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IBS and/or MC - Flux & Others, need help

479 Views 7 Replies 4 Participants Last post by  Mike NoLomotil
Please understand, my intention is not discredit my wife�s doctor by posting what follows. I realize the complexities of the issues surrounding intestinal tract disorders and that specialist and professionals of unquestionable expertise will have opposing views on this subject matter. My intent is only to receive input on the opposing views that follow so that I can weigh that input, like so many others on this board, in my search for direction to minimize the terrible impact this illness has imposed on my wife�s quality of life.As for background on Dr. fine, whose opposing view follows: Dr. Fine, who specializes in intestinal disorders, is a board certified internal medicine doctor and gastroenterologist, professionally involved in patient care, medical research, and teaching for over 10 years. And for anyone interested, his website is www.finerhealth.com. Now to the meat and potatoes �. I posted the following message on Dr. Fine�s bulletin board:�Dr. Fine; My wife was diagnosed with MC (Microscopic Colitis) last October. She had been through numerous tests and procedures including colonoscopy and endoscopy, both with biopsies. Her symptoms are diarrhea (95% morning thing with 3 to 5 BM�s in first 2 hours of waking) and the cramps (pain) that are there all the time and run from mild to dibilitating (definitely the worst part of this ordeal). She also had weight loss. She�s 5� � 6� and went from 138 to 113 in three months and is at 118 now. In January, on the follow-up with the gastro, it was explained that patterns had developed suggesting IBS. One example is that stress can set the cramps off in less than a minute and they are severe. You should also know that food, mainly dinner, also sets it off quickly and water will even set it off. Because of the reaction to stress, the gastro changed his diagnosis to IBS with MC. Additionally, I spend a great amount of time, daily, on a IBS group self help bulletin board where it�s easy to see that her symptoms are more closely tied to IBS, but there�s slight differences in some cases that have me believing there is MC with the IBS. My questions are: 1) Have you ever heard of a person having both IBS and MC going on at the same time? 2)If yes to the above, does IBS and MC tend to work against each other (I was told that they do by a knowledgeable guy on the IBS bulletin board)? 3) Do you have any advise for treatment if this is a combo of IBS and MC?�Dr Fine Responded:�Stress aggravates the symptoms of most GI disorders, especially immune diseases and diarrhea. This would not constitute a diagnosis of IBS and by definition, IBS patients have no other definable syndrome.I would not agree with this diagnosis (and a patient with another diagnosis doesn't need a diagnosis of IBS because it serves no purpose). Most MC patients with pain and cramps have concomitant gluten sensitivity. All MC patients should be tested for this and if positive need to avoid gluten in the diet.Tests for gluten sensitivty are available online from www.enterolab.com Good luck.�There you have it. Sorry for the book, but input on this is extremely important to me. If anyone can help, it would be greatly appreciated.Thank you!
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Dr. Fine's statement that gluten sensitivity will appear in most MC patients is on the money. Better than 70% will test positive and repsond to a gluten-free diet quickly. He sent you to a test, you can also use rudimentary dietary mgt. and oral challenge to check it out. he is also correct that stress is an aggravant to GI disorders with an immune basis. Quick reaction is do as he suggests. Standard differential dx to r/o gluten sensitivity.
BUD: naw...I was writing fast becasue I am in a hurry...got the kids this weekend (wife working at night) and had to go home early...same today...gotta go soon and my PC at home is still in the box (moved a week ago). What my too-quick statement meant is that I felt the DOCTOR was following a typical approach in differential diagnosis...and there are many ways to look for gluten sensitivity. It just depends what direction you want to come at it from. Double blind placebo controlled oral challenge is still the gold standard, and no I would not suggest our company is the only one to go to for this. You can look on the product board for a colorful conversation on what the doctors I work with do and realtive reactions to same. For what you appear to have you should get satisfactory outcomes with traditional means. I will have to defer until another day when I have more time to reply to Flux's usual suggestions that everything we do is a fantasy or made up. Have to go pull references, and frankly since a whole body of immunologic research by respected doctors is basically being ignored and will continue to be ignored as somehow delusional, why bother?
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