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IBD/IBS/GERD

IBD/IBS/GERD

Do you have any experience using serum-derived bovine immunoglobulin or protein isolate, SBI, products like the product EnteraGam for IBD patients? What are your thoughts on its use in IBD patients?

Dr. Amy Nett: I’ve seen some research on SBI for IBS-D, but I haven’t seen it for IBD. I haven’t...

On the Doctor’s Data stool test, a patient had 3+ Yersinia enterocolitica. IBS has improved on 30-day reset and avoiding suspected food intolerances. Question: Should I treat?

Dr. Amy Nett: Well, that’s a great question, and I would ask back, what are the remaining symptoms? If she...

Do you have a preference for specific rectal probiotics in IBD?

Chris Kresser: Not usually. I’ll have patients experiment with different ones. Soil-based organisms, some of the lactic acid-based probiotics, although...

In your experience, if a patient has a hiatal hernia associated with GERD, do they still respond favorably to the GERD treatment protocol, or do you have to consider adding another type of supplement or treatment with it?

Chris Kresser: When there are structural issues, people still do typically respond well, but they may not always respond as...

What is the 12-week recommendation of Xifaxan in IBD based on?

Chris Kresser: It’s based on studies showing that 12 weeks of Xifaxan induced remission in active IBD patients. And there...

Regarding GERD, I’m wondering about using melatonin before bed to manage symptoms for gastroesophageal reflux. I was a patient of Dr. Wright from Tahoma Clinic years ago, and he was using six drops of melatonin before bed to help with acid reflux, but I felt like it didn’t treat the root cause.

Dr. Amy Nett: Yeah, great question. I think Chris has written about the use of melatonin in gastroesophageal reflux previously....

I’m reading the article “5 Causes of IBS Your Doctor May Not Be Looking For,” and Intolerances to other foods like dairy products, eggs, peanuts, and seafood are also common among IBS sufferers. These may be true food allergies (IgE-mediated) or more mild intolerances (IgG- or IgA-mediated). I’m not really sure how I’ve missed this, but does this mean that true food allergies are IgE mediated, and IgG and IgA are actually only mild intolerances? What does a true allergy mean, and what does a mild intolerance mean?

Dr. Amy Nett: Great question. I’m glad you asked. I think this is an important point because I do try...

How much PHGG do you recommend for IBS daily? Is there a particular brand that you recommend?

Chris Kresser: The study showing that PHGG improved treatment outcomes while patients were taking rifaximin was 5 grams. Other studies...

In the GERD treatment section, one suggested step is supplementing with digestive enzymes, but no specific product is recommended. Is there a particular product recommendation that you’ve had success with or general guidelines to look for when shopping for a product?

Dr. Amy Nett: For digestive enzymes, we commonly use Digestzymes. I think that’s a Designs For Health product. Digestzymes is...

Should HCl be avoided in IBD patients, given that they, by definition, have ulcers all over their GI tracts?

Chris Kresser: Actually that’s not true. IBD can be very localized in one particular part of the intestine, and there’s...

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