[betterthroughscience]

Frequent readers of this bulletin board will notice that the same questions are asked over and over and that there are some logically inconsistent answers that seem all too commonly accepted.The most important thing to understand about IBS is that it is just a name for a collection of symptoms. The definition is provided by the Rome Criteria (the third edition is quoted here):_________________C1. Diagnostic Criteria* for Irritable Bowel SyndromeRecurrent abdominal pain or discomfort** at least 3 days per month in the last 3 months associated with 2 or more of the following:1. Improvement with defecation2. Onset associated with a change in frequency of stool3. Onset associated with a change in form (appearance) of stool*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.**Discomfort means an uncomfortable sensation not described as pain. In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation for subject eligibility.Diagnosis depends on careful interpretation of the temporal relationships of pain/discomfort, bowel habit,and stool characteristics. Pain/discomfort related to defecation is likely to be of bowel origin, whereas that associated with exercise, movement, urination, or menstruation usually has a different cause. Fever, gastrointestinal bleeding, weight loss, anemia, abdominal mass, and other “alarm” symptoms or signs are not due to IBS, but may accompany it.GASTROENTEROLOGY 2006;130:1480â€"1491 (pubmed: http://www.ncbi.nlm.nih.gov/entrez/query.f...=pubmed_docsum)_______If you have these symptoms you have IBS, by definition. IBS is, by definition, just a group of symptoms affecting the digestive tract that haven’t been explained. Unlike cancer, a stroke, or the flu, IBS is more of a starting point than a diagnosis, because it doesn’t provide any new information, it is just a name for what is already known. Once a person has the symptoms it is necessary to do additional testing to identify the cause of those symptoms - what you might call an actual diagnosis. Once you have an actual diagnosis, then you can treat whatever it is that causes the symptoms and usually stop them.A second common misconception is that IBS symptoms are only caused by one thing. Nothing could be further from the truth. The digestive tract is very complicated, but can only display a limited range of symptoms. There are many things that can cause constipation, diarrhea, and associated abdominal discomfort/pain. Any individual might have one or more of the causes as any one time. There is a wide range of causes of IBS symptoms and many patients have more than one cause, sometimes several causes, at the same time. To correctly diagnose the cause of IBS symptoms it is necessary to test for a range of potential causes. If you don’t treat all of the conditions you have, your IBS symptoms probably won’t be resolved.The third misconception is that there is a single treatment for IBS. This misunderstanding goes along with the previous misconception- that there is only one cause. The reason that there isn’t a single treatment for IBS is that there isn’t a single cause. If all IBS were caused by bacterial infection, treatment would be simple â€" use antibiotics to remove the infection and probiotics to re-establish the needed digestive bacteria. Any of you gentle readers who have tried the 'cure' for IBS know that no single cure works for everyone. That is because there are many, sometimes overlapping causes. For this reason there will never be a single simple treatment for IBS symptoms. Lastly, but perhaps the most common misconception is that IBS is caused by stress. If this were true the world would be full of IBS patients. (Our brave men and women in Iraq would be incapacitated completely). Patients are told all the time by their doctor that stress is the problem, but once you identify the cause or causes and treat them, the symptoms are resolved. This has been show in treatment of people with food allergies (like celiac), bacterial issues (like SIBO), parasitic issues (like Giardia), etc. What is even more interesting is that many patients report that while they had IBS symptoms they also had a heightened sense of anxiety, but that it went away when they treated their underlying condition. That is not to say that stress can’t make IBS worse. Stress can affect the immune system and that can impact IBS symptoms. But stress is almost never the main cause of the symptoms.This is an informational posting. Please feel free to consider the logic for yourself, or refer to the vast array of research published on the subject. I won't be responding to any postings that may follow this one.EDIT by Moderator to make it so the long link is known to the BB software as a link so it will allow the thread to be a more readable width.

 

[Jeffrey Roberts]

I felt this was really well written. I hope many members and visitors take the time to read this.Thanks.Jeff

 

[eric]

Your not a doctor though.You have also consistently posted inaccurate information on IBS on this bb or you leave out VERY IMPORTANT IBS research.You left out IBS is a GI disorder of function for one, one of some thirty functional disorders."Once a person has the symptoms it is necessary to do additional testing to identify the cause of those symptoms "This is not always true and to much testing is not always a good thing, nor does it usally find more then IBS if the criteria are applied right and by a knowledgable doctor."what you might call an actual diagnosis. Once you have an actual diagnosis"IBS IS AN ACTUAL DIAGNOSES!!! You don't seem to get that or want too. They don't know the exact cause of IBS, which is why they use the Rome criteria to diagnose it, however state of the art generated research understands IBS as,From Dr Drossman, the Chairman of the Rome Commitee on Gi disorders of function on IBS and and Co-director of the Center and Professor of Medicine and Psychiatry at UNC-CH. He established a program of research in functional gastrointestinal disorders at UNC more than 15 years ago and has published more than 250 books, articles, and abstracts relating to epidemiology, psychosocial and quality of life assessment, design of treatment trials, and outcomes research in gastrointestinal disorders.among many other thing postions and titles."The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug "http://www.ibshealth.com/ibs_foods_2.htm"The third misconception is that there is a single treatment for IBS."While there is no single as of yet cause for IBS, there are treatments shown to work for IBS patients statisitcally and from research. Some help 25% some 50 % some 80% of IBS patients.It is important to know that IBS is treatable in the majority of Patients and that there is mild, moderate and severe IBS and IBS effects more women then men."Lastly, but perhaps the most common misconception is that IBS is caused by stress."The vast majority if not all of the researchers know IBS is not caused by stress. However its more important to know how stress and anxiety and even negative emotions can trigger the underlying disorder and stress reduction in IBS is effective in moderate to severe IBS and for pain connections in IBS. If you want to know more about that.This thread will help and the accompying one also talks about actual physical findings in IBS and how they are related to stress and the communication between the gut and the brain and back.Stress and Irritable Bowel Syndrome: Unraveling the CodeBy: Yvette Taché, Ph.D., Center for Neurovisceral Sciences and Women Health, Digestive Diseases Center, Department of Medicine, Digestive Diseases Division, University of California at Los Angeles and VA Greater Los Angeles Health Care System, CaliforniaDr. Taché was the recipient of the IFFGD 2005 Research Award to Senior Investigator, Basic Science. Her early publications put the "brain-gut axis" on the map. Since then, she has been one of the pioneers in this field. In many ways, it has been her energy and enthusiasm that has ensured the continued vibrancy of the field. Her identification of the role of corticotrophin-releasing factor (CRF) signaling pathways in stress-related alterations of gut motor function and visceral pain are of major and lasting importance.http://www.giresearch.org/Tache.htmlhttp://ibsgroup.org/groupee/forums/a/tpc/f...261/m/906107392This is on Diagnosing IBS from expert doctors.http://ibsgroup.org/groupee/forums/a/tpc/f...02372#289102372History of Functional Disorders"PRESENT PATHOPHYSIOLOGICAL OBSERVATIONSDespite differences among the functional gastrointestinal disorders, in location and symptomfeatures, common characteristics are shared with regard to motor and sensory physiology,o central nervous system relationships,o approach to patient care.What follows are the general observations and guidelines.MOTILITYIn healthy subjects, stress can increase motility in the esophagus, stomach, small and largeintestine and colon. Abnormal motility can generate a variety of GI symptoms includingvomiting, diarrhea, constipation, acute abdominal pain, and fecal incontinence. Functional GIpatients have even greater increased motility in response to stressors in comparison to normalsubjects. While abnormal motility plays a vital role in understanding many of the functional GIdisorders and their symptoms, it is not sufficient to explain reports of chronic or recurrentabdominal pain.VISCERAL HYPERSENSITIVITYVisceral hypersensitivity helps to account for disorders associated with chronic or recurrent pain,which are not well correlated with changes in gastrointestinal motility, and in some cases, wheremotility disturbances do not exist. Patients suffering from visceral hypersensitivity have a lowerpain threshold with balloon distension of the bowel or have increased sensitivity to even normalintestinal function. Additionally, there may be an increased or unusual area of somatic referral ofvisceral pain. Recently it has been concluded that visceral hypersensitivity may be induced inresponse to rectal or colonic distension in normal subjects, and to a greater degree, in personswith IBS. Therefore, it is possible that the pain of functional GI disorders may relate tosensitization resulting from chronic abnormal motor hyperactivity, GI infection, or trauma/injuryto the viscera.5BRAIN-GUT AXISThe concept of brain-gut interactions brings together observations relating to motility andvisceral hypersensitivity and their modulation by psychosocial factors. By integrating intestinaland CNS central nervous system activity, the brain-gut axis explains the symptoms relating tofunctional GI disorders. In other words, senses such as vision and smell, as well as enteroceptiveinformation (i.e. emotion and thought) have the capability to affect gastrointestinal sensation,motility, secretion, and inflammation. Conversely, viscerotopic effects reciprocally affect centralpain perception, mood, and behavior. For example, spontaneously induced contractions of thecolon in rats leads to activation of the locus coeruleus in the pons, an area closely connected topain and emotional centers in the brain. Jointly, the increased arousal or anxiety is associatedwith a decrease in the frequency of MMC activity of the small bowel possibly mediated by stresshormones in the brain. Based on these observations, it is no longer rational to try to discriminatewhether physiological or psychological factors produce pain or other bowel symptoms. Instead,the Functional GI disorders are understood in terms of dysregulation of brain-gut function, andthe task is to determine to what degree each is remediable. Therefore, a treatment approachconsistent with the concept of brain-gut dysfunction may focus on the neuropeptides andreceptors that are present in both enteric and central nervous systems.THE ROLE FOR PSYCHOLOGICAL FACTORSAlthough psychological factors do not define these disorders and are not required for diagnosis,they are important modulators of the patient's experience and ultimately, the clinical outcome.Research on the psychosocial aspects of patients with functional GI disorders yields three generalobservations Psychological stress exacerbates gastrointestinal symptoms in patients withfunctional GI disorders and can even produce symptoms in healthy patients (but toa lesser degree).o Psychological disturbances modify the experience of illness and illness behaviorssuch as health care seeking. For example, a history of major psychological trauma(e.g. sexual or physical abuse) is more common among patients seen in referralcenters than in primary care and is associated with a more severe disorder and apoorer clinical outcome. Additionally, psychological trauma may increase painreportingtendency.o Having a functional GI disorder has psychological consequences in terms of one'sgeneral well-being, daily functional status, concerns relating to control oversymptoms, and future implications of the illness (e.g. functioning at work andhome)."http://ibsgroup.org/groupee/forums/a/tpc/f...710974#19710974

 

[cookies4marilyn]

Yes, interesting, and provides a lot of different aspects to the IBS equation, and conditions similar to IBS. Many things to consider - and a lot of research and information can be found on this website. When I first arrived on this BB, I was overwhelmed by all the information out there - and it certainly is confusing to people newly diagnosed to be sure. Even in my own journey, speaking with many physicians, gastroenterologists, researchers, etc. I keep finding that there is a lot of information to gather...A lot of what is defined as IBS, I believe in actuality is not true IBS - that is, if a "cause" is found - I believe that once a dx of say, SIBO, or parasites is found, it is not then IBS - it is SIBO, or symptoms caused by parasites, or food allergy, or whatever "cause" and the IBS symptoms usually go away when that specific cause is found. But because it does have a "cause" then I believe it is not really IBS. If folks all had their IBS resolved by it being dx'd and treated as one of these conditions, then the IBS condition, and criteria, would no longer exist or be needed. But sometimes once the "cause" is removed, the patient is left with IBS symptoms - so there is an overlap there - like in post-infectuous IBS, for example.IBS by definition, is a condition of exclusion - if all other conditions have been tested for, that is when the IBS dx is usually given.For my own situation, having been tested for parasites (twice), SIBO, 4 colonoscopies, food allergies, intolerances, diets, probitotics, and having taken every med known for IBS, and even off-lable use, etc. there was never resolution or a "cause" for my IBS found per se, other than that I had a mis-communication of the mind and gut, which is physical, and which can be determined. I had no stress or anxiety about IBS until I already had the IBS!

quote: What is even more interesting is that many patients report that while they had IBS symptoms they also had a heightened sense of anxiety, but that it went away when they treated their underlying condition

For me, the underlying condition was the mind-gut connection - as no other "cause" was found. The IBS caused me anxiety once I had it - not the other way around - I suspect this is true for many folks.IBS is not food allergy, intolerance, SIBO, etc. but it can occur alongside these things.There is no cure for IBS - there are treatments for conditions that cause IBS-like symptoms - and as a result may continue on as IBS once the "cause" to the other condition has been addressed.There are treatments for IBS, once that dx is isolated, and there is nothing else going on - I know this because for my own situation, I can eat anything, (no food restrictions), I do not have SIBO, etc. but I had a very strong mind-gut component, and that I WAS able to treat successfully - but it is not a cure - it was a treatment, and does not work for everyone - that is correct - different treatments, for different causes of symptoms, which may or may not be IBS...And, as suggested - yes, do always read the medical research for any possible diagnosis and treatment. Make sure of your diagnosis, and also that the treatments are right for your individual condition/cause.

 

[Kathleen M.]

quote:The third misconception is that there is a single treatment for IBS."

There ireally isn't any any disease or disorder on the planet for which there is one and only one treatment that works for every patient with nothing else ever needed.I really don't know who is arguing that there is one and only one thing needed to treat IBS (well other than a few people selling a given treatment who are usually making other claims that discredit the whole arguement).Even with something like celiac where the only real treatment is "avoid gluten" they may need additional treatment for the anemia, or loss of bone, etc. Avoiding gluten alone may not be enough to restore full health quickly. It is also very difficult to always avoid gluten 100% of the time so they use other treatments for the symptoms that come up when they accidentally eat something with gluten in it.K.

 

[eric]

FYISymptoms and Characteristicsof IBS http://www.aboutibs.org/characteristics.html

 

[19277]

I really appreciated the first post by betterthroughscience. My personal experience and success came from finding a philosophy of treatment that treated my case like an individual and strove to identify the cause of my symptoms.I really liked where they pointed out that IBS may have many diverse causes and hence may have different successful treatments.Further, I have been victim to MD's telling me that the cause of my problem was stress.While IBS is a real medical diagnosis, this idea gets no more faith from me. If I had continued to believe them and this philosophy, I may have been ill forever.Thanks for the good ideas.Steve

 

[eric]

Steve, do you have d IBS or C or d/c?Do you have pain?You posted on another thread how IBS effected you emotionally? In what way did it effect you emotionally?

 

[19277]

Eric,When I suffered severely from IBS, the first few years it was IBS-D then for about a year it was IBS-C and then went back to IBS-D until I got it figured out.How did it affect me emotionally? How about severe anxiety and depression because of inability of conventional medicine to controla severely life altering disorder. Thoughts of suicide because my social life was ravaged by not being able to go out in public. I made no friends in my first2 years of Grad school as I could not be social because of pain and having to stay by bathroom.

 

[eric]

quote:Further, I have been victim to MD's telling me that the cause of my problem was stress.

Perhaps and I wasn't there and doctors don't explain this well. He was suggesting stress is playing a role, not that stress causes IBS. If a doctor believes that lose them, if a good doctor talks about the connections and why they effect IBS and how you can work on doing somethings to counter it imporves IBS. They know this for sure now.These feelings"How did it affect me emotionally? How about severe anxiety and depression because of inability of conventional medicine to controla severely life altering disorder. Thoughts of suicide because my social life was ravaged by not being able to go out in public. I made no friends in my first2 years of Grad school as I could not be social because of pain and having to stay by bathroom."Contribute to pain and d and altered functioning of the enteric nervous system and effects the sympathetic and parasympathetic nervous systems and utimitaly IBS. That is not stress causes IBS, but someone under chronic stressors, all of which you mentioned above and all of which are common in a lot of IBSers as well as a natural functioning of the human body, effect the physiology of IBS.

 

[eric]

This is from rome 11 and they are now using rome 111 butIrritable Bowel Syndrome - An Evidence-Based Approach to Diagnosishttp://66.218.69.11/search/cache?p=Irritab...&icp=1&.intl=us

 

[betterthroughscience]

Recent posts underline the need to continue providing information to help people understand of IBS. IBS is just a collection of symptoms. The symptoms can be caused by a variety of conditions. For many, if not most people with IBS, there are two or more conditions working together to cause the symptoms. Frequently the situation is confusing because we tend to want to ascribe the symptoms to a single cause: food triggers for example. When the same food can sometimes be no problem, sometimes result in mild symptoms, and sometimes result in a terrible problem, people often get confused. And often they cast about for a magic cure - a single pill or whatever that will solve their problem.There is a significant body of literature and data that shows that for many people, IBS symptoms can be avoided. But because the causes are myriad there is no single magic treatment that works for everyone. Solving IBS for you may mean altering your diet, treating an infection, re-establishing a healthy collection of microorganisms in your gut, replacing missing hormones or enzymes, managing your weight, dealing with stress, or all of the above and a few other things.The first step is to understand that you need to work with a doctor who has lots of experience with IBS, is most often successful at getting things solved, and is willing to get the data you need to decide which changes are needed for you.

 

[eric]

"IBS is just a collection of symptoms"Its a specific cluster of symptoms."The symptoms can be caused by a variety of conditions."Other conditions can mimick Some IBS symptoms.FYI: Am J Gastroenterol. 2007 May 3; [Epub ahead of print]What Patients Know About Irritable Bowel Syndrome (IBS) and What They Would Like to Know. National Survey on Patient Educational Needs in IBS and Development and Validation of the Patient Educational Needs Questionnaire (PEQ).Halpert A, Dalton CB, Palsson O, Morris C, Hu Y, Bangdiwala S, Hankins J, Norton N, Drossman D. Center for Digestive Disorders, Boston University School of Medicine, Boston, Massachusetts, USA.Patient education improves clinical outcomes in patients with chronic illness, but little is known about the education needs of patients with IBS. OBJECTIVES: The objective of this study was to identify: (1) patients perceptions about IBS; (2) the content areas where patients feel insufficiently informed, i.e., "knowledge gaps" about diagnosis, treatment options, etiology, triggers, prognosis, and role of stress; and (3) whether there are differences related to items 1 and 2 among clinically significant subgroups. METHODS: The IBS-Patient Education Questionnaire (IBS-PEQ) was developed using patient focus groups and cognitive item reduction of items. The IBS-PEQ was administered to a national sample of IBS patients via mail and online. ANALYSIS: Frequencies of item endorsements were obtained. Clinically relevant groups, (a) health care seekers or nonhealth care seekers and ( users or nonusers of the Web, were identified and grouped as MD/Web, MD/non-Web, and non-MD/Web. RESULTS: 1,242 patients completed the survey (371 via mail and 871 online), mean age was 39.3 +/- 12.5 yr, educational attainment 15 +/- 2.6 yr, 85% female, IBS duration 6.9 +/- 4.2 yr, 79% have seen an MD for IBS in the last 6 months, and 92.6% have used the Web for health information. The most prevalent IBS misconceptions included (% of subjects agreeing with the statement): IBS is caused by lack of digestive enzymes (52%), is a form of colitis (42.8%), will worsen with age (47.9%), and can develop into colitis (43%) or malnutrition (37.7%) or cancer (21.4%). IBS patients were interested in learning about (% of subjects choosing an item): (1) foods to avoid (63.3%), (2) causes of IBS (62%), (3) coping strategies (59.4%), (4) medications (55.2%), (5) will they have to live with IBS for life (51.6%), and (6) research studies (48.6%). Patients using the Web were better informed about IBS. CONCLUSION: (1) Many patients hold misconceptions about IBS being caused by dietary habits, developing into cancer, colitis, causing malnutrition, or worsening with age; (2) patients most often seek information about dietary changes; and (3) educational needs may be different for persons using the internet for medical information.PMID: 17488254 Aliment Pharmacol Ther. 2007 Jun 1;25(11):1329-41.Irritable bowel syndrome: patients' attitudes, concerns and level of knowledge.Lacy BE, Weiser K, Noddin L, Robertson DJ, Crowell MD, Parratt-Engstrom C, Grau MV. Section of Gastroenterology & Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.Background Irritable bowel syndrome (IBS) is a common, chronic disorder that reduces patients' quality-of-life. Although highly prevalent, little is known about patients' understanding of this disorder. Aim To evaluate the knowledge, fears and concerns of IBS patients. Methods Seven hundred thirty-six IBS patients (Rome II criteria) were eligible for inclusion in this prospective study. Each patient received a validated questionnaire to evaluate knowledge, attitudes and fears regarding IBS. Results A total of 261 of 664 potential respondents completed the questionnaire (39.3%). 83% of respondents were women, with a mean age of 53.7 years, and mean duration of symptoms of 14.2 years. Patients frequently believed that IBS develops because of anxiety (80.5%), dietary factors (75.1%) and depression (63.2%). Few respondents (28.7%) recognized that abdominal pain is the cardinal symptom of IBS, and 40.6% stated that colonoscopy can diagnose IBS. One in seven patients stated that IBS turns into cancer, and 29.9% noted that IBS increases the risk of inflammatory bowel disease. Conclusions Many IBS patients have significant misconceptions regarding the nature of their disease and its prognosis. An overwhelming majority of IBS patients believe that anxiety, dietary factors and depression cause IBS. These findings are discordant with physicians' views and practices and highlight the need for patient-oriented educational programs.PMID: 17509101 I am posting this one for you betterthroughscience since you use the elisha test for foods at the natruopathic doctor you work for.Clin Exp Allergy. 2007 Jun;37(6):823-30.Alterations of food antigen-specific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia.Zuo XL, Li YQ, Li WJ, Guo YT, Lu XF, Li JM, Desmond PV. Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, China.Background Post-prandial worsening of symptoms as well as adverse reactions to one or more foods are common in the patients with functional gastrointestinal diseases, such as irritable bowel syndrome (IBS) and functional dyspepsia (FD). However, the role played by true food allergy in the pathogenesis of these diseases is still controversial and there are no well-established tests to identify food allergy in this condition. Objective To investigate serum food antigen-specific IgG, IgE antibody and total IgE antibody titres in controls and patients with IBS and FD, and to correlate symptoms with the food antigen-specific IgG titres in IBS and FD patients. Methods Thirty-seven IBS patients, 28 FD patients and 20 healthy controls participated in this study. Serum IgG and IgE antibody titres to 14 common foods including beef, chicken, codfish, corn, crab, eggs, mushroom, milk, pork, rice, shrimp, soybean, tomatoes and wheat were analysed by ELISA. Serum total IgE titres were also measured. Last, symptomatology was assessed in the study. Results IBS patients had significantly higher titres of IgG antibody to crab (P=0.000), egg (P=0.000), shrimp (P=0.000), soybean (P=0.017) and wheat (P=0.004) than controls. FD patients had significantly higher titres of IgG antibody to egg (P=0.000) and soybean (P=0.017) than controls. The percentage of individuals with detectable positive food antigen-specific IgE antibodies of the three groups did not show any significant differences (P=0.971). There were no significant differences between IBS patients, FD patients and controls in the serum total IgE antibody titres (P=0.978). Lastly, no significant correlation was seen between symptom severity and serum food antigen-specific IgG antibody titres both in IBS and FD patients. Conclusion Serum IgG antibody titres to some common foods increased in IBS and FD patients compared to controls. But there is no significant correlation between symptom severity and elevated serum food antigen-specific IgG antibodies in these patients.PMID: 17517095 Dr Drossman has major experince with IBS. There is also a realy good probiotic info. 80 percent of gut flora is still not understood."work with a doctor who has lots of experience with IBS, "New Perspectives on Pathophysiology, Diagnosis, and Treatment-Douglas A. Drossman, MD http://www.expertinsightscme.com/ddrossman.cfmalso for anyone interested in why a gi might send someone for counseling. FYI UNC "Digest""Ask the ExpertStephan R. Weinland, PhDQuestion Why see a psychologist when the diagnosis is IBS?Many people experience distress and anxietywhen their doctor makes a recommendation thatthey see a psychologist. This reaction often comes from the belief that a referral to a psychologist carries with it assumptions about symptoms being all in your head or the result of mental illness.These are two of the biggest misconceptionsabout the practice of psychology in a medicalsetting, and they can often stand in the way ofpatients achieving a meaningful reduction insymptoms. In this column, I hope to dispel someof these misconceptions around psychology in amedical setting, and in doing so communicate afew of the benefits you might be able to achievein working with a psychologist to address yoursymptoms of IBS.First things first, your physical problems arereal!"http://www.ibsgroup.org/forums/index.php?showtopic=60484

 

[eric]

There are a lot of misconceptions on how IBS is diagnosed, its not every gi symptom.Diagnosing IBShttp://www.ibsgroup.org/forums/index.php?showtopic=65559

 

[16229]

IBS is a nervous disorder between the bowels and the unconscious brain. When being dx'ed you need to look at your symptoms and get the proper testing done that could be caused by those symptoms. It's probably smart to be screened for Celiac as it can be unpredictable symptom wise. There are many other things to possibly be tested for, but you don't need all of it, just things that may crossover symptom wise.You don't want to overdo it with testing. Not only because of monetary concerns, but because the bad effects all the testing has on the body.IBS is a real disorder or a set of related ones. The medical understanding, or lack of, of our nerves is a big hurdle right now in classifying things. Science does not even know how our nerves communicate. A lot of the successful therapies dealing with the nerves are a product of blind luck. Something works, then we try to figure out why it works. But it still doesn't change there isn't a good understanding of the processes that underlie all of these problems.When dx'ed properly with the newer Rome standards, a person should feel comfortable with an IBS diagnosis. I would still think some symptom based testing would be called for to be on the safe side.I'd really like to see a study on how many doctors use Rome properly to dx IBS. I think that would be more of an answer to this debate that's been going on for a while now.

 

[Kelly_K]

I don't know if stress causes or contributes. But I do know this...at the age of 19 I had duodenal ulcers. The doctor didn't say what the actual cause was but he did mention something about it possibly being bacteria. I wasn't tested for bacteria. I was given Tagamet at the time and that was it. What I do know is that at the time I got those ulcers, I was under ALOT of stress. I was on Tagamet for awhile and it wasn't until my cause of stress went away that suddenly I was better and the ulcers healed. I've since had stress (who doesn't have stress) but not as much as I did at that time...until last year. Then last summer I started getting gastritis, then had a stomach ulcer, then acid reflux, and after an endoscopy my gastroenterologist didn't think I had gastritis so much, but that something was causing the gastritis symptoms. So then I had a colonoscopy and along with my symptoms given to my dr, she diagnosed me with IBS. I did nothing or ate anything unusual or really bad, but I DID have ALOT of stress. Quite frankly, if they don't REALLY know what causes IBS then I don't think it can be said that someone under an extreme amount of stress (I mean more than daily stress or else yes, as one person pointed out, everyone in the world would have IBS) isn't going to get IBS from it. Stress not only affects people mentally and emotionally, but it can physically do some damage. If one is under an unusual amount of stress, I can't see why that couldn't cause the intestines to suddenly not function like they used to. I'm not a doctor, and I'm fairly new to this IBS thing. But like everyone else I'm still trying to figure out, and I don't rule out ANYTHING...stress included.

 

[postmortem]

i don't see how ibs would not worsen though... well maybe not the ACTUAL ibs itself, but the person who goes through all of this #### will eventually get weaker and develop other things right...?

 

[16229]

i don't see how ibs would not worsen though... well maybe not the ACTUAL ibs itself, but the person who goes through all of this #### will eventually get weaker and develop other things right...?

I don't think that anything can be ruled out 100%, but it does not appear that IBS causes any actual long term damage to tissue. Now that could change in the future as they have identified some small changes in the body, but we are not talking about systemic tissue breakdown like you may see with, say, IBD or cancer.IBS can worsen over time, but for many it stays the same and for many others it goes away just as mysteriously as it arrived. There is not really a rhyme or reason to it. We all have our own path here.Physical activity has actually been shown to be good for those with IBS and it does not worsen the condition even if one is in a flare. On the flip side, resting has not shown to make IBS symptoms any better. There is no reason for us to get weaker over time, though of course if your IBS gets worse then you will probably feel weaker.Kelly,A lot of people out there think stress has some to do with things. But it's looked at more as a trigger than a base cause. A lot of things in the body are balanced very gently. Like a person may have some small predisposition to IBS, which in and of itself is pretty controllable. A period of high stress would then be a trigger that throws that balance out of whack.But, it could be stress. All kind of stuff can happen with a lot of stress. But with the sheer amount of conditions that stress seems to effect, I think that is why it's looked at more as a trigger than an underlying cause.

 

[eric]

They have found that stress can contribute to Post infectious IBS.The stress system helps fight infections. However stress doesn't cause the underlying disorder. However since were talking about nervous systems here is easy to see how stress can have a negative impact. For me a big negative impact I didn't fully understand until I started learning about the connections. For example the fight or flight is a part of the stress system and is very important in IBS.Living with IBS can get harder over time, but it doesn't lead to serious conditions on its own. Mnay people like myself have had it for over thrity or forty years some poeple even longer. I have to say I am extremely glad its better via hypnotherapy and that I learned that here.

 

[Kelly_K]

I don't think that anything can be ruled out 100%, but it does not appear that IBS causes any actual long term damage to tissue. Now that could change in the future as they have identified some small changes in the body, but we are not talking about systemic tissue breakdown like you may see with, say, IBD or cancer.IBS can worsen over time, but for many it stays the same and for many others it goes away just as mysteriously as it arrived. There is not really a rhyme or reason to it. We all have our own path here.Physical activity has actually been shown to be good for those with IBS and it does not worsen the condition even if one is in a flare. On the flip side, resting has not shown to make IBS symptoms any better. There is no reason for us to get weaker over time, though of course if your IBS gets worse then you will probably feel weaker.Kelly,A lot of people out there think stress has some to do with things. But it's looked at more as a trigger than a base cause. A lot of things in the body are balanced very gently. Like a person may have some small predisposition to IBS, which in and of itself is pretty controllable. A period of high stress would then be a trigger that throws that balance out of whack.But, it could be stress. All kind of stuff can happen with a lot of stress. But with the sheer amount of conditions that stress seems to effect, I think that is why it's looked at more as a trigger than an underlying cause.

Ok, that does make sense.