In recognizing the need for new treatment options and a cure for IBS, the Resolution calls attention to the challenges IBS can create and the serious loss in quality of life that can occur with chronic digestive disorders. The impact of IBS on military personnel is singled out, in response to growing scientific evidence indicating that IBS is a major health issue among veterans.

Specifically, the Resolution urges the National Institutes of Health (NIH) to significantly increase their research activities, and it encourages the Food and Drug Administration (FDA) to take pro-active steps to ensure that innovative IBS treatments are developed. The Resolution also asks the Department of Defense and the Veterans Administration to bolster their efforts to study IBS and functional digestive disorders among military personnel, particularly combat veterans.

The International Foundation for Functional Gastrointestinal Disorders (IFFGD), patients, researchers and health care advocates worked closely with Members of Congress to introduce the Resolution in the House of Representatives. Moving forward, IFFGD is encouraging people affected by IBS and other chronic digestive disorders to contact their Representatives and ask them to show support for this digestive health effort by co-sponsoring House Resolution 1309.

A copy of the Resolution can be found at: www.iffgd.org/H.RES.1309.

IFFGD is a nonprofit digestive health and research organization based in Milwaukee, WI. Since 1991, IFFGD has been providing information, education and support to people affected by chronic digestive disorders, including functional gastrointestinal and motility disorders. More information about IFFGD, the Resolution, and ways that individuals can participate in IFFGD’s advocacy effort can be found at www.iffgd.org/resolution.

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Patients were treated with a multispecies probiotic product (Multi-Flora Plus) containing Lactobacillus acidophilus (DDS-1 strain), bifidobacterium longum, bifidobacterium bifidum, and bifidobacterium lactis with a combined potency of 12 billion CFU/g. The study participants evaluated the severity of their symptoms on a scale of one to 10.

Improvements in the symptoms were significant after 60 days of treatment with 84 percent of the participants showing improvement in abdominal pain, 73.9 percent in bloating, 92 percent in belching, 88 percent in flatulence, 90.9 percent in diarrhea and 86.9 percent in constipation. No clinically evident side effects were observed.

Symptom Number of patients showing improvement at the end 30 days Percentage of patients after 30 days treatment Number of patients showing improvement at the end 60 days Percentage of patients after 60 days treatment
Abdominal pain 8/25 32% 21/25 84%
Bloating 12/25 48% 18/25 72%

Belching 13/25 52% 23/25 92%
Flatulence 7/25 28% 22/25 88%
Diarrhea* 17/22 77.27% 20/22 90.9%
Constipation** 19/23 82.6% 20/23 86.96%

*Diarrhea was noted in 22/25 patients, ** Constipation was noted in 23/25 patients

The gastrointestinal tract contains both pathogenic and normal commensal bacterial flora. It is possible that an alteration in the balance between commensals and pathogenic bacteria might be responsible for the excessive gas production and lead to a diverse group of symptoms which are similar to IBS. The results of this study are consistent with the idea that probiotic bacteria can help to keep pathogenic bacteria in check. This study has been submitted for publication.

Multi-Flora Probiotics are manufactured and marketed by UAS Laboratories, Inc. of Eden Prairie, MN.

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Because this vitamin promotes calcium absorption and bone mineralization it is very important that we get enough. If we don’t, our bones will become soft and weak over time, setting the stage for osteoporosis later in life. While this may not seem like something that you need to be concerned about, I urge you to think again.

Physical activity, calcium and vitamin D intake are now known to be major contributors to bone health for individuals of all ages. Even though bone disease often strikes late in life, the importance of beginning prevention at a very young age and continuing it throughout life is now well understood.

One of the big problems in regard to adequate intake is that vitamin D is not prevalent in foods. Good sources of D include fortified milk, cereal, breads and margarine, egg yolks and fatty fish sources such as salmon, mackerel, sardines and herring.

According to studies from the American Dietetic Association, milk consumption in America is low. This is due in part to sugared beverages displacing milk’s place in the diet.

Vitamin D is produced naturally when skin is exposed to sunlight. In order to synthesize Vitamin D through sunlight it is recommended that skin is exposed to the sun for at least 15 to 20 minutes, without block, at least three times per week. This goes against the recommendation for sunscreen but a short time in the sun with maximal skin exposure is necessary. However, be careful to avoid extended exposure to sunlight without sunscreen.

The recommendations for vitamin D are listed as an Adequate Intake in micrograms (mcg) and International Units (IU):

Do I need to take a vitamin D supplement?

When diet is not enough, you may need to take a supplement to help you reach the desired intake of vitamin D. As you will see, vitamin D can be toxic at high levels, so the goal is to reach the appropriate level, not exceed it.

The two primary types of vitamin D supplements are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Most experts believe that vitamin D3 is the ideal choice for these reasons:

• Vitamin D3 is the most potent form, it’s more stable on the shelf, and it’s less toxic than D2.
• Vitamin D3 is the one that is synthesized when the sun hits your skin, so it’s considered to be the most natural.
• Most of the research that has been done on vitamin D and its health benefits has used vitamin D3

In addition to its role in bone health, researchers are discovering hopeful connections between vitamin D status and chronic disease such as type 1 diabetes, cancer, heart disease, depression and multiple sclerosis.

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St. John’s wort is an herbal supplement which has been shown in several trials to be effective for treatment of depression. Antidepressants are frequently used as a treatment for IBS, however, there have been no previous studies to determine if St. John’s wort was a effective treatment for IBS.

“Several of the chemical neurotransmitters that are in the brain are also in the colon. Therefore, it’s been thought that antidepressants may affect sensation in the colon in a similar way to how they affect sensation in the brain. Our goal was to evaluate the usefulness of St John’s wort in treating IBS.” – Yuri Saito, M.D., M.P.H., gastroenterologist and study lead.

The Mayo Clinic trial included 70 Irritable Bowel Syndrome patients. Sixty of the patients were women and the average age was 42 years. During the 3 month trial half of the participants received St. John’s wort, while the other half were given a placebo.

The study participants were observed for symptoms such as constipation, diarrhea, back pain and bloating. The researchers found that the group taking the placebo had more improvement in their symptoms than the group taking St. John’s wort.

“Because people tend to struggle with IBS for several years, patients are really looking for inexpensive, over-the-counter treatments such as St. John’s wort,” says Dr. Saito. “Unfortunately, our study showed that St. John’s wort was not successful in helping IBS patients.”

Results of the study were published in the January issue of the American Journal of Gastroenterology

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The Dutch research study, a randomized trial involving 275 IBS patients, demonstrated the benefits of psyllium taken with yogurt early as one month. The test group was divided into three groups, one third received 10g psyllium, another third received 10g bran and the last third received 10g placebo (rice flour) daily.

For every four patients treated with psyllium at one month, one reported fourteen days relief from abdominal pain or discomfort.

Patients taking psyllium reported a 90-point reduction in symptom severity on a 500-point scale at three months, compared with a 49-point reduction in the placebo group and a non-significant 58-point reduction in the bran group.

Early drop-out was highest in the bran group, with the authors warning bran might worsen symptoms of IBS, especially at the beginning of treatment, and should be advised only with caution.

Writing in the British Medical Journal, the authors said those left in the trial taking bran were probably a small subset of patients who responded well to the supplement.

Psyllium was most effective in patients with a positive diagnosis of IBS based on the Rome II criteria, but it also reduced symptoms in patients whose IBS was only suspected, the study found.

Overall there was a 40% drop-out rate, which the authors said was comparable with similar trials. The main reason was that participants felt worse taking the fiber supplement, they said.

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Dr. Weinstock developed the theory that there is a relationship between IBS and RLS when his cousin developed both conditions after having travelers’ diarrhea. Dr. Weinstock also said he has heard reports of IBS being associated with fibromyalgia, which, in turn, has been linked to RLS.

Dr. Weinstock found that bacterial overgrowth in the small intestine, one factor in IBS, also may play a part in RLS and that antibiotics appear to help both conditions.

The test involved 13 patients who have both IBS and RLS. The patients were given a 10-day course of the antibiotic rifaximin. All of the participants experienced improvement in IBS symptoms and 10 found significant relief from their RLS symptoms.

Rifaximin is not absorbed by the bloodstream. Participants in the study also were given long-term prescriptions for the IBS drug tegaserod, marketed under the trade name Zelnorm, and a one-month course of zinc and probiotic therapy. Dr. Weinstock, who is a consultant and speaker for Salix pharmaceuticals, marketer of rifaximin, is now starting a multicenter trial that will involve 600 patients.

Restless leg syndrome is a condition that is characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations.

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Singing in a choir may help ease the symptoms of irritable bowel disease. Sufferers who took singing sessions once a week for a year reported less pain than those who did not, according to a recent Swedish study.

Benefits: Singing in a choir can reduce the pain of irritable bowel syndrome by increasing the levels of feel-good hormone oxytocin.

The researchers believe that singing increases levels of the feel-good hormone oxytocin, which may have a painkilling effect.

Irritable bowel syndrome affects ten to 15 per cent of the population, causing symptoms such as abdominal pain and cramping, bloating and diarrhea.

It is three times more common in women, there is no cure and treatment includes dietary changes, medication to treat the spasms, and even antidepressants.

Although its cause is unknown, there is evidence that psychological factors, such as stress, play an important role in irritable bowel syndrome.

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Previous studies have shown that regular exercise can relieve constipation and feelings of bloating. Therefore, it seems plausible that regular exercise could help IBS sufferers find relief from these symptoms.

This 12 week study was conducted with 56 adult participants, most of whom were women. This group was randomly assigned to usual care or to an exercise program. The exercise program consisted of two 40-minute one-on-one exercise consultations designed to provide exercise skills, knowledge, confidence and motivation with the goal of performing 30 minutes of moderate intensity exercise 5 days a week.

After 12 weeks, the group that did regular exercise reported significantly greater declines in symptoms of constipation.

The study was conducted by Dr. Amanda J. Daley of the University of Birmingham in the UK. The fact that this brief, pragmatic exercise intervention led to a significant increase in the amount of exercise IBS patients engaged in is “encouraging,” Daley and her colleagues say, especially considering that people with IBS may avoid participating in exercise because of their abdominal symptoms.

In conclusion, the report emphasizes the potential for exercise to be an effective way for people to manage their IBS symptoms, particularly constipation.

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IBS is a chronic functional gastrointestinal disorder which for many sufferers is marked by abdominal discomfort, bloating, constipation and/or diarrhea. It is estimated that between 10% and 15% of the U.S. adult population suffers from IBS symptoms, yet only 5% to 7% of adults have been diagnosed with the disease. According to studies, IBS patients make more visits to their physicians, undergo more diagnostic tests, are prescribed more medications, miss more workdays, have lower work productivity, are hospitalized more frequently, and account for greater overall direct healthcare costs than patients without IBS.

The IBS Treatment Matrix for patients was built based on a new ACG systematic review of the evidence on IBS treatments. Published in the January 2009 issue of The American Journal of Gastroenterology, the review offers graded recommendations on the full spectrum of options for testing and treatment of IBS, addressing everything from new IBS drugs to alternative therapies including psychotherapy and acupuncture.

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Analysis from the trial, which involved 711 participants from 123 clinics in the U.S., South America and Europe, showed the drug did not significantly relieve the symptoms of diarrhea-predominant IBS (IBS-D), which include pain/discomfort or change in severity of pain.

The trial utilized four different regimens which included three different dosage levels of Rezular as well as placebo. This was a double-blind trial that was conducted over a period of 12 weeks. Results of the trial included:

• The study did not show statistically significant differences between treatments in the primary endpoint of patient reported adequate relief of IBS symptoms
• Statistically significant evidence favoring Rezular treatment was achieved in a number of secondary endpoints, particularly those relating to aspects of diarrhea (e.g. stool form as assessed by the Bristol Stool Scale), stool frequency and in the majority of sub-categories of quality-of-life (IBS-QOL) scores and in the overall IBS-QOL score
• There were no statistically significant differences between treatments in adequate relief of pain/discomfort or change in severity of pain

AGI said it didn’t believe the drug would meet regulatory requirements as an effective therapy for the broad IBS-D population.

AGI’s CEO, John Devane Ph.D., said that while AGI is disappointed with results, it would not be a prudent use of resources to continue development of Rezular as a treatment for IBS-D. “A safe and effective therapy for patients with IBS-D remains elusive. We will now focus on prioritizing our pipeline and plan how best to move these forward.”

AGI is currently developing several other treatments for gastro-intestinal disorders:

• A proof-of-concept Phase II trial with AGI-004, a controlled release transdermal mecamylamine patch, in the treatment of chemotherapy-induced diarrhoea (CID)
• AGI-006, which contains the pure r-isomer form of the racemic CNS disorder drug, baclofen, and is in development for a number of GI and related conditions.
• The ulcerative colitis candidate AGI-022 is being developed as an improved, once-daily form of aminosalicylic acid (ASA), formulated in a colon-targeted delayed-release/controlled-release delivery system

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