Explanation of body temperature changes and perception of body temperature changes by some IBS patients:Many victims of d-predominant and "cyclic" IBS experience both perceived and actual changes in body temperature as coincident "systemic" symptoms in addition to their gut specific symptoms.This is an effect of specific mediators (example: cytokines Interleukin 1 and TNF-alpha and several others) that are normally released in the acute phase of certain types of inflammtory reactions. This is only supposed to occur in response to specific infection, as you have all experienced when you have had one (gut infection or otherwise).However, since it is now known that the (general term for simplicity) "inflamatory response system" (an aray of immunologic reactions deisgned to be self-protective) can be and is abnormally activated by one to several immunologic and non-immunologic mechanisms as a precursor to and as part of the development of a so-called "episode", (as well as chronic perisstent activation) an array of proinflammtory mediators are released from various classes of immunocytes(beginning in the small bowel tissue and microvasculature).Some mediators can create the perception of temperature change as they alter blood vessel tone (in addition to permeability) which can cause a sensation of hot, cold, flashes or clamminess depending upon the specific combinations which are released or synthesized at the time.Also there are other cytokines which can penetrate the blood-brain barrier and act directly upon the hypothalmus when released. Among their intended effects are altered body temperature via this CNS mechanism, and others which act upon peripheral muscle and fat cells altering energy mobilization and thus temperature rise in tissue themselves.Now in a person who has had either an episode of actual food poisoning, or food contmaination, which actvated the IRS these mechanisms would have been activated and their effects can persist beyond the acute phase.In an IBS patient this will also reduce oral tolerance further than it has already been compromised, lowering the threshold of response to any food or chemical sensitivity or exists, as well as lowering the respnse threahold of the IRS to other endogenous and exogenous stress events, and thus amplifying the effects for some time. This is all well known.Even in persons who have no immediate precursor clincial infection whatsoever, these symptoms can and do many times precede an epdisode since this is part and parcel of the array of things taking place when you have provoked the IRS to activate regardless of the mechnism of activation, such as by consuming something that tolersance has been reduced or lost to and thus creating an inapprorpiate reaction (humoral and cellular mediated reactions can both occur and produce this effect).So while one does not see such things as "fever" and "hot flashes" or "dizziness" or "fog brain" in the "Rome Criteria", this does not mean that they do not occur nor are experienced. heck, less than a year and a hlf ago "the prevailing thinking" among some of the parties considered "leaders" in IBS was still things like "there is 'no inflammtion' in IBS even though though IRS activation in IBS patients had been shown time and time agin by other investigators over a 20 year period. This just illustrates how rapidly understanding can progress when we combine the observations and finidngs of gorups studying different aspects of any poorly-understood condition. The paradigm can change in an instant.So while these other systemic symptoms indeed are not "diagnostic" of IBS, a wholly correct statment to make, they are however known secondary symptoms with a known and proven set of mechanisms which provoke and then create them, which occur in a population of IBS victims which is subtantial, but most found within the d-types and cyclics since these are the symptom sets most closely associated with the IRS mechanisms which result in acute bowel evacuation as a protective mechanism, triggered inappropriately.Eat well. Think well. Be wellMNL
