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IBS and Rosacea


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Another theory on the cause of rosacea is that irritable bowel syndrome is related to rosacea. "Rosacea may be a symptom of an unhealthy gastrointestinal system and healing the entire gastrointestinal system may be the basis for eliminating rosacea. Many people with rosacea also have been diagnosed with Irritable Bowel Syndrome (IBS), Crohn's Disease or some form of Colitis." [1]

"Our meta-analysis confirmed a significant bi-directional association in occurrence of IBD and rosacea." [2]

We need more citations on this theory but a possible clue could be found in a related subject, my SIBO and Rosacea post which has more citations and papers than IBS.

However, in Googling this subject I ran across this interesting article written in 1896 by Dr. Leviseur:

"There are a number of skin diseases which occur in connection with disturbance of the stomach and intestine. This fact is well supported by clinical evidence, but, viewed from the more elevated standpoint of theoretical science, it must be admitted that the true nature of this connection is far from being clearly understood….All writers agree that a large percentage of cases of acne rosacea is caused by indigestion…..These patients have factor ex ore, especially in the morning, sour eructations, constipation, and perhaps a distressing feeling of fulness after meals; in short, all the symptoms of a mild fermentative gastritis…..In severe cases lavage is indicated and has sometimes a surprisingly good effect on the skin eruption. It must not, however, be expected that the mechanical removal of the fermenting masses stops the fermentation; the latter will promptly start again with the very next food supply. Careful dieting is almost always necessary; the amount of carbohydrates should be limited; alcohol, tea pastry, the coarser vegetables and milk should be forbidden. Bismuth, carbonate of sodium, creosote, carbolic acid, thymol, and ichthyic may be employed. I have had good results from the use of fluid extract of ergot…..It would carry me too far if I were to consider the various drug eruptions which appear in connection with gastrointestinal disturbances, as for instance erythema after the use of quinine, antipyrin, turpentine, balsam of copaiba, sandalwood oil, arsenic, etc….." [3]

Is inflammatory bowel disease (IBD) the same thing as Irritable Bowel Syndrome (IBS)? Answer

Skin manifestations associated with irritable bowel syndrome

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End Notes

[1] Dr. David Dahlman, a Chiropractic Physician with a degree in Nutrition

[2] Clin Res Hepatol Gastroenterol. 2018 Oct 30;
The relationship between inflammatory bowel disease and rosacea over the lifespan: A meta-analysis.
Han J, Liu T, Zhang M, Wang A

[3] Remarks of Some Skin Diseases Occurring in Connection with Gastro-Intestinal Disturbances
by Fred. J. Leviseur, M.D.
Medical record, A Weekly Journal of Medicine and Surgery
Volume 50, No. 3, Whole No. 1341, New York, July 18, 1896, p 84, 85
edited by George Frederick Shrady, Thomas Lathrop Stedman

Image courtesy of Wikimedia Commons

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"Our results suggest a correlation between IBS and DED. DED symptoms can cause further complications in patients with IBS, and should be considered in their management. However, further research is needed to establish a possible pathophysiologic association."

Irritable bowel syndrome might be associated with dry eye disease

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“This nationwide cohort study provided evidence of an association between rosacea and incident IBD,” the researchers concluded. “The link between long-term antibiotic use and development of IBD needs further investigation.”  – by Bruce Thiel. Healio Dermatology

Rosacea may be tied to increased risk for inflammatory bowel disease
Wu C-Y, et al. J Am Acad Dermatol. 2017;doi:10.1016/j.jaad.2016.11.065.

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A study in 2017 [1] conducted on 'individuals with self-reported gluten sensitivity' was done to understand better "non-celiac gluten sensitivity' since it is unclear what the mechanisms or biomarker are for this disorder. So what is 'non-celiac gluten sensitivity'?  

"Non-celiac gluten sensitivity is characterized by symptom improvement after gluten withdrawal in absence of celiac disease."

The study concluded: 

"In a randomized, double-blind, placebo-controlled crossover study of individuals with self-reported non-celiac gluten sensitivity, we found fructans to induce symptoms, measured by the gastrointestinal symptom rating scale irritable bowel syndrome version." [1]

Anyone who suggests that fructan is the issue rather than gluten to someone on a gluten free diet will without a doubt be raising some ire and shake the core foundation of their belief. After all, for years they have been told 'it has to be the gluten.' 'How can fructan be involved?' They will cry 'the study must be flawed.'  One report says, "a full 63% of Americans believe that a gluten-free diet could improve their mental or physical health. And up to a third of Americans are cutting back on it in the hope that it will improve their health or prevent disease." [2]

The study used a "a randomized, double-blind, placebo-controlled crossover study of individuals with self-reported non-celiac gluten sensitivity" and concluded the fructan induced the symptoms. 

So what is fructan? "A fructan is a polymer of fructose molecules." Wikipedia

Doesn't that make more sense that a sugar is the culprit? Yes, sugar is the culprit

For all the naysayers, there will be other studies done on this and in time gluten will no longer be the 'bad' culprit and instead recognized for what it really is, "a protein complex that accounts for 75 to 85% of the total protein in bread wheat." Wikipedia

If you have Celiac Disease, "a genetic autoimmune disorder marked by an abnormal immune response to gluten proteins present in wheat, barley, and rye [which]  damages the lining of the small intestine, interfering with nutrient absorption," [3] you really do have a sensitivity to gluten. The study referred to above was conducted on those who do not suffer from celiac disease but who self-report gluten sensitivity and report doing better avoiding gluten. So those who think gluten is bad may need to re-think what they are really sensitive to. So if you still think you have a gluten sensitivity you should ask your doctor to test you. There is a DNA test for Celiac Disease. However, there is no test for non-celiac gluten sensitivity. [4]

End Note

[1] Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-reported Non-celiac Gluten Sensitivity
Gry I. Skodje'Correspondence information about the author Gry I. SkodjeEmail the author Gry I. Skodje, Vikas K. Sarna, Ingunn H. Minelle, Kjersti L. Rolfsen, Jane G. Muir, Peter R. Gibson, Marit B. Veierød, Christine Henriksen, Knut E.A. Lundin
PlumX Metrics

[2] Ditch the Gluten, Improve Your Health?, by Robert Shmerling, M.D., Harvard Health Publishing, Harvard School of Medicine

[3] What You Need to Know About Gluten
BY ROSANE OLIVEIRA, US DAVIS, Integrative Medicine 

[4] "Currently, there are no recommended methods to test for non-celiac gluten sensitivity. Some doctors offer saliva, blood or stool testing. However, these tests have not been validated and are therefore not accepted." GLUTEN SENSITIVITY TESTING, Beyond Celiac

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