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October 7, 2003

This week ~ Age, elderly people, & Irritable Bowel Syndrome

Hello to everyone!

This newsletter welcomes in autumn with a delicious gingery Sweet Potato / Pumpkin Muffin recipe and lots of IBS news as well. First though, I'd like to apologize to everyone who did not receive a proper version of the September 17 newsletter. This was a terrific issue that was just stuffed with special IBS announcements and news, but as a result of a database crash at my email publishing service, many of you received the newsletter without working links.

If that happened to you, I'm so sorry - please read the newsletter (with a Mushroom Stroganoff recipe and working links!) where it's posted here. I'd also like to note that as a result of the crash and other service problems, I've switched email publishing companies altogether. My new service may well be reaching subscribers who were not receiving the newsletter previously, so there may be some readers who joined the IBS Newsletter quite a while ago but are just now seeing the first issue. If this is the case, and you don't wish to receive the newsletter after all, please unsubscribe from the link at the bottom of this page, and my apologies to you. If you have any feedback about the IBS Newsletter and all of the changes it's been going through, I would love to hear what you have to say, and you can simply reply to this email to tell me your thoughts.

For those of you who missed the big September 17 newsletter, it welcomed everyone to my comprehensive new website for Irritable Bowel Syndrome,, which not only offers a wealth of information, research, support, and tangible help for all IBS symptoms, but also has a complete "Shop for IBS" section, with everything from books, organic herbal teas, and enteric-coated peppermint capsules, to IBS hypnotherapy programs, hot packs, and more. Everything in the store is specific to IBS and/or IBD, is the highest possible quality available, and has supporting clinical studies in the IBS Research Library wherever applicable. My goal for this site is to offer all of the information people need to take control of their symptoms and lives, along with the support systems, community services, and my own special line of IBS products to help them do this. Please come visit us, make yourself at home, and consider yourself warmly welcomed to stay as long as you like!

Now, I'd like to take this issue to give a special thank you to the volunteer IBS Message Board moderators. These folks - TessLouise, HanSolo, Mags, ShawnEric, YogaTeacher, JillSklar, and Ruchie - are the heart of the friendliest, most well-informed, (and good-lookin' - check out those photos!) website resource for IBS around. They're on the boards daily welcoming new members and answering every question asked with intelligence, links to research and resources, and good humor. (As we all know too well, if you're not laughing about IBS, you're crying.) Our moderators share their personal IBS experiences and hard-gained knowledge freely with the sole intent of helping others, and I truly thank them for this. If you're not yet a part of the Message Boards, you're missing drop on by, say hello, and see for yourself just how fabulous our boards are thanks to these moderators!

Best Wishes,
Heather Van Vorous

Autumm Sweet Potato / Pumpkin Muffins from Moderator Mags!

These delicious muffins are simply terrific for IBS. They have a very low fat, high soluble fiber basis, with a luscious moist texture from nutrient-packed sweet potatoes or pumpkin. Soy milk replaces dairy, egg whites replace whole eggs, and ginger provides not just a terrific flavor punch, but is a digestive aid as well.

Makes 12 muffins

1 3/4 cups all-purpose flour
3/4 cup firmly packed light brown sugar
2 tsp baking powder
1/4 tsp baking soda
1/4 tsp salt
1/2 tsp ground cinnamon
1/4 tsp ground ginger
3/4 cup mashed baked sweet potato, cooled (or canned pumpkin)
1/2 cup room temperature soy or rice milk
4 egg whites at room temperature, lightly beaten
3 T canola oil
1 1/2 tsp vanilla
1/4 to 1/3 cup finely chopped crystallized ginger

Preheat oven 375F. Lightly coat twelve 2 5/8" x 1 1/8" (about 3 oz.) muffin cups with nonstick cooking spray.

In a large bowl, sift and whisk together flour, sugar, baking powder, baking soda, salt, cinnamon, and ground ginger. In another bowl, stir together sweet potato or pumpkin, soy milk, egg whites, oil, and vanilla until blended. Make a well in center of dry ingredients; add milk mixture and stir just to combine. Stir in crystallized ginger.

Spoon batter into prepared muffin cups. Bake for 15-20 minutes, or until a toothpick inserted in center of one muffin comes out clean.

Remove muffin pan to wire rack. Cool for 5 minutes before removing muffins from cups; finish cooling on rack. Serve warm or cool completely and store in an airtight container at room temperature.

Thanks to Mags, our IBS Diet Board moderator who contributed these fabulous muffins to the IBS Recipe Board.

Wait, There's More!

For tons of delicious recipes like this one, there's an amazing IBS recipe resource available - the IBS Recipe Exchange Index, which catalogues literally hundreds of terrific IBS-friendly recipes. The index was just completely updated and re-organized by our tireless moderator Mags, so if you haven't yet checked this out, don't wait. A million cheers and hugs to you, Mags!
Are you just learning how to eat for IBS? A little intimidated at the thought of special IBS recipes? Don't worry! Come see the diet section, and find the answers to all your questions.

divider Infectious Gastroenteritis Linked to Irritable Bowel Syndrome
Infectious gastroenteritis is associated with the development of irritable bowel syndrome (IBS), according to the results of a prospective, community-based study published in the September issue of the American Journal of Gastroenterology. "IBS might develop after gastroenteritis," writes Sally D. Parry, from the University of Newcastle in the U.K., and colleagues. "Most previous studies of this relationship have been uncontrolled, and little is known regarding other functional gastrointestinal disorders (FGIDs) after gastroenteritis." Check here for more information...

Evaluation of Drug Treatment in Irritable Bowel Syndrome
The irritable bowel syndrome (IBS) remains a therapeutic challenge in part because of the limited understanding of the pathophysiology. The placebo response rate varies in randomized controlled trials from 20 to 70%, and can persist for up to at least 1 year. Check here for more information...

High Fiber, Low Fat Diet Reduces Estrogen Levels & Breast Cancer Risk
The strength of the hypothesis that fiber reduces the risk of breast cancer is its biological plausibility, which is supported by experimental and interventional findings and by the coherence of observational studies. Intervention studies taking the plasma concentration of estrogens as an end-point showed significantly lower levels of breast cancer in women with a high-fiber and low-fat diet than in women with usual Western diets. Any reduction in breast cancer risk appears to be significantly dependent on the level of fiber intake. Check here for more information...

Detection of Pulmonary Involvement in Inflammatory Bowel Disease
Pulmonary involvement is common in patients with Inflammatory Bowel Diseases. A high degree of suspicion is necessary to detect the pulmonary abnormality in IBD, because considerably large proportions of the symptom-free patients have abnormal findings in pulmonary function tests (PFT) and high-resolution computed tomography (HRCT) tests. Check here for more information...

Step-down Dosage of PPI drugs for Hearburn
Management costs for gastroesophageal reflux disease are high because of the expensive medications used for maintenance therapy. Previous studies have illustrated the success of step-down from proton pump inhibitors (PPIs) to less-expensive therapy once symptoms have abated. This study was conducted to determine whether patients requiring greater than single-dose PPI for initial symptom resolution could be stepped-down to single-dose PPI and whether this intervention decreased costs or adversely affected quality of life. Check here for more information...

Essential Oils as Part of Diet-Based Management of H. Pylori Infection
An increased density of Helicobacter pylori in the gastric mucosa can be associated with more severe gastritis and an increased incidence of peptic ulcers. Therefore, people with asymptomatic gastritis would certainly benefit from a nutritional approach to help them manage the infection and therefore decrease the risk of development of associated pathologies. This study analyzed the activities of 60 essential oils against H. pylori and identified 30 oils that affected growth. Check here for more information...

Mild to Moderate Crohn's Disease - Defining a New Treatment
Previously, clinicians have had few choices in treating mild to moderate Crohn's disease. They currently treat these Crohn's disease patients with oral mesalamine and antibiotics. This treatment approach is based on the safety of these agents, and the perception that they are effective. This perception regarding efficacy may be influenced by publication bias. This review examines the efficacy and safety data of the conventional corticosteroids, mesalamine, sulfasalazine, budesonide and antibiotics for inducing the remission of mild to moderate Crohn's disease from randomized controlled trials, and proposes an evidence-based treatment approach. Check here for more information...

Looking for the latest IBS research and news?
Check out the IBS Research Library!

divider Age and IBS Diagnosis
"I'm 52 years old and just diagnosed with IBS. Is it possible to develop IBS at my age?"

The short answer here is that yes, it is possible to develop Irritable Bowel Syndrome at any age. However, the older you are at diagnosis, the more tests you will likely need to rule out more serious disorders than can mimic IBS. This is particularly true if your symptoms just recently started. 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 may be 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. Instead, the older you are at the onset of IBS, the more likely it is that you can point to a specific incident that started your symptoms. This is termed an "insult to the gut." No one really yet knows exactly why some people develop IBS and others don't, but there is mounting evidence that for some IBS sufferers the condition is precipitated by this type of grievous insult to the gut - dysentery, food poisoning, intestinal flu, abdominal surgery, even pregnancy. I would personally add severe stress to the list of possible "insults" as well, having 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 these 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, it's probably nice to have a 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) when your symptoms begin, and particularly 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. These exams will likely include:

Complete blood count, sedimentation rate, and chemistries
Stool for ova, parasites, and blood
Liver function tests
Rectal exam
Abdominal x-rays
For women, a gynecological exam including CA-125 blood test for ovarian cancer

Basically, your doctor needs to eliminate the following disorders first, before you can be diagnosed with IBS: Colon cancer; Inflammatory bowel diseases (Crohn's and Ulcerative Colitis); Bowel obstructions; Diverticulosis / Diverticulitis; Gallstones; Food allergies; Celiac (a genetic, autoimmune disorder resulting in gluten intolerance); Bacterial infections; Intestinal parasites; Endometriosis; Ovarian cancer. For patients with any numbness in association with constipation, Multiple Sclerosis should be excluded. For patients with indigestion, nausea, and bloating, an abdominal ultrasound should be given to rule out gallstones.

The older you are, the more likely it is that you may have one of the more serious diseases on this list (particularly colon cancer and diverticulitis), and thus the more thorough your diagnostic work-up must be.

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 II Guidelines are the current standard for this definition; if you're not familiar with the guidelines, they are detailed here, in the Irritable Bowel Syndrome glossary.

As so many people missed the September 17 newsletter, I'm including the topic from the Ask Heather column in that issue here as well...

Herbs as Medicine for IBS
"What about herbal remedies for IBS symptoms? Do they really work?"

The idea that herbs are nature's medicines is especially true when it comes to IBS. According to the American Botanical Council, whose mission continues the historical tradition of disseminating scientific information that promotes the safe and effective use of medicinal plants, several herbs are particularly effective digestive aids for IBS. One is an exceptional stand-out for its multi-symptom effectiveness: peppermint. This herb is safe for daily use and has no risk of short- or long-term side effects, which is a terrific plus when you compare it to prescription drugs.

Peppermint has pain-killing properties that have been recognized for millenia. Menthol and methyl salicylate are the main active ingredients of peppermint. Internally, they have anti-spasmodic actions, with calming effects on the muscles of the stomach, intestinal tract, and uterus. They also have powerful analgesic (pain-killing) properties, which are mediated, in part, through activation of kappa-opioid receptors, which help block pain signal transmission.

Peppermint is extremely useful for indigestion, gastrointestinal spasms, and menstrual cramps. It is anti-bacterial, increases gastric juices, and relieves gas, nausea, vomiting, and morning sickness. Peppermint also contains essential oils that stimulate the gallbladder to secrete its store of bile, which the body uses to digest fats. This makes peppermint a wonderful digestive aid for heavy meals. It also improves the function of the muscles that line the stomach and intestines, relieves diarrhea, and has a calming, numbing effect on the entire GI tract.

One of the easiest and most effective way to use peppermint for IBS is to brew it (fresh or dried) with boiling water into hot tea (do not actually boil the herb in water as this can destroy its volatile oils, and thus its effectiveness). Peppermint tea can ease IBS symptoms virtually immediately; from the first sip to the end of the cup you should feel a significant improvement. It's important to try and find the freshest, largest-leaf cut dried peppermint available to brew your tea. The volatile oils in the mint, which will give the medicinal effects, evaporate with age and degrade quickly when the leaves are finely cut. Bulk loose peppermint is always preferable to tea bags, as it will be a higher quality and potency. Organic is a good choice as well.

Because peppermint tea is most effective when you're in the habit of drinking several strong cups each day, it's helpful to buy it in quantities large enough to last through a month or two of daily use. This usually means buying the mint in bulk (or you'd be going through more than a box of tea bags a week, which is very expensive), but this isn't an option at most grocery stores.

To this end, I've developed Heather's Organic Peppermint Tummy Tea. This tea is quite noticeably stronger than your typical peppermint tea bag, not just in minty aroma and flavor, but in its medicinal strength as well. The tea has a volatile oil quantity of 2%, which is exceedingly high (twice as high as that of many tea bags), and it's a very large leaf cut (too large for tea bags), which means that it is stronger and fresher to begin with, and it will also stay that way for a longer period. The tea is sealed in airtight bags in 1 lb. quantities (equal to more than 10 boxes of teabags), so you have a generous quantity on hand. The idea behind the Tummy Tea is to give an ample supply of the herb, so you can feel free to use it liberally both in terms of brewing strength (try 2 full tablespoons per cup) and frequency. As with most herbs for IBS, peppermint works best when you're using it regularly, not saving it for special occasions.

Peppermint is actually such a powerful smooth muscle relaxant that it can trigger GERD (Gastroesophageal Reflux Disease) or heartburn in people who are susceptible. If you're prone to these upper GI problems, avoid peppermint tea and try another terrific option: enteric-coated peppermint oil capsules.

Peppermint oil capsules are meant to be taken before or in between meals, to help prevent IBS symptoms in the first place. Peppermint capsules are specially coated so they don't dissolve in the stomach (which could trigger heartburn); instead, they dissolve in the intestines, where they act as a muscle relaxant and pain killer. Because the capsules use peppermint oil, which is extremely potent, they're often amazingly helpful. As they don't take an effect until they've passed partially through your digestive tract, they have a more delayed reaction than peppermint tea, so it's actually helpful to use both the tea and capsules on a daily basis; they'll work far better together than either one will alone.

Peppermint capsules have been proven highly effective (and safe) in several clinical trials, including some of the few IBS studies ever conducted that focused specifically on children with IBS. I've personally used peppermint tea for years but hadn't tried the capsules until quite recently. I've been completely astonished by how effective they are, even under some pretty trying circumstances (including severe menstrual cramps, which the caps also helped a great deal). They have worked much better for me than any of the prescription anti-spasmodic drugs I've ever tried, and without a single side effect.

I've added enteric-coated Peppermint Capsules to the new IBS store, in a formulation that has not just pure peppermint oil but also ginger and fennel oil. Ginger is helpful for a wide variety of gastrointestinal ailments ranging from simple indigestion to severe nausea and cramps, it contains very powerful digestive enzymes, acts as an anti-spasmodic, helps prevent vomiting, and improves the tone of intestinal muscles. Fennel has anti-spasmodic properties and it stimulates the production of gastric juices. It's useful for gastrointestinal and menstrual cramps, diarrhea, colic, heartburn, indigestion, and stomachaches. Fennel is also exceptionally beneficial for bloating and gas, and if those symptoms are your primary concern, the new Heather's Organic Fennel Tummy Tea should be very helpful. divider Heather & Company for IBS, LLC is dedicated to serving people with Irritable Bowel Syndrome. Our mission is to provide education, support, and products that allow people with IBS to successfully manage their symptoms through lifestyle modifications.

We offer extensive information and tangible help for IBS, including the world's best-selling and best-reviewed books for the disorder. We provide the internet's top IBS web site resources; a twice-monthly IBS Newsletter; seminars and classes; dietary brochures for patient distribution by health care professionals; an IBS Research Library; and Heather Cooks!, a healthy cooking show on Seattle television. Much of our work is based on Heather's development of the first and only comprehensive IBS dietary guidelines and recipes, an achievement which has earned numerous awards and accolades as well as thousands of thank you letters from IBS sufferers.

Heather & Company also provides the only patient-expert moderated IBS Message Boards on the internet with forums for diet, recipes, hypnotherapy, yoga, plus Crohn's and Colitis. In addition, we support and coordinate the formation and continuation of local in-person IBS support groups across the USA, Canada, the UK, Australia, and New Zealand. We will soon have other IBS services and products available.

Our websites receive over 900,000 visits each year, and our newsletter is sent to over 18,000 people. Every month over one thousand new people join our email list. We are regular exhibitors at the Digestive Disease Week and American Dietetic Association conferences.

Sponsorship opportunities are available for the message boards and this newsletter for companies and/or products that have been legitimately established as helpful for digestive disorders. Please click here to contact us for information.


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LEGAL DISCLAIMER - This email is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Any application of the recommendations in this email is at the reader's discretion. Heather Van Vorous and Heather & Company for IBS, LLC are not liable for any direct or indirect claim, loss or damage resulting from use of this email and/or any web site(s) linked to/from it. Readers should consult their own physicians concerning the recommendations in this email.

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