GASTROINTESTINAL DISORDERS: DIAGNOSIS AND TREATMENT

Irritable bowel syndrome, celiac disease, Crohn's disease and ulcerative colitis are a group of gastrointestinal (GI) disorders that that share a variety of lower abdominal symptoms. These include pain, cramping, bloating, gassiness and either or both diarrhea and constipation. Symptoms typically occur after a meal or during stressful situations. The gastrointestinal tract is sensitive to various stimuli, so stress, diet, pharmaceuticals, hormones and any other irritant may aggravate the colon's tendency to contract.

There are many treatment options, including the prescribing either antispasmodic drugs or bulk-producing agents. In either case, the practitioner's sympathetic approach plays a major role in treatment. Conventional treatments focus on relieving symptoms, but the integrative approach we use at Fratellone Medical Associates addresses the causes of various gastrointestinal disorders. As with many conditions, nutrition plays a large role. Food allergies can cause or aggravate most GI disorders and must be addressed to provide lasting relief.

ADDRESSING ALLERGIES

A food allergy occurs when the body's immune system responds to otherwise benign proteins, known as allergens. In a classic reaction, the immune system attempts to counteract the food allergen by stimulating antibodies, which react with the allergen, releasing histamine and other chemicals. This results in an immediate allergic reaction that includes such symptoms such as itching, a rash, swelling and sometimes difficulty breathing. 

However, more common than these immediate adverse reactions to certain foods are delayed responses, which are less obvious, and may include gastrointestinal distress as well as other symptoms. Such hypersensitivity to a certain food or group of foods--the most common are dairy, wheat, gluten, corn, peanuts, eggs, soy and tomatoes---can be measured by with the RAST IgG blood test, which identifies allergens that result in insidious slow reactions as well as the more immediate reactions. At Fratellone Medical Associations, we utilize the more specific IgG food allergy test (RAST) are presently fewer than 10 laboratories that offer such testing methods.

Once the IgG RAST test identifies the food allergens or irritants to which an individual is reacting, he or she should completely eliminate them from the diet. While this approach is desirable, the reality is that many busy often eat out and may have difficulty with such rigid compliance. This is why our practice uses specific forms of immunotherapy to treat allergies. The primary goal is to desensitize the patient to the underlying cause of symptoms by making him or her more tolerant of specific food allergens. Traditionally, the American approach to immunotherapy has consisted of weekly injections in the allergist’s office.

Our practice offers an easier, more convenient and more affordable method. Sublingual (meaning under the tongue) immunotherapy has been used for more than 60 years to help patients develop a tolerance for specific foods. Instead of injections, the person simply places drops under his or her tongue three times a day. The specific drops are determined by the results of the IgG Food RAST test. Much like injection therapy, the sublingual immunotherapy delivers a gradually increasing amount of an FDA-approved antigen that, over time, can build the body’s tolerance to that food allergen. Over time, typically from one year to 18 months, desensitization to the offending allergen results in fewer gastrointestinal symptoms and reduced need for medication. This approach can actually alter the underlying gastrointestinal disorder, rather than mask it

The Nutritional Approach
At Fratellone Medical Associates, we believe in promoting an alkaline diet, which is has an anti-inflammatory effect. In the simplest terms, this approach involves reducing the intake of foods made from white flour, sugar and other processed carbohydrates as well as beverages full of high fructose corn syrup, while alkaline increasing the pH of the body. (For more on alkalinity, see The Importance of Alkalinity; for more on diet, see The Importance of Diet.)

Supplements
Supplementing with fiber helps reduce the abdominal pain, cramping and gas that are symptoms of GI disorders. Taking digestive enzymes before meals can also help enhance digestion and normalize bowel function. Supplements such as acidophilus, bifidium and lactobacillus that promote healthy bacteria in the GI tract are essential in treating gastrointestinal disorders. Both magnesium and vitamin B complex supplements help reduce stress, which in turn, help minimize bowel symptoms. Our practice uses powdered supplements, because most patients with gastrointestinal disorders have problems with absorption of tablets. We also highly recommend both glutamine, D-ribose and MSM for certain conditions.

Herbs
It is essential to diagnosis which bowel disorder(s) a patient has before prescribing herbal therapies. Some commonly used herbs may be used singly or in combination. Enteric-coated peppermint oil is a potent antispasmodic, which reduces bowel irritability. Fennel promotes the elimination of intestinal gas after a meal. The combination of valerian, anise seed, wild yam and meadowsweet enhances digestion and reduces inflammation if taken before a meal.