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Common Misconceptions about IBS

6K views 27 replies 12 participants last post by  flux 
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:eek: 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:eek: 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
 
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?
 
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.
 
"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
 
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.
 
Some places like the one better through science works for with a natruropathic Doctor, post this to there website"There are several hundred potential causes of IBS, but they can be broken down into two major categories. Food Allergies and Intolerances Problems with Intestinal Bacteria, Yeast/Candida, or Parasites "However IBS is not cause by food allergies or by parasites or yeast candida. There is no eveidence for these as causes and there is a lot more evidence from state of the art research on abnormalities in IBS.What about structural abnormalities or biochemical abnormalities and a host of things that cannot be broken down into foods or pathogens? They don't actually research IBS though. Nor are they really posting all the science behind it real IBS research doctors have already done on not just IBS, but other functional disoders.Gastroenterology April 2006 Issue:Rome III Table of ContentsThe Functional Gastrointestinal Disorders and the Rome III ProcessD. A. DrossmanFundamentals of Neurogastroenterology: Basic ScienceD. Grundy, E. D. Al-Chaer, Q. Aziz, S. M. Collins, M. Ke, Y. Taché,and J. D. WoodApplied Principles of Neurogastroenterology: Physiology/Motility SensationJ. E. Kellow, F. Azpiroz, M. Delvaux, G. F. Gebhart, H. R. Mertz,E. M. M. Quigley, and A. J. P. M. SmoutPharmacological and Pharmacokinetic Aspects of Functional Gastrointestinal DisordersM. Camilleri, L. Bueno, F. de Ponti, J. Fioramonti, R. B. Lydiard, and J. TackGender, Age, Society, Culture, and the Patient's Perspective in the Functional Gastrointestinal DisordersL. Chang, B. B. Toner, S. Fukudo, E. Guthrie, G. R. Locke, N. J. Norton,and A. D. SperberPsychosocial Aspects of the Functional Gastrointestinal DisordersR. L. Levy, K. W. Olden, B. D. Naliboff, L. A. Bradley, C. Francisconi,D. A. Drossman, and F. CreedFunctional Esophageal DisordersJ. P. Galmiche, R. E. Clouse, A. Bálint, I. J. Cook, P. J. Kahrilas,W. G. Paterson, and A. J. P. M. SmoutFunctional Gastroduodenal DisordersJ. Tack, N. J. Talley, M. Camilleri, G. Holtmann, P. Hu, J.-R. Malagelada,and V. StanghelliniFunctional Bowel DisordersG. F. Longstreth, W. G. Thompson, W. D. Chey, L. A. Houghton, F. Mearin,and R. C. SpillerFunctional Abdominal Pain SyndromeR. E. Clouse, E. A. Mayer, Q. Aziz, D. A. Drossman, D. L. Dumitrascu,H. Mo¨nnikes, and B. D. NaliboffFunctional Gallbladder and Sphincter of Oddi DisordersJ. Behar, E. Corazziari, M. Guelrud, W. Hogan, S. Sherman, and J. ToouliFunctional Anorectal DisordersA. E. Bharucha, A. Wald, P. Enck, and S. RaoChildhood Functional Gastrointestinal Disorders: Neonate/ToddlerP. E. Hyman, P. J. Milla, M. A. Benninga, G. P. Davidson, D. F. Fleisher,and J. TaminiauChildhood Functional Gastrointestinal Disorders: Child/AdolescentA. Rasquin, C. Di Lorenzo, D. Forbes, E. Guiraldes, J. S. Hyams, A. Staiano,and L. S. WalkerDesign of Treatment Trials for Functional Gastrointestinal DisordersE. J. Irvine, W. E. Whitehead, W. D. Chey, K. Matsueda, M. Shaw, N. J. Talley,and S. J. O. Veldhuyzen van ZantenThe Road to RomeW. G. Thompsonhttp://www.romecriteria.org/GastroIssue.htm"The DiagnosisSymptom-Based CriteriaThe use of symptom-based criteria allows the physician to make a "positive diagnosis" of IBS, thereby reducing the need for excess diagnostic tests/studies to exclude other conditions. These criteria also serve to legitimize the disorder to patients and physicians. However, developing diagnostic criteria is challenging because of the absence of specific physical or biochemical findings, the variability of the symptoms (with regard to pattern, location, and severity) among patients -- and even in the same patient over time, and the inconsistency of the clinical course. Several symptom-based diagnostic approaches for IBS have been proposed over the last 2 decades in an attempt to standardize the diagnosis and increase its specificity. These criteria were selected through use of clusters of symptoms thought to be consistent with the disorder.[11,12] In a study done 20 years ago, 6 symptoms were identified that differentiate between patients with irritable bowel from those with organic intestinal diseases.[41] These symptoms, later known as the "Manning criteria," for the first time suggested the feasibility of a positive diagnostic approach to IBS based on symptom criteria. Although widely used in epidemiologic and clinical studies, these criteria have been of limited clinical value in differentiating IBS from organic, lower GI tract diseases.[42] Nevertheless, they have provided the basis for the more recent "Rome criteria," first published for IBS in 1989[43] and for all of the functional GI disorders in 1990.[10]""Additional support for a positive diagnosis of IBS also comes from studies that have looked at long-term outcomes. In long-term follow-up studies (up to 9 years from the diagnosis), no other explanation for the symptoms was found in 95% to 100% of patients.[49-51] This suggests that a positive diagnosis using symptom-based criteria, the absence of "red flags," and limited investigations rarely requires revision. http://www.medscape.com/viewarticle/407962_3So IBS is based on a specific cluster of symptoms.Using ""IBS" is just a catch-all term" is FALSE and would incorporate all functional disorders and disease, if you had any GI Sympotms. But these conditions including IBS have started to be broken down into subgroups. Functional d, IBS and functional C, functional abdominal pain ect.. It does a diservice to IBSer to say it is just all gi symptoms and a catch all. The symptoms can differenate between organic diseases and IBS.as for porbiotics, 80% of the 500 speicies of gut bacteria have not been studied. This has a chart on some which have been found to be benefical for IBS.Expert Insights: Y. Ringel, MD on Novel Approaches to Treatment: Probiotics http://www.expertinsightscme.com/pdf/IBS-Pt2-NL.pdfas for bacteria, no single pathogen has been found to cause IBS. but different bacterial pathogens have been found to cause post infections IBS and after resolution of the intial infection changes in the cell structures of the digestive system which ARE VERY important. See the above PI IBS link.Post infectious IBS hads been demonstrated as a brain gut axis issue.Bacteria is still an extremely active area of IBS research although not the only very active research area."Gut Bacteria and Irritable Bowel Syndrome By: Eamonn, M. M. Quigley M.D., Alimentary Pharmabiotic Centre, University College Cork, Cork, IrelandBacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These "normal" bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the flora and its host, and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article presents a discussion of the possible role of bacteria in IBS and various treatment approaches."Do bacteria play a role in IBS?The possibility that gut bacteria could have a role Irritable Bowel Syndrome (IBS) may surprize some; there is indeed, now quite substantial evidence to support the idea that distrubances in the bacteria that populate the intestines may have a role in at least some patients with IBS. What is this evidence? It can be summarized as follows:1. surveys which found that antibiotic use, well known to distrub flora, may predispose individuals to IBS.2. The observation that some individuals may develop IBS suddenly, and for the first time, following an episode of stomach or intestinal infection (gatroenteritis) caused by a bacterial infection. (see post infectious IBS above)3. recent evidence that a very low level of inflammation may be present in the bowel wall of some IBS patients, a degree of inflammation that could well have resulted from abnormal interactions with bacteria in the gut. (there is also strong research on the bodies stress system, fighting infections and the brain gut axis, in a subgroup of IBSers, especially those that developed PI IBS that lead to clinical IBS. 4. The Suggestion that IBS maybe Associated with the abnormal presents, , in the small intestines, of types and numbers; a condition termed small bacterial overgrowth (SIBO)>5. Accumaliting evidence to indicate that altering the bacteria in the gut, by antibiotics or probiotics, may improve symptoms in IBS.For some time, various studies have suggested the presence of changes in the kind of colonic flora in IBS patients. The most consistent finding is a relative decrease in the population of one species of 'good' bacteria, bifidobacteria.However, the methods employed in these studies have been subject to question and other studies have not always reproduced these finding. Nevertheless, these changes in the flora, maybe primary or secondary, could lead to the increase of bacterial species that produce more gas and other products of their metabolism. These could CONTRIBUTE to symptoms such as gas, bloating and diarrhea.""We still don't know the exact role bacteria has in IBS. More research is needed."http://www.aboutibs.org/Publications/currentParticipate.htmlThe SIBO theory although has not been proven to cause IBS. Its still unclear if IBS can cause sibo or sibo can cause IBS or that it is bacteria in the colon in general that plays a role. The testing emplyoed is not always accurate either, nor do they know how many conmtrols have sibo. You can have sibo and not have IBS. That to me is important.Treatment for Bacterial Overgrowth in the Irritable Bowel Syndromehttp://www.annals.org/cgi/content/full/145/8/626Aliment Pharmacol Ther. 2007 Jun 1;25(11):1271-81. Links Review article: the role of antibiotics vs. conventional pharmacotherapy in treating symptoms of irritable bowel syndrome.Frissora CL, Cash BD. Division of Gastroenterology and Hepatology, Weill Cornell Medical College of Cornell University, New York, NY, USA.Background The concept of augmenting the management of irritable bowel syndrome with antibiotics is evolving, and many questions remain regarding this therapy relative to known and hypothesized irritable bowel syndrome pathophysiology. The clinical evidence of small intestinal bacterial overgrowth as an important aetiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar; however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of enteric bacteria affect intestinal motility in irritable bowel syndrome. Aim To discusses the efficacy and tolerability of current symptom-directed pharmacotherapies and of antibiotics in the treatment of irritable bowel syndrome. Methods A computerized search of PubMed was performed with search terms 'IBS', 'pharmacotherapy' and 'antibiotics'. Relevant articles were selected, and the reference list of selected articles was reviewed to identify additional references. Results Antibiotic treatment benefits a subset of irritable bowel syndrome patients. The non-absorbed antibiotic rifaximin has a favourable safety and tolerability profile compared with systemic antibiotics and demonstrates a therapeutic efficacy comparable with symptom-based irritable bowel syndrome pharmacotherapies. Conclusion Rifaximin is the only antibiotic with demonstrated sustained benefit beyond therapy cessation in irritable bowel syndrome patients in a placebo-controlled trial. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research.PMID: 17509095This is a highly controversial area of IBS research. It is not clear even if just taking antibiotics or probiotics, just help the bacteria, regarless of SIBO. The last sibo and IBS study, bloating was the only thing that improved. Read the above "Treatment for Bacterial Overgrowth in the Irritable Bowel Syndrome" link. This has not stopped some doctors in giving antibiotis to patients without sibo testing. Basically as study subjects. Sibo is also a functional disorder, abnormal functioning cause the normal bacteria to enter the small bowel. There are symptoms to sibo that are not symptoms to IBS. Malnutrition for one. People who have surgery can develop sibo and not have IBS.
 
almost every IBS patient effectively demonstrates alter serotonin signaling.altered serotonin signaling and ibs compilationhttp://www.ibsgroup.org/forums/index.php?showtopic=80198and a new study on food allergyClin 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 It should be noted that the mast cell palys a role in IBS and in stress and in immune food reactions.""Dr. Jack Wood, a renowned physiologist at The Ohio State University calls the ENS “the little-brain-in-the-gut.” "Dear Shawn eric:Sorry for the delayed reply to your question. I generally agree with Dr. Drosssman’s response. A subgroup of individuals when they become sensitized to specific molecules in certain foods respond to ingestion of the molecules with symptoms of cramping abdominal pain, fecal urgency and explosive watery diarrhea. These are also the primary symptoms of diarrhea-predominant IBS. Enteric mast cells, by mechanisms we don’t understand, become sensitized to the food molecule and respond to its presence by releasing a signal to the brain-in-the-gut (ENS) which is interpreted as a threat. The ENS responds by “running” a program which organizes secretion and motility into a behavior pattern of the bowel, which rapidly clears the threat from the lumen. Because to be effective secretion occurs in large volumes and the contractions that accomplish rapid propulsion are strong, running of the program has the side effects of diarrhea and cramping pain. Big brain input to mast cells during stress activates the mast cells to evoke the symptoms resulting from exposure of the mast cells to sensitizing food antigens. Aside from food allergens and mast cells, certain chemicals such as those in hot peppers, stimulate sensory nerves in the ENS and we are beginning to understand how this can also lead to food-related symptoms that might mimic or exacerbate IBS.Hope this helps,Jackie (Jack) D. Wood " You have two brains: one in your head and another in your gut. Dr. Jackie D. Wood is a renowned physiologist at The Ohio State University. He calls the second brain, "the-little-brain-in-the-gut." This enteric nervous system is part of the autonomic nervous system and contains over one hundred million neurons, which is as many as are in the spinal cord. This complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. This little brain in the gut is connected to the big brain by the vagus nerves, bundles of nerve fibers running from the GI tract to the head. All neurotransmitters, such as serotonin that are found in the brain are also present in the gut.Dr Wood has discovered that this little-brain-in-the-gut has programs that are designed for our protection and which are very much like computer programs. They respond to perceived threats in the same way that the limbic system or the emotional brain does. So the threat of a gastrointestinal infection can activate the program that increases gut contractions in order to get rid of the infection. The symptoms are abdominal cramping and diarrhea. Dr. Wood has determined that a type of cell found in the body and the gut, called the mast cell, is a key to understanding the connection of the big brain in the head with the little-brain-in-the-gut. Mast cells are involved in defense of the body. In response to certain threats or triggers, such as pollen or infection, mast cells release chemicals, such as histamine, that help to fight off the invader. Histamine is one of the chemicals that causes the symptoms of an allergy or a cold. When an infection of the gut occurs, such as food poisoning or gastroenteritis, the mast cells of the gut release histamine. The little-brain-in-the-gut interprets the mast cell signal of histamine release as a threat and calls up a protective program designed to remove the threat â€" at the expense of symptoms: abdominal pain and diarrhea. The brain to mast cell connection has a direct clinical relevance for irritable bowel syndrome and other functional gastrointestinal syndromes. It implies a mechanism for linking allostasis and the good stress response to irritable states (e.g., abdominal pain and diarrhea) of the gut. Mast cells can be activated to release histamine in response to perceived psychological stress, whether the stressor or trigger is consciously perceived or not. So the end result is the same as if an infection activated the program in the-little-brain-in-the-gut: abdominal pain and diarrhea."http://www.parkviewpub.com/nuggets/n5.html So the fight or flight can activate the mast cell like a food problem. Any threat to the organism, real or perceived. Pain and d can set it off so it can be physicall or mentally. and a new study on smells and serotonin from ddw.I have often noticed smells can trigger my IBS.Studies assess effectiveness of serotonin and nerve stimulants on irritable bowel syndromesWASHINGTON, D.C. (May 21, 2007) - Studies have shown that gastrointestinal (GI) tract function is often influenced by specific stimulants or reactors, which sometimes cause irritable bowel syndrome (IBS) or constipation. Two studies presented today at Digestive Disease Week® 2007 (DDW®) take a closer look at GI stimulation, including one examining the role of serotonin and reactions to certain types of foods and another looking at the potential therapeutic value of nerve stimulation for constipation. DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery."We know that conditions of the bowel, such as constipation, diarrhea and irritable bowel syndrome, are quite troubling for a large number of individuals. These conditions can be highly volatile and unpredictable, but we are still trying to determine how we can manage these variables and what preventive or treatment options may help patients who suffer from these conditions," said Alan Buchman, M.D., MSPH, AGAF, Feinberg School of Medicine of Northwestern University School of Medicine. "These two studies point to options that may help doctors manage symptoms in their patients and hopefully lead to better treatment options in the future."Olfactory Receptors on Human Intestinal Enterochromaffin (EC) Cells Function as Sensors for Spices and Odorants (Abstract #W1581)One primary research focus in GI disorders is how and why the system reacts to certain foods or other stimulants; specifically, researchers are investigating the primary factors responsible for regulating digestion. Enterochromaffin (EC) cells, which are present throughout the digestive system, release serotonin (a chemical associated with the etiology of various diseases such as migraine, diarrhea, respiratory disturbances and hypertension) and are important in regulating gut motility. Researchers from the Technical University of Munich and the Ludwig Maximillian University of Munich in Germany investigated whether EC cells in the intestine express nasal olfactory receptors (ORs, receptors used for smelling) to determine whether odorants present in spices, fragrances, cigarettes, detergents and cosmetics may cause serotonin release, thereby provoking a GI response. To evaluate this connection, researchers studied human EC cells isolated from mucosal biopsies by laser microdissection and an EC derived cell line. The experiments revealed expression of several ORs in the isolated EC cells, as well as the cell line. Using digital fluorescence imaging, the team found that activation of the cells with odorants caused elevation of intracellular Ca2+, followed by serotonin release up to 10-fold that of the controls. Odorants like thymol (thyme), eugenol (cloves), bourgeonal (floral, lily-of-the-valley), helional (brown algae) and substances present in roses, bananas or raspberries, specifically, caused an elevation of Ca2+ levels.The findings suggest that these types of odorants may cause a serotonin-related GI reaction. The effects could be inhibited by known OR antagonists, such as methyl isoeugenol (a competitive antagonist of eugenol) or by blocking Ca2+ influx (e.g., via Ca2+ channels with nifedipine, a drug used in the treatment of hypertension because it relaxes blood vessels). "Our results show that odorants present in the gut may stimulate serotonin release via olfactory receptors expressed in human enterochromaffin cells in the gut mucosa," said Petra Voland, Ph.D., of the Technical University of Munich, and one of the lead investigators of the study. "Serotonin controls peristalsis and is implicated in pathological conditions such as vomiting, diarrhea and irritable bowel syndrome. Thus, olfactory receptors are potential novel targets for the treatment of gastrointestinal diseases and motility disorders."Dr. Voland will present this study on Wednesday, May 23, at 8:00 a.m. in Hall E. Digestive Disease Week® (DDW®) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute , the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 19-24, 2007 in Washington, D.C. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.http://www.eurekalert.org:80/pub_releases/...a-sae051707.phpThere is also the association and many links between serotonin and other non gi problems in IBS.
 
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