I'd like to know what people's opinions are as to how strongly the mind can affect the gut...?I made a post yesterday describing my symptoms. After reading what other people are going through, my symptoms are very very mild. As I said in that post, mild abdominal pain that never goes away, along with increased BM's from 1 to 1-3 times a day. A little bit of gas, a little bit of gurgling and thats about it.However, because its always there its always on my mind. I've had it for a little over a year now and while the symptoms have never directly affected my life, my mental state as a result of the pain has, to the point where have less desire to do things, and I'm cranky towards people. I'm even more cranky at the moment because I'm on this stupid Vivonex liquid diet for bacterial overgrowth (which I'm skeptical about now...).ANYWAY, I'm also a pretty stressed kinda guy. I'm trying to get my green card, working for a company thats struggling, and I've never wanted anything more in my entire life than my green card. I started the process about a month before all these problems started, and I'm still a hell of a long way from being safe. I also had a car accident a few months before that was my fault, started getting a lot of dental work done (I had to be sedated) over a long period of time. I also entered my first relationship a few months before the problems started. Anyway... Eventhough I know I'm an anxious person, and I worry over every damn little thing (people at work scare the #### out of me when they walk into my cube and say Hi), I've always been skeptical about anxiety and psychological issues being the sole cause of my chronic abdominal pain. Is such a thing physically possible?- Douglas.
All in the head?
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Dear Douglas,For me IBS is a combination for physical and mental. When I get really excited, edgy or stressed I have trouble. I can also get pretty sick for no appearate reason (or so it seams). But, in reading about IBS I have learned a lot about the reactions of the colon during an attack and the use of fiber and calcium to help calm the "beast with in".You have a lot going on in your life. I hope you can learn some relaxation techniques before your stress levels take an even more sever toll on your health. I had to quit a good job due to the stress. I know what stress can do to the body and it isn't pleasent. Good Luck whit all that is going on. Take a deep breath and enjoy life, it's to short to get sick over (I know that from experience) Pat
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This is how I view it.You have a complex nervous system in your abdomen that controls every aspect of digestion and senses every aspect of digestion.This nervous system is connected to your brain.What is going on in your brain/mind sends signals to the GI tract. You also have connections from your brain to the mast cells that are in the GI tract. When the mast cells are triggered either from your nervous system or immune system they will cause diarrhea. (basically this is the how to flush stuff you don't want in your body out as quickly as possible)What goes on in your brain can effect what goes on in your gut. Basically I think that when you have unusual amounts of GI symptoms there is something wrong in the gut's nervous system. Your mind/brain can effect that. It can increase the symptoms or decrease the symptoms (which is how I think CBT and hypnotherpay work...they train you to use your mind/brain to alter your symptoms through the nervous system. Kinda like a feedback system. You can either send a "keep it up more more" signal or a "knock it off stop stop" signal. For most of us stress tends to send "keep it up more more" signals).So it isn't strictly "all in your head" that is if we cut your head off and put it on someone elses body (with no symptoms) you would feel the same things because they aren't real, just psychologically created with no basis in reality. There is something real and physical going on, *and* the brain has direct connection with what is real and physically causing symptoms. This connection can reinforce or diffuse the real physical thing going on.K.
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Hi Doug.To save time since this stupid dialup line may decapitate me at any moment, let us assume that you have been worked up by a GI doc properly and using the standard differential diagnosis they cannot find any organic disease...(yet)..."yet" should now be the amendment of all such statments because the probability is that there IS an organic basis for the symptoms you experience but the tools being used are not sufficient to find it.The probability, for patient suffering significant symptoms of an IBS symptom set which includes diarrhea, is that there is an organic basis for the symptoms. Many people have shown over the years, especially recently when it bagan dawning on people to start studying the small intestine not just the colon, that these patient suffer from abnormal reactions of the immune system (immune cell types) which interface with the GI tract. For some reason, and there are several underlying possibilities, this subpopulation (of what is presently called the "entire IBS population" if you collected all the people who have been "diagnosed with IBS" )immune system starts reacting to various things they eat (and it is different things for different people NOT the same things for everyone) as if it is a pathogen, not something safe. This should not happpen. This starts in the small bowel where digestion is proceeding and the immune system has mechanisms for looking at what you eat to spot pathogens, and react to them.Now, there are multpile ways by which this symptom generating meachnism can be caused, "loss of oral tolerance" is one phrase used to describe the problem in simple terms, only a few of which have been considered and even fewer demonstrated and even fewer isolated enough to develop an absolute way of assessing it. You can tell now that it is happening, and you can tell what provokes the response so you can avoid it, but that is as far as we can go as of yet with absolute certainty.In this population, while there is speculation from some sources that this mass-immune dysfunction could be the consequence of some neurologic primary dysfunction, it does not look like that is often the primary source, just bcause it could be, if you take into account both the exact mechanisms and the patients history. It appears more likely that ofetn there is another organic basis for this dysfuntion, such as a predisposing infection or other such trauma which provoked activation of the cellular immunity (and even the humoral immune system) in some, others it seems to be probable it is dysbiosis from one of many possible causes (dysbiosis in general tends to disrupt the normal digestive process which in turn can lead to dysfunction of the gut-systemic immune interface). So the amplified effects of the way in which the peripheral nervous system sends information to the brain, and the brain processes it and then responds with instructions, and the way in which the gut neural network operates autonomously...the dysfuntions oberserved in those systems are just as likely to be secondary to the effects of chemical mediators released by the immunocytes. The system is a closed loop, though, so its like a nuclear reactor...once activated it is self-perpetuating and can be ratcheted up if you move the rods' position in the reactor core.After a period of time, though, one has to consider learned behavior, anticipatory behaviors, self-fulfilling prophecy, and the like as being sources of further amplification (or attenuation of the symptoms if you can blunt the consequences of these behaviors with therapy) as a complicating factor in trying to assess the chicken-or-egg question.So this is a source of debate, as there are different investigators with different backgrounds and credentials and focus looking at it from (often) divergent perspectives....sort of like an Englishman and an American discussing the American Civil War: the facts of the events are the facts...but what one views as fact and the other views as fact will of necessity be colored by thier perspectives...they interpet what they see in the context of their own experience. So if someone wants to get closer to the plain facts alone, when listening to how the two each interpret what they see and how they form beliefs, examine it objectively. The one will arrive at a more balanced view.This is just the way it is with so called IBS research and clinical therapy....it is also natural as the evolution of understanding of any syndrome proceeds.On the flipside you have patients with mild symptoms. It is also clear from the literature that this is the group where it would be just as likely that symptoms could be traced to a primary dysfunction involving the central nervous system and systemic nervous system and the organs innervated as it is they could be traced to a modest organic problem. There is certainly a population of people whose natural reactions to anxiety and distress, and how they activate different systems which alter organ function, can produce sysmptoms of various types through whichever organs are affected. It is also possible that this patient could have a mild primary pathology....be it infective or "organic"...eliciting symptoms.This is the challenge to the practitioner presented with these patients of the various populations of people who come forth with mild to severe symptoms we associate with what we now, for the moment, call "IBS".At what point does the practitioner stop seeking the root cause of the dysfunction and symptoms and simply write it off as a "functional disease" (which is just a term the medical profession has used to conveniently and cleanly explain that for the most part they have not advanced their knowledge enough at that given moment to be able to find the causal basis for the symptoms...or that the practitioner assigning the diagnosis has exhausted his or her personal knowledge base).Some beleive in going farther than others. The advocates of symptom-based diagnosis draw a line much sooner than certain others who are advocates of exhausting all possibilities in a search for a causal basis of the symtoms. In any event, the upshot of this brief essay is that while it is possible that some symptoms can have a pure "mind-body origin" just as some therapies can produce treatment which is of a purely "mind-body origin" it is not so easy as some would have us beleive to discriminate clearly that symptom or dysfunction which is primarily attributable to that source from one which is purely pathologic/pathogenic/patho-whatever.Most of the time, the best word I can think of is that the problem is blended-origin as these systems are fully integrated bodily systems and it is nigh impossible to segregate their interaction and interdependency.Hey. I did not gett disco'ed for aa whole 10 minutes...wowMNL
Douglas Garstang , here is some important info on this very subject. There is a lot of information on this and IBS. There is another good article but their site is down at the moment. http://www.ibsgroup.org/other/usnews000403.htm http://www.med.unc.edu/wrkunits/2depts/med...aldisorders.htm http://www.med.unc.edu/wrkunits/2depts/med...rymediators.htm
Thanks all for the replies, and especially Mike for the really long reply.I really have to wonder about my symptoms though. My symptoms don't seem to get worse with food or better with going to the bathroom. Stressful situations (like going to the doctor) may have an affect but its very subtle if at all.Its just that constant 24x7 mild abdominal pain. I'd be wondering if I had CFAP except its my understanding that altered BM's would remove that as a possibility. Then again, maybe it could all be connected. I just don't know!!
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Douglas, I dunno, you sound pretty tired of that "mild" pain.You know, after a while anything, even mild(?), can wear you out.I'm wondering what you call mild.Before my surgeries the medical professionals would always ask me to rate my pain.1 being your best and least painful day and 10 being the oh my gosh worst.I kept saysing oh, I don't know somewhere around 6 or 7.Well, it wasn't unitl I had my surgeries that I realized that what I had been living with and coping with as maybe 5, 6 or 7 pain was really about 9 or 10 by regular standards and when I got to the place of what I was thinking might be a 9 or 10 was probably actually about a 15 because my gut was dying and I was getting ready to have emergency surgery.So perspective of ones pain often becomes distorted when we live with it day after day.At some point the old endorphins kick in and then we get up and go do a bit of living life in our up zones.Heck, I rode horses in severe pain.I rode green young horses in severe pain.It's no wonder that when my arabian broke my toe when he was being a jerk and stepped on me that I got a little dizzy and sat down for a moment and then I dusted my self off and got on his back and rode him through an hour of disciplined boring ring work which he hated so he could ponder his unruly sins.It was only my endorphins that kept me going.I didn't know that at the time though.But I know it now. I known it in retrospect because now I have decent pain control.Endorphins. they are some amazing stuff.So Douglas, I think what ever is going on with you is pretty real.I know you are worried abuot disease and physical malady. It's valid cause for worry.But you know, on the up side, you are on the road of diagnosis.You are further along than you were when you bagan your journey.For some of us it takes a long and frustrating time but the search and the push to find our individual answers is well worth the effort when one day we finally really do KNOW.And yes, that day does come.Your probelms and pain are valid and real and important because they are your problems and your pain and they bother you.Diagnosis takes a lot of time. Too much time in my opinion.If we're lucky we run across a brilliant diagnostics person and we get to the answer in a few months.It is a slow process.So while continuing on the search for the answer that will tell you about what is going on with your body, talk to which ever doctor you find to be the most understanding and begin somewhere step by step bit by bit one day at a time.Who knows, maybe when one thing gets relieved maybe the rest of the diagnosis can become clear.Keep on your quest for wholeness and help and take the little answers one at a time.Hang in There!Hugs and Hope,Kamie
Nope Nope...My IBS is not in my head... that would be the wrong end....
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Seriously, some good information here as usual. I believe any weak spot in the body will be made worse by negative thinking and stress. I don't understand the totatl chemcial reactions that take place but I know that they do.And sometimes I believe it is our deepest fears that control our bodies and we don't always even know what they are. I believe that they are buried very deep and not at the surface to jump out at us. My Dr. puts it like this...somtimes you have to get out of your bubble and stop thinking that things will happen; learn to stop the viscious cycle that we can fall into without realizing it and then when we do realize it we don't always know how to get out of it.
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Doug:This is interesting as a little more comes out... _____________________________________"Eventhough I know I'm an anxious person, and I worry over every damn little thing (people at work scare the #### out of me when they walk into my cube and say Hi), I've always been skeptical about anxiety and psychological issues being the sole cause of my chronic abdominal pain. "and"My symptoms don't seem to get worse with food or better with going to the bathroom. Stressful situations (like going to the doctor) may have an affect but its very subtle if at all." _______________________________There is not always an obvious causal event-effect relationship between either our psyche or our diet. This is the part that has made it so hard to clinically assess certain chronic symptom sets where the pathology is not obvious. Sometimes what happens in the brain and/or in the gut and/or both are out of sync with our perception of symptomology.That being said, not much more can be said without further information.What testing has been done and what were the results, and by whom, as this symptom of peristent abdominal pain which varies in intensity situationally (I infer this) emerged.I do not recall seeing your other post and this stupid dialup line in htis stupid hotel is so slowwwwww I am aging as we speak just making a post or two.And I do have tor un as I have one meeting then I am hitting the highway for home!IF the info is on another thread please just give me the url and I will go check it out tomorrow moring when I get back to my beloved DSL line.Thanks....RITAMETERMAID: I am curious....____________________________________"My Dr. puts it like this...somtimes you have to get out of your bubble and stop thinking that things will happen; learn to stop the viscious cycle that we can fall into without realizing it and then when we do realize it we don't always know how to get out of it."___________________________________I am not being sarcastic when I say this is a very nice speech, and indeed is meaningful. BUT what did he give you to teach you HOW to do this?It is one thing to to TELL someone HOW to THINK and how to BEHAVE and how to PERCEIVE, but the real work is giving them tools wgich will facilitate their ability to LEARN HOW to do what one says the patient needs to do.I am curious where he went from there...or did he do what many of my doctors used to do...give a speech about something concerning altereed behavior or perception or an observation of some untoward behavior which was suggested to be the possible root of my symptoms, hand me an RX, and tell me to see the girl at the front desk to schedule an appointment to revisit in (x) months?There are ways of actually doing what your doc suggested...I just ownder if he set you up with the solution or is just admiring the problem?CU tomorrow!
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MNL
Hi Doug,In my expereince, I too had the stomach pains on a daily basis, so I assumed it wasn't anything I was eating. In some IBS cases though it is brought on by a food reaction. The pain from having one wrong thing could affect me for a day and a half. Then I would stop eating and wonder why I was still in pain..not realizing it was still the effects of the coffee I had yesterday for example. I have also read, that sometimes one food can delay digestion thus causing a reaction a day or two later. It is very easy to overlook a possible food trigger or sensitivity in this case as well. I eventually realized the only stable thing in my diet was coffee..with milk. Gave up milk and then coffee and it made quiet a difference, not just in my IBS but my overall feeling of well being. Then I was still eating Luna bars...two a day and after drinking a glass of soymilk and being sick for two days, I gave up the Luna bars too as they are full of soy. I agree with you that it is somewhat in your head as well. Heck, IBS is aggravated by anxiety and IBS causes anxiety. Many people find signifigant relief not only by watching what they eat, but with relaxation techniques as well.Kari****Yikes...excuse my grammar, I was in a hurry as I was off to a meeting!!!
Hi Kari.Well, I could have entertained the possibility that food was causing/aggrevating the problem until a few days ago. I've been on a liquid diet of Vivonex Plus for a week now and the pain is still there. Its for bacterial overgrowth that I supposedly have, which I'm now quite skeptical of.- Doug.
Douglas, I've never had a bad overgrowth problem but I have heard a lot of people who had them says they are a tough critter to smush out.I had a body therapy business and I saw lots and lots of sick folks. A lot with the overgrowth thing going on who wre looking for alternative therapies and such. So I only have the information that was repeated to me from my clients.Years, AEONS ago I had the woman yeast thing going on.I did a acidophilous/probiotic thing with some other herbal stuff for a year and never had the problem again.Since you have that tongue thing going onIt bears a visit to maybe another doctor to let your mind rest.OBVIOUSLY you are not feeling cared for or heard with the present mode of operation regarding your health.Sometimes we sit still and let the Doctor run his/her course. But then at some point if we feel unhappy and uncomfortable enough it then becomes time fo another evaluation from a new sourse.And a new source after that and even again, if you don't feel tended.As many times as need be until someone gets it right.you know Douglas, if any of the many of us here were on some wretched diet and getting no relief I'd venture a guess here that our bellies might feel bad too.Personally, nothing makes me madder and hissy fit prone than not being heard by the medical professional and not getting good solid answers I could believe in.You know, you really do owe it to yourself and your loved ones to ferret out some new medical guidance here.You sound so frustrated.I HEAR you.We've all been there.Let us know if you decide to get another new opinion.Take Care and Hang in There,Kamie
quote:. Then I was still eating Luna bars...two a day and after drinking a glass of soymilk and being sick for two days, I gave up the Luna bars too as they are full of soy. ________________________________Oh Kari, you poor thing! I did my self in on those horrible Soy foods too.What a disaster.Are you feeing better now?No soy for this Missy either.Kamie
Hi Mike,The Dr. who said to this to me last week; well I am not sure what he is admiring other than himself! Very ironic that you should say what you have based on his quote. My husband and I were both were saying the exact same things after we both had a consult with him last Thursday.Here's the deal with this Dr. He is one of those who appears to get irritated and wants to place a patient in a category if they start questioning or taking control for their own well being. That very condensending attitude begins to set in.I went to him last week for a consult and an exam because my gastro found a bump on my cecum during a colonoscopy. Something that is pressing on the colon from outside the colon. Possibly an ovarian problem. So after the colonoscopy I scheduled a time to see my gynecologist and first had a consult with him to let him know what was going on with me etc. He acted very "smug" about the whole thing and said things that made no sense at all and was talking from both sides of his mouth. And during the conversation he was even trying to degrade my gastro for wanting the CT scan that he ordered. He said things like oh your Dr. must like x-rays. He actually said to me well you know he is looking for tumor but I am sure he did not tell you that because he didn't want to worry you. My eyes just got very large when I glared at him and I said to him well you don't even know my gastro nor have you consulted with him to know what he is thinking.He tried to hint that perhaps at times I do get myself in a bubble-like state because I do worry from time to time about lymphoma because my mom died from lymphoma when I was young. Anyway, this was all after my gastro told me that he thinks the bump might be caused by lymph nodes, a looped bowel, an ovary problem, or an appendix problem etc. He ordered a CT scan to find out what is going on. While I waited for the CT scan I made the appointment with my gynecologist. I also had him draw blood for the CA135 test and he said the only reason he would do it was to get me past the worry... So be it... I was satisfied with that ... I don't care ... I wanted the test.I think it is natural for anyone going through diagnostic testing to exhibit some type of anxiety. He and I talked about that ... he never said that I had anxiety about the issues at hand but I almost resented what he said about the bubble. I don't live in a bubble and most people have to find a happy medium between the bubble and non-bubble that he was talking about.It is like when your kid is sick and you run them to the Dr. Well they didn't really need to go. Or the time that your kid gets sick and you don't run to the Dr. and then they should have gone sooner. Sometimes you are damned if you do and damned if you don't.I resent the professional who makes blatent statements like that to make himself appear as though he is in charge and you are not...The more I thought about the whole visit and the whole conversation I decided that he is not really for me and it might be time to find a new gynecologist. After the exam he tells me...oh it is probably good you are having the CT scan! At that point I didn't really care what he said to me.
Hi Kamie.Thanks for the support. Your damn right I'm frustrated. Its not so much that the doctors aren't giving me care, its that they take so long in doing it.I got referred from my local GI to an IBD specialist in around March because we suspected I might have IBD. Well, it took the IBD doctor SIX MONTHS to finally tell me that he can find no evidence of IBD. It initially takes a few weeks to get in and see him, and each time you try something new or he schedules a new test you have to wait around a month again to get in and see him! Arrrggh! I've just been referred to the Motility Unit.You'd think after a year I'd have a clue what was wrong with me! But no.
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And whats with doctors in this country not working weekends? I'm from Australia and doctors work on the weekends there!
Hello Again Doug
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,Sorry for the horrible grammar before. I am surprised anyone understood what I wrote
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How long does your doctor think it will take to kill off the bacteria? Does he suggest taking "good" bacteria along with treatment? I ask because I kow when you take an antibiotic, it kills off both the "good" and the "bad" bacteria, which causes people problems as well. I assume that is what the stuff you are on is doing?Are they definite that it is a bacterial overgrowth or are they doing this to rule it out?Another possibility is Candida overgrowth. People seem to assume this is only a female thing, but men can get it in the intestines, from whatI have read. Beer, cheeses, wine and other fermented foods can attribute towards this. If your diet was rich in fermented foods, perhas you can have them check into this as well.I hear you about the discouraging results with doctors and I too am a worry-wort. I harp on things that worry me too, thus making the situation worse. My job is extremely stressful, and so have some of the course of events in my life, but I also am guilty of putting a lot of unnecessary pressure on myself. In fact, when my IBS became chronic, was when I was under extreme stress. I suppose it was going to happen regardless sooner or later. Who knows
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Good Luck Doug. I hope you find a solution soon. Hi Kamie,Yes, I am doing better now, thanks for asking. Funny, I never suspected soy. It's unfortunate as it is hard to find anything that doesn't contain dairy or soy as most milk substitutes in food are soy. Then you have the soybean oils and soy isolates...soy is everywhere. I don't have to tell you, I'm sure you see it too. Yes I too did myself in with soy. Geeze, now that I can barely eat anthing, you would have thought I would have lost a few pounds.
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no such luck.
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Kari
Hi Kari.I've been on a liquid diet for 8 days now. Something called Vivonex Plus. Its an elemental pre-digested power that gets mixed with water. Its _all_ I have been eating since last Monday (and water). The theory is that it gets absorbed at the upper part of the small intestine and therefore starves the bad bacteria.I've been told by the doctors at the Motility Unit of Cedars Sinai hospital that antibiotics are only 40% effective at destroying bacterial overgrowth, and this Vivonex diet is 85% effective. I was also told people normally could expect to start to feel better after 3-4 days. Well, I'm on day 8 and I don't think I feel an improvement!I took flagyl a few months ago, and apart from making me feel horrible it didn't cure me. A graphs of the hydrogen breath test results taken a little while after the flagyl showed roughly a 20% decrease.They haven't brough up good bacteria at all. Its something I was going to ask them when I go back to get retested next week. Regarding if they are certain or not... I really don't know! The junior doctor I saw at the Motility Unit seemed convinced that bacterial overgrowth was the cause of my symptoms. I even asked him THREE times if constant mild abdominal pain was consistent with bacterial overgrowth and each time he said Yes. So, then when I spoke to the more senior doctor he wasn't so sure! He said that the gold standard is that the abdominal pain gets worse after eating, which isn't really what happens to me. Now THAT annoys the hell out of me. He even thought my symptoms could be caused by GERD which surprised the heck out of me, because I'd been down that path before and a 3 month course of prevacid and pepcid didn't get rid of my abdominal pain, I've never had a burning sensation, and the pain is in my abdomen not my stomach (although he said it doesn't work that way). Well, if it doesn't work that way, then ANY of my other internal organs down there could be causing the problems! Arrrghh!Candida... yeah thats something I'll be sure to ask next time I visit. I haven't really brought it up yet.- Douglas.
Hey Douglas I'm with Kari on that Candida/yeast thing. Lots of ill in the world caused by that stuff.You might want to ask a pharmacist if probiotics are compatable with the diet and meds you are on.Oh who knows whats up with doctors.getting matters tended is a big ol stinky frustrating slow moving drag.We must feel pretty bad to put up with the whole mess of it (LOL) Pretty sad don't you think?But alas our ailments have brought us to this place where we are forced to stand up for ourselves and get nosey and ask questions and say no more when they torture us too bad.My husband has started coming with me to my doctors appointments because he's still mad about all the garbage I had to endure regarding my illness.Ya know what, Doctors are a little bit different when two people show up.(better)What a phenomena.Kamie
I didn't read through all the replys, but I want to post this. When I had diahrrea all the time, and the pain in my gut all the time, I was worried about going to the dr. dentist, etc. A person is always afraid that an accident will occur and after awhile that fear makes the ibs worse and then the worsening ibs makes the fear and anxiety so much more worse. It's possible this senario si what's happening to you. I take levbid for the pain in my gut and it helps. After I got rid of the contant pain and feeling like I had to go all the time, the anxiety went away also. Good luck. Dianne
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