Hey everybody, Dr Hagmeyer here and today we are talking about the Ileocecal valve-What it does, Why it’s important, Symptoms that occur when the IC valve is stuck open, Why it get stuck open, How it relates to IBS, SIBO and many other GI disorders and finally 3 scenarios you should be aware of that correlate with IC valve dysfunction. Let’s start unpack some of these important concepts- before I forget to mention- If after watching today’s video, if you think you have a problem with your IC valve-
I shot a video a while back that explains a step by step process on “How to massage the lleocecal valve” this technique also called “Ileocecal Valve Release Technique” how you do it, how long you should do it for. So you can go back and watch that.
So….. what is the ileocecal valve and why it is so important- if you look at this picture, the Ileocecal Valve separates the small intestines(orange areas) from the large intestines(darker red area). It is located in the lower right quadrant of your belly-
If you were to draw a vertical line through your belly and a horizontal line through your belly you would end up with 4 quadrants- the lower right quadrant- that’s the location of where you can find the IC valve it also the quadrant where you find the appendix.
Many people will have pain in this region and think it’s the appendix. If you can jump up and down without pain- its probably not your appendix- its probably your IC valve that is causing pain. But my disclamer here is that this video is for informational purposes and its not for diagnosis. If you have signs of fever, nausea, vomiting and jumping causes pain- you should go see your doctor and rule out an appendix.
So What Does This IleoCecal Valve do?
The normal function of the ileocecal is to function like trap door between small and large intestines- opening and closing at the appropriate time.
Most of the time it remains closed, opening only when food is ready to pass from the small intestine into the large intestine for further digestion.
When food pushes against this valve and the small intestines distend a reflex is created
It opens briefly to allow the contents of the small intestine to exit into the large intestine. After food has moved through it, it then closes again quickly to prevent contents of the large intestine from leaking back into the small intestine. That what should happen!
With SIBO and many other functional GI problems, the ileocecal valve becomes one of many risk factors like I just mentioned.
A valve stuck in the closed it can cause tightness in the abdomen, cramping and ultimately constipation and toxicity.
If it stays open too long, or spasms and gets stuck in the open position it can cause frequent diarrhea, malabsorption of vitamins, mineral deficiencies, electrolytes, and dehydration.
Most of bile (that helps break down fats) is re-absorbed in then end/distal part of the small intestines. If you have too much bile entering into the large intestines- we call this bile acid malabsorption and this is a common problem for people with Diarrhea. We can often detect fat, proteins in the stool with a special test called a Functional Stool test. People with SIBO the problem is the IC valve getting stuck in the open position.
In a study done in digestive diseases and Science what researchers wanted to find out was if pressure (high or low) in the small intestines was related to intestinal bacterial overgrowth (SIBO) and if it could be correlated with a positive lactulose breath test.
As you already may know, SIBO is diagnosed with a special test called hydrogen and methane breath test
In this study, they used a WMC (wireless motility capsule) a pill that patients swallowed and it records the pressures and PH of the region where the small and large intestines meet.
What they found was that that patients with a lower pressure and open valve, had positive lactulose breath test readings but they also had symptoms of fullness during meals, gas, and bloating.
They also noticed that patients with a higher pressure had negative lactulose breath readings and those patients denied having any gastrointestinal symptoms and complaints.
The results of these studies show us that an open ileocecal valve is highly related to SIBO– Small intestinal bacterial overgrowth (1).
The researchers concluded that malfunction of the ileocecal valve is a “prominent player in intestinal disorders” and should be considered in patients struggling with gastrointestinal complaints.
So without undergoing this kind of research testing, How Do you know If you have a Problem with your Ileocecal valve-
Three scenarios that I think are good indicators you have a problem with the ileocecal valve.
- Do you feel pressure under your ribs, or pain to the right of your belly button and angled about 45 degrees-
- Do you have mid to upper back pain or pain that wraps around the right side of your back?
- Do you have pain that radiates to right shoulder? (While this could also be a gall bladder problem it may also be the ileocecal valve)
If you answered yes to any of these- after watching todays video, I recommend that you go watch a video I did on “How to release the ileocecal valve” through a self-massage technique and see if it helps- If it does then that only increases our suspicion of a IC valve problem.
If you are interested in watching that video, (I will leave a link in the description so you can view that when you are ready)
So, If you suspect you have a problem with the ileocecal valve, I suggest you start with massaging the ileocecal valve, but be sure to rule out other problems such as appendix, or if you are a woman problems with your ovaries. See my video titled, “How When and Where To Massage the Ileocecal Valve”
The last thing I want to share with you today is some of the causes and reasons why the IleoCecal valve may have developed a problem.
The Ileocecal valve can be disrupted through a number of mechanisms (they are all somewhat related). Remember that the ileocecal valve is a muscular sphincter– and these muscles receive signals from surrounding nerves. Some of the things I think about when I suspect Ileocecal valve dysfunction will also be things that I think about when it comes to motility issues. There are many things to consider here and certain kinds of functional testing can help here.
#1 Neurological insult- something is interfering with the MMC- Migrating Motor complex, cleansing waves or the pacemaker cells. These are the cells that control intestinal contractions.
#2 Post infectious IBS– This occurs after a bout of food poisoning. Antibody/ autoimmune reaction to Vinculin- which is a protein that functions in the MMC.
#3 A bout of food poisoning from E.coli, Salmonella, Shigella or Campylobacter- all of these bacteria produce a toxin called Cdt-B toxin (Cytolethal Distending Toxin B (see video that explains this in or more detail)
#4 PH of the ileum and colon– PH of the ileum can affect motility- stool testing.
#5 Levels of Short chain fatty acids (SCFA)- low levels of SCFA can also affect motility and in another video I will explain why testing PH, SCFA and other functional stool markers are so important. But for right now just understand that both (PH and SCFA) affect intestinal emptying and motility.
#6 Bloating– the very nature of bloating will cause the valve to stay open or go into spams-
#7 Emptying and filling of the Gall Bladder– this is tied into the migrating motor complex
#8 STRESS- Fight or Flight response to Stress involves the Vagus Nerve– we know that stress puts our bodies in a sympathetic dominant state as opposed to parasympathetic- Digestion is a parasympathetic dominant state and you never want to eat when stressed when you eat during times of acute stress, blood flow moves away from the organs of digestion where they are needed. Finally
#9 Medications– cannabis, alcohol, pain medications.
That’s going to wrap up today’s video, I know we talked about many things, but dealing with SIBO is much more than just an overgrowth of bacterial in the small intestines. Working with a doctor who understands these things and one who will look at the BIG picture is super important.
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And I hope that you will join us next time take care.