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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
 

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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!
MNL
 

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Rita…Well at least he talked himself around full circle finally to where you wanted him to be…uh, I think so anywayDoug....I see you have another thread with more detail on your wild ride with chronic gut pain of indetermionate etiology...I will jump there and see what that is all about.Also, just to help keep things in perspctive, while imaging studies are very interesting in IBS vs controls, and are one of the several investigations that must be done, they have been done so far in a vacuum from investigators who are investigating systemic and local (gut) immune activation in IBS patients...up to and including specific mediator studies. And, of course, vice versa is also true...those investigators are studying systemic and local immune activation and isolating specific inflammatory mediator release and lookig at provojking events,(there are even people studying possible etioligies such as systemic immune activation linked to gut-local and systemic pathogen markers)...but each has not connected the dots to the other as of yet. Since we understand how immunologic as well as endocrine mediation of the CNS occurs, and vice versa, each group can only postulate (or pontificate as the case may be) on what is the chicken and what is the egg. The postulates vary as the perspectives of each group working independently vary.So until the vaccuum is overcome, what we can do is OBSERVE WHAT is happening in different parts of the system and then understand HOW it can influence physiology and thus generate symptoms, it is not yet possible to clearly elucidate WHY...the causal basis of the observed dysfunction. So even though we can address observed dysfunctions which generate symptoms and address them with prophylaxis (dietary intake therapy) or attenuation therapies (behavioral and pharmaceutical)we are still groping around with the different causes of the observed dysfuntion.One thing is for sure...nerves generally do not just, for lack of a better word "alter their own function" any more than granulocytes and lymphocytes and platelets and mast cells et al alter THEIR own function. There are specific means by which function is altered. When you isolate those you isolate cause and effect and then you have reached the rail-end so to speak.But, as the man was fond of saying in Gladiator, "Not yet. Not yet."
MNL
 

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KAMIE:Sorry...I was at the doctor all afternoon and have some new issue sof may own unrelated to IBS to deal with.
You and Doug can read what I posted on Dougs other thread as it will express the same thing that should be explained here in this coversation. http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=1;t=029926 Since I go to great lengths not to post anything that is not pretty clearly fact, that which I may write on that other thread, whether someone accepts it or not because it does or does not fit any particular perosons' paradigms about so called IBS is not relevant to whether it remains fact.Indeed, Doug and Kamie, the statement posted above from the tutorial referenced, which states "An increase in inflammatory mediators alone is insufficient to explain thepathogenesis of IBS." is NOT a statement that ANYONE who has done their homework on IBS would disagree with. SO don't infer from it that anyone would disagree...even the most dogged investigator of immune aberration in IBS.The release of proinflammtory mediators by tissue and circulating immunocytes is a primary and significant Symptom Generating Mechanism in about 70% of people that get labelled with the IBS tag. It does not indeed explain the Pathogenesis, it is a CONSEQUENCE of the pathogenesis...and there are likely mulptiple causal bases for the dysfunctional and aberrant immunocyte reactions seen in both in vivo studies by Bengtsson et al, immunomodulating experiments by Stefanini over the years, clincal observation and therapeutics of Brostoff, and in vitro with the technology of the Mediator Release Test developed by Pasula.Rather, now knowing that this is where many of the SYMPTOMS come from directly, if you can PREVENT the release of mediators then you can reduce or even PREVENT the symptoms.This distinction seems awfully difficult to convey at times in spite of repeated efforts to ensure the distinction is clear. Especially to parties in the field who for years beat the drum loudly, and pontificated about, the non-existent role of proinflammtory mediators and immunocyte aberrations in IBS. Dogma dies a dogs death, even in medicine.But, as Groucho once said:"A child of five would understand this. Send someone to fetch me a child of five."
This is a very important piece of information to the people who SUFFER the symptoms, the clinicians who care for them, and the insurance companies who have to keep shelling out for the never ending care of people whose symptoms will not resolve.The application of this knowledge clinically to the therapy of the affected patients results in much better therapeutic outcomes...which is the immeidate goal of any treatment program for such a condition, and need not be delayed in clinical implementation untile the causal basis of the abnormal immunocyte provocation by diet and "stress responses" is roted out.While the article tends to approach this from the viewpoint of the effects of stres upo the immune system htis is less than half of the equation. Others, taking the immuno-primary approach, have as much evidence so far to suggest that there are immuno-pathways heretofore unseen and unexplored that occur within the small bowel.The truth is probably a combination of the two.Gotta roll
MNL
 

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Hi Kamie....SIDEBAR: ____________________________________"I was talking about MY POST that I,me, myself and.....I.....Posted about my husbands pre-cancer condition.And so I wrote............" ____________________________________Oh yeah I wasn't posting anyting that had anything to do with you, only to warn against getting drawn into the tunnel of narrow-vision and to point out where that can occur among people of various "stations in life" who research write talk prosthelytize about IBS...(in fact I figured you would come back and tell me, clarify, what you needed as I was not sure) so I side-stepped that to stick to the topic of the diffeerence between pathogenisis of IBS and dysfunction in IBS as a consequence of the pathogenesis, as this is quite often confused, and confusing to, people who suffer IBS and are looking for SYMPTOM relief as distinct from seeking the pathology...which is much more elusive. its 2 diferent subjects and they are not mutually exclusive, so for the benefit of the other readers of data on the thread I just wanted to point that out.Now, where are we with your seeking of input....I am running like mad, sorry, as I have to hit the road again within 48 hours on short notice as I have to get some surgey of my own done and have to get some projects out of the box before I stop to have it. Ah, getting old sux.Oh, I see we need to clarify further sorry... _________________________________"...you think what you want and I'll think what I want no matter how misguided and idiodic any one may decide that I am because it's all up to the colon anyway and we ALL know there's no real accounting for colons and their counterparts.." __________________________________Not talking to you in my post, or anyone else specific for that matter unless the shoe fits, only addressing in general the tendency of investigators and their collaborators on both sides of the issue of the underlying disease(s) of IBS to use too much tunnel-vision, or to be so attached to their own paradigm that they are unable to step outside it and look at it form another perspective...and incorporate that perspective into interpreting their finidings...which are made in a vacuum relative to the findings of others. You are not among that population...so don't take any of that as addressed to you...I would be more direct if there ws something you said that I wanted to hash over with you...I don't see any such thing.
___________________________________"Sorry to be a bother. __________________________________no sick person trying to honestly learn with objectivity has ever been a bother to me. The things that bother me are the quid pro quos and dogma that exist within the healthcare realm. While after 30years I must surrender to the fact this is human nature, so anything populated by humans will be subject to these things, its one thing when it occurs in carpentry and wuite another when the outcomes of treating sick people are at stake. But, at least I have mellowed over the years as when I was young, I partnered (in the filed I worked within)ONLY with physicians and other therapists who were of like-mind. Sort of Attila and the Huns.
Indeed there were hospitals where people would see us coming down the halls or into the ICU and literally run for cover as the Huns were coming. Its hard to explain if you have not been in the environment from the caregiver side...and been able to do that in many types of positions over a long period of time...it is hard to convey the epxerience and perspective that color ones approach to things. Hmmm....oh well the verbiag is becoming turgid again...sorry.OK...aha there is the question I totally missed so you mistakenly thought Iw as tlaking to you in some mysteriously weird way....I can undrstand that for sure....lets see you said: ________________________________________"Hi Everyone,We got the lab result on the Polyp that was removed during the Colonoscopy.It's pre-cancerous.So what to do from here " ________________________________________What do you do?
Jump up and down and CHEER! (NOT him...keep his a-- DOWN!).That is great that they scoped him found the origin of the bleeding and got that sucker outta there. Precancerous should be taken in the same context as "pre emphysema" or "pre-preganant", in that it is NOT but the situation is that it could have LED TO the feared diagnosis.Now your GI doctor will recommoend what to watchj for and how often to be rechecked now that you found that hubby is a guy who might be prone to getting a polyp form time to time. Each guy has his own "monjtoring protovol". It's like scoping a guy with GERD and seeing some tissuie changes in the distal esophagus from chronic GERD...you just have to recheck from time to time to make sure that no tissue changes occur...like getting any checkup periodically.SO the doctor will give you his best advice based on what he/she saw nside and knows of your husbands history and whether there is any familial history which would be associated with this etc.What else shoudl you do?Well, to be blunt coming from the perspective of listening to immunologists and allergists who are food and chemicals-in-food conscious, try to makea lifetyle change wghich will minimize the epxosure of the GI tract and all its structures to potential carcinogens, and keep the detoxifying load placed on the GI tract and liver to a minimum.In simple terms this translates into laying off the big fat grilled steaks and roasts and burgers and dogs and all the processed foods and fast foods. Keep that to a minumum. You do not have to go nuts trying to be Ozzie and Harriet, but ry to pretend it is 1957 and eat a balcned whole foods diet modified to be light on the red meats and zero on the charcoaled stuff.You could also consult with a dietician who can give you supplement tips on antioxidants, for example, and how to incorporate those into the diet.BUT do not get tempted into the realm of anything which attenuates immunoresponse as this is the FLIPSIDE of what you want to do for hubby...you hae to think in terms of keeping the immune system fully, highly activeated and on guard s it has amaing abilities to isolate and destroy abnormal cells when they appear (and they do, this is normal). As we age, though, and the more we stress ourselves with toxins in the diet the more challening this becomes for the immune system and the more likely we are to develop malignancies and such.So thats all I can suggest and thaty is realy all you need to do to keep him around and doing well for a long long time...well, that, good genes, and careful driving! See you out on the road!
MNL
 

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Doug: ____________________________________"I might be very ill?Thats the sort of stuff that really freaks me out. My mother died of stomach cancer (yes, I've been cleared on that) and to be honest nothing scares me to the very pits of my soul more than being sick." ______________________________________Easy now....you might NOT be very ill, either. Depending upon the degree of invasive testing you have had so far, the likelihood of you being seriously ill and not knowing it is sort of "inversely proportionate".that is the more involved the docs have been so far, and the less they come up with, the less likely it is that you have some heinous disease hiding in there chewing you up.That does not necessarily mean that you abdominal pain is imaginary, it is not, but if this is indeed your only symptom and you have had a full differential diagnosis by a board certified GI doc, then this suggests that it would be a good idea to get off that road and get another opinion.Abdominal pain is not always an easy thing to find a specific pathology for, especially when all the standard tests draw blanks.There are indeed processes which can occur in the bowel which can cause abdminal pain which is primarily, for example, related to certian types of immunoprotective cells releasing mediators which activate the pain receptors directly or secondarily.This is very very hard to isolate as it happens in a place that is hard to study...the small bowel.And it is true that this can occur from external things, in your diet, which can provoke it, and then the anxiety which accompanies the sympotms amplifies it, OR it isa also true that chronic anxiety, fear, and the associated stress, could be the primary mechanism and then the "reactive gut" even the immune dysfunction can be secondary.This is one of the reasons that stress reduction strategies like HT can really help reduce symptomology.I suggest reading up on, and considering, both options.I suggest you take a littel time to read these, or at least the first one.IBS: A DOCTORS PLAN FOR CHRONIC DIGESTIVE TROUBLESBy Gerard Guillory, M.D.; Vanessa Ameen, M.D.; Paul Donovan, M.D.; Jack Martin, Ph.D. http://www.amazon.com/exec/obidos/search-h...9085785-1742301 "FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff , M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, London http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 I also think, after watching the threads and listenig to your issues for some time, that you should speak to Eric about Mike Mahnoneys program, or at trhe very least give Dr. Weinstocks program a try www.ibstherapy.comRegardless of whether you choose to take your chart and all the tests and history and go have a different doctor look everything over for another perspective, lloking at the books, talking to people about anxiety redution methods, looking at how chemicals in the diet can make the gut hurt, these are not things we have to do one at a time. I didn't ...I had to get kkind of aggressive to overcome my symptoms, which were not the same as yours, but thats not the point. These are simp,y places wherein an answer may lie for you so the idea is just to point at the rocks and suggest you turn these over too.Its out there you just have not found it yet...On the road again...
MNL
 

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Damn it is cold in Cleveland! Now I remember why I moved to Florida in 1975.Have been real busy for a few days but popped in to see how the discussion with Doug was going. Much dialogue....a couple of things though that are posted are very close to getting the range of considerations narrowed.________________________I've had so many tests done and nothing has come up except some mild inflammation of the small bowel, which an IBD specialist and biopsies from 2 colonoscopies tell me isn't IBD, and small bowel bacterial overgrowth_________________________Succinctly, the presence of an abnormal small bowel inflammatory reaction which is different than IBD and is also different than IgE food allergy causes was finally quantified back in, uh, 1994 for the first time by a new procedure developed in Sweden. It has been reported the last two years running at Digestive Disease Week, and has been shown for many years prior to have been present using inidirect means. Depending upon which types of immunocytes are involved a wide array of different “proinflammtory mediators” can be released, so people can get widely different combinations of symptoms, and diarhea is not always (usually but not always) one of those symptoms.The cellular (and mucosal) immune cells which are involved can be provoked into this reaction by substances in the diet which work through other mechanisms than immunoglobulins to the foods (which would be allergy) to keep on reacting as long as the provocation continues to be proved by ingestion. The reaction is delayed onset and dose dependent and hard to isolate but it can be done.Also, the reacting immunocytes can also be provoked into perpetual mediator release and added epsisodic mediator release through the effects of anxiety, fear, and other emotions which we associate with normal stress and added-stress. It becomes a closed-loop of perpetuated symptoms.Why this kind of problem arises in some people and not others, and can cause IBS-d type syptoms, so called “functional diarrhea”, “functional” abdominal pain, and wild array of other problems throughout the body as the chemicals mosey around in the plasma cannot yet be isolated with specificity. All that can be isolated is WHAT is happening.As you have all been taught, active infection and/or dysbiosis vis imbalance of the normal flora is ONE possible basis for this dysfunction…anything which alters the gut flora alters digestive and immune function, so in theoiry if you reverse that process and restore gut flora balance the loss of oral tolerance and exagerrated stress responses should subside thus the symptoms should subside.Other precursor events are wide ranging up to and including some patients who have a priro history of regular use of NSAIDS, especially tylenol.In Dougs case the presence of the inflammatory response and the apparent dysbiosis lead the physician to do the obvious, try one of the protocols which might help restore the flora to normal balance. THIS can take time.The difficulty at this time, which Doug is experiencing, the assessment and quantification of dysibiotic conditions and the restoration of the flora is a very inexact science, especially if one understands the person-specific nature of the normal flora. __________________Yes, I've thought about food relationships the last 2 weeks. On the one hand I thought that food must not be a factor because the pain is still there. On the other hand, the white powder does have a long list of ingredients. I guess the only way to know for sure would be go to into hospital and get fed on a drip!_____________________Naw it would not require that degree of committment. There are other ways. But this is importnat to remember.As long as the problem exists which has caused the normal immune response in the digestive tract to be altered there will be patient specific loss of oral tolerance to varying degrees, as immunocytes respond inappropriately to certain things and stimuli they should not respond to.Due to the fact that no circulating specific antibodies (except sometimes IgG which is one mechanism) are present allergy tests cannot isolate the exact subatnces that patient has lost tolerance to. And since these cellular reactions are dose dependent and delayed onset (up to 72 hours) it is alomost impossible to accuratley isolate them using the standard dietary intake monitoring techniques, as these ar based on presumptions that reactions will at least BEHAVE in a fashion similar to food allergy: rapid onset, not dose dependent, and highly reprodicoble with oral challenge. This is not the case and the vast majority of practitioners and dieticians have not been trained or even exposed to methods to assess and manage this type of problem. In short the net effect is that it can seem that anything brings on symptoms, or just some mechanical stimulus brings on symptoms, or that they are perpetual therefore they must be wholly psychological in origin.The more Doug describes his problem the clearer it becomes that indeed the doctors are on a logical track with trying to get at the root cause, the problem is only that while doing so not tools have been available to them they are aware of to isolate what exactly is provoking this perpetual reactivity so one sort of is stuck living with it until the causal basis is corrected.But the part they are doing is logical and clearly worth trying. Doug fits the picture.___________________My doctor prescribed diflucan when he saw the coating on my tongue. I took it for 5 days instead of the 7 he recommended (stupid insurance!) and would you believe it was almost gone, and 24 hours after I stopped taking the diflucan it was completely back! I wonder what that means. Maybe its just part of the detox process._______________Question: did the doctor do serial stool cultures as well to check for the degree of candida growth and how reproducible it is? This is a very very controversial, even contentious, area of dissussion or form of possible dysbiosis (candida overgrowth) as the dogma has been that a diagnosis of intestinal candidiasis cannt be made without a biopsy which shows the hyphae actaully spreading through the intestinal wall. In general not much credecne is given to the postulate that you can have excessive candida growth in the bowel without it being invasive and that it is sufficient to disrupt normal digestion and even normal gut immune function. While I don’t wan to get into the usual and customary debate as it goes nowhere, I can only relate personal experience, and observations of many many cases managed by the care givers I work with….Personally I had an exacerbation of my symptoms after long period of being asymptomatic on my dietary program. This made no sense until there were signs that for some reason there was simply heavy candida growth within my GI tract. One of the physicians I work with put me on the standard Nystatin regimen and my experience was similar to that reported…my IBS symptoms subsided again…temporarily…and the signs of candida overgrowth diminshed. HOWEVER withina couple weeks it returned with a vengenace. So 2 of the docs talked it over and the second one reocmmended a much more aggressive regimen which included bashing the Nystatin into powder so as to remove the prtotective enteric coating and taking a larger dose for a longer period of time. That time my symptoms subsided I returned to my “normative state” and this problem never returned.I have had the opportunity to witness similar situations with more IBS-d type patients than one would expect if one just looks at the literature and the way intestinal candiasis is classically viewed.Take from that what one will I can only report it to be factual._________________________Correct me if I am wrong, but don't most people just take one dose of diflucan? Or is that some other med I am thinking of?_______________________No, you’re correct. Candida overgrowth apparently can be tough to “get the genie back in the bottle” once he is released. Some people will need, uh, "agressive therapy" as compared to the standard antifungal regimens. In any event this IS a possible pathogensis at least for some indeterminant number of people with refractory symptoms. It is also an area that was thought to be well understood which is being revealed to be less well understood than medicine had thought.One thing to keep in mind is that again once this local inflammatory process is provoked regardless of the causal basis, it is true that the state of mind of the victim can influence the degree of inflammatory response both negatively and positively so there is also value not only in trying to isolate provoking elements in the diet, isolate the underlying causal basis and correct it but to also utilize a modality which is designed to blunt the psychological responses to the condition which can also perpetuate it. If that be counselling face to face with a psychotherapist experienced in this area or self-directed stress management by hypnotherapy, matters less than whether the patient actually FOLLOWS the treatment program. The protocol that will work best is the one you will believe in enough to value it so you will do it. (Doug, Perhaps your doctors are versed in this area as well and can discuss your options with you. I would also suggest kicking things around on the CBT/HT forum as well to see what other preferences and experiences are with these forms of stress reduction treatment).Back to deep freeze.MNL
 
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