Complementary and Alternative Medicine (CAM) for IBS

CAM is used combined with diet and medications in patients with difficult to treat chronic disease.
CAM use is highest in female & in those with high education and anxiety.

In IBS CAM includes prebiotics, probiotics, symbiotics, psychotherapy, acupuncture and herbal medicine

Gut Microbiota, prebiotic, probiotics, antibiotics & IBS:
Gut microbiota is an auxilliary and virtual organ. It plays a role in energy harvest, storage and expenditure. it changes in response to diet and plays a role in obesity. high fat diet reduces bacterioedetes, and increase firmicutes and proteobacter. methane producing Archaea are in abundance in obese human and mice.
gut microbiota preserve energy and convert fermentable but indigestable nutrients to micronutrients, gases and reduce harmful toxins.
Methanogen bacteria oxidize H2 to produce methane (CH4) leading to higher production and absorption of short-chain fatty acids which may lead to obesity. reduces H2 gas and flatulence by 4 folds. methane is eliminated 80% by flatus, 20% excreted by lungs. methane slows intestinal transit and cause constipation.

Probiotics (for life):
Defined as live organisms that when ingested in adequate amount exert a health benefit to the host. the most commonly used probiotics are lactic acid bacteria and nonpathogenic yeast. several organisms such as L. acidophilus, L. casei, L.GG, and Bifidobacterium Animalis are effective in reducing abdominal pain, flaulence constipation and bloating in IBS. yogurt is rich in probiotics. VSL#3 is anti-inflammatory, B. infantis help pain in IBS
S boulardi 200 to 1000 mg daily reduces antibiotic associated diarrhea and diarrhea due to antibiotic used to treat H. Pylori.
mixture of lactobacilus casei, streptococus thermophilus and lactobacillus bulgaricus reduces antibiotic associated diarrhea and C Difficile diarrhea.
Increased bifido results in increased absorption of vitamines,and minerals, improve digestion, protects against harmful bacteria, fungi and viruses.
Yogurt brought to Turkey by Mongols millenia ago. mixture of Lactobacillus Bulgaricus, L. Acidophilus and Strep Thermophilus ferments lactose to lactic acid. Probiotics present in most yogurt in the US are mixture of S. Thermophilus, L. Bulgaricus, L. Acidophilus, Bifidus and L. Casei.
Feta cheese is made of fresh raw milk of goat or sheep, add 1/2 cup of cultured buttermilk to warm milk, after 1 wk ready. first made by mountain man in Greece.

Prebiotics:
Prebiotics are defined as non-digestable, but fermentable foods that beneficially affect the host by selectively stimulating the growth and activity of one species or a limited number of species of bacteria in the colon specially lactobacilli and bifidobacteria. inulin type fructans and fructo-oligosaccharide are present in significant amount in many fruits and vegetables including wheat, onion, chicory, garlic, leeks, artichokes, asparagus, rye, and banana. substances such as fiber, fiber supplements and lactulose for example exert prebiotic effec.
short-chain prebiotics such as oligifructose fements more quickly in the colon. long chain prebiotics such as inulin ferment more slowly. full-spectrum prebiotics such as oligofructose enriched inulin target the entire colon.

Symbiotics:
Combination of prebiotics and probiotics aim to increase survival and activity of proven probiotics in vivo.

Antibiotics:
Antibiotics are both a risk factor for IBS by reducing useful bacteria and treatment for IBS patients with SIBO.
A short course of antibiotic Rifaximin 550 mg twice daily for 2 weeks can reduce abdominal discomfort, bloating and flatulence up to 10 wks.