Gas

man holding his gassy upset stomach

The TMI Zone: Can Gas Hurt You?

Gas is one of those “TMI zone” issues people deal with every day.

It’s just part of the human condition. Everyone “emits” gas anywhere from 14-20 times a day. For the most part, it’s no big deal…

Recently, I had a reader ask me what would happen if he tried to hold onto his gas for an extended time at work when he couldn’t take a break, especially if his excessive gas was typically smelly. (You were warned this was a “TMI zone!”)

It’s not an unusual question!

Not surprisingly, this is a very common and stinky problem people search on Google for guidance, especially in the workplace.

In fact, a federal employee working for the Social Security Administration was reprimanded by his manager for excessive gas emissions that created a “hostile work environment” in his office.

Hostile sounds pretty appropriate, given 60 episodes were documented over 17 days in a story that made national headlines several years ago.

The real health issues

Some believe holding back on gas could create its own set of health issues. Fact is, excessive gas, as experienced by this federal employee, could be a sign that diverticulitis could be a problem too.

That extra gas may be creating other issues, like problems with your stools (a lack of consistency or the presence of blood), a change in the frequency of your bowel movements and even nausea and vomiting.

And, it could also be a warning sign that gastroesophageal reflux disease (GERD) or acid reflux are real problems that must be dealt with right away.

What can you do?

So, if holding back isn’t a great solution, how do you reduce intestinal gas?

For starters, you may have heard about FODMAPs, the kinds of carbohydrates contained in some dairy products, fruits and vegetables, sweeteners, legumes and wheat.

Some people have a harder time tolerating these kinds of carbs which creates the opportunity for more gas, so you’ll want to work with your doctor on a healthier, less gassy diet that’s better for you.

SLOW DOWN when you’re drinking fluids and eating meals, especially big ones.

That may also mean cutting back on consuming so many sugary sweet carbonated drinks, including diet beverages made with artificial sweeteners that harm your gut health in many other ways.

Are you having a hard time tracking what you’re eating in your head on a daily basis? Maintaining a food diary on paper (here’s a free worksheet from the National Institutes of Health) or on your cell phone is an easy way to stay on the right side of good health.

A simple solution for this “TMI Zone” issue of extra stomach gas: Take a probiotic made with 10 species and 20 billion CFUs of beneficial bacteria and a prebiotic that feeds the good bacteria in your gut like EndoMune Advanced Probiotic.

someone holding hot water bottle

An Expert’s Take on Dealing with Gas

Out of the many gut-related issues patients have discussed with me over the years, problems with excess air and gas resulting in bloating, a sensation of fullness in your abdomen, are the most common by a long shot.

Just to make it really clear, EVERYONE produces gas — anywhere from 1-4 pints daily and passes it about 14 times a day — and it can build up in your gastrointestinal tract.

But how does this common issue go from an occasional embarrassment to a more serious health issue?

The GI tract

There’s a number of reasons why patients may have problems, and some may have more to do with the upper digestive tract and swallowing too much air, creating belching or bloating. In fact, this extra air may never reach the stomach or lower GI tract at all.

Much of it builds up in the esophagus, especially if patients are overdoing it on certain foods or they smoke, chew gum or drink and eat too fast.

Because most of these causes are obvious signs of the body reacting badly to a more stressful go-go-GO! lifestyle, we’ve got some simple solutions that could help.

More symptoms

Some signs that extra air and gas may be a real problem, however, are when patients begin experiencing symptoms of acid reflux (the backward flow of stomach acid to the esophagus), gastroesophageal reflux disease (GERD), a more severe form of acid reflux in which frequent heartburn is common, or an H. pylori infection in the stomach.

(Most people assume GERD and acid reflux are the same thing, but medical experts see them as slightly different health problems, according to the Mayo Clinic.)

And, for patients who have experienced a dramatic change in weight loss or gains, a hernia, any abdominal surgery or changes in the frequency or color of their stools (or see blood in them), you should visit your family physician for more guidance.

Minor challenges, easy solutions

Fortunately, the large majority of our symptoms will be minor inconveniences or embarrassing, at worst, in the moment. Here are some simple ways to treat bloating, belching or excess gas you may want to try first.

  1. Spend a little more time eating meals or drinking fluids. The more you rush, the more opportunities you have to swallow air that comes back in uncomfortable and embarrassing ways.
  2. Limit your intake of high-fiber foods (like broccoli, beans and onions) and fatty foods for a short time. After your symptoms lessen, try re-introducing those foods, and pay close attention to which ones give you trouble.
  3. Reduce your intake of carbonated drinks and foods that use sugar alcohol substitutes like sorbitol. Consuming fizzy drinks or chewing gum sweetened by sorbitol or xylitol just adds to your gas problems.
  4. Are you doing any exercise? Think about taking a short walk after your meals.
  5. Consider taking a probiotic. A healthy solution like EndoMune Advanced Probiotic — containing multiple species of beneficial bacteria — is a good way to restore the healthy balance of bacteria in your gut.

Taking a probiotic is important considering carbohydrates can be poorly absorbed by the gut, creating imbalances in your gut bacteria.

Also, multi-strain probiotics like EndoMune offer the extra benefit of treating constipation, another way food waste gets trapped in the colon and creates opportunities for excess gas to escape when you least expect it.

Probiotics can improve hypertension

Study after study shows that probiotics help treat gastrointestinal issues including IBS, diarrhea, gas and constipation. However, the benefits aren’t confined to digestive health.

Recent studies are also proving that probiotics can improve hypertension, more commonly known as high blood pressure. Primarily caused by environmental factors such as salt intake, minimal exercise, weight gain and high cholesterol due to bad diet, high blood pressure is a major risk factor for stroke, heart attacks and heart failure.

The International Journal of Molecular Science published a review on various studies conducted on how probiotics improved hypertension, particularly the effects on cholesterol and diabetes. Among their conclusions, researchers proved that probiotics could reduce the amount of cholesterol, thus decreasing the chance of high blood pressure. Additionally, probiotics provide a safe alternative treatment to drugs or hormone therapy, with milder or no known side effects.

Probiotics not only treat digestion problems, but they also help lower your risk for hypertension. Add a daily probiotic like EndoMune Advanced Probiotic to your diet to improve your chances for a healthier life.

Bloating: Can We Talk About Gas?

Bloating (Intestinal gas) is a very common problem in the general population and is a frequent reason why people seek medical attention. Passage of intestinal gas is viewed differently depending your age and gender.

Kids make lots of jokes and take pride in telling someone to “pull my finger.” Boys grow up to be men who believe passing flatus is not rude or embarrassing and like to use phrases like “whoever smelt it dealt it” or “whoever denied it supplied it.”

Females would like to deny that intestinal gas exists and will try to hold it to avoid any embarrassment. This practice can certainly lead to increased intestinal symptoms of bloating, distention, and discomfort.

One of the most common symptoms leading individuals to seek gastrointestinal evaluation is “gas.” They are convinced that excess gas is the cause of their abdominal bloating and distention. In addition, they believe that the need to belch and expel flatus is also due to an excess production of gas.

There have been many studies evaluating the above mentioned symptoms and results are rather surprising.

BELCHING

Belching is due to swallowing excess air. It is not due to increased intestinal or gastric production.

We all swallow some air when we eat or drink especially carbonated beverages. But people who complain of needing to belch frequently usually have developed an air-swallowing habit. This usually occurs for one of two reasons:

  • Sometimes people swallow excess air to ease symptoms due to heartburn or ulcers. Easing these symptoms with acid suppressive medications may lessen the desire to swallow air.
  • The other reason for chronic belching is due to an unconscious way of dealing with stress or anxiety. For these individuals, making them aware of their excess air swallowing can sometimes be helpful.

BLOATING AND DISTENTION

When people experience the discomfort of abdominal bloating and distention, they believe it is due to excess gas production in the intestines.

Studies have determined that people who have symptoms of bloating have no more intestinal gas than normal people1. The cause of the symptoms has been attributed to “visceral hypersensitivity.”

Visceral hypersensitivity is a term used to describe the heightened level of intestinal discomfort that individuals experience due to normal intestinal activity.

Research studies have found that when air is instilled into the intestines of individuals with visceral hypersensitivity, they experience symptoms of bloating and distention while the normal group notices no discomfort.2

Visceral hypersensitivity has been thought to be part of the syndrome of Irritable Bowel Syndrome(IBS). Historically, this syndrome has been attributed to psychological disorders. However, recent observations have noted that up to 30% of individuals who experience an episode of infectious diarrhea develop post infectious IBS symptoms3. One of the most prominent symptoms of IBS is bloating.

The current thinking is that an intestinal infection disrupts the healthy intestinal bacterial flora resulting in an immune response that leads to chronic low-grade inflammation. The inflammation then causes visceral hypersensitivity.

Recent studies using probiotics to re-establish the normal intestinal bacterial flora have been successful in down regulating the inflammation and easing the symptoms of bloating.4,5

FLATULENCE

Here are some interesting facts you can share with your friends, about flatulence:

  • Passage of gas or flatus is normal. Generally, healthy people pass 8-25 ounces daily. Frequency is 10-20 passages/day.

 

  • Gas is produced by intestinal bacteria primarily located in the colon.

 

  • The amount gas produced is determined by three factors:
  1. The amount and type of carbohydrates consumed
  2. The amount and types of intestinal bacteria present
  3. The ability of the small intestines to digest and absorb the carbohydrates

 

  • Two common causes of excess flatulence are:
  1. poor digestion of the sugar lactose in dairy products;
  2. limited absorption of fructose which is a sugar found in soft drinks and certain fruits like apples and bananas.

 

  • Some vegetables have starches that are only partially absorbed. The nonabsorbed starches pass into the colon and contribute to excess flatus production. Beans, brussel sprouts, carrots, onions and celery are the major offenders.

 

  • The carbohydrates in bread and pasta can be a problem for some people. Recently, there has been a lot written about “gluten sensitivity.” Avoiding the grains of wheat, barley, and rye can help some people lessen the production of excess flatus.

 

  • Colonic bacteria normally generate intestinal gas through fermentation of the carbohydrates that escaped absorption in the small intestines. An imbalance in the gut bacterial flora may result in excessive gas formation. Some bacterial groups are more prone to gas production than others. Hence, improving the bacterial balance with a probiotic may improve gas-related symptoms.8

Take Home Message

If you are experiencing symptoms of bloating, distention, or increased flatus, consider taking a high quality probiotic like EndoMune.

In addition, you may want to modify your diet by avoiding foods that contribute to flatulence. It is always wise to check with your doctor if your symptoms persist.

Eat healthy, exercise and live well!!!

Best Wishes,

Dr. Hoberman

Foods that may cause gas include:*

  • Beans
  • Vegetables, such as broccoli, cabbage, brussels sprouts, onions, artichokes, and asparagus
  • Fruits, such as pears, apples, bananas and peaches
  • Whole grains, such as whole wheat and bran
  • Soft drinks and fruit drinks
  • Milk and milk products, such as cheese and ice cream, and packaged foods prepared with lactose, such as bread, cereal, and salad dressing
  • Foods containing sorbitol, such as dietetic foods and sugar-free candies and gums

References

*National Digestive Diseases Information Clearinghouse
Gas in the Digestive Tract

http://digestive.niddk.nih.gov/ddiseases/pubs/gas/

1) An understanding of excessive intestinal gas.
Suarez FL, Levitt MD.Curr Gastroenterol Rep. 2000 Oct;2(5):413-9. Review.

2) J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:119-21. doi: 10.1111/j.1440-1746.2011.06640.x.Visceral hypersensitivity in irritable bowel syndrome.
Kanazawa M, Hongo M, Fukudo S

3) Incidence of post-infectious irritable bowel syndrome and functional intestinal disorders following a water-borne viral gastroenteritis outbreak.Zanini B, Ricci C, Bandera F, Caselani F, Magni A, Laronga AM, Lanzini A; San Felice del Benaco Study Investigators.Am J Gastroenterol. 2012 Jun;107(6):891-9. doi: 10.1038/ajg.2012.102. Epub 2012 Apr 24.

4) The putative role of the intestinal microbiota in the irritable bowel syndrome.
Collins SM, Denou E, Verdu EF, Bercik P.Dig Liver Dis. 2009 Dec;41(12):850-3

5) Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study.
Ringel-Kulka T, Palsson OS, Maier D, Carroll I, Galanko JA, Leyer G, Ringel Y.
J Clin Gastroenterol. 2011 Jul;45(6):518-25.

6) Non-Celiac Wheat Sensitivity Diagnosed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity.Carroccio A, Mansueto P, Iacono G, Soresi M, D’Alcamo A, Cavataio F, Brusca I, Florena AM, Ambrosiano G, Seidita A, Pirrone G, Rini GB.Am J Gastroenterol. 2012 Jul 24. doi: 10.1038/ajg.2012.236.

7) Review article: the treatment of functional abdominal bloating and distension.Schmulson M, Chang L.Aliment Pharmacol Ther. 2011 May;33(10):1071-86. doi: 10.1111/j.1365-2036.2011.04637.x. Epub 2011 Mar 29. Review.

Probiotics are Effective Treatment for Pediatric IBS

If you’re a parent, then you are probably familiar with the phrase, “My stomach hurts!”

This is often a self limited problem, but some children do experience recurrent abdominal pain which is often diagnosed as Irritable Bowel Syndrome (IBS).

A recently published study examined the benefits of probiotics for alleviating the symptoms of IBS in children(1). IBS is a common problem in pediatrics, and no safe and effective treatment has been available up until now(2).

Suspected Causes of IBS

The symptoms of abdominal bloating, gas, pain and change in stools are very common in both children and adults. Once appropriate tests have ruled out any underlying disorder like ulcers, colitis, or celiac disease, the diagnosis is often IBS.

Between 5 to 20% of kids have IBS, and about one in five adults do, too. It’s not fun, but the good news is that IBS doesn’t lead to more serious problems. It is more about quality of life for the child and the family.

Since the cause is not really known, and the symptoms can vary, IBS can be hard to treat.

Over the years a variety of theories have been offered to explain IBS symptoms in children. These have included emotional stress, intestinal hypersensitivity, altered intestinal motility, dietary intolerances and genetics(3,4).

In the last several years there has been a shift in the paradigm, and now alterations in the intestinal bacteria are thought to be a major factor leading to IBS.

We are all familiar with the term “food poisoning” — a bout of infectious diarrhea due to the consumption of harmful bacteria in contaminated foods or drinks.

Researchers in the area of IBS noted that many of the people who developed symptoms of IBS had experienced a recent episode of food poisoning(5). It was theorized that the infection caused a disruption of the healthy intestinal bacteria resulting in ongoing intestinal inflammation and GI symptoms(6).

Recent studies have supported this association and identified post-infectious irritable bowel syndrome (PI-IBS) as a disorder due to a previous bout of  infectious gastroenteritis. Approximately 30% of individuals with IBS can date the onset of their symptoms following an episode of gastroenteritis(7).

Pediatric Medical Studies

In February of this year, a study(8) was published that documented for the first time that exposure to acute gastroenteritis in childhood is associated with an increased risk of IBS in early adulthood. There was an outbreak of infectious gastroenteritis due to drinking contaminated city water. Children were followed for 8 years after the exposure. The children who had a bout of gastroenteritis had a greater than fourfold increase in IBS compared with unexposed children.

This now brings us back to the new medical article that I mentioned at the beginning of this newsletter. The study(1) enrolled children 4 to 18 years of age who fulfilled the criteria for IBS. The children received a probiotic or a placebo. A daily record of their symptoms was maintained. At the end of the study, the results were reviewed.

The group receiving probiotics had a better than 50% improvement in their symptoms of abdominal pain, and bloating compared to the placebo group.  There was also an improvement in the passage of stools. Additionally, no adverse effects were noted in the group taking probiotics.

In 2008, a review article(2) on medications to ease the symptoms of IBS in children stated, “The lack of clear evidence of effectiveness for any of the recommended drugs suggests that there is little reason for their use outside of clinical trials.” The new study on childhood IBS, though, does show that probiotics are effective.

Take Home Message

If your child has IBS, probiotics may help to ease their symptoms. Fortunately, there have been no adverse effects associated with their use. Consider using EndoMune Jr for children less than 8 years of age and EndoMune Advanced for older children. It won’t hurt, and it certainly may help!

Eat healthy, exercise and live well!
Dr. Hoberman

(1) VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study.Guandalini S, Magazzù G, Chiaro A, La Balestra V, Di Nardo G, Gopalan S, Sibal A, Romano C, Canani RB, Lionetti P, Setty M.J Pediatr Gastroenterol Nutr. 2010 Jul;51(1):24-30.

(2) Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood.Huertas-Ceballos ALogan SBennett CMacarthur CCochrane Database Syst Rev. 2008 Jan 23;(1).

(3) Irritable bowel syndrome: epidemiology, diagnosis and treatment: an update for health-care practitioners.Grundmann O, Yoon SL.J Gastroenterol Hepatol. 2010 Apr;25(4):691-9. Epub 2010 Jan 13.

(4) Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions.Ohman L, Simrén M.Nat Rev Gastroenterol Hepatol. 2010 Mar;7(3):163-73. Epub 2010 Jan 26. Review.

(5) The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases.CHAUDHARY NA, TRUELOVE SC. Q J Med. 1962 Jul;31:307-22.

(6) Bacillary dysentery as a causative factor of irritable bowel syndrome and its pathogenesis . Wang LH , Fang XC , Pan GZ . Gut 2004 ; 53 : 1096 – 101.

(7) Postinfectious irritable bowel syndrome–a meta-analysis.Halvorson HASchlett CDRiddle MS.Am J Gastroenterol. 2006 Aug;101(8):1894-9; quiz 1942.

(8) An Outbreak of Acute Bacterial Gastroenteritis Is Associated With an Increased Incidence of Irritable Bowel Syndrome in Children Marroon Thabane, Marko Simunovic, Noori Akhtar-Danesh, Amit X Garg, William F Clark, Stephen M Collins, Marina Salvadori, John K Marshall The American Journal of Gastroenterology 105, 933-939 (23 February 2010).

 

What Causes Gas – Is it a Normal Occurence?

All humans have gas in their gastrointestinal tract. The type of food, and beverages consumed and whether the individual smokes or chews gum will have a significant impact on the amount of gas produced and passed. Carbonated beverages will increase intestinal gas. Eating a healthy diet of fruits, vegetables and high fiber grains increases intestinal gas formation.

Dependent upon how it is measured, the gas in the intestinal tract varies from 3 to 6 ounces. The average adult produces 16 to 48 ounces of intestinal gas resulting in about 14 to 23 gas passages/day.

  • Complex Carbohydrates: The human intestinal tract can’t digest some of the complex carbohydrates in vegetables, fruits and whole grain products. These carbohydrates pass through the small intestines into the colon where they are fermented by gas producing bacteria. Hydrogen, carbon dioxide and methane are the main gases produced. Depending on the diet and the intestinal microflora, the amount of gas produced and expelled will vary from individual to individual. The strong odor sometimes associated with intestinal gas is due to the very small production of sulfide gases which is dependent on diet and intestinal bacteria.
  • Lactose is a sugar in dairy products which must be broken down to a simpler form to be absorbed by the intestines. Thirty to 50 million Americans develop lactose intolerance beginning after the age of 2. It is a common problem in the Asian, African American, American Indian, Hispanic, and Eastern European Jewish populations. Undigested lactose prevents fluid absorption and the sugar is fermented by the bacteria in the colon which results in increased intestinal gas and at times, diarrhea. The main form of therapy is to avoid lactose containing foods.
  • Fructose: Another dietary sugar that can cause excessive gas, bloating and loose stools is fructose. Fruits that are high in fructose include apples, apricots, pears, cherries, plums, prunes and peaches (as well as their juices). It is also a used as sweetener in soft drinks and other products. The small intestine has a limited ability to absorb dietary fructose. If it is exceeded, fructose will be fermented in the colon leading to excess gas formation.
  • Sorbitol is found naturally in fruits, including apples, pears, peaches, and prunes. It is also used as an artificial sweetener in many dietetic foods and sugar free candies and gums. Sorbitol is not well absorbed by the small intestines. Excess intake will also lead to bloating, gas, and diarrhea.

Studies have found that some individuals with symptoms of bloating and distention may be more sensitive to the amount of gas and fluid in the intestines. Some may have slow intestinal motility leading more fluid and gas in the intestines.

Having the right balance of bacteria in the intestines can be important to lessen the symptoms of bloating, distention and gas.

Probiotics, containing bacterial strains similar to those in Endomune have been studied and utilized to help lessen these symptoms. There have been positive results in many of the studies. There are no effective prescription medications to alleviate excess gas formation. One of the nice aspects of probiotics is the fact that they are safe and without significant side effects. Given the positive studies, taking Endomune may improve the digestion and absorption of the complex and simple carbohydrates.

How Probiotics Can Aid IBS Sufferers

I have spent a lot of time talking with physicians, pharmacists, and patients about the benefits of probiotics. The one topic that comes up most frequently is how probiotics can aid individuals who suffer with Irritable Bowel Syndrome (IBS).

IBS affects up to one in five Americans. Second only to the common cold as a leading cause of workplace absenteeism in the U.S., IBS costs the U.S. healthcare system up to an estimated $30 billion annually in direct and indirect costs.

Medical Presciptions for IBS

When I first went into gastroenterology, the understanding of IBS was very limited. It was generally thought that the symptoms of bloating, gas, diarrhea, and constipation were most likely related to stress. If the intestinal symptoms were manifestation of the stress, then controlling the stress would alleviate the problem. Commonly prescribed therapies included tranquilizers like Librium and phenobarbitol, and antidepressants like Elavil and Aventyl, which were then combined with other drugs – antispasmotics – that affected the nerves that go to the GI tract.  The typical drug armament included such medications as Librax, Bentyl, Levsin and Donnatal. They were relatively safe, but did have side effects of dry mouth and sedation.

Other longtime therapies have included fiber type products that increase stool bulk, like Metamucil and Fibercon.

More recently, drugs that interact with serotonin receptors in the GI tract have been developed. Serotonin is a neurotransmitter that is primarily found in the gastrointestinal tract and in the brain. Serotonin increases intestinal motility, probably by stimulation of 5-HT4 and 5-HT3 receptors. Two prescription medications that interact with the serotonin receptors were developed and approved by the FDA.

Zelnorm, approved by the FDA in 2002, eases constipation by stimulating the 5HT4 serotonin receptor.  It was withdrawn from the market in 2007 due to serious adverse effects on the blood supply to the intestines.

Lotronex was approved by the FDA in 2000 for women with severe diarrhea-predominant irritable bowel syndrome. Lotronex blocks the 5HT3 serotonin receptor. It is called a 5HT3 antagonist. Clinical studies showed only a 15-20% improvement in diarrhea symptoms in patients taking Lotronex versus placebo.  There have been serious adverse effects associated with this medication. Overall, Lotronex has very limited use in treating IBS patients.

A major concern with prescribing prescription medications is adverse drug interactions. Most medications are metabolized and eliminated by the liver. In the liver there are enzymes that can modify and eliminate drugs. The blood level of a specific medication can be increased or decreased by a second drug’s effect on the liver enzymes. The second medication can induce or inhibit the enzyme system resulting in elevated or reduced blood levels of the first drug. Changing the blood level of a medication can cause significant adverse drug reactions.

What About Probiotics for IBS Sufferers?

Here is the good news with regard to probiotics:

  1. Probiotics are safe and not associated with any severe adverse effects in healthy individuals.
  2. There are no drug interactions with other medications.
  3. Studies have shown that probiotics can alleviate symptoms of IBS.

Two recent reports(1, 2) reviewed the available studies using probiotics to treat symptoms of IBS. Both reports concluded that probiotics appear to be efficacious in IBS but the magnitude of the benefit and the most effective species and strains are uncertain. This means that probiotics show statistical significance in reducing IBS symptoms compared to patients taking a placebo. The problem is determining what types of probiotic bacteria and what dosage of probiotics work best.

There are a number of studies that indicate that the dosage of a multispecies/strain probiotic should be at least 5-10 billon organisms per day.

The mechanisms by which probiotics lessen IBS symptoms are being actively investigated(3).  For example, studies have shown that the bacterial flora in patients with IBS is different than in individuals without IBS symptoms. The bacteria in IBS patients can produce increased gases like methane which causes constipation and bloating(4). By altering the bacteria population with probiotics, it is possible to lessen methane production and ease symptoms of constipation.

I can go on about how probiotics improve intestinal function, but I am afraid I will start to bore you.

The point I am trying to make is that probiotics can help people with IBS symptoms, and they are very safe. If you have symptoms, then consider a trial of a probiotic. Obviously, if you have new onset symptoms, it is best to consult your physician first.

The problem is trying to choose the right probiotic product. It’s important to consider:

  1. Dosage per serving size – how many billon organisms/serving?
  2. Number and type of different probiotic bacteria – how many Lactobacillus, Bifidobacteria strains in each serving?
  3. What is the shelf life at room temperature?
  4. Does the product also contain fructooligosaccharides (FOS) – prebiotics*?
  5. Is the packaging in dark, glass bottles, helping to lessen exposure to oxygen and sun light?

Take Home Message

If you have symptoms of IBS, consider taking an excellent probiotic like EndoMune Advanced. Each capsule contains 10 different bacteria strains.  A serving size of two capsules contains 16 billon organisms and 50mg of FOS.

For children, consider EndoMune Junior. Each serving size of ¼ Tsp contains four bacterial strains, a total of 10 billon organisms, and 50mg of FOS.

Eat healthy and live well!
Lawrence J Hoberman MD

*FOS are prebiotics. Prebiotics are starches in foods like those found in the fiber of fruits, beans and the bran in whole grain breads and cereals. They are called resistant starches because our intestines can’t break them down. These starches enter the colon and are used as nourishment by the good bacteria, Lactobacillus and Bifidobacteria. These bacteria ferment these starches and produce short chain fatty acids that nourish the colon cells and enhance its healthy function.

(1) The efficacy of probiotics in the therapy of irritable bowel syndrome: a systematic review.Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein A, Brandt L, Quigley E.Gut. 2008 Dec 17.

(2) Meta-analysis of probiotics for the treatment of irritable bowel syndrome. McFarland LV, Dublin S.World J Gastroenterol. 2008 May 7;14(17):2650-61.

(3) The role of probiotics in management of irritable bowel syndrome. Borowiec AM, Fedorak RN.Curr Gastroenterol Rep. 2007 Oct;9(5):393-400.

(4) Methane and the Gastrointestinal Tract.Sahakian AB, Jee SR, Pimentel M. Dig Dis Sci. 2009 Oct 15.

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