Post by Trevor on May 10, 2012 20:43:21 GMT
Re: restless leg syndrome - RLS & CD and IBS orSIBO
Posted by Charlotte, Oxford on 10/5/2012, 18:59:18, in reply to "1st Gastro appt & restless legs"
RLS can have a number of causes, some more serious than others. It is common (as 'secondary RLS') in CD and should improve on the diet. It would be worth discussing iron levels with your consultant.
www.ncbi.nlm.nih.gov/pubmed/20461805
Mov Disord. 2010 May 15;25(7):877-81.
Restless legs syndrome is a common feature of adult celiac disease.
Moccia M, et al
www.ncbi.nlm.nih.gov/pubmed/19731029
Dig Dis Sci. 2010 Jun;55(6):1667-73.
Celiac disease is associated with restless legs syndrome.
Weinstock LB, et al
Came across this coincidentally only yesterday by the same author which might be worth pursuing (if you have any symptoms of IBS or SIBO).
NB SIBO is extremely common even in treated CD. Rifaxamin is a safe non-absorbed antibiotic with few side effects but only available from abroad. It is a very useful drug. Other antibiotics can treat SIBO, at least in short term, which can help diagnose SIBO. Will be posting latest on CD/SIBO soon.
www.ncbi.nlm.nih.gov/pubmed/21570907
Sleep Med. 2011 Jun;12(6):610-3. Epub 2011 May 13.
Restless legs syndrome is associated with irritable bowel syndrome and small intestinal bacterial overgrowth.
Weinstock LB, Walters AS.
Source
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA. lw@gidoctor.net
Abstract
BACKGROUND:
Restless legs syndrome (RLS) is linked to gastrointestinal disorders. The prevalence of irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) in RLS patients was determined.
METHODS:
RLS subjects were recruited from unbiased ads that did not mention gastrointestinal symptoms. RLS diagnosis was confirmed by a neurologist and utilized the International RLS Study Group criteria. General population controls (GPC) were spouses of gastrointestinal clinic patients and were excluded for RLS. Completely healthy controls (CHC) were excluded for RLS and gastrointestinal symptoms. IBS was diagnosed by Rome II criteria. SIBO was diagnosed by the lactulose breath test (LBT).
RESULTS:
There were 32 RLS subjects (23F/9M; 57 yo), 25 GPC (13F/12M; 58 yo) and 30 CHC (19F/11M; 44 yo). Twenty-nine had RLS unassociated with other GI diseases, one had celiac disease, and two had gastric resections. IBS was diagnosed in 28% of RLS subjects compared to 4% GPC (p=0.0317). SIBO was diagnosed in 69% of RLS subjects compared to 28% of GPC (p=0.0033) and 10% of CHC. Using a false positive rate of 10%, 59% of positive LBT results are associated with RLS.
CONCLUSIONS:
IBS and SIBO are common in RLS. Three hypotheses developed are (a) RLS patients are selectively immunocompromised or genetically predisposed and thus more subject to SIBO; (b) SIBO leads to autoimmune changes, and subsequent auto-antibodies attack brain and/or peripheral nerves and (c) SIBO inflammation leads to increased hepcidin and CNS iron deficiency which, in turn, leads to RLS. These hypotheses bear further investigation.
Full text:
www.gidoctor.net/client_files/file/Treatment-of-Primary-RL-%20with-Rifaximin.pdf
Posted by Charlotte, Oxford on 10/5/2012, 18:59:18, in reply to "1st Gastro appt & restless legs"
RLS can have a number of causes, some more serious than others. It is common (as 'secondary RLS') in CD and should improve on the diet. It would be worth discussing iron levels with your consultant.
www.ncbi.nlm.nih.gov/pubmed/20461805
Mov Disord. 2010 May 15;25(7):877-81.
Restless legs syndrome is a common feature of adult celiac disease.
Moccia M, et al
www.ncbi.nlm.nih.gov/pubmed/19731029
Dig Dis Sci. 2010 Jun;55(6):1667-73.
Celiac disease is associated with restless legs syndrome.
Weinstock LB, et al
Came across this coincidentally only yesterday by the same author which might be worth pursuing (if you have any symptoms of IBS or SIBO).
NB SIBO is extremely common even in treated CD. Rifaxamin is a safe non-absorbed antibiotic with few side effects but only available from abroad. It is a very useful drug. Other antibiotics can treat SIBO, at least in short term, which can help diagnose SIBO. Will be posting latest on CD/SIBO soon.
www.ncbi.nlm.nih.gov/pubmed/21570907
Sleep Med. 2011 Jun;12(6):610-3. Epub 2011 May 13.
Restless legs syndrome is associated with irritable bowel syndrome and small intestinal bacterial overgrowth.
Weinstock LB, Walters AS.
Source
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA. lw@gidoctor.net
Abstract
BACKGROUND:
Restless legs syndrome (RLS) is linked to gastrointestinal disorders. The prevalence of irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) in RLS patients was determined.
METHODS:
RLS subjects were recruited from unbiased ads that did not mention gastrointestinal symptoms. RLS diagnosis was confirmed by a neurologist and utilized the International RLS Study Group criteria. General population controls (GPC) were spouses of gastrointestinal clinic patients and were excluded for RLS. Completely healthy controls (CHC) were excluded for RLS and gastrointestinal symptoms. IBS was diagnosed by Rome II criteria. SIBO was diagnosed by the lactulose breath test (LBT).
RESULTS:
There were 32 RLS subjects (23F/9M; 57 yo), 25 GPC (13F/12M; 58 yo) and 30 CHC (19F/11M; 44 yo). Twenty-nine had RLS unassociated with other GI diseases, one had celiac disease, and two had gastric resections. IBS was diagnosed in 28% of RLS subjects compared to 4% GPC (p=0.0317). SIBO was diagnosed in 69% of RLS subjects compared to 28% of GPC (p=0.0033) and 10% of CHC. Using a false positive rate of 10%, 59% of positive LBT results are associated with RLS.
CONCLUSIONS:
IBS and SIBO are common in RLS. Three hypotheses developed are (a) RLS patients are selectively immunocompromised or genetically predisposed and thus more subject to SIBO; (b) SIBO leads to autoimmune changes, and subsequent auto-antibodies attack brain and/or peripheral nerves and (c) SIBO inflammation leads to increased hepcidin and CNS iron deficiency which, in turn, leads to RLS. These hypotheses bear further investigation.
Full text:
www.gidoctor.net/client_files/file/Treatment-of-Primary-RL-%20with-Rifaximin.pdf