metsol maia

The attached published paper is an excellent review of the mechanism that causes lactose intolerance and the strategies that can be used to manage the problem. This article concurs with the previously reported success in using the FODMAP diets but also warns that these diets can have unintended health effects. For example, the article points out that there is a significant decrease in the concentration of probiotic bifidobacteria after four weeks of a low FODMAP diet and lactose free diets often result in calcium deficiency.

This is a wonderful article because it presents many accurate facts about small intestinal bacterial overgrowth. There are too many so called SIBO “experts” who have populated the internet with self serving views that are presented as fact when in reality they are unproven.
Let’s take a look at a few truths:
1. Antibiotics are an effective treatment to eradicate SIBO but the cure is usually not permanent since the underlying cause of SIBO is not being treated.

Ongoing research continues to support the link between small intestinal bacterial overgrowth (SIBO) and Parkinson’s disease. This new article explains some of the complex cellular level reasons for the link and why SIBO helps exacerbate Parkinson’s. So it seems important to test for SIBO in patients that show early signs of Parkinson’s disease. If the test is positive it would be reasonable to pursue a treatment program to eradicate the bacteria. How much this will help with Parkinson’s symptoms is still unknown but there is no harm in eliminating the bacteria which if nothing else will improve gastrointestinal health. What is needed at this point is a study looking at whether SIBO eradication leads to better outcomes for Parkinson’s patients.

H. pylori is a bacteria found in the stomach that is responsible for peptic ulcer disease. In the last decade millions of Americans have be treated with antibiotics to eradicate this bacteria. Typically patient’s gastric distress symptoms disappear once the bacteria are eradicated. However, eradicating the bacteria is becoming more difficult because of the growing resistance to commonly used antibiotics. For example, levofloxacin was shown to be ineffective against the H. pylori 31.3 percent of the time. This means that if you have been treated for H. pylori in the past few years and still have gastric problems it is possible that the therapy was unsuccessful. The urea breath test is a very accurate method to determine whether your H. pylori eradication was unsuccessful.

This article is a simple explanation of lactose intolerance. Importantly it stresses that although many people are lactose intolerance it does not mean that they shouldn’t consume any dairy. Quite to the contrary most people with lactose intolerance can tolerate some dairy and the amount needs to be determined with trial and error. For those with little tolerance there are dietary aids such as Lactaid so that everyone can get the benefits of dairy consumption without risking that sickening feeling. Also, if you are are unsure about whether you have lactose intolerance or another gastrointestinal problem like IBS consider taking a hydrogen breath test.

A recent peer reviewed publication presented evidence that probiotics may significantly improve the symptoms of leaky gut syndrome. While the study was done on athletes there is no reason to believe that the findings wouldn’t apply to normal people. Essentially the findings were “The probiotic treatment decreased Zonulin in feces, a marker indicating enhanced gut permeability. Moreover, probiotic supplementation beneficially affected TNF-α and exercise induced protein oxidation.” So what does this mean? First you need to know that zonulin is a protein that is believed to modulate the permeability of tight junctions between cells of the wall of the digestive tract. Zonulin was discovered in 2000 by Dr. Alessio Fasano and his team at the University Of Maryland School Of Medicine. Based on Dr. Fasano’s research, we know that the two most powerful triggers to open the zonulin door are gluten and gut bacteria in the small intestine. As the zonulin level rises, the seal between the intestinal cells diminishes, opening up spaces between cells that allow all sorts of things to pass right through. This is called “leaky gut”. So by showing the probiotics can decrease the volume of zonulin that means the space between the cells is diminishing and leaky gut is being successfully treated.

Lactose intolerance is prevalent in India. I recently came across an article in an Indian newsletter that offered some substitutes for dairy when cooking. Some of the ingredients might not be found in your supermarket but I found all of them in my local Indian specialty grocery store. The suggestions include:

Great article on the differences between food allergies (very rare) and food intolerances (more common). In addition this article contains an insightful discussion of gluten free diet craze. So before you swear off dairy or gluten take a look at this article.

A recent panel of expert gastroenterologists gather in Japan to write guidelines for the management of H. pylori. The highlights of the findings are:

The link between rosacea and small intestinal bacterial overgrowth (SIBO) is not new but has been largely ignored by dermatologists. Until recently the publications of scientific studies of the link has been limited. However, A recent study presented at the American College of Gastroenterology Annual Scientific Meeting and reported in the Journal of the American Academy of Dermatology indicates confirms that there is a link. Furthermore, the articles states that 46% of prospective patients with rosacea had SIBO, and these patients were prescribed rifaximin, an antibiotic commonly used for traveler’s diarrhea. After rifaximin, 78% of those patients saw an improvement in their rosacea. For a hard to treat disease that is a remarkable improvement.