In some people who take antibiotics, the uncomfortable side effect of diarrhea results. This happens because antibiotics disturb the gut bacterial balance. Antibiotics, aptly named as they are, work by killing bacteria—both good and bad bacteria. This alteration of gut bacteria can result in an imbalance that favors pathogenic bacteria, resulting in diarrhea. This is known as antibiotic-associated diarrhea (AAD). One of the most severe forms of AAD is Clostridium difficile-associated diarrhea.

A recent review of 22 studies, and a recent meta-analysis of randomized controlled trials, both sought to determine the effectiveness of probiotics on the prevention of antibiotic-associated diarrhea. In the review, the lead researcher stated, “Overall in twenty-two studies, probiotic prophylaxis significantly reduced the odds ratio of developing AAD by approximately 60 percent. This analysis clearly demonstrates that probiotics offer protective benefit in the prevention of these diseases.” A researcher presenting the results of the meta-analysis stated, “The preventive effect of probiotic use remained significant regardless of species used, adult versus child populations, study quality score and antibiotic administered.”

These findings were presented at the American College of Gastroenterology’s 76^th Annual Scientific Meeting in Washington, D.C. in late October. The acknowledgement of the beneficial effects of probiotics by such a group is encouraging. Certainly, the evidence is impossible to ignore. Next time you are prescribed antibiotics, ask your doctor about taking probiotics. If your doctor is not familiar with probiotics, educate him/her!

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A particular parasite, called Cryptosporidium, is showing up in pools, lakes and fountains, causing a diarrheal disease known as cryptosporidiosis, or “crypto” for short. A new report from the Centers for Disease Control and Prevention found 134 disease outbreaks associated with recreational water in 2007 to 2008, when the most recent data is available. That is a 72 percent increase over the previous two-year period. Of all 105 confirmed disease outbreaks in pools and fountains, Cryptosporidium was responsible for 57 percent of them, causing over 12,000 illnesses.

The parasite can cause diarrhea in all age groups, but immune-compromised individuals, the very young, and very old are particularly susceptible to more serious illness upon infection. Symptoms of crypto include abdominal cramping, frequent watery diarrhea, nausea, feeling ill, and even malnutrition and weight loss in severe cases. In most people, however, a crypto infection is not dangerous, but it’s uncomfortable.

Cryptosporidiosis spreads by contact with contaminated water, and as the bacterium is tolerant of chlorine, it may not be possible to avoid contact. While it is not common for a pool to be contaminated with this parasite, Cryptosporidium contamination is increasing. Proper sanitation and hygiene are important for prevention of this illness. People, and especially infants, with diarrhea should not swim in pools until their diarrhea subsides. Infants should wear protective diapers when swimming. Try not to swallow water and be sure to wash hands after swimming to stay on the safe side.

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Probiotic use for digestive conditions has seen a gradual increase in dosage over the past couple decades. Doses of 7 billion were thought to be very high just ten years ago, while average doses were about 250 million. Today, an average probiotic dose is around 1–5 billion with high-dose probiotics ranging from 30 to 450 billion or more. This increase comes with improvements in the development of probiotics and increased interest in studying high-dose probiotics, as is reflected in the literature.

The gut is home to about 100 trillion bacteria cells—10 times the amount of cells that make up the entire human body. For this reason, high-dose probiotic therapy may have a greater impact on the beneficial modulation of the gut flora, or microbiota. Here I’ll review a few studies on high-dose probiotics for gastrointestinal conditions.

In a randomized, double-blind, placebo-controlled study published in 2010 in the Journal of American Gastroenterology, 225 patients were randomized to one of three groups: two probiotic capsules per day providing 100 billion CFU (colony forming units) of live organisms, one probiotic capsule and one placebo capsule per day providing 50 billion CFU of live organisms, or two placebo capsules.¹ A dose-ranging effect was shown in which the group receiving the 100 billion CFUs had lower incidence of antibiotic-associated diarrhea (AAD) than the 50 billion group, and both probiotic groups had lower incidence versus placebo. In those patients who did acquire AAD, Clostridium difficile-associated diarrhea (CDAD) incidence was lower than the 500 billion CFU group, and both probiotic groups had lower CDAD incidence than placebo.

A previous dose-response study published in 1991 in the journal Microbial Ecology in Health and Disease investigated fecal recovery of the probiotic Lactobacillus casei strain GG (LGG).² In this study, healthy volunteers were assigned to six different groups: 1.5 million, 15 million, 150 million, 1.5 billion, 15 billion and 150 billion CFU per day of the probiotic. LGG could not be recovered from the feces of groups taking up to 150 million CFU per day. In the group taking 1.5 billion, LGG was occasionally recovered at low levels in two of the seven volunteers. In the group taking 15 billion CFU per day, all volunteers were colonized. LGG was recovered at the highest level with the highest dose—150 billion. This study showed a dose-response effect at higher dosage levels of 15 to 150 billion CFU per day required for fecal probiotic recovery.

A high-dose multistrain probiotic formula containing eight strains (three bifidobacteria, four lactobacilli and one Streptococcus) has also been shown to colonize the gut and maintain remission of ulcerative colitis (UC) in children and adults.^3-5 In children, 900 billion CFU per day of an eight-strain probiotic formula induced remission.³ In adults, 500 billion CFU per day of that same formula colonized the gut and maintained remission in UC patients.⁴ In another trial, a daily dose of 3.6 trillion CFU per day of the multistrain formula induced remission in adult patients not responding to conventional therapies.⁵

This same preparation (dosages ranging from 450 billion to 1.8 trillion CFU per day, based on weight of patient) was also found to induce and maintain remission of ulcerative colitis in children.⁶ In a randomized, double-blind, placebo-controlled trial of 29 children with UC, probiotics or placebo were added to standard treatment. In the probiotic group, 92.8 percent achieved remission compared to only 36.4 percent in the placebo group. Further, there were no biochemical or clinical adverse events related to the probiotic treatment in these children.

Two more randomized, controlled trials evaluated the effects of this probiotic preparation in twenty-five patients with diarrhea-predominant irritable bowel syndrome (IBS-D). In the first study, patients were assigned to receive either the probiotic mixture (450 billion CFU per day) or placebo for eight weeks. The multistrain probiotic relieved abdominal bloating when compared to placebo. In the second study, 48 IBS patients were randomized, double-blind, to receive either the probiotic mixture (450 billion CFU per day) or placebo for 4 or 8 weeks. The multistrain probiotic mixture reduced flatulence and slowed colonic transit without altering bowel function in patients with IBS and bloating.

In another double-blind, placebo-controlled trial, sixty patients with functional bowel disorders—non-constipation IBS, functional diarrhea and functional bloating—received a probiotic mixture of two strains, Lactobacillus acidophilus and Bifidobacterium lactis, at 200 billion CFU daily for eight weeks.⁷ Abdominal bloating improved in the probiotics group at four and eight weeks when compared to placebo. A subgroup of patients with IBS was analyzed and also found to have reduced bloating when compared to placebo.

Studies evaluating high-dose probiotics are most common for inflammatory bowel diseases, though as we see from the studies cited above, other conditions are also benefitted from a high-potency probiotic therapy. The trend toward increasing dosage of probiotics is influenced and supported by studies using doses ranging from 50 billion up to 3.6 trillion or more.

References

1. Gao XW, et al., “Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients.” Am J Gastroenterol. 2010 Jul;105(7):1636-41.
2. Saxelin M, et al., “Dose-response colonization of faeces after oral administration of Lactobacillus casei strain GG.” MicroEcol Health Dis. 1991 Jan;4:209-14.
3. Miele E, et al., “Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis.” Am J Gastroenterol. 2009 Feb;104(2):437-43.
4. Ringel Y, et al., “Probiotic bacteria Lactobacillus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders—a double-blind study.” J Clin Gastroenterol. 2011 Jul;45(6):518-25.

1. Miele E, et al., “Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis.” Am J Gastroenterol. 2009 Feb;104(2):437-43.
2. Venturi A, et al., “Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis.” Aliment Pharmacol Ther. 1999 Aug;13(8):1103-8.
3. Bibiloni R, et al., “VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis.” Am J Gastroenterol. 2005 Jul;100(7):1539-46.

1. H.J. Kim, et al., “A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating.” Neurogastroenterol Motil. 2005 Oct;17(5):687-96.
2. H.J. Kim, et al., “A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome.” Aliment Pharmacol Ther. 2003 Apr 1;17(7):895-904.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Celiac disease is a condition in which the small intestinal lining becomes damaged as a result of a reaction against a common dietary ingredient, gliadin, a protein in gluten found in wheat, barley and rye. About one percent of the U.S. population is affected by celiac disease, yet most have not been diagnosed. Celiac disease diagnosis is confirmed by biopsy of the small intestine.

Scientists are trying to determine why so many cases of celiac go undiagnosed. A recent study by Colombia University Medical Center has found one reason—improper intestinal biopsy. Celiac disease affects patches of the small intestine, not the entire intestine. Medical recommendations for intestinal biopsy suggest that at least four specimens be taken to ensure that enough areas of the intestine are sampled to detect damage. Researchers used a nationally representative database of over 100,000 individuals who had undergone intestinal biopsy for symptoms like diarrhea, abdominal pain, esophageal reflux, and anemia and found that only 35 percent had the recommended four specimens taken. Most had only two.

In those individuals in whom four specimens were taken, the diagnosis rate for celiac disease more than doubled. “The process of increasing the number of specimens from two to four takes approximately one extra minute during endoscopy,” said Dr. Lebwohl, lead author of the study.

Celiac disease is the most severe form of gluten intolerance, another condition that doesn’t involve intestinal damage—yet! If you are undergoing a biopsy to detect celiac disease, be sure to ask the doctor if they’re taking at least four specimens. If the biopsy comes back negative, however, don’t think you can jump right back into eating gluten. You may have the milder form of gluten sensitivity. A stool test from enterolab.com could help you determine if this is what ails you.

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Autism is a developmental disorder characterized by severe abnormalities in communication, social awareness and skills, and behavior. Before the 1980s, autism occurred in 2 to 5 of every 10,000 children. Today about 1 in every 110 children gets autism. This rapid increase cannot only be attributed to improved diagnosis, and also indicates there is more to the disorder than simply genetics. Indeed, autism is a combination of genetic predisposition with environmental factors that triggers its development.

One aspect of contributing factors, at least in a subset of children, involves gut dysfunction. Many reports describe gastrointestinal symptoms and abnormalities in up to 84% of children with autism.[1] From constipation, diarrhea, abdominal discomfort, food sensitivities and abnormal gut flora to immune dysfunction and gut and systemic inflammation, the digestive system plays a central role in many cases of autism.

One gut abnormality—lactose intolerance—found in people with autism was recently reported in the journal Autism. Intestinal disaccharidase activity was measured in 199 individuals with autism. Disaccharidase is an enzyme that breaks larger sugars (disaccharides) like lactose, maltose and sucrose into smaller sugars like glucose. Deficiency of lactase enzyme, the enzyme that breaks milk sugar, or lactose, into galactose and fructose, was found in 58 percent of autistic children and 65 percent of autistic adults. In children, boys under 5-years-old had 1.7-fold lower lactase activity than girls of the same age, indicating the problem may be more severe in boys. The study concluded that lactase deficiency is common in autistic children and may contribute to abdominal discomfort, pain and the observed abnormal behavior seen in autism. Further, the study points out that most autistic children with lactose intolerance are not identified when doctors take a clinical history.

A decrease in activity of a variety of carbohydrate-digesting enzymes has been reported in children with autism.[2] Carbohydrase and disaccharidase enzyme deficiency results in the incomplete breakdown of carbohydrates in the small intestine. These partially undigested carbs move into the colon where they are greeted by a large supply of “hungry” bacteria—including potentially pathogenic bacteria. This may explain the increased presence of Candida and Clostridia species found in the guts of autistics.[3][4]

Carbohydrate-digesting enzymes are not the only digestive enzymes that may cause problems in autism. Fat malabsorption is seen in some autistic children, resulting in fatty, loose, floating, foul-smelling stools, also known as steatorrhea. Further, a particular enzyme known as dipeptidyl peptidase-4 (DPP4) may be deficient in those with autism. This enzyme breaks a specific peptide bond in gluten and casein proteins. In fact, it is thought that a deficiency in this enzyme is responsible for the incomplete breakdown of casein and gluten peptides (known as gluteomorphins and casomorphins) that act as opioids in the central nervous system and are thought to contribute to autistic symptoms. Following a gluten-free and casein-free diet has been found helpful in many autistics because it eliminates exposure to these peptides, often relieving symptoms. Supplemental DPP4 can be given in cases where accidental ingestion of gluten- or casein-containing foods is suspected, but it is not recommended as a replacement for the gluten-free, casein-free diet.

In all, we see a variety of enzyme deficiencies in autism and it would be wise to supplement with a digestive enzyme formula that includes a variety of enzymes. Further, due to the many digestive abnormalities seen in autism, the HOPE Formula (High-fiber, Omega oils, Probiotics and digestive Enzymes) is a wise daily maintenance program to support gut health.

[2] Horvath K, et al., “Gastrointestinal abnormalities in children with autistic disorder.” J Pediatr 1999;135:559-63.

[3] Finegold SM, et al., “Gastrointestinal microflora studies in late-onset autism.” Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.

[4] Shaw W, et al., “Assessment of antifungal drug therapy in autism by measurement of suspected microbial metabolites in urine with gas chromatography—mass spectrometry. The Clinical Practice of Alternative Medicine Magazine. 2000;1:15-26.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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abdominal discomfort, Autism, bacteria, Candida, casein, casomorphins, Children, Clostridia, Constipation, Diarrhea, Digestive Enzymes, environmental factors, Enzymes, fat malabsorption, food sensitivities, gastrointestinal, gluten, gluteomorphins, gut, gut dysfunction, Gut flora, high-fiber, immune dysfunction, inflammation, lactose intolerance, Omega oils, pain, Probiotics, small intestine, symptoms

Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean, opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

Irritable bowel syndrome (IBS) is a common gut disorder characterized by abdominal pain and discomfort, and altered bowel habits—constipation, diarrhea, or usually, alternating between both. People with IBS have a decreased health-related quality of life. Often, they also experience such conditions as fibromyalgia, depression, or even colon cancer.

It is known that women with IBS are less physically active than healthy women, and that women with IBS who do participate in regular physical exercise experience less fatigue or bowel complaints. A study published in the American Journal of Gastroenterology takes this association one step further by testing whether increased physical activity decreases IBS symptoms, and whether it increases quality of life.

As it turns out, regular exercise—20 to 60 minutes of moderate-to-vigorous physical activity 3 to 5 days per week—improved gastrointestinal symptoms and quality of life in people with IBS. The researchers recommend that physical activity be used as a primary treatment modality for IBS. 

I recommend exercise a lot because I believe it should be a part of everyone’s routine. It helps improve gut function, yes, but it also helps improve just about every area of health. So this week, if you or someone you know has IBS and you aren’t getting enough physical exercise, get moving. Find some form of exercise that makes you feel good, and just do it.

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On May 27, 2011 a New York Times article reports that Sherwood Gorbach, a 71 year doctor, has been instrumental in the development of a new antibiotic, Dificid, also known as fidaxomicin, for treating C. difficle (C. diff) diarrhea. Dr. Gorbach spent most of his professional life as professor of medicine and public health at Tufts University. He is also well known in the natural health community as one of the co-inventors of a probiotic known as Lactobacillus GG  (GG stands for Drs. names: Sherwood Gorbach and Barry Golden).  So it is needless to say he is well versed in the use of probiotics.

The discovery and bringing to market of Dificid is no doubt a wonderful event. One reason is there are more antibiotic resistant C. diff strains due to the overuse of Flagyl and Vancocin which have been the mainstays for C. diff treatment. It is important to point out that there are many studies in the medical literature that show the concurrent use of probiotics or probiotic yogurts with antibiotics greatly reduce or prevent C. diff in the first place. ¹ Also, prolonged use of probiotics after a C. diff infection reduces the likelihood of getting recurrent C. diff infections. What a novel concept—why not use probiotics and/or fermented yogurt on a regular basis?  

It turns out that the Dificid, at this point in time being the “new kid on the block,” was shown to be much better than Vancocin in preventing recurrent C. diff. About 25 percent of the Vancocin users had a recurrence compared with only about 15 percent of the Dificid users. Why would this be?  It’s too soon and too new for resistant C. diff strains to develop! What’s more, Dificid like most prescription drugs, has its dark side—namely side effects of nausea, vomiting, abdominal pain and gastrointestinal hemorrhage. Now let’s talk about cost; the drug is likely to be at least as expensive as Vancocin, which costs $1,000 or more for a course of treatment. Optimer, the pharmaceutical company that sells Dificid, is predicted to make about $159 million per year after a few years of selling the drug.

If we really had a health care system in addition to a sickness care system, probiotics would be taken as seriously (if not more so) than antibiotics in both the prevention—and yes, the treatment—of most all infections. It would be interesting for both Dr Gorbach and the New York Times to tell the more complete story of how Dificid could be avoided, but if truly needed, be complemented with probiotics that would include multiple species and strains of Lactobacillus and Bifidobacteria in a high enough dose to really matter, several hundred billion probiotic bacteria per day.

1. Hickson M, et al., “ Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial.” BMJ. 2007 Jul 14;335(7610):80. Epub 2007 Jun 29.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Unnecessary antibiotic use is a common practice, especially in pediatric medicine. Children with ear infections are often prescribed antibiotics, which often aren’t necessary. A recent analysis of 135 published studies found that most kids who see a doctor for ear infection do not need an antibiotic.

The review, published in the Journal of the American Medical Association (JAMA) determined that 80 percent of children with ear infections will get better on their own in about three days. When antibiotics are prescribed, this number only increases to 92 percent, but comes with many side effects—three in ten will develop a rash in reaction to the medication, five in ten more will get diarrhea, and an unpredictable number will be at risk of developing antibiotic resistance. 

Experts encourage doctors to give parents a “safety-net antibiotic prescription,” which is a prescription that parents take home and only use if the child does not improve after three days. This reduces the amount of office visits necessary (which can be one reason for parents to push early prescriptions), and reduces the number of children who take antibiotics unnecessarily.

I see so many people with digestive issues that stem from repeated antibiotic use as a child, and  I know how destructive that can be first hand. The long-term consequences of unnecessary antibiotics can wreak havoc on a person’s digestive system.  They did mine, and it took a long time (and the right supplements) for me to get back to vibrant health.  The more we know about safe ways to avoid antibiotics, the better. 

So the next time one of your little ones has an ear infection, talk to your doctor about a three-day safety-net antibiotic prescription. In the meantime, a bedtime dose of ibuprofen was recommended for best relief.

As always, when taking antibiotics, a probiotic should be taken (not within the same 2 hours) during and after, to help replenish the healthy gut bacteria that are depleted with antibiotic use.

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A recent Cochrane Systematic Review, which involves an extensive review of the scientific literature, found that probiotics are effective at reducing diarrhea. The results were similar across all 63 different trials that were analyzed.

A separate review was done for trials involving children with persistent diarrhea. Though only four trials were available for review, results showed that probiotics can reduce the length of time of an episode of persistent diarrhea.

Diarrhea often occurs as a result of infection by many different organisms. This results in a big imbalance in the ratio of good to bad bacteria, so probiotics, (also known as good bacteria), are sometimes recommended as a way to repopulate the gut and bring balance back to the intestines. Indeed, if the Cochrane Review is confirming this, you can’t get more mainstream than that. 

More research needs to be done on specific strains of bacteria and on preventing the progression from short-term to persistent diarrhea. But probiotic therapy can be used safely in addition to rehydration fluids, which are also given during diarrhea treatment.

Diarrhea can be a serious condition. If you are experiencing an episode of diarrhea, talk with your doctor about taking probiotics to help rebalance your gut.

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There is still a general belief with medical doctors and the public as well that Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are mostly stress-related psychological disorders. I have personally had many patients who were reluctant to discuss their bowel problems for fear of being labeled a “psych” case. Many practitioners still aren’t aware there can be legitimate causes of disease that come from both mind and body.

With IBS and IBD, as with most discussions, there is often an element of truth on both sides or there would be no controversy. First, let’s look at the validity of the stress factors. People with genetic short serotonin transporter systems react negatively to stress-related increases in cortisol (a stress hormone) than people with normal serotonin transport systems.1 Second, ALL people react to significant stress, which can produce damage to the gut epithelial lining. However, people with a history of IBD generally show more gut lining damage than those without IBD. The damage includes: increased levels of stress hormones, activation and degranulation of mast cells, mitochondrial damage in epithelial cells, and mucosal protein oxidation which can create multiple problems with permeability (leaky gut) and immunity.2 Again, this happens to everyone under stress, but is worse with IBS and IBD because stress can trigger a relapse of either condition.

On the other hand, there are many reports that suggest anywhere from 20 to 60 percent of IBS and IBD patients have had a serious gastrointestinal infection days or weeks before they began having symptoms of chronic bloating, abdominal pain, diarrhea or constipation (or both diarrhea and constipation) that may have lasted years. A study was done on 111 patients with IBS using the lactulose breath test (measures hydrogen and methane gas produced by too many of the wrong bacteria) and 84 percent of patients were positive, which indicates small intestinal bacterial overgrowth (SIBO). Those who were treated with a non-absorbable antibiotic, Neomycin, had a statistically significant improvement both in symptoms, and normalization of the breath test.3 A more recent study4 showed that patients with IBS, but without constipation, treated with rifaximin (a broad spectrum non-absorbable antibiotic) for two weeks provided significant relief of IBS symptoms including: bloating, abdominal pain, and loose or watery stools.

Both of these studies strongly suggest that bacterial overgrowth, which creates a low-grade infection, is a major part of IBS, and can be treated with antibiotics. In addition, I think the standard of care today strongly suggests using probiotics while on antibiotics. This has been shown to lower the incidence of antibiotic associated diarrhea (AAD), and especially Clostridium difficle diarrhea, which can lead to total removal of the colon or even death.

Probiotics alone have been shown to significantly help with IBS. More specifically, probiotics enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response. They reduce visceral hypersensitivity associated with both inflammation and psychological stress. More importantly, probiotics can alter colonic fermentation and stabilize the colonic microbiota, show that dietary exposure to pathogens maybe less likely to create another relapse of symptoms.5

Once again we can see that the use of high fiber, essential oils (omegas), probiotics and digestive enzymes (Brenda Watson’s HOPE Formula) can be beneficial in preventing or treating intestinal inflammation—be it IBS or IBD.

1. Way BM. “The Serotonin Transporter Promoter Polymorphism Is Associated with Cortisol Response to Psychosocial Stress.” Biol Psychiat. 2010 Mar 1;67(5):487-92.
2. Farhadi A, et al. “Heightened Responses to Stressors in Patients with Inflammatory Bowel Disease.” Am J Gastro. 2005;100:1796–1804.
3. Pimentel M., et al. “Normalization of Lactulose Breath Testing Correlates With Symptom Improvement in Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Study.” Am J Gastro. 2003;98:412-19.
4. Pimentel M., et al. “Rifaximin Therapy for Patients with Irritable Bowel Syndrome without Constipation.” N Engl J Med. 2011 Jan;364:22-32.
5. Spiller, R. “Review article: probiotics and prebiotics in irritable bowel syndrome.” Aliment Pharmacog Ther. 2008 Jun;28(4):385-96.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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