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.
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time for bed...my brain obviously needs a rest!
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reviously 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.
