Have you heard of carrageenan? Carrageenan, extracted from seaweed, is used extensively in the processed food industry as a thickener and emulsifier. It is found in almond milk, soy milk, coconut milk, cottage cheese, whipped cream, eggnog, and other related products. But not for long. It’s become impossible to ignore the large amount of evidence showing that it is highly irritating to the stomach lining.
So this past week, in welcome news, WhiteWave Foods, manufacturers of a number of product lines, including those marketed under the brands Silk and Horizon, announced that they plan to phase out the use of carrageenan completely by 2016.
Through the years, I have seen a lot of patients previously diagnosed with “irritable bowel syndrome.” The word “syndrome” — a constellation of symptoms — can be helpful at times, both framing a problem as well as pointing both patient and physician in a more constructive direction. But not always. I wonder about diagnoses like “irritable bowel syndrome,” which is not a diagnosis at all, but rather a conclusion to which doctors frequently turn when we cannot figure out the cause of, for example, gastrointestinal distress. Giving symptoms a name satisfies the need to 1) reassure patients with a diagnosis and 2) bill the insurance company. These are important, but they don’t begin to get at the root of the patient’s belly pain.
What is irritable bowel “syndrome” anyway? It’s the diagnosis we assign to patients after we’ve tested for everything we can think of, and yet the entire negative workup has yielded no answers. With no test to prove its existence. it becomes a diagnosis of elimination as doctors rule out all the other possibilities.
When I meet a patient who carries a diagnosis of “irritable bowel syndrome,” the very first question I ask myself is “what could be causing this patient’s discomfort?” Could it be a medicine the patient is taking for an otherwise unrelated condition? undiagnosed gall stones? leaky gut? atypical migraines? porphyria? Crohn’s? ulcerative colitis? urinary tract infection? depression? anxiety? esophageal reflux? post nasal drip? appendicitis? endometriosis?
Or is it a food sensitivity, like a milk allergy, celiac disease, gluten sensitivity, soybean-sensitivity, or maybe a sensitivity to “processed American cheese food”? Some of these are, admittedly, much more common than others. For example, I myself have diagnosed porphyria only once, which is probably once more than your average internist. But yes it’s still a possibility, even though it’s a long shot.
Or could it be a normal reaction to carrageenan? Could it be that it’s actually the carrageenan, or some other additive, that is making yourself sick? Perhaps your irritable bowel symptoms are a normal reaction to an abnormal situation.
Remember this: carrageenan is not food, and it’s not the only thing that belongs in that category. #notfood