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Heather's IBS Newsletter ~ For Irritable Bowel Syndrome

October 30, 2007

Special IBS Age Issue!

Worst IBS Her Doctor Had Ever Seen - Why She's Now Better Than Ever!

Hello to everyone ~

We have a really amazing letter this week from a woman who had "the worst case of IBS" her doctor had ever seen. But in just five months, she's now so much better that she's traveling across the country, and her doctor is recommending her discoveries to his other IBS patients. See how she did it!

We have part one of a special age issue this week, with a focus on older people and Irritable Bowel Syndrome. Just how old is too old to develop IBS, anyway?

Also, I'd like to send my hopes and prayers to everyone in Southern California. We've heard from so many folks who are struggling with the fires and at risk of losing everything. Please know that you are in our thoughts and hearts.

Finally, I'm thrilled to announce numerous new stores and, as always, we have the latest IBS news and research!

Best Wishes,
Heather Van Vorous

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Fennel is terrific for bloating & gas, Peppermint is great for IBS pain & spasms.


Orange Cappuccino Cake

This is a super fast and easy dessert with unexpectedly sophisticated, adult flavors. It's also low fat, dairy-free, and high in soluble fiber.

Interestingly, although coffee is often a potential IBS trigger, using small amounts of instant decaf coffee granules when cooking or baking is usually very tolerable, and a great way to punch up chocolate desserts. This recipe is a perfect example of how you cook and eat making as much of a difference as what you eat.

Makes 12 Servings

Preheat oven to 325F.

Spray a 10 inch bundt pan with cooking oil and set aside.

Sift together in large bowl and whisk together well:

2 tablespoons Acacia Tummy Fiber (optional)
2 cups all-purpose flour
2 teaspoons baking soda
1/3 cup unsweetened cocoa powder
1 tablespoon cornstarch
1 cup white sugar
1/2 teaspoon salt

In a medium-large bowl microwave until quite warm:
1/4 fresh orange juice

Stir into warm juice:
2 tablespoons freshly grated orange zest (from about 1 large orange)
2 Tablespoons instant decaf coffee granules

After coffee dissolves, whisk in:
1 1/2 teaspoons cinnamon
1 3/4 cup unsweetened applesauce
1/4 cup canola oil
1 tablespoon vanilla

Add the wet ingredients to the dry with a few swift strokes just until blended. Pour into bundt pan. Bake about 60 minutes, until a toothpick comes out with moist crumbs. Cool on rack.

For a special treat, serve this cake as dessert after a delicious cup of Cream of Celery Soup with Buttery Bacon Croutons.

Are you just learning how to eat for IBS? A little intimidated at the thought of special IBS recipes? Not quite sure just what makes these recipes special in the first place? Don't worry! Come see the IBS Diet pages, and find the answers to all your questions.

~ Eating for IBS ~
Comprehensive IBS Diet Information & Safe Foods vs. Trigger Foods

Eating for IBS
Addresses multiple IBS symptoms * Teaches substitution, never deprivation

Finalist for the Julia Child cookbook award!

divider Worst Case of IBS Her Doctor Had Ever Seen

Dear Heather,

Your website and organic products have saved my life. I need to write you a letter and let you know the shape I was in and what 5 months have done for me.

I am a 58 year old woman who was "diagnosed" (since everything else was ruled out by having a colonoscopy and nothing was found) in June of 2005.

As a child, teenager, and young adult I had a real problem with constipation. It got severe when I had my gallbladder removed in 1999. I began having frequent attacks of severe cramps and diarrhea. This got progressively worse to the point of my blood pressure dropping so low that I would pass out physically but not mentally. I have for the last 4 or 5 years had bouts so severe that EMS had to take me to the hospital with my blood pressure at 60/40.

The medication Zelnorm came on the market and it helped but all it did was stretch the time between episodes. It did not take the problem away. When they took Zelnorm off the market I thought "woe is me." I did not know how much longer my boss would put up with my leaving sick almost once or twice a week. I absolutely did not go far from home - no vacations or day trips even.

I found your website and thought, what do I have to lose? Well, in the last 5 months I have lost between 40 and 50 pounds, the cramps, diarrhea, and the horrible blood pressure drops. My doctor is amazed and has copies of the information that I pulled from your site. He is recommending your website to other patients since it has done so much for me. He said that I had the worst case of IBS he had ever seen.

I just want to say a big thank you and let you know that I am flying to New York for the Thanksgiving holidays to see my son. I would never have done this before. You certainly may use my letter and if someone needs encouragement I would be more than happy to email with them.

Again, thanks for giving me the most normal life I have ever had.

Judy Cantey
Florence, South Carolina

Thank you so much, Judy - I am so thrilled you're feeling better!

Did you miss the recent letter from Sarah, who has gone two years without an IBS episode after 42 years of pain and fear?

~ Heather's Tummy Fiber ~
For the Dietary Management of Abdominal Pain, Diarrhea, &, Constipation

IBS Acacia Tummy Fiber

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New Retail Stores Carrying Heather's Tummy Care Products
We're continuing our special rebate offer for people who buy Tummy Care products at their local stores, and we have new store announcements this week as well.

Leslie Freeman Nutritional Counseling
2945 Ellesmere Ave
Costa Mesa, CA 92626

Santa Rosa Community Market
1899 Mendocino Ave
Santa Rosa, CA 95401

Wellness Architecture
2100 Gordon Ave
Menlo Park, CA 94025

A Way of Life
9359 Milwaukee Ave
Niles, IL 60714

Herbal Works - Marshfield
1100 Spur Dr Ste 20
Marshfield, MO 65706

Bear Creek Gifts
755 Bowman Rd
Hamilton, MT 59840

Stein Acupuncture & Physical Medicine
38 Maurice Lane
Hatboro, PA 19040

Dr. Myrna Alexander
3850 S 9th Rd
Arlington, VA 22204

If you don't have a store in your area carrying Tummy Care products yet, please give them this flyer to ask them.

~ Heather's Tummy Tamers Peppermint Oil Capsules ~
IBS Peppermint Caps
Peppermint Oil Caps Called "Drug of Choice for IBS"

Our Peppermint Oil Caps have the added benefits of fennel and ginger oils, and they help prevent abdominal pain, gas, and bloating!

divider Diagnostic Test Relevance & the Growing Evidence of "Pure" IBS
A recent article in Nature Clinical Practice Gastroenterology & Hepatology asked, "Why do clinicians continue to order tests for suspected IBS despite data that show that these tests generally have a low diagnostic yield?" In light of the medical–legal interface in the US, one possibility is that some clinicians believe that diagnostic testing is a form of inoculation against litigation.

Clearly this is an inappropriate reason to pursue diagnostic testing, especially as data indicate that the quality of the physician–patient relationship is a critical predictor of outcomes, and probably a more important predictor of litigation than testing proclivity.

A second possibility is the belief that even negative diagnostic tests are useful because they can allay patient concerns about serious illness and provide reassurance. We have shown, however, that a negative colonoscopy, in particular, is not associated with reassurance or improved quality of life in young IBS patients. In fact, we found a nonsignificant trend towards less reassurance in patients who received a negative colonoscopy versus no colonoscopy at all.

A third possibility is that IBS patients with multiple unexplained somatic complaints and physical illnesses potentially related to their underlying psychosocial distress are sometimes misclassified as having several underlying organic conditions, and subsequently undergo diagnostic tests to chase these symptoms.

We found a linear and highly significant relationship between levels of such somatization and the amount of diagnostic testing in IBS, which suggests that clinicians should be aware of somatization in patients with IBS, and aggressively treat or refer such patients in lieu of performing potentially unnecessary tests.

The most common reason for diagnostic testing in IBS, however, might be that the Rome criteria have a 98%, rather than a 100%, positive predictive value, therefore, no matter how strong the evidence is that diagnostic testing has a low yield, a real possibility of underlying organic disease remains.

This argument is simply not debatable, particularly in light of growing evidence that patients diagnosed with IBS are a heterogeneous population with a core of pure IBS patients surrounded by small subsets who have alternative diagnoses such as celiac sprue and bacterial overgrowth. Go here for comprehensive information about diagnosing IBS.

Go here for more information about this study...

IBS May Not Affect Small Bowel Transit Time, but Age Does
A recent study in Digestive Diseases & Sciences examined the effect of age and selected indications, including IBS, for capsule endoscopy on small bowel transit times. Indications for referral for capsule endoscopy were as follows: 372 obscure gastrointestinal bleeding, 96 suspected Crohn's disease, 65 celiac disease, 54 irritable bowel syndrome, and 116 familial adenomatous polyposis, intestinal lymphoma, or ulcerative colitis. One group consisted of patients less than 40 years old, and the other patients greater than 40 years old. Age discrepancies were found in that the younger group had significantly shorter small bowel transit times. The IBS group, however, did not. Go here for more information about this study...

Researchers call gut-directed hypnotherapy a "cure" for IBS!

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divider Age and IBS - Can you be too old to develop IBS?
"Is it even possible to develop Irritable Bowel Syndrome past a certain age?"

The short answer here is that yes, it is possible to develop Irritable Bowel Syndrome at any age. The good news is that IBS in older people will respond to the same treatments that are effective for younger patients, and the same non-drug products.

However, the older you are at the onset of symptoms, the more tests you will likely need to rule out other disorders than can mimic IBS. While many people have IBS for quite a few years before they're finally diagnosed, the later in life your symptoms begin the more likely it is that there is something other than IBS causing problems.

It is unusual (though certainly not unheard of) for people to develop IBS out of the blue as they age. But, the older you are at the onset of IBS, the more likely it is that you can point to a specific incident that triggered your symptoms. These types of incidents are known as "insults to the gut." This would include such traumas as dysentery, food poisoning, intestinal flu, abdominal surgery, and even pregnancy.

I would personally add severe stress to the list of possible insults as well, as I've heard from too many people at this point who can pinpoint their IBS onset to a period of acute emotional distress. The insult-to-the-gut theory says that even after full physical recovery from a traumatic events, the nerves within the gut retain a memory of the insult and remain hyper-sensitive to further stimulation, as well as prone to subsequent over-reaction.

You likely know if you experienced any abdominal trauma immediately prior to the onset of your IBS symptoms, and if you did, this is the logical explanation for what has happened to your GI tract and why.

If, however, you're an older patient (usually defined as over age 50, but if you have any family history of colorectal diseases I'd say over 40) when your symptoms begin, and especially if you can't pinpoint a cause for their onset, it's essential that you have a full course of diagnostic exams to eliminate other potential disorders and diseases.

In particular, your doctor will want to rule out colon cancer, inflammatory bowel diseases, bowel obstructions, diverticulosis/diverticulitis, celiac, bacterial infections, intestinal parasites, endometriosis, and colon cancer. For patients with any numbness in association with constipation, Multiple Sclerosis should be excluded. For patients with indigestion, nausea, and bloating, gallstones should be ruled out. (As a side note, ALL people over 50 years old should routinely undergo colorectal cancer screening regardless of IBS symptoms.)

The older you are, the higher the odds that you may have one of the more serious diseases on the list (especially colon cancer and diverticulitis), and thus the more thorough your diagnostic work-up must be. In particular, you should receive a colonoscopy, the gold standard for diagnosing serious bowel diseases and disorders.

Finally, in addition to having the necessary exams, it's also crucial that your doctor verifies that your symptoms match those that have been medically established as definitive of Irritable Bowel Syndrome.The Rome Guidelines are the current standard for this definition; if you're not familiar with the guidelines, they are detailed here.

Coming next time, we'll tackle the other end of the spectrum - can you be too young to develop IBS?

~ Heather

Did you miss the recent "Ask Heather" and how gender affects IBS treatments? Find it here...

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