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IBS digestive distress – is there a problem with bread?

Many people with IBS state that bread is a real issue in provoking symptoms. Is this true? What is it about bread that is the problem? This post aims to discuss the provocateurs of digestive distress in IBS (Irritable Bowel Syndrome).

Cited as sustenance – for example, the line ‘give us this day our daily bread’ in the Lord’s prayer – having access to bread was life for the poor in the past and bread is a staple food in the United Kingdom. The first piece of toast dripping in butter and a cup of tea after a period of fasting through having surgery is one time I recall, and bread was all the food I desired. How wonderful it tasted. The mouthfeel of gluten is undeniable and can be identified by those who do need to follow gluten, wheat or fructans free diet. I have identified it when I have infrequently made a mistake, as in ‘wow, this gluten-free bread tastes GREAT’ only to later realise my mistake at a cost and in fact it was the standard wheat based bread I had consumed!

The-Chemistry-of-Bread-MakingIn the past bread was made locally and bakers were part of the local community. When industrialisation arrived, bread, needed in large quantities as a staple food, soon was produced in factories, one of the possible reasons was because it was terrible work – bakers had to rise early and work hard to provide the daily loaf for their community. Is industrialisation the cause of bread symptoms? Many blame the Chorleywood bread making process and fast fermentation – but harking back to the bread of the past does not always leave a rosy glow. Adulterating food with cheap ingredients was commonplace in Victorian history, alum (aluminium salt) was added to the dough to improve it’s colour and was thought to be one cause of Rickets, by reducing the availability of phosphorus, leading to decreasing its absorption from the diet.

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So, let’s take a look at bread more closely. There are possibly a few protagonists for digestive discomfort after eating bread, and the reason may be different for individuals – we will now discuss some of those possible causes:

Resistant starch content

‘Resistant’ starch does what its name suggests – it resists digestion and is a component of fibre.  Produced by heating/cooling treatment, these resistant carbohydrates are based on wheat (and other) grains. Now for a little bit of chemistry, not too complicated, I promise. Starch is a crystalline polymer (think of a chain of a necklace containing many small beads, each small bead representing a sugar molecule, the necklace representing a polymer chain – a starch). Chains of the starch molecules closely line up on cooling, forming crystals within the bread matrix, links (imagine two or more necklace strings joined together) or bridges between the starch chains makes the structure a tightly packed area, where our digestive enzymes (amylases) can’t penetrate. The speed and repetition in cooling and heating will affect the amount of the resistance formed. Exposed to up to 20g of resistant starch per day from our diet some of the bacteria (amylolytic) in our large intestine may be able to ferment these crystalline resistant areas more successfully . IBS has alterations in the gut microbes, meaning that gut fermentation is a possible consequence and symptoms likely, in those people with IBS.

Research has shown that only certain types of bacteria are capable of digesting resistant starch of the form Bifidobacterium spp. and Clostridium butyricum but these types of study are limited. Consumption of these starches enriches the gut microbial populations with more of the microbes capable of breaking down the starch. We know that people with IBS have different populations of gut bacteria than the general public – a changing diet to improve symptoms is a possible cause of this difference.

Similar mechanism to the mechanism that causes issues from resistant starch – in other words poorly absorbed starch components causes these starches to be fermented in the large bowel resulting in symptoms when the colon is overly sensitive in IBS.

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Gluten

Gluten is a different component, and it is a protein, not a starch. Different mechanisms occur with proteins. During bread mixing initially, the gluten is softened by adding water to the flour, then kneading the bread with the salt that is added strengthens the gluten bonds gives a stretchy mixture, which traps air giving a better rise. Proteins tend to solidify when heated during baking, producing the tight structure or links between the protein molecules. Some research has found by blinding during trials that it does appear to be the fructans in wheat that result in the majority of problems for people with IBS. However is it still possible for individuals to have an issue with gluten? It does make you wonder, for those people who can tolerate all other fodmaps except wheat, whether this is, in fact, a non-coeliac gluten sensitivity. In my experience, most people following a low fodmap diet will go utterly gluten-free despite the fact that small amounts of wheat are tolerated well. Or perhaps the problem is a non-IgE wheat allergic reaction, or maybe natural toxins developed by the wheat is the problem…

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Wheat ATIs

Wheat amylase-trypsin inhibitors are proteins that are found naturally in wheat and are resistant to digestion and were developed by the plant to act as a defence against parasites and insects. They are activators of innate immunity and are suggested to lead to digestive symptoms by activating an immune reaction in the gut mucosa resulting in low levels of inflammation. Bioactivity of these proteins was found to be lower in spelt flour – often stated to be tolerated better for digestion. Is it possible that these ATI’s or gluten activate an immune response that then sensitises the colon leading to reactions to fodmaps?

The processing of wheat to produce bread, however, reduced ATI’s bioactivity up to 30-50%. But some people state bread is explicitly a problem so we should look at the manufacturing process specifically.

Chorleywood bread making process – the case for fructans?

All the above are commonly found in all wheat-based food, but bread is processed, what effects does this have? The Chorleywood process was developed in 1961 and improves production time reducing costs of bread production. This production method can also use a lower protein content flour, which was the type of flour available in the UK, to reduce costs of having to import flour with higher protein. The protein content in UK wheat has increased since this development, but this process is still used and widely disparaged as a cause of digestive distress.

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One fascinating study looked at the differences in symptoms between the general population and those with IBS and whether a longer fermentation would lead to lower gut fermentation and gas (1). Now, this study was tiny and was completed in vitro (it was not a controlled trial in human subjects, although human stool from volunteers was used) so, the conclusions would need further study. The Chorleywood process produced more gas more quickly, after simulated digestion. The more prolonged fermentation process also led to a higher level of bifidobacteria in the stool, the levels of these microbes are reduced in IBS. Bifidobacteria also produce less fermentation in the gut, suggesting increasing numbers compared with others may help reduce symptoms.

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So, the combination of less gas delivered more slowly and increasing commensal bacteria that produce less gas anyway, was suggested to equal better tolerance, which is perhaps a leap of faith to suggest that this reduction will reduce symptoms without it being tested in humans. Voila, testing in humans has been done (2)! A more extensive study in humans also looked at Chorleywood process compared with sourdough and showed that a more extended fermentation leads to the breakdown of ATI components and reduced fodmap levels BUT NO DIFFERENCE IN SYMPTOMS OF IBS. Both studies used constipated volunteers, so no difference there, the symptom production in the second study was reported to possibly be a nocebo effect – expecting symptoms due to previous experience. Which is possible, six slices per day is a considerable amount to consume for people who have an intolerance to wheat. Diet was excluded as a confounding factor but what is not clear is how the bread was eaten and whether this was different in the two groups – toasted, fresh, or frozen, perhaps taking us back to resistant starches? Also, about a third of people with constipation based IBS will have pelvic floor dyssynergia, which in theory could elicit symptoms that might not necessarily be helped by changes in the diet, if symptoms are severe. Both these studies were pilot studies and need further investigation on a broader population of people with IBS.

Yeast

For many people with IBS yeast is anecdotally reported to result in symptoms. We do not have any evidence that this is a problem and this has been dismissed by the medical establishment as a cause. No evidence means precisely that, we don’t know, so would it be an issue? Saccharomyces cerevisiae, a yeast, has been studied in improving IBS symptoms, so we have another situation of modulating the gut microbiota to improve symptoms. While we have absolutely no evidence that a low yeast diet is useful, in IBS treatment, it might lead to altering the microbiome and should not be advised, but this is an area indeed worthy of further study.

I think in conclusion, symptom inducement in IBS with bread is complicated and needs further study – with this detail of research required for one food item – is it any wonder that we have not got a cure for this medical condition?

  1. Adele Costabile, Sara Santarelli, Sandrine P. Claus, Jeremy Sanderson, Barry N. Hudspith, Jonathan Brostoff Alison Lovegrove, P R. Shewry, Hannah E. Jones, Andrew M. Whitley, Glenn R. Gibson (2014) Effect of Breadmaking Process on In Vitro Gut Microbiota Parameters in Irritable Bowel Syndrome PLOS one Volume 9 Issue 10 e111225
  2. Laatikainen R, Koskenpato J, Hongisto SM, Loponen J, Poussa T, Huang X, Sontag-Strohm T, Salmenkari H, Korpela R (2017) Pilot Study: Comparison of Sourdough Wheat Bread and Yeast-Fermented Wheat Bread in Individuals with Wheat Sensitivity and Irritable Bowel Syndrome. Nutrients. 2017 Nov 4;9(11). pii: E1215. doi: 10.3390/nu9111215.

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Homeopathic Medicines – Are There Any Risks Using Them?

If you were to try to compile a list of all the homeopathic medicines that have been used throughout history, then your fingers would need a homeopathy treatment for arthritis or carpal tunnel syndrome before you were all done. Hundreds of different books have been written and published in the last hundred years alone. That does not take into account all of the homeopathic practitioners’ notes or special solutions that they have developed themselves. But for the sake of knowing what you are dealing with, here are a few of the ones that you definitely should pay attention to before taking.

A look at the ingredient list for many homeopathic medicines from the past may have you running for the bathroom. It was not uncommon for a remedies homeopathy to contain questionable ingredients, such as blood, tissue, respiratory discharge, urine and even fecal matter. Yes, that may be disgusting but you do have to remember that these treatments are diluted down so much that almost nothing of the original substances remained. Considering some of the more dangerous substances, this is a good thing.

Take for example Lachesis Muta, or more commonly known as the Bushmaster snake. This snake is one of the largest pit vipers in the world. And it is deadly. But homeopaths use the venom diluted down by water and/or alcohol to use for a variety of cures. It might seem dangerous but properly prepared, there is really nothing left of the venom in the final solution except the “essence.” It is probably far more dangerous to try and collect the venom than to use it as a homeopathic medicine.

Another great example is belladonna. The substance used is called Astropa belladonna and it is used to cure high fevers that come with redness, except that belladonna is part of the deadly nightshade plant family. A little belladonna can even act as a sleeping potion. Too much can cause death. So as you can see, though homeopathy medicine is for the most part harmless, it does come with a little risk if you do not know who prepared the solution.

Are you likely to die from homeopathic medicines made from toxic materials? The chances are pretty slim because the solution has been diluted down thousands of times. But it is good to know what you are ingesting or using when it comes to homeopathic medicine and cures. The more knowledgeable you are aware of about your treatment, the better off you will be. Visit a book store to find the latest homeopathic books.

A free homeopathic doctor audio gift awaits you at Mike Selvon portal site, where you can enrich your knowledge further about the homeopathic medicines.

More Homeopathic Remedies For Eczema Articles

Sebborheic Dermatitis: Is There Any Cure at All?

Seborrheic dermatitis – it is defined as a skin condition classified under eczema wherein the old glands are affected. Commonly, this is a disease wherein the old gland is not able to produce sufficient amount to moisturize the skin, thus causing dry skin. This is disease can be commonly seen in the scalp. Have you ever seen people with very dry scalp wherein flakes started to appear? Most often, dandruff is the first signs of seborrheic dermatitis, and then it gradually turns into this particular disease.

With seborrheic dermatitis, the glands that are produced are yellowish and pus like instead of the normal oil that moisturizes the skin, most particularly the scalp. If you have been experiencing this kind of problem, this simply means that your body has more toxins, and that the toxins are being released through the skin. This is the reason why some people have this particular type of disease. Lifestyle and the food you eat may also be a contributing factor on why you are getting this particular type of skin disease.

Thus, if you have noticed that you are already carrying the signs and symptoms of a person with seborrheic dermatitis, it is important for you to know and understand the things that you must do in order to treat them – or if you haven’t experienced this yet, better yet you have to know the things to do in order to avoid them

One of the best things that must be accomplished is the change of diet and lifestyle. Since seborrheic dermatitis is caused by the toxins inside the body, you must be cautious about the food that you eat. Don’t eat too much fat, or take too much food that only includes junk substances and ingredients. Remember, that eating healthy is one of the best precautions and the best treatment in any particular form of eczema, including seborrheic dermatitis. The intake of essential vitamins, minerals and even fiber is strongly recommended. Of course, trim down the intake of fats and sugar that can even worsen the production of your oil glands in your body. If you really want to avoid these kinds of situations, you must first work towards getting used to eating healthy foods and working on your healthy lifestyle both at the same time.

Another important thing that you could always consider to avoid or prevent suborrheic dermatitis is to replenish your vitamin E and intake of fatty acids. Although some situations can be treated and corrected by merely eating the right diet, there are some worse cases of seborrheic dermatitis wherein medical treatment and help is required. Don’t worry, if you are someone who have had been suffering this for quite some time, there are products in the market and people that can help you most when it comes to situations like these.

Taking and using these types of products will help you recover those oil production that you have missed for quite some time, and help you restore the original circulation of the oil glands in your skin. Do not be ashamed to ask for professional help. This must be taken care of as soon as you have discovered it.

Seborrheic dermatitis is a disease that thousands of people have been suffering. If you are someone or if you know an individual suffering with this particular type of disease, it is important that it should be treated as soon as possible. We are here to help you out.

Why there will be no cure for eczema for at least 25 years

In a previous post, I made the Eeyore-like prediction that we are unlikely to see a cure for eczema during my lifetime, which means the next 40 years.

Upon reflection, I have become more optimistic: now I only think we might have 25 years to wait.

Several factors combine to make this so: our incomplete understanding of eczema; the ratchet-like course of the disease; its allergic component; and the expense and inertia of drug development.

As currently understood, eczema is initially a defective skin barrier that lets in allergens. In the first few years of life, children develop antibodies that protect them from disease over their lifetime. The defective barrier overstimulates this part of the immune system, and children build the capacity for allergic reactions to common things in the environment that most people don’t react to—pollen and foods for example.

The allergies get locked in. What may originally have been a leaky skin barrier now gets connected to allergies and inflammation.

In recent years scientists have discovered a number of genetic defects in various components of the skin barrier—the super-protein filaggrin, in particular. I can understand that the average patient must have the impression that with this genetic data is coming in, all that scientists have to do is develop targeted drugs to solve the defects. Or gene therapy to replace the bad genes. Surely these are on the horizon?

Here’s why they aren’t. Let’s start with gene therapy. Only one gene therapeutic has been approved anywhere in the world. The European Commission gave permission for Glybera to be used to treat a rare metabolic disease. Gene therapy is most famous in the US for the 1999 death of a teenager who signed up for a risky clinical trial. It is unlikely that over the next few decades we’ll see gene therapies emerge for anything but rare, fatal, incurable diseases. Eczema doesn’t qualify—and even if you could fix the skin barrier by gene therapy, you’d have to act within the first few months of life. What parent would let doctors give their newborn a potentially lethal treatment based only on the likelihood that the kid might grow up to have eczema?

Another possibility is RNA interference, a technique that blocks the conversion of genetic information into protein. RNAi was discovered sometime in the past two decades and recently the FDA approved the very first RNAi therapeutic, for a rare metabolic disease. To treat eczema, RNAi might be used to cut down on the amount of inflammatory molecules produced in the body or in the skin. A number of academic laboratories–I am aware of a couple in Japan–are looking at RNAi for eczema. However, there are no therapies anywhere near a clinical trial, and new “drugs” in this field would face even steeper regulatory hurdles than conventional drugs. Conversely, the reason to get excited about RNAi is that in theory it could allow us to choose which inflammatory molecules to turn off (rather than shutting down most of the immune system, as steroids do).

Now, let’s consider traditional drug discovery. Research does show that filaggrin defects are found in up to 50% of patients with severe eczema. (Naturally, there are apparently unaffected people who have filaggrin defects, as well as eczema patients who do not.)

So you’re going to develop some drug to target filaggrin? Irwin McLean, the filaggrin expert, says that targeting filaggrin could have a big payoff. But he admits that little is known about how the filaggrin gene is turned on or off. Eventually we will know, and perhaps that knowledge will suggest what drug might work.

The question is how a drug might fix or compensate for the defect. [See the comments for a couple possibilities.] And if we eventually find a drug that can correct for a single or double filaggrin mutation, there is still the question of how much benefit that will provide if a patient has already developed allergies.

Drugs are just not custom-designed—that is currently a pipe dream. Drug discovery is time-consuming and costly. It takes $ 1 billion and 15 years of trials to get a drug approved by the FDA. Scientists start with the protein of interest. Then they screen gigantic libraries of drugs to see if any of them affect the protein in useful ways. They tweak those initial “lead” compounds to make them better.

Then they file an application for a new drug. Then they proceed to animal trials: mice, rats, dogs, pigs, chimps. Then human trials—phase 1, 2, 3, 4. At any stage, and if you’re lucky it’s the early going, it can become apparent that your drug is ineffective or toxic.

And here’s another factor: many proteins are just not “druggable” for various reasons. Because of the shape of the molecule or the way it interacts with something else, tiny drug molecules can’t get to the active site; or they get in but can’t get out. Etc.

It is extremely difficult to develop new drugs.

Also, in the past few years the pharmaceutical industry has been in a slow-motion crash. Big companies are laying off scientists because a lot of the original big moneymaking drugs are coming off-patent and not generating enough income for R&D anymore.

Add to this the fact that there’s hardly anything in the pipeline for atopic dermatitis. I know Anacor has two candidates in Phase II trials—new topical anti-inflammatories. Great,  but hardly revolutionary. Regeneron has something interesting going: dupilumab, a monoclonal anti-IL4 antibody. It’s in Phase I.

Venture capital won’t even invest in startup companies unless their technology has passed Phase II.

You can understand my pessimism.

Next: why I might be wrong
End Eczema

Soya allergy and guar gum – is there a connection?

If you are allergic to soya you should take a very hard look at anything containing guar gum. This is something I’ve never come across from any doctor or allergy specialist so I’ve never worried about it before. However, if you examine ingredient lists from many freefrom foods, guar gum is often present.

So what does it do and what is guar gum?

Guar gum, also called guaran, is a galactomannan. It is primarily the ground endosperm of guar beans. The guar seeds are dehusked, milled and screened to obtain the guar gum.[1] It is typically produced as a free-flowing, off-white powder. (Wiki)

It increases yield in baked goods and also helps thicken dairy products but it’s uses are not just limited to food, though typically they are most widely used in gluten free goods. Guar gum is also used in the paper, explosives, pharmaceutical and cosmetics industries, to name just a few.

Why on earth are we eating this stuff?

But I’ll get to the point. The point that guar gum can contain traces of soya protein.

The Super Healthy Children website says, “Because guar gum may contain traces of soy proteins, eating it can lead to an allergic reaction. Symptoms may include vomiting, nausea, diarrhea, cramping, runny nose, nasal congestion, shortness of breath, wheezing, coughing, chest tightness, hives or skin rashes. A severe and possibly life-threatening reaction of anaphylaxis could occur in rare cases with the consumption of soy proteins.”

Well… I’m speechless.

I’ve been having random and unexplainable, albeit mild but still worrying allergic reactions now so could guar gum be the culprit? It still might not be the guar gum but I’m suspicious and Mr What Allergy discovered this link whilst googling the problem.

I was eating a Coconut Collaborative Dark Chocolate Snowconut Stick and my throat began to itch and tingle. It didn’t progress from there but if you have ever had anaphylaxis, this is where it begins. I felt a very slight shortness of breath and the sypmtoms lasted for quite some time. So we checked the ingredients. Nothing in there that I was worried about…

Ingredients: Coconut Cream (32%), Water, Grape Juice Concentrate, Chocolate (17.2%) (Cocoa Mass, Coconut Sugar, Cocoa Butter), Inulin (from Chicory), Natural Flavour (1%), Vegetable Emulsifier: Mono & Diglycerides of Fatty Acids, Stabiliser: Guar Gum, Locust Bean Gum, Vanilla Pod (1%)

Coconut Collaboratives Snow Coconut sticks and soya allergy
I had ignored the ‘may contain soya’ warning, thinking it was probably from the chocolate and soya lecithin which is not such a problem for those allergic to soya. But no… it would seem it was a very valid warning.

I have eaten their yogurts no problem and if you look at the ingredients for them they contain corn flour instead of guar gum. So just consider, because one product from a company is OK doesn’t mean they all will be.

Mr What Allergy has kindly and happily eaten the other two, proclaiming them to be just as good as any ‘normal’ ice cream on a stick. He is somewhat of a connoisseur in this field so this is high praise.

And since I am now on a mission to ‘cut out processed food’, he has helped me by removing any temptation to try another one.

So watch out for anything with guar gum if you have a soya allergy and also heed warnings on packs.

Has anyone else experience a reaction from guar gum? or from these choc ices? Where does the risk of soya come from in this product. I have sent an email to the people at Coconut Collaboratives to find out.

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