Florastor

[Gigi]

I'm wondering about other people's experience with Florastor. I had used it about 2 years ago when I first got ongoing diarrhea, before I was diagnosed with LC or even heard of the disease for that matter. When my initial symptoms appeared I thought I was dealing with a gut dysbiosis since I had recently been given IV ampicillin during an outpatient procedure. Florastor actually always seemed to help normalize my bowel movements. Of course, eventually I'd end up back with diarrhea at some point. With my last flare and the one that sent me to the GI doc who diagnosed me, Florastor did not seem to help. So fast forward to now. I've been gluten free and dairy free for 2 weeks. My stools had improved and less frequency but still usually watery. So I decided to try Florastor again and now I'm down to one soft bm a day.

So assuming this is not just coincidence my question for all you smart people is, if Florastor benefits me, why would that be? What does it tell me about my particular gut situation? Especially considering that it is a yeast and not a bacteria? Any ideas?

[JFR]

Florastor is made from Saccharomyces boulardii, a yeast that some people here have found helpful. I checked it out on their website and it contains Lactose. There are other brands of saccaromyces boulardi that have no lactose. You might want to check those out. Here is one from a company I trust:
http://www.iherb.com/Kirkman-Labs-Sacch ... lsrc=aw.ds

It is important to always check the ingredient additives in any supplement you take, many contain either soy or dairy. Also 2 weeks dairy and gluten free is not a very long time. You might be better off not adding anything at this point. In fact, if you have not already done so, you could omit soy and then eggs to see if that helps. It is always better to take away things that are causing symptoms than adding things to help control them.

Jean

[Gigi]

Thanks for the link a Jean. I am awaiting Enterolab results before I eliminate eggs and soy. I will say I have been avoiding soy but knowing how ubiquitous it is I'm not certain I have entirely eliminated it. Regarding lactose, I agree it is prudent to avoid it until you've determined you can tolerate it. But that raises another question for me. Antibodies to milk are produced in reaction to the proteins in milk. I've not understood why it would bother someone with MC unless they are lactose intolerant. Primary lactose intolerance is due to the inability to produce the enzyme lactase necessary to break down lactose. I tolerated dairy just fine before MC so I'm guessing I make lactase. I guess I can see MC could cause a secondary lactose intolerance if there is damage to the mucosa which impairs the secretion of lactase.

[Gigi]

Thank you for the link. I love Iherb! Yes Florastor does have 33 mgs lactose. I'm pretty sure I'm not lactose intolerant though. Possibly casein sensitive. And lactose intolerance is not an immune response. Even if I have some secondary lactose intolerance due to gut inflammation 33 mgs is a very minute amount. A glass of milk has several grams of lactose. I am awaiting results from Enterolab to decide whether to eliminate soy and eggs.

[tex]

I'm pretty sure I'm not lactose intolerant though. Possibly casein sensitive. And lactose intolerance is not an immune response. Even if I have some secondary lactose intolerance due to gut inflammation 33 mgs is a very minute amount. A glass of milk has several grams of lactose.

You've done your homework, and what you say is true. Unfortunately though, Either pharmaceutical grade lactose is simply not pure enough, IOW it's commonly cross-contaminated with casein, or some pharmaceutical companies are using industrial grade lactose in their products, because we find that many, many members here react to pharmaceutical products that contain lactose. Yes, some of us can tolerate such products, but many of us cannot.

Another problem is that you are basing your assessment of the risks of lactose on a normal setting where lactose intolerance is the only problem, in an otherwise normal digestive system. With MC, most of that information based on "what works for normal digestive systems" goes out the window, because with MC, we most definitely do not have a normal digestive system, and we will never again have a normal digestive system.

Everyone (and I do mean everyone) who has enteritis, has lactose intolerance, because they very quickly lose their ability to produce enough lactase enzyme to digest more than a token amount of lactose. This is typically much more severe than conventional lactose intolerance, where a lactose-intolerant patient may be able to drink up to a pint or more of milk without reacting, because they still produce small to moderate amounts of lactase. The condition is temporary (as you are obviously aware), but it still causes significant digestive issues when inflammation is present. As you say though, lactose does not promote the production of antibodies — the source of the problem that we typically have to deal with is contamination, or lack of purity, however you prefer to view it.

Another complicating issue is tolerance. I (and a few others here) can tolerate casein without obvious GI clinical symptoms. However, I produce antibodies to casein, so I avoid it (since I don't need any hidden inflammation). Tolerance is possible for other antigens (asymptomatic celiacs are somewhat common, for example), but the antibodies are still there, whether they cause clinical symptoms or not.

The basic problem here is a lack of understanding (by "experts") on just what constitutes "pure" ingredients. The "experts" claim that soy oil and soy lecithin is safe for people who are soy-sensitive. They base their claim on their poor understanding of the manufacturing process, during which all soy proteins are assumed/claimed to be removed during processing. It simply isn't true. As an engineer, I can absolutely guarantee you that no such commercial manufacturing process results in an absolutely pure product. It's impossible by virtue of the processes involved, and the way that the processes are executed in real world processing equipment.

True, all but a tiny amount of protein is removed, but no refining process is perfect, and therein lies the problem. As proof of that, virtually every member here who is sensitive to soy, finds that they do indeed react to soy oil and/or soy lecithin, even in small amounts. So it's pretty clear that the "experts" are wrong. And they are probably wrong about pharmaceutical grade lactose also. Commercial processing isn't good enough to provide truly pure products. Still, this wouldn't be a problem if we weren't sensitive to such tiny amounts of these antigens. Unfortunately, many/most of us here are sensitive to trace amounts that many "experts" consider to be entirely irrelevant. They're not irrelevant — not to us, anyway, because we have to be concerned about them. YMMV.

Regarding your use of S. boulardii, please keep us posted on how that treatment program works for you (IOW, will it continue to be effective, etc.), because that probiotic species seems to show the most promise for possible use in treatment programs for this disease, and we are always open to learning about better ways to treat this disease.

Tex