Constipation in IBS/CFS/FM

On Friday I was messaged by a reader that have had extreme constipation. I have not done a post on constipation yet, but I do have a case report from another reader that had severe constant constipation, no longer has it (nor needing to take any drugs for it)

“Dec 24, 2015 started with:

  • Prescript Assist
  • L. Casei  – 4 capsules per day or (Yakult etc)
  • 15 mg gum arabic

January 9, 2016 – constipation effectively gone.

Remember oats, fruits, vegetables and whole grains”


Moving on to PubMed, remember some probiotics can increase constipationit is not just probiotics, but the right ones!

There are no studies on Prescript Assist and constipation. Prescript Assist is well studied for IBS and found effective.

Unusual Finding

In reviewing the literature for this post, I came across this — an article that found that rhubarb effectiveness can be increased up to 2000 fold by taking with a pro

  • Multidrug pump inhibitors uncover remarkable activity of plant antimicrobials.[2002] “It is possible that the apparent ineffectiveness of plant antimicrobials is largely due to the permeability barrier. ….The results show that the activities of the majority of plant antimicrobials were considerably greater against the gram-positive bacteria Staphylococcus aureus and Bacillus megaterium and that disabling of the MDRs in gram-negative species leads to a striking increase in antimicrobial activity. Thus, the activity of rhein, the principal antimicrobial from rhubarb, was potentiated 100- to 2,000-fold (depending on the bacterial species) by disabling the MDRs.”
    [Full Text]

    • More on multidrug pump inhibitors: Bacterial multidrug efflux pumps: Mechanisms, physiology and pharmacological exploitations [2014] “Another group of EPIs is called the quinoline derivatives, because of their structural similarity with quinolones [143].”  – interesting because Jadin’s protocol includes the concurrent use of quinolones with other antibiotics.
    • “In Gram-positive bacteria, EPIs against the NorA system in S. aureus has been intensively studied. A large number of both synthetic and natural compounds have been found to be EPIs against S. aureus NorA, especially those of natural origins such as genistein isolated from Lupinus argenteus, spinosan A isolated from Dalea spinosa and Tiliroside isolated from Herissantia tiubae”  Genistein is available as a supplement.

Bottom Line

The successful elimination of constipation reported by the reader is supported by PubMed articles. There are additional probiotics reported with good results in the literature. Symbioflor-2 and Mutaflor are both cited.

Rhubarb and genistein taken together is another approach, one that I would suggest be tried before (and NOT concurrent with) probiotics. There is a significant herx risk from this.

— as always consult with your knowledgeable medical professional before making any changes in supplements.

Cistus Incanus

A member of a Spanish group that I work with asked about Cistus Incanus. She knows that I am always interested in herbs — for two reasons, no prescription needed to get, likely less collateral damage than prescription medication. There are only 29 citations on PubMed. She reports very good response to it.The graphic below may explain part of the why.


Cistus species … have been employed in Mediterranean folk medicine as herbal tea infusions for healing digestive problems and colds, as extracts for the treatment of diseases, and as fragrances…. Various preparations from Cistus species have traditionally been used as remedies in folk medicine around the Mediterranean basin, especially in Greece, Italy, Spain, and Turkey. The targeted conditions and diseases include anxiety, arthrosis, asthma, bronchosis, various types of cancer, bacterial and fungal infections, cardiopathies, catarrh, corn, diarrhea, duodenosis, dysendery, dyspnea, fracture, gastrosis, headache, hepatosis, hernia, hysteria, induration, infection, inflammation, insomnia, leukorrhea, myalgia, neuralgia, osteoarthritis, polyp, proctosis, rhinosis, sore, spasm, splenosis, ulcer, uterosis (Duke et al., 2008).

Organic and aqueous leaf extracts of C. monspeliensis, and also C. villosus (=incanus), growing naturally in Morocco and Tunisia were shown to have antimicrobial and antifungal properties that were mostly active against Staphylococcus aureus, Enterococcus hirae, and Pseudomonas aeruginosa and the yeast Candita glabrata (Bouamama et al., 2006).

Exhibited a rather weak activity against E. coli and P. aeruginosa, moderate against Candita albicans, Micrococcus luteus, and S. epidermidis, and most active against S. aureus and Bacillus subtillis (Demetzos et al., 1995), ” [2014]

Bottom Line

Recommended:  E.Coli is almost resistant to it (for CFS a very good thing), it is very effective against S.Aureus (a strong suspect). It has also a long history of being used in folk medicine for digestive issues — the type of herbal usage signature that I look for!

Migraines, FM Pain and Brain Fog

I am a modeler and the model that I ended up for FM/CFS/ME/IBS came out building “sub-models” that took collection of research findings and found a simple model that explains all of the research results.

Today, I chatted with a CFS person who has severe migraines and was wanting to try probiotics. She was wisely warned to delay starting them because some probiotics can give massive headaches — massive headaches on top of migraines will likely result in non-compliance to the approach.

Why would probiotics cause headaches? Probiotics produces antibiotics against other strains and species. These can kill off those bacteria — just like taking an antibiotic.

In this post I will describe the model that I use for the topics in the title. A model explains what is happening and thus can suggest things that could be tried.

The diagram below shows the model:


The root cause of all three symptoms is low oxygen delivered to the brain (or in the case of FM, to tissue).

The symptoms are likely a result of DNA, see this page for DNA SNPs associated with Migraines, and for DNA SNPs associated with Fibromyalgia

Looking at what can cause low oxygen, hypoxemia,  we actually have a significant list:

  • Thick blood aka hyper-coagulation. Blood moves slower and thus the volume of blood (oxygen) that gets delivered is reduced.
  • Low iron — hemoglobin in the blood is what transfers oxygen. It needs iron.
  • Inflammation – swelling of tissue and blood vessels means that the volume of blood that gets thru is reduced. Instead of having a 1″ garden hose, you have a 1/4″ hose.
  • Vascular constriction – this may be due to inflammation OR due to other causes.
  • There are a few other causes:
    • Living at altitude (i.e. one mile or 1.5 kilometer above sea level)
    • Mild carbon monoxide poisoning, as well as a variety of other chemicals

A few diagnostic points:

  • Oxygen saturation in the blood may be normal (except for iron deficiency). The problem is with oxygen delivery and not the oxygen level in the blood. It can also be localized to specific spots (the brain or tender spots in FM) This is why SPECT brain scans for CFS  that show hypoperfusion (low oxygen delivery to brain tissue) is important.  [Post with references to studies]
    • SPECT was performed on 5 patients with classical migraine and 18 patients with migraine accompagnée. At the time of investigation, all patients were symptom-free. Cerebral blood flow was decreased in all patients with migraine accompagnée, and often corresponded to the site of headache as well as to the topography of transient neurological symptoms. This reduction was most obvious in a patient with persisting neurological symptoms. Most patients with classical migraine, however, did not show any alteration of cerebral perfusion. It appears that migraine–and in particular migraine accompagnée–is characterized by a permanent alteration not only of cerebral blood flow but also of neuronal activity. Migraine attacks may occur in connection with exacerbations of preexisting metabolic alterations.” [1987]


Our model above has multiple possible causes — someone with migraines can attempt to address one cause at a time to see if it reduces the severity of the migraine.  My suggestions (to be discussed with a knowledgeable MD always) are:

  • Hypercoagulation: also see this post also:
    • Grape Seed Extract (as alternative to aspirin)
    • Alpha Lipoic Acid
    • Turmeric (with some black pepper mixed in)
    • Piracetam.
  • Low Iron – a good PubMed article is here. It can be associated with H. Pylori and Giardiasis infections.
    • Iron supplements
  • Inflammation – there are many herbs and supplements that are anti-inflammatory. Unfortunately there are no studies comparing their effectiveness in human patients.
    • My own preferences are the gums such as boswellia, mastic and myrrh. Many of these can be chewed in the mouth.
  • Vascular constriction
    • Regular flushing niacin. This is also the cheapest niacin. You do NOT want no-flush niacin, nor time release. You want to turn red as a lobster!
    • “We have found that when red blood cells are exposed to abnormally low oxygen for long periods, they become depleted of an essential substance that they normally release to relax blood vessels in the lung,” [2005]

If any of the above does reduce the severity of migraines, then it points in a direction for further treatment. If you suffer from migraines, then a herx — dumping of toxins into the body will likely make the migraine very much worst.

Again, this is a model to provide a framework for experiments to deduce the cause. I believe strongly is systematic and progressive experiments. Almost all of the items above can be associated with microbiome shifts – which leads back to my model.



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