., et al: Effect of elimination on food-specific IgE antibodies and lymphocyte proliferative responses to food antigens in atopic dermatitis patients exhibiting sensitivity to food allergens. J Allergy Clin Immunol 1993; 91: pp. 668-679

 

Kremmyda L.S., Vlachava M., Noakes P.S., et al: Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review. Clin Rev Allergy Immunol 2011 Aug; 41: pp. 36-66

 

Barnes B.: Thyroid therapy in dermatology. Cutis 1971; 8: pp. 581-583

 

Maintz, L., et al. “Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema.” The Journal of Allergy and Clinical Immunology. Vol. 117, No. 5 (2006): 1106–1112.

 

Worm, M., et al. “Exogenous histamine aggravates eczema in a subgroup of patients with atopic dermatitis.” Acta Dermato-Venereologica. Vol. 89, No. 1 (2009): 52–56.

 

SIBO: Build Back Your Digestive Defenses

SIBO Dr. Eric Viegas Naturopathic Medicine Ottawa

SIBO: Build Back Your Digestive Defenses

 

Dr. Eric Viegas, ND

 

Our microbiome is the collection of microbes, in and on our bodies, that offer a mutual benefit. The health of our microbiome dictates our overall health status. Human cells that compose us are dwarfed by the number and variety of microbes those cells house. Our microbiota, the friendly microbes in our gut, help to digest food, strengthen our immune system, defend our intestines from unfriendly bacteria, and heal our gut (Gerritsen et al., 2011). The balance of our individual microbiota lies in a complex relationship between our genetics, diet, environment, and even our social circles. Our microbiota is one of the numerous defense systems our bodies use to keep out unwanted organisms from the small intestine. When one or more of these systems fail, an overgrowth of unfriendly microbes is possible.

 

We secrete stomach acid and pancreatic enzymes to better digest our food, but our bodies also use it as a safeguard against unwanted microorganisms. When poor stomach acid secretion fails to defend against colonies of foreign microbes, an overgrowth of these bacteria in the small intestine leads to an imbalanced microbiota. In addition, digestive tract abnormalities, abdominal surgery complications, and impaired gallbladder & pancreatic function can allow overgrowth of foreign microbes that disturb the balance of our microbiota.

 

Impaired migrating motor complexes (MMC) also set the stage for foreign bacteria to colonize the small intestine (Miyano et al., 2013). MMC initiates peristalsis, the muscular contraction of our intestines that moves food through the gut into the colon. MMC also occurs in a fasting state and acts to sweep unfriendly bacteria into the colon, limiting SIBO (Deloose et al., 2012). The vagus nerve controls MMC during parasympathetic nervous system activity (our rest and digest functions). The strength and conditioning of the vagus nerve (‘vagal tone’) also dictates our heart rate and breathing rate. Variation of our heart rate and breathing rate, known as respiratory sinus arrhythmia (RSA), can improve the efficiency of the cardiovascular and digestive systems. RSA is more significant in children and athletes than the elderly. Also, RSA is associated with better mental health and positive social interactions. Vagal tone is enhanced through RSA by practicing yoga (Streeter et al., 2010). Interestingly, deep laughter also stimulates the vagus nerve, causing RSA (Miller et al., 2009). Like to sing in the shower? Singing and making music also enhances RSA and vagal tone (Vickhoff et al., 2013).

 

What about SIBO and its relation to IBS?

 

IBS patients that do not improve with conventional IBS treatments are often diagnosed with SIBO. Long-standing MMC problems result in impaired peristalsis and dysbiosis. IBS patients with SIBO require digestive support coupled with eradication of bacterial overgrowth (Ghoshal et al., 2016). SIBO symptoms overlap with the gas, bloating, diarrhea, constipation, and abdominal pain that is common in IBS. It is estimated that more than half of all IBS patients have SIBO, and about half of all celiac cases also have SIBO (O’Leary, 2003). In celiac disease and SIBO, intestinal inflammation and permeability cause problems with nutrient absorption in the small intestine. As a result, patients are typically deficient in iron and vitamin B12; nutrients that are absorbed in a healthy small intestine. A lack of MMC also affects the secretion of bile for the digestion and absorption of fats and fat soluble vitamins (A,D,E,K) in the small intestine (Simren et al. 2006). In SIBO, some bacteria also digest bile before we can use it, further contributing to fat and fat soluble vitamins ending up in stool (Miyano et al., 2013). Weight loss due to malnutrition is a common symptom in long standing celiac disease and SIBO.

 

...IBD (Crohn’s Disease and Ulcerative Colitis) and SIBO?

 

Complicated cases of crohn’s disease require surgery to remove the ileocecum, a junction point in your digestive system between the small and large intestine. The ileocecal valve sits between the ileum of the small intestine, and the cecum of the large intestine. Though not a true ‘valve’, a healthy ileocecal valve successfully separates the colonies of microbes native to the large intestine from microbes of the small intestine. Once the ileocecum is surgically removed, so is the defense system that prevents colonic bacteria from entering the small intestine, and SIBO occurs. Other abdominal surgeries can also impair MMC.

 

In fact, there are a whole host of conditions that can lead to, or are caused by, SIBO. Any disease state that alters immune function, creates dysbiosis, and/or affects the MMC sets the stage for bacterial overgrowth. Since bacteria can squander bile acids needed for digestion and absorption of fats, the initial breath test for SIBO was the bile acid breath test. Bile acid breath testing fell out of favour, and now hydrogen and methane breath tests are used in the diagnosis of SIBO (Ghoshal, 2016). Patients are instructed to fast, then consume a lactulose or glucose drink. If SIBO is present, bacteria in the small intestine will begin to digest the sugars into hydrogen and methane before the expected colonic bacteria do the same. The reliability of breath testing for SIBO has been questioned due to the variability in normal and abnormal results (Simren et al., 2006). Though, if a positive breath test is present with diarrhea, weight loss, and malnutrition, doctors will treat presumptively. Depending on which gas scored higher on the breath test, doctors will prescribe antimicrobials specific to hydrogen or methane producing bacteria (or a combination).

 

So what can you eat to cut down on methane and hydrogen producing bacteria?

 

In terms of dietary recommendations for SIBO, there is no one size fits all approach. The FODMAPs diet, Specific Carbohydrate Diet (SCD), or Gut and Psychology Syndrome diet (GAPS) may work for some patients, but not others. It is important to identify your own individual food triggers. Sometimes a combination of the previously mentioned diets is what works for patients. An interesting treatment principle when dealing with SIBO is that well fed bacteria are easier to eradicate. So, eating food triggers that cause bacteria to ferment carbohydrates will lead to more efficient eradication using antibiotics and antimicrobials (Chedid et al., 2014). Once bacteria levels and SIBO symptoms are reduced, patients enter a recovery phase to rest and replenish the gut. Certain strains of probiotics can alleviate SIBO after short term therapy, and it is important to speak with your doctor about which strains are most appropriate for you (Kwak et al. 2014).

 

What are some ways to help manage SIBO in my day to day?

 

Successful treatment of SIBO, as with any chronic disease, relies on a holistic focus. Equal emphasis should be placed on eradicating bacteria, repopulating with probiotics, restoring vagal tone/MMC, avoiding food triggers, and healing the gut. Also, Exercise can improve digestive functions by enhancing MMC. Above all, patients should know that the road to recovery will never be linear, relapses often happen (Grover et al., 2008). Understanding mental-emotional health as an overarching goal will help give a big-picture context to patients, and build defenses against stress. Awareness of the connection between our mind and body is what will lead to building back digestive defenses. It’s no wonder that a relaxed state and laughter improves digestion. Finding enjoyment in exercise will also lead to improvements in MMC (Soffer et al., 1991). Finding something that brings you joy, something that leads you to more self-expression, is what will lead to a truly meaningful change. Rest and Digest!

 

For more information on SIBO: sibocenter.com

 

References:

 

Gerritsen J., Smidt H., Rijkers GT., de Vos WM. Intestinal microbiota in human health and disease: the impact of probiotics. Genes Nutr 6; (2011): 209-240. Print.

 

Miyano Y, et al. “The role of the vagus nerve in the migrating motor complex and ghrelin-and motilin-induced gastric contraction in suncus.” PloS one 8.5 (2013). Web.

 

Deloose, Eveline, Pieter Janssen, Inge Depoortere, and Jan Tack. “The Migrating Motor Complex: Control Mechanisms and Its Role in Health and Disease.”Nature Reviews Gastroenterology & Hepatology 9.5 (2012): 271-85. Web

 

Streeter, Chris C., Theodore H. Whitfield, Liz Owen, Tasha Rein, Surya K. Karri, Aleksandra Yakhkind, Ruth Perlmutter, Andrew Prescot, Perry F. Renshaw, Domenic A. Ciraulo, and J. Eric Jensen. “Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study.” The Journal of Alternative and Complementary Medicine 16.11 (2010): 1145-152. Web.

 

Miller, Michael, and William F. Fry. “The Effect of Mirthful Laughter on the Human Cardiovascular System.” Medical Hypotheses 73.5 (2009): 636-39. Web.

 

Vickhoff B, Malmgren H, Astrom R, Nyberg G, Ekstrom S-R, Engwall M, et al. “Music structure determines heart rate variability of singers.” Frontiers in Psychology Auditory Cognitive Neuroscience 334.4 (2013): 1-16. Web.

 

Ghoshal, Uday C., et al. “A proof-of-concept study showing antibiotics to be more effective in irritable bowel syndrome with than without small-intestinal bacterial overgrowth: a randomized, double-blind, placebo-controlled trial.” European journal of gastroenterology & hepatology (2016).

 

O’leary, C. “Small Bowel Bacterial Overgrowth, Celiac Disease, and IBS: What Are the Real Associations?” The American Journal of Gastroenterology 98.4 (2003): 720-22. Web.

 

Simren M, Stotzer P-O. “Use and abuse of hydrogen breath tests.” Gut 55.3 (2006): 297-303. Web.

 

Ghoshal, Uday C. “Overview of Hydrogen Breath Tests in Gastroenterology Practice.” Evaluation of Gastrointestinal Motility and Its Disorders (2016): 87-94. Web.

 

Chedid, Victor, et al. “Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.” Global Advances in Health and Medicine 3.3 (2014): 16-24.

 

Kwak DS, Jun DW, Seo JG, Chung WS, Park SE, Lee KN, et al. “Short-term probiotic therapy alleviates small intestinal bacterial overgrowth, but does not improve intestinal permeability in chronic liver disease.” Eur J Gastroenterol Hepatol 26.12 (2014): 1353-1359. Web.

 

Grover, Madhusudan, et al. “Small intestinal bacterial overgrowth in irritable bowel syndrome: association with colon motility, bowel symptoms, and psychological distress.” Neurogastroenterology & Motility 20.9 (2008): 998-1008.

 

Soffer EE, Sumers RW, Gisolfi C. “Effect of exercise on intestinal motility and transit in trained athletes.” Am J Physio 5.1 (1991): 698-702. Web.

 

Irritable Bowel Syndrome (IBS): Finding Physical and Emotional Well-Being

IBS Dr. Eric Viegas Naturopathic Medicine Ottawa

Irritable Bowel Syndrome (IBS): Finding Physical and Emotional Well-Being

Dr. Eric Viegas ND

 

Having an urgency to run to the toilet at all times of the day? Do you have abdominal pain that improves after passing a bowel movement? Bloating and gas with loose and/or constipated stools?

 

An estimated 5 million Canadians suffer from IBS, with 120 000 new cases each year (Fedorak RN, et al. 2012). 40% of Canadians suffering from severe IBS symptoms seek medical treatment, while patients with milder symptoms use a combination of lifestyle changes, food trigger avoidance, pharmaceuticals, and/or supplements to manage their wellbeing. The typical IBS sufferer misses 13 days of work per year (Fedorak RN, et al. 2012).

 

You have an increased risk for IBS if you have a family history of a first-degree relative (parent or sibling) with IBS. Onset is usually in a patient’s teenage years and is more common in women than men. Researchers have postulated that this gender difference exists because women are more likely than men to seek healthcare services for their symptoms, and clinical trials indicate that gender differences occur in responsiveness to drug treatment, pain processing, transit time (the time it takes for your food to move through your digestive tract), and effects of hormones (estrogen, progesterone) on digestive functions (Anbardan SJ., et al. 2012). In general, males tend to report a higher frequency of of loose bowel movements, and women tend to report more nausea and constipation  (Anbardan SJ., et al. 2012). Regardless of the gender differences, IBS can be a very debilitating and frustrating condition that leaves patients feeling powerless.

 

A patient fits the category of IBS if the symptoms have been present at least 3 days per month in the last 3 months, started at least 6 months ago, and symptoms (specifically, abdominal pain) are relieved after a bowel movement (Jung HK, 2011). Symptoms are associated with a change in stool number, stool appearance, and incomplete emptying of bowels. IBS sufferers may also have bloating, heartburn, and nausea (Jung HK, 2011). Other diagnostic methods should be used to rule out other serious conditions like colorectal cancer, inflammatory bowel disease, and celiac disease. There are currently 3 main categories of IBS; IBS-C (constipation dominant), IBS-D (diarrhea dominant), IBS-A/M (alternating/mixed). However, it is possible that a patient with IBS might not fit into any of these categories, and instead be classified into ‘pain-predominant’, or IBS-PI (post-infectious) patterns.

 

Some of the known causes of IBS include a history of gut infections, abdominal surgery, changes in diet, antibiotic use, and/or bacterial/hormonal/neurotransmitter imbalances. IBS pain is tied to changes in a healthy human microbiota (the friendly microbes in our gut), the immune system, and brain-gut communication (Grice EA, 2012). Think of brain-gut communication as our mind-body connection, one that exists through the central (mind) and enteric (gut) nervous systems.

 

Peristalsis is coordinated muscle contraction that promotes movement of food through the GI tract. In IBS, irregular peristalsis (spasm) can slow transit time or increase it through constipation or diarrhea, respectively. 95% of serotonin receptors are found in the enteric nervous system, and some of them increase or decrease peristaltic action (Gershon MD., 2005).

 

Peppermint oil is an effective tool in managing IBS symptoms (Cash et al., 2016). Menthol, an essential oil, is an antispasmodic and can help to calm the muscular and mucosal (mucus) walls of the intestine. Through this mechanism of action, peppermint oil helps abdominal pain and regulates peristalsis (Khanna et al., 2014). In an ancient Egyptian text from 1550 BC, mint was indicated for abdominal pain. In ancient Greece, Hades softened a spell on his mistress Minthe, so that ‘when people walked upon his lover they would smell her sweetness’. Mint has a relaxing effect to the enteric and central nervous systems, and has been shown to increase patient quality of life scores (Bharani et al., 2016).

 

Similar to peppermint, probiotics can be an effective symptom management tool. Studies have shown that certain probiotic strains, specifically the lactobacillus and bifidobacterium families, can relieve symptoms of abdominal pain, gas, and bloating (Majeed et al., 2016) (Moraes-Filho JP., Quigley EM, 2015). However, not all patients have the same reaction to probiotics. To give some perspective, the human microbiota is the size of an ocean compared to the small droplet of probiotics delivered to our bodies by supplements. Scientists still have many questions regarding the human microbiota. Does it control us? Do we control it? If so, how? The complex relationship between our mind and our microbiota is one that can be slightly altered through diet, environment, and our stress level (Grice et al., 2012).

 

The ability of your body to fully digest and absorb the calories from the food you eat is controlled by your own microbiota (Grice et al., 2012). Avoiding dietary triggers that alter the capacity of friendly microbes, and possibly feed the harmful ones, should be a treatment goal to reduce inflammation within the digestive tract. Our microbes have the ability to heal the gut wall and mucosa, so the diet and lifestyle factors necessary are those that create the ideal conditions for the friendly bugs we were born with.

 

Acupuncture tends to be favoured by IBS patients over traditional pharmaceutical approaches (Manheimer et al., 2012). Acupuncture, an effective tool in IBS management, assesses and treats the individual patient holistically. IBS patients receiving acupuncture for symptom management reported greater improvement than patients receiving only pharmaceutical therapy (Manheimer et al., 2012). It is important to keep in mind that IBS affects both physical, and mental-emotional wellbeing. Patients should receive an IBS treatment plan that addresses both physical and psychological factors. IBS can be very difficult to deal with, but its symptoms can be managed and so can your stress.

 

Always consult your doctor before taking any new supplement or medication

 

 

References:  

 

Fedorak RN., Vanner SJ., Paterson WG, Bridges RJ. Canadian digestive health foundation public impact series 3: irritable bowel syndrome in canada. Incidence, prevalence, and direct and indirect economic impact. Can J Gastroenterol 26(5); (2012): 252-256. Print.

 

Anbardan SJ., Daryani NE., Fereshtehnejad S-M., Vakili ST., Keramati R., Ajdarkosh H. Gender role in irritable bowel syndrome: a comparison of irritable bowel syndrome module (rome iii) between male and female patients. J Neurogastroenterol Motil 18(1); (2012): 70-77. Print.

 

Jung, Hye-Kyung. “Rome III Criteria for Functional Gastrointestinal Disorders: Is There a Need for a Better Definition?” Journal of Neurogastroenterology and Motility 17.3 (2011): 211–212. PMC. Web. 23 Nov. 2016.

 

Gershon MD. Nerves, reflexes, and the enteric nervous system: pathogenesis of the irritable bowel syndrome. J Clin Gastroenterol 39(5); (2005): 184-193. Print.

 

Cash BD., Epstein MS., Shah SM. A novel delivery system of peppermint oil is an effective therapy for irritable bowel syndrome symptoms. Dig Dis Sci 61; (2016): 560-571. Print.

 

Bahrani HR., Hamedi S., Salari R., Noras M. Herbal medicines for the management of irritable bowel syndrome: a systematic review. Electronic Physician 8(8); (2016): 2719-2725.

 

Khanna R., MacDonald JK., Levesque BG. Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol 48(6); (2014): 505-512. Print.

 

Majeed M., Nagabhushanam K., Natarajan S., Sivakumar A., Ali F., Pande A., et al. Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutrition Journal 15(2); (2016): 1-10. Print.

 

Gerritsen J., Smidt H., Rijkers GT., de Vos WM. Intestinal microbiota in human health and disease: the impact of probiotics. Genes Nutr 6; (2011): 209-240. Print.

 

Moraes-Filho JP., Quigley EM. The intestinal microbiota and the role of probiotics in irritable bowel syndrome: a review. Arq Gastroenterol 52(4); (2015): 331-338. Print.

 

Maron DF. Does our microbiome control us, or do we control it? Scientific American. January 13 2016. Retrieved from www.scientificamerican.com/article/does-our-microbiome-control-us-or-do-we-control-it/

 

Grice EA., Segre JA. The human microbiome: our second genome. Annu Rev Genomics Hum Genet 13; (2012): 151-170. Print.

 

Manheimer E., Wieland LS., Cheng K., Li SM., Shen X., Berman BM. Acupuncture for irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol 107(6); (2012): 835-848. Print.

Understanding irritable bowel syndrome (ibs). Canadian digestive health foundation. Retrieved from http://cdhf.tdcbeta.com/bank/disorder_pdf_en/12-irritable-bowel-syndrome-ibs.pdf#zoom=100

7 Eastern and Western Herbs for Ulcerative Colitis: New Evidence

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

7 Eastern and Western Herbs for Ulcerative Colitis: New Evidence

Dr. Eric Viegas, ND

What is UC?

Ulcerative Colitis (UC) is a form of irritable bowel disease that targets the end of the large intestine; most notably the rectum and anus. With significant inflammation of the innermost layer of gut tissue, Ulcerative Colitis causes bloody stools, abdominal pain, weight loss, fever, dehydration, and frequent urges to have a bowel movement.[1]

 

Some UC bowel movements are “false urges”; this means that although the need to pass stool feels urgent, very little is passed into the toilet bowl. Inflammation is the main culprit in false urges.

 

There will be periods of time where Ulcerative Colitis sufferers will be in symptom “remission”; their bowel movements will improve along with their quality of life, but the tissue in their colon will still be inflamed. Stress and diet triggers will often cause relapses for people with UC.[1]

 

Complications of UC include anemia and colorectal cancer. Relapses are frequent, so doctors and patients must work together to reduce inflammation and pain to improve quality of life.

 

Medications, nutritional supplements, herbs, diet, and surgery are all useful tools for individual cases of UC. Unfortunately, no cure exists, but with the proper diet and lifestyle choices the risk of UC relapse can be reduced.

 

A 2017 systematic review and meta-analysis in the European Journal of Integrative Medicine looked at common western and eastern herbal medicines, their effect on relapse rates, and the rates of symptomatic & endoscopic remission in people with UC.

 

The researchers sifted through 3050 studies and filtered their search to include only the best evidence. In the end, 29 randomized controlled trials that included over 1800 people with UC were selected.

 

Five single-herb remedies were effective in reducing the risk of relapse, maintaining symptom remission, in UC:

 

  1. Curcumin

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

The first herbal therapy, is called curcumin. Curcumin is an extract of the spice turmeric (aka curcuma longa), and the recent surge in popularity of “turmeric lattes” may prove beneficial to people with UC.

 

Curcumin was shown to maintain remission of UC up to six months, and was also beneficial in improving quality of life during active UC.[2]

 

The traditional use of turmeric is as an anti-inflammatory agent for joint pain and liver dysfunction. It is no surprise then, that curcumin is an effective anti-inflammatory for UC.

 

  1. Silymarin

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Silymarin, the anti-inflammatory component of the seeds of milk thistle (aka silybum marianum) also demonstrated remission maintenance in people with UC for up to six months.[2]

 

Traditionally, silymarin has been used to regenerate diseased liver cells and improve liver function.

 

  1. Aloe Vera Gel

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Aloe vera gel, a commonly used botanical for painful sunburns, was shown to help achieve symptom remission in active UC.[2]

 

The gel is found inside the long leaves of the aloe vera plant and has been used traditionally as an anti-inflammatory agent for digestive concerns such as ulcers.

 

Aloe has also demonstrated an ability to stimulate connective tissue formation and wound healing.

 

  1. Cannabis Oil

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

A proprietary extract of cannabinoids from cannabis sativa oil, known as GWP42003, was helpful in achieving symptom remission in UC.[2]

 

Although still not legal for use as an over the counter remedy, these promising results in UC gives hope for the eventual legalization and greater accessibility of medical marijuana oils in Canada.

 

Speak with your doctor to find out if this is the right treatment for you.

 

  1. Andrographis

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Andrographis paniculata, known as the “king of bitters” in India, is a good digestive tonic for certain cases of gastrointestinal disease. Andrographis was also helpful in achieving symptom remission in active UC.[2]

 

Commonly used to fight against cold and flu symptoms, andrographis has anti-viral properties and is now found in most herbal cold and flu remedies.

 

  1. EGCG

Ulcerative Colitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Finally, it’s a good idea to grab a cup of green tea. Epigallocatechin-3-galate (EGCG) is an antioxidant found in green tea, and people taking EGCG were more likely to achieve Ulcerative Colitis symptom remission than those taking placebo.[2]

 

Another useful property of green tea is the anti-anxiety effect of theanine; an amino acid exclusive to green tea that promotes a relaxed state while not compromising alertness.

 

UC sufferers often experience mood disorders as a consequence of their disease, so a few cups of green tea a day can go a long way to promote a better quality of life.

 

  1. Traditional Chinese Medicine

In combination with standard drug therapy, the chinese herbal formulas Chan Yu ning syrup/granule, Gu chang zhi xie wan, and Kui jie ling granules, were all shown to improve both symptoms and gut inflammation in active cases of UC.[2]

 

Licensed acupuncturists and traditional chinese medicine doctors use their knowledge of pathology and organ systems to formulate an herbal preparation that is individualized to your specific needs.

 

Everyone is different, and their responses to stressors are different; TCM takes this into account with the use of botanicals and acupuncture to improve health and wellbeing.

 

With a long history of botanical medicines in cultures around the world, it is no surprise that herbal remedies exist to treat some of the most prevalent gastrointestinal diseases we face today.

 

For more information on Ulcerative Colitis and to find out which remedies are right for you, speak with your naturopathic doctor.

 

References:

 

  1. Garud S., Peppercorn MA. Review: ulcerative colitis: current treatment strategies and future prospects. Therapeutic Advances in Gastroenterology 2009; 2(2): 99-108.
  2. Kim Seoyeon, Lee Byung-Hee, Zhang Xiuyu, Park JaeWoo, Lee Sle, Lee Hyangsook. Adjunctive herbal medicine therapy for inflammatory bowel disease: a systematic review and meta-analysis.European Journal of Integrative Medicine http://dx.doi.org/10.1016/j.eujim.2017.03.009.