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Hello,This is my first post here. When I was 3 days old I was diagnosed with an intestinal maltrotation and underwent surgery the next day. They also removed my appendix, as is typical with surgery to repair a malrotation.I was always constipated as a child, which I beleive is the cause of my hiatal hernia, which in turn is the cause of my GERD.I recently went to a GI specialist for a consult, he sounded confident that I have IBS- my primary symptoms are bloating and constipation, with occasional bouts of diareaha and vomiting.He perscribed me Zelnorm, which I'm undecided about. I may not have perscription coverage when I change insurance, and it's so expensive, so I'm not sure if it's worth it.The main thing I'm wondering about is if there is a known connection between malrotation and IBS?
 

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No.
 

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KateyC,Please do not take the above curt response as representative of this group. Setting aside the question whether the poster has the sort of encyclopedic knowledge and intimate connections to the medical community to answer your question with such an air of authority, I'll just recommend that you keep one thing in mind: There may be no "known" connection, but that does not mean there is no connection.I frankly wonder how we could know there was a connection. Neonatal intestinal obstruction occurs in 1 in 1500 births according to an article posted at a U. Chicago Web site (http://pedclerk.bsd.uchicago.edu/Neonatalintestinalobst.html). Only a fraction of those cases are due to malrotation. What is the likelihood that some researcher would want to track down these cases 20 or 30 years later and find out whether they had developed IBS? And what pharmaceutical company would have anything to gain by financing such a study?For what it's worth, a former gynecologist of mine ("fired" because he wouldn't stop bugging me to have a hysterectomy) thought my fibroid tumors and/or endometriosis were the cause of my IBS. It sounds like you forgot or didn't get a chance to ask your gastroenterologist about the malrotation. He should be able to determine whether any lingering physical abnormality of the bowel has caused or is contributing to your constipation. If not, I think it is still possible that the neonatal malrotation and the IBS are different manifestations of a basic (neuromuscular?) problem, and you will have to manage the IBS symptoms, as most of us do, until/unless you find a way to address the underlying cause.Unfortunately, it sounds as if your gastro is attempting diagnosis by prescription, an approach to chronic illness that has become all too popular in the age of managed care. He probably figures, if Zelnorm works, that clinches the IBS diagnosis and no further tests are needed. You will have to decide whether you can play along with that strategy.My advice would be to make sure you have exhausted all possible modifications of diet and lifestyle, including conservative experimentation with nutritional supplements, before you allow yourself to become dependent on a prescription drug to move your bowels.Let us know how things are going, and we'll help if we can. If we can't, at least most of us will empathize.
 

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KateyC,Please do not take the above curt response as representative of this group. Setting aside the question whether the poster has the sort of encyclopedic knowledge and intimate connections to the medical community to answer your question with such an air of authority, I'll just recommend that you keep one thing in mind: There may be no "known" connection, but that does not mean there is no connection.I frankly wonder how we could know there was a connection. Neonatal intestinal obstruction occurs in 1 in 1500 births according to an article posted at a U. Chicago Web site (http://pedclerk.bsd.uchicago.edu/Neonatalintestinalobst.html). Only a fraction of those cases are due to malrotation. What is the likelihood that some researcher would want to track down these cases 20 or 30 years later and find out whether they had developed IBS? And what pharmaceutical company would have anything to gain by financing such a study?For what it's worth, a former gynecologist of mine ("fired" because he wouldn't stop bugging me to have a hysterectomy) thought my fibroid tumors and/or endometriosis were the cause of my IBS. It sounds like you forgot or didn't get a chance to ask your gastroenterologist about the malrotation. He should be able to determine whether any lingering physical abnormality of the bowel has caused or is contributing to your constipation. If not, I think it is still possible that the neonatal malrotation and the IBS are different manifestations of a basic (neuromuscular?) problem, and you will have to manage the IBS symptoms, as most of us do, until/unless you find a way to address the underlying cause.Unfortunately, it sounds as if your gastro is attempting diagnosis by prescription, an approach to chronic illness that has become all too popular in the age of managed care. He probably figures, if Zelnorm works, that clinches the IBS diagnosis and no further tests are needed. You will have to decide whether you can play along with that strategy.My advice would be to make sure you have exhausted all possible modifications of diet and lifestyle, including conservative experimentation with nutritional supplements, before you allow yourself to become dependent on a prescription drug to move your bowels.Let us know how things are going, and we'll help if we can. If we can't, at least most of us will empathize.
 

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quote: Neonatal intestinal obstruction occurs in 1 in 1500 births according to an article posted at a U. Chicago Web site (http://pedclerk.bsd.uchicago.edu/Neonatalintestinalobst.html). Only a fraction of those cases are due to malrotation. What is the likelihood that some researcher would want to track down these cases 20 or 30 years later and find out whether they had developed IBS?
Presumably, if someone were born with some serious structural defect in their intestine, they have their hands full with that. How could anyone in this state ever get diagnosed with IBS? By defintion, IBS means there is no organic, meaning structural defect, to account for the symptoms. If there were, then that would be diagnosed.At the same time, however, the presence of any structural defect doesn't automatically rule out IBS or necessarily imply that it is responsible for IBS symptoms.
quote:possible that the neonatal malrotation and the IBS are different manifestations of a basic (neuromuscular?) problem, and you will have to manage the IBS symptoms, as most of us do, until/unless you find a way to address the underlying cause.
This is theoretically possible, that something out there that causes IBS in almost all cases that it causes something but in rare instances, it causes something else to occur. As noted above malrotation is rare but IBS is extremely common (an astounding 1 in 10).
quote:Unfortunately, it sounds as if your gastro is attempting diagnosis by prescription, an approach to chronic illness that has become all too popular in the age of managed care. He probably figures, if Zelnorm works, that clinches the IBS diagnosis and no further tests are needed.
That is not necssarily a bad approach. Sometimes, you have to treat something without knowing what it is.
quote:My advice would be to make sure you have exhausted all possible modifications of diet and lifestyle, including conservative experimentation with nutritional supplements, before you allow yourself to become dependent on a prescription drug to move your bowels.
This too is sound medical practice.
 

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quote: Neonatal intestinal obstruction occurs in 1 in 1500 births according to an article posted at a U. Chicago Web site (http://pedclerk.bsd.uchicago.edu/Neonatalintestinalobst.html). Only a fraction of those cases are due to malrotation. What is the likelihood that some researcher would want to track down these cases 20 or 30 years later and find out whether they had developed IBS?
Presumably, if someone were born with some serious structural defect in their intestine, they have their hands full with that. How could anyone in this state ever get diagnosed with IBS? By defintion, IBS means there is no organic, meaning structural defect, to account for the symptoms. If there were, then that would be diagnosed.At the same time, however, the presence of any structural defect doesn't automatically rule out IBS or necessarily imply that it is responsible for IBS symptoms.
quote:possible that the neonatal malrotation and the IBS are different manifestations of a basic (neuromuscular?) problem, and you will have to manage the IBS symptoms, as most of us do, until/unless you find a way to address the underlying cause.
This is theoretically possible, that something out there that causes IBS in almost all cases that it causes something but in rare instances, it causes something else to occur. As noted above malrotation is rare but IBS is extremely common (an astounding 1 in 10).
quote:Unfortunately, it sounds as if your gastro is attempting diagnosis by prescription, an approach to chronic illness that has become all too popular in the age of managed care. He probably figures, if Zelnorm works, that clinches the IBS diagnosis and no further tests are needed.
That is not necssarily a bad approach. Sometimes, you have to treat something without knowing what it is.
quote:My advice would be to make sure you have exhausted all possible modifications of diet and lifestyle, including conservative experimentation with nutritional supplements, before you allow yourself to become dependent on a prescription drug to move your bowels.
This too is sound medical practice.
 

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Discussion Starter · #10 ·
Hello,I am still doubtful of the IBS diagnosis- though the Zelnorm DOES seem to help. I generally assumed that I had adhesions and some sort of partial obstruction that was not allowing me to have bowel movements with normal frequency. The GI specialist I saw, though, said that I definately had no symptoms of adhesions. I guess I'm really wondering if I have IBS at all, or if I am just experiencing symptoms of my malrotation.
 

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Discussion Starter · #11 ·
Hello,I am still doubtful of the IBS diagnosis- though the Zelnorm DOES seem to help. I generally assumed that I had adhesions and some sort of partial obstruction that was not allowing me to have bowel movements with normal frequency. The GI specialist I saw, though, said that I definately had no symptoms of adhesions. I guess I'm really wondering if I have IBS at all, or if I am just experiencing symptoms of my malrotation.
 
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