Monthly Archives: January 2007

I’ve recently doubled the amount of fiber I’m taking each day, and it does seem to have helped. I’ve basically had a pretty good few months on the IBS front, with a couple of quite strange attacks, but these were of the quick-and-painful kind rather than the everyday grind-you-down kind, and so in a way they were actually quite easy to deal with. I say they were ‘strange’ because one of them involved me shivering like I had a fever or something for a couple of hours, and I felt so ill I couldn’t even eat my Rice Krispies (you see how bad it was).

Actually, I’m not sure that the shivering/fever attack was even solely due to the IBS, because it was quite bizarre, but anyway – it’s over now, and the day-to-day intestinal situation is fairly positive. And as I say, I’m mainly attributing this to my increase in fiber.

I take two fiber supplements each day. Please don’t ask me why I take two different ones, I really don’t know why except it’s just one of those illogical things you do when you’re trying to feel better. I suppose at some point I thought that if one of them didn’t work then the other might, so I took both at once, and the habit just stuck.

The ones I use are Normacol (sterculia fiber) and Celevac (methylcellulose fiber). I’m lucky in that I don’t seem to have any problems with bloating or gas if I increase my fiber, but I do have one main complaint about fiber supplements, and it is this – they are indescribably dull. I mean, they’re fine for a few days or weeks, but when you’re swallowing the stuff twice a day, every day, for years, they become just a little on the tedious side.

The Normacol isn’t too bad, because it’s little granules that you can just swallow, but the Celevac comes in pink tablets which have to be chewed beforehand, which takes a good few minutes and gets them stuck all round your teeth.

Compared to the fiber supplements you drink though, these are paradise. I’ve tried the psyllium stuff that you mix into water and drink immediately (tastes like sawdust) and the Citrucel stuff which is methylcellulose that’s meant to taste of oranges (tastes like orange sawdust) and the acacia fiber which looks like cocaine and tastes like tasteless sawdust. They’re really no fun at all.

You can get some more interesting fibers if you live in America, like fruit-flavored tablets and wafers and things, but to be honest even if they were available over here I’m not sure I’d use them – I really don’t want to be eating more sugar and chemicals if I can avoid it. So I guess I’ll just stick to the pink stuff for now.

(If you want to do a little experiment to see how good your fiber is, just put a few tablespoons in a container of water and leave it overnight. It’ll go all squidgy. I did this with my Normacol and was really quite impressed at how much bulk you get out of a couple of tablespoons of the stuff, and it does help to understand why it might work for IBS.)

I’ve just watched a very interesting feature on food intolerance tests on the UK consumer program Watchdog. Basically the perfectly healthy reporter just picked three kinds of tests to see if he’d get the same results from all of them. Needless to say – he didn’t. Here’s what happened.

Vega test

The patient holds an electrode, which apparently lets the therapist record the body’s energy levels, which in turn can be used to diagnose food intolerances. It’s available in branches of Holland and Barrett, a respected healthfood store, which in itself is a bit worrying.

The Watchdog reporter took two separate Vega tests in two different shops, and he got very different results. This was also the case when two other reporters from the BBC tried the test out for a programme called Inside Out a while back. The Inside Out reports showed similarly confusing results – they never agreed on which foods to cut out, and often reported wildly different intolerances.

Verdict: To my mind, this is pretty conclusive proof that Vega tests don’t work. If the test can’t even agree with its own results then it’s clearly useless.

Perhaps the most startling thing about the Inside Out report was that the chairman of the Vega company agreed that the test is useless – or at least that it only works 70% of the time, and that the “science” of the test “does stretch the imagination”.

Wow. I’m not sure what you’re supposed to do if you happen to try the test on one of its 30% days off – I guess you’re just meant to cut out a whole load of completely irrelevant foods and pay the Vega people for the privilege. What a service!

Bionetics hair analysis

The patient sends off a hair sample and the Bionetics company analyse it somehow (I can’t be bothered to find out how, tell you why in a minute). The Watchdog reporter got another completely different list of intolerant foods for this one, including such gems as elderberry and paw paw. I don’t know about you but I’d be very disgruntled if I had to give up my daily paw paw and elderberry fix.

Verdict: The reason I can’t be bothered to even explain this one properly is that hair tests are rubbish science. I’ve never seen a shred of evidence to suggest that you can test food intolerances based on hair samples. And what the hell is paw paw?

ELISA blood tests

The patient does a pinprick test at home to get a small sample of blood. This is sent to a lab, where they check it for levels of IGg antibodies to various foods. The theory is that the higher the levels of antibody, the more intolerant you are to that food.

The Watchdog reporter used the York company, but this kind of test is also available from Cambridge Nutritional Science, and in fact I was tested myself using this method last year.

The reporter sent off two samples, both his own blood, under two different names. One sample showed no intolerances at all, and one sample showed slight reactions to cow’s milk, lemon, lime, orange and grapefruit.

Verdict: The ELISA test came out of this report with the most credit – the two tests nearly matched, and there weren’t any major reactions to any foods. There has also been a clinical trial of the York method which gave some good results, although not as conclusive as the York spokesman was trying to suggest on the program.

So – what do you do if you want to get tested for food intolerances? My views after watching this program are pretty much what I would have said beforehand (although it’s made me even more cautious of the Vega test).

Basically, hair tests don’t work because you just can’t get that much info from a strand of hair, so that’s no good. The Vega test comes up with different results depending on which machine you use, and the director of the company says that there’s a 30% chance that it will fail miserably, so that’s no good either.

And that leaves the ELISA blood test, which isn’t perfect either, but at least it has some decent science behind it (the IGg antibodies stuff) and also a clinical trial which showed some decent, if not entirely conclusive, results.

The reporter on the program rather innocently suggested that people should forego all of these tests and just see their GP, when of course the reason why lots of us turn to these tests in the first place is that our GP won’t help us with our diet or we can’t get a referral to a dietician.

But if you do have some cash to splash and you’re looking at these tests, it is worth remembering that it might be better just to see a private dietician or nutritionist who specialises in IBS. They might suggest an exclusion diet, a way to isolate trigger foods without taking any tests, and they can also advise on what foods might actually help your IBS, not just tell you about the ones that might harm it.

Plus, of course, they can make sure that you’re not doing yourself more harm than good by cutting out whole food groups.

UPDATE: The Digestrol product was a scam and the conmen responsible have been jailed. Read the whole story here.

I wrote a blog entry about a product called Digestrol a while back and received a quite humungous number of comments about it, so I thought it was worthy of a follow-up. Lots of people said that they were equally horrified by the Digestrol brand of marketing (which told people that they might need surgery for their IBS if they didn’t invest in a few bottles of this wonderstuff), but others said that I was wrong about Digestrol, and so I’d like to address a few of the issues raised.

Firstly, there were a few people who said that they had tried Digestrol and it worked for them, so therefore I was wrong to criticise the product.

However, my original review was an evaulation of the quality of marketing copy on the Digestrol websites, not an evaluation of whether the product would work for IBS or not, and there was a good reason for this – I have no clue whether Digestrol works for IBS or not. And this is because the manufacturers have not given me any information which could show whether their product works or not. In other words, they haven’t done any placebo-controlled, double-blind clinical trials.

Without these clinical trials, there is no way of telling whether Digestrol is any good for IBS. I always find it very amusing when I see herbal or “natural” products making all sorts of nasty claims about prescription drugs, listing all the possible side effects and the dangers of man-made chemicals, and omitting to mention the fact that at least prescription drugs have to go through vigorous and extensive testing to get approved, and at least doctors have access to a bucketload of data about how well the product works for which symptoms, as well as the side effects and possible risks. Herbal supplements just come with a leaflet.

Most IBS supplements, as opposed to IBS drugs, don’t have any clinical trial data. Now, this in itself isn’t a reason to condemn them all to the very bowels of hell: clinical trials are expensive and take a great deal of organisation, and lots of companies can’t afford them. Fair enough.

But what this means is that we sufferers have to rely heavily on the marketing copy when we are deciding which products to try. And if a company tells me very clearly in its marketing copy that it either doesn’t know the first thing about IBS (Digestrol’s website claimed that IBS was a progressive disorder, for example) or that it didn’t even bother to check the blurb that their advertising guy wrote for them, I think that’s a pretty clear signal to stay away.

Or, to put it another way…your television has exploded, and you go to the shops to buy a new one. The salesman tells you that the new TV-3000 cooks chicken in under an hour and never has problems with its wheelnuts. Would you buy a telly from this man?

Secondly, we have to be careful about our own claims as well. Because we are human beings and not petri dishes, we can never really know exactly what is making us feel better. Now, this doesn’t just apply to people taking Digestrol, this applies to everything from a new diet to a new drug.

People write to me and say “I have been taking Super-Duper-Pooper Capsules for over a week now and they are really working”. But how do they know it is the capsules that are working, rather than the diet they ate that week, or the fact that they stopped taking another medication, or their stress levels, or some entirely mysterious factor?

We all eat different things every day, drink different things, and IBS waxes and wanes naturally. We need to be careful that we don’t make assumptions about which particular aspect of our lifestyles is causing our relief. And, of course, this is exactly why we need proper clinical trials – because they attempt to eliminate all other variables except the one treatment being tested.

Thirdly, perhaps one of the things that I should have concentrated more on in the earlier review was the actual cost of Digestrol ($57 for a one-month supply, about £30 for the Brits). Digestrol just contains digestive enzymes, nothing else, and I can buy the very same enzymes in my healthfood store for a fraction of the price. So why shouldn’t I?

And last but not least, I do want to say that I’m not in the least trying to tell people what to do, and in fact I’m always ever so slightly worried when someone starts using a new treatment based on what I have said on my websites. All I am saying is that every treatment should be evaluated carefully, using all the information we have at our disposal, be that clinical data or marketing copy or personal recommendations or whatever else.

We’re all going to come to different decisions, and that’s the way it should be. If anyone chooses to take Digestrol, then that’s fine by me – just as long as they’ve evaluated the possible risks and rewards for themselves, and they’re not just being influenced by the fancy advertising that is a bucketload of style and no substance.