Norman Robillard - Fast Tract Digestion IBS

First edition
ISBN 978-0-9766425-2-7

Copyright 2013 by Norm Robillard
All rights reserved
Self Health Publishing
Watertown, Massachusetts

Printed in the United States of America. No part of this book may be used or reproduced in any manner whatsoever without prior written permission of the author, except in the case of brief quotations embodied in critical articles or reviews.

Recipes: Rie Tanaka
Editor: Edward Walters
Figures, Tables and HTML Coding: Mahesh Gudapakkam
Cover design: Karrie Ross

The creation of the Fast Tract Digestion book series was supported by the efforts of several people.

Rie Tanaka was the creative force behind the recipes in each book. Her innate knowledge and creativity in the preparation and presentation of American and Japanese cuisine give the recipes their special appeal.

Dr. Mike Eades was supportive of my research asking key questions that helped me focus on the real problem and develop a method to quantify the symptom risk of foods.

Gary Taubes helped me gain perspective on the limitations of observational studies particularly with regard to the health aspects of fiber.

My editor, Ed Walters, made sure the ideas in the books were organized and simplified to help the reader cut to the chase and gain the maximum benefit from the information.

Mahesh Gudapakkam, my HTML editor, carefully reviewed and improved the HTML coding of the book, including the tables and figures to support its viewing as an eBook across several devices.

Karie Ross created the cover design for the Fast Tract Digestion book series.

The information presented in this book is not intended as medical advice or as a substitute for consultations with your primary care provider. This information should be used in conjunction with the advice of your own doctor. Consult your doctor before changing or discontinuing current medications or initiating any diet.

Any trademarks or product names used herein are the property of their owners, and are for identification only, and no claim is implied by their use.

In writing Fast Tract Digestion IBS, Dr. Norm Robillard has turned his own struggles into a mission to help millions of people looking for healthy, science-based solutions to irritable bowel syndrome (IBS). This book puts his passions into an Occam's razor approach arriving at a novel and rational solution to treating this debilitating condition.

The Fast Tract diet evolved from Dr. Robillard's earlier work in which he introduced a new theory about why carbohydrate restriction was effective in treating the related condition, acid reflux. For over 30 years I myself have used carbohydrate restriction to successfully treat gastroesophageal reflux disorder (GERD). However, when patients or even other doctors asked me why it worked, I had to admit I didn't really know.

But that changed some years ago when I first got a call from Dr. Robillard, a microbiologist and GERD sufferer. He was a big fan of Protein Power and had, in fact, cured his own acid reflux with a low-carb diet. My curiosity was piqued when he told me he had come up with a mechanism for how such diets worked, which had to do with bacteria in our gut. I got together with him, and he explained his theory. His was the first explanation that truly made sense.

Bypassing 50 years of scientific dogma on trigger foods and alcohol causing relaxation of the low esophageal sphincter, Dr. Robillard proposed that gases produced during bacterial fermentation of malabsorbed carbohydrates create intragastric pressure which drives stomach acid into the esophagus. When these gastric juices come into contact with the delicate membrane lining the esophagus, they cause the discomfort of heartburn, as well as many other symptoms of acid reflux. He posits that small intestinal bacterial overgrowth (SIBO) is the problem driving the process. When carbs are reduced, the gas-producing bacteria in the small bowel have nothing to ferment: therefore they die off, and GERD goes away.

After Dr. Robillard's explanation, I thought it through and speculated that the treatment could maybe be refined a little more. Since the gas-producing bacteria in the small bowel dine primarily on complex carbohydrates and fiber, I wondered if simply reducing the intake of those specific carbs would get rid of GERD. In other words, people could eat certain carbs, yet would not develop heartburn. My reasoning stemmed from my assumption that some easier to digest carbohydrates would absorb through the wall of the GI tract quickly enough to keep from providing food for the bacteria.

I posed a question to Dr. Robillard: which carbs are more difficult to digest and wouldn't they be the worst offenders?

He didn't know the answer, but the idea sounded reasonable to him. Unbeknownst to me, he went back to the scientific drawing board, fiddled with the idea for a few years and tested it on himself and others. Based on his work, he derived an entirely new system for treating not only GERD, but any condition caused by SIBO, using a calculation called the Fermentation Potential (FP).

It turns out that IBS is linked to GERD and to SIBO. Dr. Robillard clearly explains the connection between carbohydrate malabsorption, SIBO and IBS. The gases produced by SIBO drive not only the acid reflux and consequent heartburn, but the abdominal pain, bloating, cramps and altered bowel habits associated with IBS. Even constipation can be caused by methane-gas-producing gut bacteria.

People with IBS and any other SIBO-related conditioncan benefit from this book. Dr. Robillard shows the reader why the Fast Tract approach is superior to other diets, drugs, antacids and even antibiotics, which are often prescribed in an off-label manner for IBS. The book also contains a comprehensive evaluation of each class of IBS drug and an entire chapter explaining the potential problems with taking antibiotics for anything short of the most severe forms of IBS.

The antibiotic option is one many physicians choose for treatment, but readers of this book will think twice about going on such a regimen until all other options are explored. Most importantly, the Fast Tract approach Dr. Robillard created limits only the most difficult-todigest carbohydrates. Thus, the means of relief is flexible where both the types and amounts of symptom-causing foods can be adjusted based on personal dietary preferences. Even people with the most challenging symptoms will be pleased with their improvement. I can't recommend this book heartily enough.

Almost fifteen years ago, Elaine Gottschall, in her book, Breaking the Vicious Cycle, proposed that "faulty digestion" could lead to the malabsorption of certain sugars, starches and fibers and ultimately result in the overgrowth of bacteria in the small intestine. These overgrowing bacteria can cause injury to the lining of the small intestine thus impairing digestion and causing even more malabsorption. She linked this cycle of overgrowth, injury and malabsorption with several digestive conditions including Crohn's disease, ulcerative colitis, diverticulitis, celiac disease, and chronic diarrhea.

Fast Tract Digestion IBS, the second book in the Fast Tract Digestion book series on digestive illness, picks up where Breaking the Vicious Cycle left off. Research on the root cause of IBS can be summed up in two conclusions: