Is IBS real?
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I do not believe that is the case for most doctors.They have done a lot of research into IBS and which symptoms you have to have are very well defined. They have a fair idea of what is wrong with people.Most people say this because there is no test that specifically proves you have IBS.It is not something IBS patients make up. It is real. They have real pain and real problems with bowel habit.There are enough people who all have the exact same set of symptoms that it is hard to believe that everyone has something different and random wrong with them that is competely undetectable by every medical test known to man.Some doctors do diagnose it in ways that make people feel like it isn't a real thing, but that doesn't mean a whole lot. Some doctors aren't very good and don't keep up with the latest knowledge. Don't judge the whole syndrome on bad doctors.K.
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Yep that's the way it goes.I don't believe syndrome is the same as totally imaginary and only things that could be classified as a "disease" are real and worth-while treating or researching.There are a number of syndromes. Each has its own specific pattern of symptoms. They don't call any symptom in any organ system IBS. At some point most of what any person would define as a "disease" was a "syndrome" because that's where it starts. You don't find a cause and then look for the symptoms. You find the symptoms first, and then look to see what patterns exist and eventually for most things you do eventually find a cause.I mean Acquired Immunodeficiency Syndrome still has the name syndrome from when it was just a collection of symptoms. Even before HIV was discovered people didn't say AIDS was not real and just something they diagnose people with when they don't want to bother with them.K.
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Every disease is a syndrome, after all.Nowhere does it ever say Syndrome = not real and Disese = real *shrug*Doesn't change that people suffer and need treatment. Doctors that think IBS is no big deal and all imaginary anyway need to be fired.
Lisa here is some info for you.The diagnoses of IBS has come a long way. It is also a specific cluster of symptoms.http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/316101372andTHE JOHNS HOPKINS UNIVERSITY Gastroenterology and Hepatologyhttp://hopkins-gi.nts.jhu.edu/pages/latin/...se=43&lang_id=1and http://www.aboutibs.org/"Irritable bowel syndrome (IBS) has been described as a “functional†disorder, which is a “diagnosis of exclusion.†Thus, many physicians still think IBS has no demonstrable pathophysiologic defects and that it can only be diagnosed after other “organic†disorders have been ruled out with multiple diagnostic tests.Recent data demonstrate the fallacy of this assumption. Irritable bowel syndrome IS characterized by multiple pathophysiologic defects:Altered gastrointestinal motility (1-2) Visceral hypersensitivity (1-2) Abnormal IL-10/IL-12 ratios consistent with pro-inflammatory Th-1 state (3) Infiltration of lymphocytes and neuronal degeneration in the myenteric plexus (4) Defects in serotonergic signaling mechanisms in the enteric nervous system of the GI tract (5) Unfortunately, these pathophysiologic defects cannot be identified by conventional laboratory testing. Therefore, we rely on the symptom-based IBS diagnostic criteria of the ROME committee (i.e., the presence of abdominal discomfort for at least 12 weeks in the past 12 months associated with a change in the consistency/frequency of stool or relief of discomfort with passage of stool) or the American College of Gastroenterology (i.e., IBS is defined as abdominal discomfort associated with altered bowel habits) (1-2). However, the reliance on symptom-based criteria to diagnose IBS should not de-emphasize the pathophysiologic defects expressed by IBS patients."
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Just because people don't know what causes IBS doesn't mean that it's not real or is not a valid diagnosis - doctors often don't have a clue what causes cancers. We don't need to know the cause to enable us to name the disorder. IBS is a recognised diagnosis - the Rome III criteria are pretty strict, and doctors agree that IBS is characterised by visceral hypersensitivity and a brain-gut dysfunction. There are also recognised starting points for IBS, such as food poisoning, surgery, or a time of extreme stress such as a bereavement.
In my field of Physical Therapy we see a condition called Reflex Sympathetic Dystrophy. It basically is the same as IBS but affects the peripheral nerves of a body part. Most people get it after severe trauma. Unfortunately there is no cure. Fibromyalgia is also a very similar condition. Simply put IBS is a sort circuit of the visceral nervous system.
Truth is, no one knows for sure what is the cause or what are the causes of the symptoms labeled IBS. There are several hypothesis (ex: colonic dysbiosis, small intestine bacterial overgrowth, Hypothalamic-pituitary-adrenal axis disfucntion) and, at the end of the day, they may all explain a certain percentage of cases. This does not mean in any way shape or form that the symptoms labeled IBS are not real. After all, having diarrhea 3 times a day is quite objective.
Except for this pain that Ive had for 5 weeks, my stool is pretty normal.Only time I have "d" is when Im upset or overly anxious. Somehow after reading the Rome III criteria I really don't fit the profile.I always knew I had a nervous stomache, never felt the need to see a Dr. The abdominal pain (or discomfort) was the reason for the ER trip and the Dr visit.I have fibro and was tested well to rule out other things first, I just don't want a colonoscopy and sonogram and get well umm you must have IBS then. I want to know how and why they come to this conclusion.Lisa
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Some doctors use IBS for EVERY ONE of the functional bowel disorders.It doesn't matter much in the clinic as they treat based on symptoms rather than which label they stick on it. There are several functional bowel problems, IBS is the most common and most of the others are IBS - a symptom of IBS.If every stool was always normal, ("pretty normal" can still fit a change in stool consistancy or frequency, you don't need full blown diarrhea several times a day every time you go, just a change from normal) then it generally fits Chronic Functional Abdominal Pain. Which is basically all the pain and discomfort of IBS but normal bowel habit.That you have D that is triggered by emotions fits with IBS. Some IBS triggers are physical, others are emotional.It may be a bit early to label you IBS as the diagnositic criteria usually say wait 6 months to see if it goes away, first.How they come to the conclusion? Similar to Fibro, actually, you seem to think that is real, even though a lot of people think it is a "fake" diagnosis when they don't know what is wrong, really, it has a lot of the same diagnositic issues. There has been a lot of problems getting doctors to believe it actually exists over the last couple of decades. Patient has specific symptoms, Patient doesn't have other problems that explain the symptoms. I'm not sure what you are seeing as not at all what Rome criteria says IBS is?1.Patient complains of stool consistancy and/or frequency changes.2. Patient complains of abdominal pain and discomfort. (usually 1 and 2 go together, and often the pain goes away after a BM, but it doesn't have to)3. Patient does not exhibit any of the red flag symptoms that mean it is probably not IBS. (Are you losing weight all out of proportion to what you are eating? Starving yourself and losing weight is normal weight loss, this is abnormal weight loss. Do you have bloody stools? Do you have pain that wakes you from a deep sleep in the middle of the night? Do you have anemia? Do you have an elevated sedimentation rate? Do you have a pathogen in your stool? Do you have repeated bouts of watery diarrhea at night?)Red flag symptoms tend to point disorders that are not functional. Having some but not all of the IBS symptoms usually means one of the other functional disorders.4. Medical tests based on what needs to be ruled in or out are done. Different doctors have different ideas of how much testing you need. Typically in clinical studies if the patient ONLY has symptoms of IBS and has no red flag symptoms at all no matter how many tests you run the tests are normal and the patient ends up with an IBS diagnosis. Only a few % of patients have anything, and some of those have anatomical variations that do not explain the IBS as other people with them are normal.Some people will with repeated and extensive testing have their IBS get worse. The stress of the tests and being told over and over again that the results are normal can really do a number on some people. Some people will not believe it could be IBS unless they have every test known to man.How many tests you need to believe it is IBS is up to you, and it may not match what your doctor needs to make the diagnosis.Usually they run at least some blood tests to see if you have inflamation in the body. Mostly because that is one of the big red flags as well as anemia that something else may be going on.If you symptoms are really typical they tend to do fewer tests. If you have some red flags they tend to do more tests.FWIW that you have a diagnosis of Fibromyalgia may factor into getting an IBS diagnosis as that is common for people to have both problems.Woman may also want to do a check with the OBGYN as some reproductive organ issues can cause pain, bloating, and other GI symptoms.It really is not any or all symptoms we can't explain no matter what the symptoms are even if the patient has obvious symptoms of something else.K.
There is also mild, moderate and severe IBS.There are also things that HELP support an IBS diagnoses that are not part of the rome critieria. Incomplete evacuation, bloating, mucus in the stools, rectal hypersensivity, relief after defication, not waking you up at night, its a bigger picture, minus red flag symptoms. Pooman, I understand what you were saying for the most part but there really isn't a viceral nervous system. There is the Central nervous system, the autonomic nervous system and the enteric nervous system (brain in the gut.)Viceral hypersensivity is a term for feeling pain from viceral organs. Autonomic nerous system runs breathing digestion, the herat etc..all of these systems communicate to each other. That is the brain gut axis."Truth is, no one knows for sure what is the cause or what are the causes of the symptoms labeled IBS. "The strongest evidence is in the role serotonin plays at gut receptors levels embbeded in the gut wall that helps explain d, d/c and c as well as its importantce in Brain gut communication and viceral hypersensivity. It is an important neurotransmitter for sensations arising from the gut. Gut permeability is a factor in some IBSers, but not likely a cause.SIBO is a different condition then IBS.Hypothalamic-pituitary-adrenal axis disfucntion is seen in IBS and this is also part a big part of the bodies stress system and is connected to the fight or flight. Again this is a part of the brain gut axis dysfunction.which is why"Only time I have "d" is when Im upset or overly anxious." The anxious activates the fight or flight and causes d.Modern research understands IBS as"The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug Drossman chairman of the Rome committe for gi disorders of function. "http://www.ibshealth.com/ibs_foods_2.htm They have also recently demonstrated""Demonstration of post-infectious IBS as a brain-gut disorder"http://www.iffgd.org/symposium2005report.htmlThey have also found STRUCTUAL abnormailites in PI IBSers as well as subgroups of IBSers.""Serotonin SignalingOf the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. ""Normal GI function relies on a properly functioning brain-gut axis, which involves the coordinated interplay of the GI musculature, the CNS, the autonomic nervous system, and the enteric nervous system (ENS). The ENS contains millions of neurons embedded in the wall of the digestive tract and functions, at least in part, independently of the CNS. The size, complexity, and independent function of the ENS has resulted in application of the terms "the second brain" and "the mini-brain."[81] Impaired function or coordination of any of these systems, or the communication between these systems and the GI musculature, can lead to symptoms of dysmotility and altered sensory perception, which are characteristic of IBS and select other GI motility disorders.82"http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/906107392
PS Lisa are you seeing and woring with a doctor now? Its very important.Also they don't always have to do a colonoscopy to diagnose IBS. take these question to the doctor with you and they can helphttp://www.medicinenet.com/script/main/art...rticlekey=13683
Inflammation? Does Pepto-Bismol work?When you were diagnosed with fibromyalgia, did your doctor check your cortisol levels? People with fibro tend to have low cortisol levels and low cortisol levels result in increased immune system activity, aka, inflammation.
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Because a few doctors are bad, or heaven forfend use one particular label too broadly, doesn't mean vitually all of them are bad.It does pay to be an informed consumer when it comes to medicine just like one does for anything else. The "damage" done from calling it IBS instead of functional {fill in the name of the symptom} is pretty minimal. They treat based on the symptoms regardless of which functional bowel problem it is. It would be different if functional constipation had to be treated with completely different drugs than IBS-C and medicating with the wrong one would cause serious problems. As long as they can figure out functional vs organic they've done their job. I don't know that alternative medical people or herb store sales people are really any more reliable, FWIW.For any service you purchase there are good practioners and bad ones. Knowing enough to know the difference is the battle. Don't avoid all doctors or refuse to take the treatments they give out because some of them are bad. I wouldn't tell you to avoid all plumbers if your pipes need fixing because some of them are less than trustworthy.K.
Hi ericYes I am working with my Dr now....I started at the ER 2 weeks after lower right ab pain, blood tests were fine. I went to my Dr 3 days later. My discomfort/pain doesnt go away after a bowel movement. This pain comes and goes all day no rhyme or reason to it.He wants the colonoscopy, he also wanted a CT scan of my pelvis and stomach but insurance denied it because they said a sonogram had to be done first. So I have that on the 15th and colonoscopy on the 13th.As for my fibro they ran normal blood work, for lupus/RA and some others, also did xrays which showed oesteoarthritis in my spine. It took awhile for me to believe fibro was real....after 6yrs I got worse this past year and finally accepted it and saw a Rheumy.I do not want extensive tests, I prefer not to have any. On the other hand I don't want a dr to spend 5 min with me and say oooo you have IBS. This is why I agree'd to the colonoscopy.Thanks for everyones inputLisa
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