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Discussion Starter · #1 ·
There are so many of us and although I can match my symptoms to several people on this board, there are some people who have vastly different symptoms than mine and for many varying reasons. I seem to be especially susceptible to food aggravations and lack of sleep and water. Some people will get symptoms no matter what they eat but they have anxiety problems. Some people are mildly aggravated by their IBS while some are nearly house-bound. Some of us can work, some of us can't. The range of symptoms is wide, and the mixture of symptoms within individuals has an unlimited number of possibilities and can change over time, like mine did. Some people are lucky enough to go into remission for a while and then suddenly have the IBS again.We all have been diagnosed with IBS but what if we actually represent a conglomoration of different disorders and/or diseases that the doctors just haven't been able to sort out yet? How can my IBS, which at the moment anyway is basically C with occassional bouts of painful loose BM's be similar at all to people who are rushing to the bathroom with D all day long? I can relate to say, nausea and bloating and C but I can't really relate to severe lower abdom. pain, having accidents, panic attacks, etc. At the beginning I was definately more D than anything (except nauseous, of course) but now I'm more C. Do I have the same problem but in a different way? Are any and all gut motility problems lumped together as IBS? Fiber helps some of us and puts others flat on their backs (or tushes, as it were, on the toilet) and calcium, good for D, is a killer for those of us prone to C. And what ever happened to the doctor who thought IBS might be considered "asthma of the gut"? Could it be an environmental thing? I know for myself that the IBS is much less severe when I'm in the mountains, in clean air. I'm sorry, I am totally babbling here. I think the barium has made me a little ditzy. Actually I had a very bizarre dream last night and have been very introspective all day long.
time for bed...my brain obviously needs a rest!
 

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The jury is still out. I'm sure there are people with IBS who have been mis-diagnosed and actually have something else (like a small intestine bacterial infection perhaps).However, I've looked at a lot of the medical studies done on IBS patients--both IBS-C and IBS-D--and find it hard to believe that they are completely separate disorders, or that all of us are suffering from a hundred different things. I feel that the variations in symptoms are still caused by the major theme--a "dysregulation," as the doctors like to say, between the Central Nervous System, the Enteric Nervous System, and the myriad chemical reactions that take place in our gut every day. I think of it like allergies, you know? Some people may be allergic to dog hair and others pollen. And those that are allergic to dog hair might get a runny nose and watery eyes while those allergic to pollen might get a stuffy nose and itchy eyes. But we don't come up with different scientific illness names for each allergy right? They're just allergies.Of course, until a cause has been found and identified, it is still all conjecture. It is not impossible, though highly improbable I would say, that all of us are suffering from a hundred different as-yet undefined diseases.-- Jared
 

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The jury is still out. I'm sure there are people with IBS who have been mis-diagnosed and actually have something else (like a small intestine bacterial infection perhaps).However, I've looked at a lot of the medical studies done on IBS patients--both IBS-C and IBS-D--and find it hard to believe that they are completely separate disorders, or that all of us are suffering from a hundred different things. I feel that the variations in symptoms are still caused by the major theme--a "dysregulation," as the doctors like to say, between the Central Nervous System, the Enteric Nervous System, and the myriad chemical reactions that take place in our gut every day. I think of it like allergies, you know? Some people may be allergic to dog hair and others pollen. And those that are allergic to dog hair might get a runny nose and watery eyes while those allergic to pollen might get a stuffy nose and itchy eyes. But we don't come up with different scientific illness names for each allergy right? They're just allergies.Of course, until a cause has been found and identified, it is still all conjecture. It is not impossible, though highly improbable I would say, that all of us are suffering from a hundred different as-yet undefined diseases.-- Jared
 

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IBS is a definition that was formulated by a bunch of doctors who like to visit Rome (spaghetti, anyone?). They define IBS based a set of simple symptoms, which are now the Rome II criteria.The goal is to really pinpoint IBS and they have also defined related conditions such as functional diarrhea and functional constipation (essentially both IBS but without the pain) along with a number of conditions (functional dyspepsia).IBS as it stands in Rome II is probably one or a few very closely related "diseases", which involve mechanisms of visceral hypersensitivity, abnormal responses to normal gut stimuli and to stress. In other words, there is really is something in the body that maps to the condition they call IBS.However, a few people probably do have other as yet undefined (or misdiagnosed) conditions which mimic IBS. Chances are if you don't meet Rome II criteria for something, then it could be something else.
 

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IBS is a definition that was formulated by a bunch of doctors who like to visit Rome (spaghetti, anyone?). They define IBS based a set of simple symptoms, which are now the Rome II criteria.The goal is to really pinpoint IBS and they have also defined related conditions such as functional diarrhea and functional constipation (essentially both IBS but without the pain) along with a number of conditions (functional dyspepsia).IBS as it stands in Rome II is probably one or a few very closely related "diseases", which involve mechanisms of visceral hypersensitivity, abnormal responses to normal gut stimuli and to stress. In other words, there is really is something in the body that maps to the condition they call IBS.However, a few people probably do have other as yet undefined (or misdiagnosed) conditions which mimic IBS. Chances are if you don't meet Rome II criteria for something, then it could be something else.
 

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A perspective Consistent with Evolution of "Syndromes" into specific "Diseases":previously posted elsewhere...If one goes to page 569 of the (17th edition) of the Merck Manual (if you have a diferent edition go to the chapter on Chronic Obstructive Pulmonary disease). Many years ago there were people with apparent lung diseases who clearly had some common base or bases for their symptoms, and they were seprated into groups based upon their primary symptoms, and they all had some symptoms which overlapped to varying degrees. Long before the pathology (underlying diseases) of COPD were understood, however, medicine was able to observe and diagnose COPD vitcims based on clinical presentation, symptoms, and history then provide therapies to reduce the sympotms (which were somewhat different for each symptom set, yet had varying degrees of commonality).As scientific prowess and technology progressed, medicine gained new means of studying the cardiopulmonary system more closely, both in vivo and in vitro. As they did, the underlying diseases slowly were understood and then it was eventually clear why the patients could be grouped by symptoms and why some were unique and some overlapped. Medicine eventually also learned how to avoid the diseases which were avoidable, and which symptom sets were not avoidable because of genetic prediposition (atopy) or genetic predisposition to deficiencies in certain protective pulmonary enzymes.So the syndrome of "COPD" has its "Pink Puffers" and "Blue Bloaters" and "Wheezers". At this stage of understanding of the synmdrome of IBS the symptom subsets are "Diarrheic Type", "Cyclic Type", "Constipation Type".As a consequence of steady advances in technology and understanding on several fronts, the underlying causal basis for the "multiple types" slowly are beginning to emerge from the foggy years of "spastic colon", and are passing through the always-inevitable symptom-based diagnsosis and treatment phase, and will in the next few years seee ach of the causal bases for the multiple overlapping disease conditions which we now call IBS revealed. The Symptom BAsed Diagnosis Phase is not the end-game, nor should it be viewed as such. It is a common and oft-repeated transitional PHASE of clinical medicine.The picture of IBS will, in the end, look alot like the overlapping-rings in the COPD picture which shows how gas-exchange airway pathology (emphysema) can overlap with conducting airway damage (chronic bronchitis) which can both overlap with reversible airway obstruction (various asthmatic conditions).Where all the controversy comes from is when investigators or practitionsers or lay people claim to have gained the sole understanding or "The Cause" Of "IBS" when in fact there is no single casue, nor will there be nor is "IBS" a distinct disease unto itself but a "syndrome" going through the phase of symptom-driven managment. In the end,as distinct pathologies are isolated and then carved-off with "oh know we know that is Disease X", the population attributed to "IBS" shrinks...and there may be in the end game some distinct pathology that medicine universally declares to be a distinct disease and let it keep the name IBS...or the overlapping conditions may be isolated but the term IBS persists as a categorization of disease sub-types, just like COPD does persist to this day for "obstructive pulmonary diseases". Only time will tell.Syndromes tend to evolve into diseases along these lines..."Idiopathic Respiratory Distress Syndrome of the Neonate" was idiopathic when I worked in the NICU at University Hospitals in Cleveland in the early 1970s' as the technology did not exist to isolate the causal basis, so diagnosis was symptomatic and treatment was palliative and often fatal (ie: the treatment was a success but the patient died) prior to the date the original Nasal CPAP was invented. ARDS, for example, was another which evolved into subcategories of adult respiratory distress syndrome or the old "shock lung" (sound like "spastic colon"?) based upon backing-into it via the precursor events, etc.As long as the pharmaceutical companies will continue to provide the funding for the Rome Committee to jet about, I guess they may as well go wherever they like since its on the drug company dime. Personally I would prefer a location which would result in the Curacao Criteria or the Polynesian Protocol. But I am just a tropical guy I guess and would have a terrible time in Rome being wheat sensitive and surrounded by all that pasta.
Eat well. Think well. Be well.MNL
 

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A perspective Consistent with Evolution of "Syndromes" into specific "Diseases":previously posted elsewhere...If one goes to page 569 of the (17th edition) of the Merck Manual (if you have a diferent edition go to the chapter on Chronic Obstructive Pulmonary disease). Many years ago there were people with apparent lung diseases who clearly had some common base or bases for their symptoms, and they were seprated into groups based upon their primary symptoms, and they all had some symptoms which overlapped to varying degrees. Long before the pathology (underlying diseases) of COPD were understood, however, medicine was able to observe and diagnose COPD vitcims based on clinical presentation, symptoms, and history then provide therapies to reduce the sympotms (which were somewhat different for each symptom set, yet had varying degrees of commonality).As scientific prowess and technology progressed, medicine gained new means of studying the cardiopulmonary system more closely, both in vivo and in vitro. As they did, the underlying diseases slowly were understood and then it was eventually clear why the patients could be grouped by symptoms and why some were unique and some overlapped. Medicine eventually also learned how to avoid the diseases which were avoidable, and which symptom sets were not avoidable because of genetic prediposition (atopy) or genetic predisposition to deficiencies in certain protective pulmonary enzymes.So the syndrome of "COPD" has its "Pink Puffers" and "Blue Bloaters" and "Wheezers". At this stage of understanding of the synmdrome of IBS the symptom subsets are "Diarrheic Type", "Cyclic Type", "Constipation Type".As a consequence of steady advances in technology and understanding on several fronts, the underlying causal basis for the "multiple types" slowly are beginning to emerge from the foggy years of "spastic colon", and are passing through the always-inevitable symptom-based diagnsosis and treatment phase, and will in the next few years seee ach of the causal bases for the multiple overlapping disease conditions which we now call IBS revealed. The Symptom BAsed Diagnosis Phase is not the end-game, nor should it be viewed as such. It is a common and oft-repeated transitional PHASE of clinical medicine.The picture of IBS will, in the end, look alot like the overlapping-rings in the COPD picture which shows how gas-exchange airway pathology (emphysema) can overlap with conducting airway damage (chronic bronchitis) which can both overlap with reversible airway obstruction (various asthmatic conditions).Where all the controversy comes from is when investigators or practitionsers or lay people claim to have gained the sole understanding or "The Cause" Of "IBS" when in fact there is no single casue, nor will there be nor is "IBS" a distinct disease unto itself but a "syndrome" going through the phase of symptom-driven managment. In the end,as distinct pathologies are isolated and then carved-off with "oh know we know that is Disease X", the population attributed to "IBS" shrinks...and there may be in the end game some distinct pathology that medicine universally declares to be a distinct disease and let it keep the name IBS...or the overlapping conditions may be isolated but the term IBS persists as a categorization of disease sub-types, just like COPD does persist to this day for "obstructive pulmonary diseases". Only time will tell.Syndromes tend to evolve into diseases along these lines..."Idiopathic Respiratory Distress Syndrome of the Neonate" was idiopathic when I worked in the NICU at University Hospitals in Cleveland in the early 1970s' as the technology did not exist to isolate the causal basis, so diagnosis was symptomatic and treatment was palliative and often fatal (ie: the treatment was a success but the patient died) prior to the date the original Nasal CPAP was invented. ARDS, for example, was another which evolved into subcategories of adult respiratory distress syndrome or the old "shock lung" (sound like "spastic colon"?) based upon backing-into it via the precursor events, etc.As long as the pharmaceutical companies will continue to provide the funding for the Rome Committee to jet about, I guess they may as well go wherever they like since its on the drug company dime. Personally I would prefer a location which would result in the Curacao Criteria or the Polynesian Protocol. But I am just a tropical guy I guess and would have a terrible time in Rome being wheat sensitive and surrounded by all that pasta.
Eat well. Think well. Be well.MNL
 

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That's a good explanation, flux. And, Mike, I haven't read through all yours yet, but I imagine it's quite informative too.
Lots of people here seem to have other symptoms in addition to the strict Rome criteria, and some don't exactly follow Rome (like me). So, it does make one wonder if 1) many of us get misdiagnosed or underdiagnosed, 2) an IBS-prone person may also be prone to other disorders.
 

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That's a good explanation, flux. And, Mike, I haven't read through all yours yet, but I imagine it's quite informative too.
Lots of people here seem to have other symptoms in addition to the strict Rome criteria, and some don't exactly follow Rome (like me). So, it does make one wonder if 1) many of us get misdiagnosed or underdiagnosed, 2) an IBS-prone person may also be prone to other disorders.
 

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Discussion Starter · #10 ·
I also don't really fit the Rome II criteria as I don't have intestinal pain relieved by bowel movement. I'm never truly C or truly have D. My GI doc insists it is still IBS and is reluctant to call it something like functional dyspepsia or something else, I think because conventional therapies don't seem to work on me (as far as acid blockers, proton pump inhibitors, etc.). I find it hard to believe that I am feeling pain that "really isn't there" or at least would never, ever be felt by "normal" people. Isn't pain the body's way of telling us something isn't right in there? I guess I will have to just be patient until the doctors out there figure out what's REALLY going on for each of our subsets and until then I'll just try to use the resources available to me now, like this BB and relaxation and the Elavil. I guess I'm just too stubborn to accept that this is incurable and that I'll have to live this way for the rest of my life. Out there somewhere is an answer for all of this, and if it takes a lifetime by golly I will find it! (or, perhaps, someone else on this board will!
)Happy New Year! May all our IBS symptoms diminish in this new year! (Hey, I can hope, can't I?)
 

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Discussion Starter · #11 ·
I also don't really fit the Rome II criteria as I don't have intestinal pain relieved by bowel movement. I'm never truly C or truly have D. My GI doc insists it is still IBS and is reluctant to call it something like functional dyspepsia or something else, I think because conventional therapies don't seem to work on me (as far as acid blockers, proton pump inhibitors, etc.). I find it hard to believe that I am feeling pain that "really isn't there" or at least would never, ever be felt by "normal" people. Isn't pain the body's way of telling us something isn't right in there? I guess I will have to just be patient until the doctors out there figure out what's REALLY going on for each of our subsets and until then I'll just try to use the resources available to me now, like this BB and relaxation and the Elavil. I guess I'm just too stubborn to accept that this is incurable and that I'll have to live this way for the rest of my life. Out there somewhere is an answer for all of this, and if it takes a lifetime by golly I will find it! (or, perhaps, someone else on this board will!
)Happy New Year! May all our IBS symptoms diminish in this new year! (Hey, I can hope, can't I?)
 
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