What are mast cells and what is mastocytic enterocolitis

What are eosinophils and what is eosinophilic allergic esophagitis

Listen and learn about eosinophils and eosinophilic esophagitis in this podcast. What are eosinophils and what is eosinophilic allergic esophagitis

Stress and the link to digestive conditions

Dr. Lewey was interviewed by Susan Rust, for an article titled "Stomach Woes: Digestive disorders -the causes and cures" featured in Nov-Dec 2011 issue of Springs Style magazine. Dr. Lewey was quoted several times in the article including the following quote: "Stress can cause a release of chemicals from the brain that results in a change in signals in the gut,"..."resulting in pain, increased contractions, water secretions, e.g. IBS symptoms...In the right setting of genetics and altered gut flora, various digestive conditions can result - IBS, IBD (Inflammatory Bowel Disease/Crohn's/ulcerative colitis), celiac/gluten sensitivity, etc." Colorado Springs Style November-December 2011, pages 46-48.

GIardia infection associated with increased risk of IBS and fatigue

Being exposed to giardia, even if successfully treated, is associated with increase risk of irritable bowel syndrome and fatigue. The risk is 3-4 times increased according a new study from Norway (Gut 2011, Wensaas). It is well-recognized that IBS may be triggered by a previous gastrointestinal infection, the post-infectious form of IBS. Antibiotics and probiotics either separately or together have had favorable results in treating symptoms of IBS, especially the diarrhea predominant form (IBS-D). In my clinical experience with IBS type patient with elevated mast cells (mastocytic enterocolitis) fatigue is a common symptom. Giardia is a parasite that commonly elicits mast cell activation. It is not known what results in elevated mast cells in the intestinal tract but previous infection is suspected. The current study did not specifically look for elevated mast cells in intestinal biopsies of patients with IBS after exposure to giardia. This would be an interesting study to perform. Obtaining a history of prior giardia infection, screening for active giardia infection and looking for elevated mast cells in patients in IBS-D, especially with symptoms of fatigue is in my opinion reasonable.