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itching and bloating and opioids and naltrexone

1684 Views 36 Replies 7 Participants Last post by  bonniei
When I have really bad ibs and I'm bloated as hell, I itch so badly that I sometimes scratch till I bleed. I did a search on itching and came across this on the Columbia University Gastroenterology site under Liver Diseases. Apparently people who have Liver Disease get very itchy.--------------------------------endogenous opioids (e.g. enkephalins), contribute, at least in part to the itch secondary to liver disease. It has been proposed that these neurotransmitters cause itch by acting on special areas of the brain. --------------------------------Okay I don't have Liver Disease, but is there some connection again with ibs and opioids??? Opioids were mentioned with regard to Naltrexone-the makers thought ibs was possibly a disorder involving something to do with opioid levels or sensitivity to opiods as opposed to a seratonin problem. i'm probably jumping the gun on this, huh?at any rate does anyone else get severe itching with ibs. sometimes i think its just the sensation of bloating that makes me itch so badly.
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i mean i'm itching my skin(like face, chest, stomach) not my butt!just to clarify
re: itching/scratching.This is often a nervous thing and not the cause of anything much at all! If you have an itch, you scratch it, right? What happens is that you stimulate the nerve endings and this causes it to itch, so you scratch it which in turn stimulates the nerve endings and so the cycle goes on.Try to refrain from scratching and notice when you are doing it and stop yourself.Take a bath, stick on some calamine if necessary but do not scratch. If it is still itching you should visit a doctor.
no its definitely not from nervousness. i only get it when severely bloated and it is intense at that time. at no other times do i ever itch-not even when nervous.
Joan, its in certain brain areas not functioning right in IBS and not releasing endorphines/Opioids back to the gut from the signal it gets from the gut with serotonin, so the serotonin issues and the Opioids are one and the same. Just fyi, you might want to see a dermatologist however.
might want to ask a real doc about this one, The body is pretty complicated and they don't know yet why naltroex works or how no matter what people here say.tom
actually, Nate seems to know how naltrexone works?tom
joanofarc, can you post a link to the article. It might give some good information on opiod mechanisms. According to something I read there are 3 kinds in the GI tract and it makes sense that some interface with the liver. I also worry that all the pumping of serotonin I did in the past with antidepressants affected these receptors in the liver.tom
susan,i can relate except i do not have any skin problems or itching. Instead, i will get joint aches when i am at my absolute worst.In other words, i would get all the customary symptoms beyond the gut symptoms like bronchial tube tightening, sinus inflammation, nervous disorders.i think it is just like the info posted by mnl. it claims that when proinflammatory mediators are flowing --they can hit just about any part of the body and brain.
yes, mnl might have some good information on this.tom
FYIon it and side effects The other issue the makers are saying is IBS is a "an imbalance of opioids in the gut".Other researchers are saying there is a problem with the release of endorphines to the gut from the brain. This is still all connected.Part of serotonin's job in the gut is to report pain from the gut to the brain."First Glimpse of Brain's Natural Painkiller System" The mu opioid receptor in particular has been found to be a major target for both the body's own painkillers and for drugs from outside the body, such as heroin, morphine, methadone, synthetic pain medications and anesthetics. All are capable of numbing pain, and, in the case of drugs of abuse, produce pleasurable sensations during use." Read the bottom of the page as there is more on IBS and the ACC.
Once again, eric, this is new research and different from old uses of naltronex. This is specifically being tested for IBS for FDA approval and patent and is a very low dose (.5), I think.And yes, yur serotonin is important as a communicator as that's what it does I think although I'm not an expert in neurotransmitters. If it's a commucator it communicates something and might communicate that opiod mechanisms aren't working right in IBS. serotonin is not a magic answer, it's a communicator. even if he wasn't able to get the origina researrch Nate did contact the people who did the study and posted that informationtom
joanofarc,Its the opiates. Liver disease (hepatitis) will cause the palms of your hands and bottoms of your feet to itch like crazy. Any opiate makes my nose and chest itch, don't worry its very common.
would that be a problem at the low dose they ae using for IBS, do ou think?tom
"this is new research and different from old uses of naltronex"Yes and that is what I am talking about."And yes, yur serotonin is important as a communicator as that's what it does I think although I'm not an expert in neurotransmitters" Yes it is very important because serotonin is a pain signaler from the gut to the brain. "If it's a commucator it communicates something and might communicate that opiod mechanisms aren't working right in IBS. serotonin is not a magic answer, it's a communicator. "I did not say it was the magic answer, it is very important however in its role in the system of the gut and pain and the release of endorphines to the gut.Its a pain communicater from the gut to the brain once again. That is important."What would be an example of new understanding?Well one example is that we're starting to understand how the brain is responding to the pain in IBS. There have been some studies done where they've artificially created a kind of an irritable bowel by placing a balloon to stretch the bowel, and that produces pain. Then they've compared people with IBS to non-IBS, or "normal" individuals. And what they've found is that when you stretch the bowel-and use PET scans to monitor the response-in normal individuals, certain areas of the brain that register pain respond and release chemicals called neurotransmitters that suppress and lower the pain. But it seems that doesn't happen as well in people with IBS. In fact, in people with IBS another area of the brain responds that is associated with anxiety. So what we find is that people with IBS, aside from having a bowel problem, may have some difficulty in terms of the way their brain is regulating the pain." "Chemical imbalance:"There may be increased excitability of the nervous system of the gut and disturbance of chemicals such as catecholamines and serotonin. Patients with IBS have increased serotonin levels in plasma and in the colon. This may cause an altered pain threshold in patients with IBS." "The neurotransmitter serotonin and 5-HT3 receptors that are extensively distributed on enteric neurons in the human gastrointestinal tract as well as other peripheral and central locations are thought to play a role in increasing the sensation of pain and affecting bowel function in patients with IBS."This last one is older and they know more now. This is why lortronex, blocks serotonin and the gut level and decreses pain in IBS.! Which they have seen through fmri and pet scans with people taking the drug."The relationship between pain and depression clearly is complex and still emerging. Recent research shows that serotonin and norepinephrine may modulate pain as well as mood. Understanding the shared pathophysiology of these phenomena will help clinicians to manage both conditions and ultimately help their patients to achieve remission. This Clinical Update will detail the epidemiologic, neurobiologic, and pharmacologic correlates of pain and depression. " "New from Digestive disease week."Opioid AntagonistsAssuming opioid tone is increased in constipation-predominant IBS, opioid antagonists theoretically could reduce delays in intestinal transit and therefore relieve symptoms. Hawkes and colleagues 27 evaluated the efficacy of naloxone, an opioid antagonist, in a randomized, double-blind, placebo-controlled 8-week pilot study of 28 22 female patients with constipation-predominant IBS. These investigators prescribed 10-mg enteric-release naloxone tablets twice daily or identical placebo. They found that 43% of patients in the naloxone group were responders compared with 25% in the placebo group, based on the end point of adequate relief. Quality of life also improved. Surprisingly, no change in stool form or frequency was observed, suggesting that any prokinetic effect was very modest. These promising results need replication in larger, controlled trials, but do suggest that this class of agents may represent a novel and safe approach for at least a subset of patients with IBS.""*This section mentions off label uses for some medications. These may describe clinical uses for medications that have not been approved by the for the link "Itch."Yosipovitch G, Greaves MW, Schmelz M.Lancet 2003;361:690-4.Itch is a common skin sensation, with substantial effects on behaviour. Neurophysiological research has permitted accurate definition of neural pathways of itch, and has confirmed the distinctiveness of itch pathways in comparison with pain. A clinical classification of itch, based on such improved understanding, describes the difference between peripheral pruritoceptive and central neurogenic or neuropathic itch. New specific and sensitive investigational methods in people and animals enable us to better understand this bothersome symptom, and have important clinical implications. We describe the clinical classification of itch, new findings on neuropathophysiology of itch, methods for assessment, and improved treatments."
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By the way Tom, this is one other reason they use antidepressants for pain in IBS"HOW DO ANTIDEPRESSANTS WORK IN IBS? The brain is always monitoring and processing everything that is going on in the body. Antidepressants are known to work at the level of the spinal cord to block pain messages between the GI tract and the brain reducing visceral hypersensitivity. Certain antidepressants can also improve abnormal bowel functions that cause diarrhea, constipation, and other IBS symptoms. These medicines can also help with other problems like anxiety and depression, which are often associated with chronic painful disorders"
eric, sorry you misunderstood me. This is not an attack on the serotonin theory. Please read the research on the new use of LOWDOSE natronex and it's use in opiod receptors in the GI tract. This is new info and probably not yet in the pages you posted. Yes Serotonin is important but they are now starting to get information on the more specific aspects of the GI system that serotonin relays to the brain. tom
thanks for everyone's responses. what is this stuff about proinflammatory mediators that mnl posted? are opioids or neutrotransmitters proinflammatory mediators? i'm totally confused! thanks bellyknot. my feet actually itch a lot and in a weird way during certain phases of ibs. this is all so bizarre!
Kel, my sinuses inflame and my muscles swell during periods of ibs. is this an inflammatory response. it doesn't seem related to food though.i found the mnl post about food intolerance, mediators, etc.what i don't get is this. all these chemicals are probably controlled by our brains and change all the time. isn't this why hypnotherapy helps. I just don't see any connection with hypnotherapy and serotonin in particular or that hypnotherapy working proves that serotonin is the issue with ibs. I mean I'm sure hypnotherapy changes levels of lots of things-not just serotonin. Eric, I guess what I don't understand is the reliance on serotonin when many other neurotransmitters and other chemicals in the body must influence ibs. I think if serotonin were as important as people think it is in all of these disease-ibs, depression, anxiety-then taking SSRI's and the like would benefit more people and provide a more uniform response. as it stands zelnorm doesn't help that many people-prozac and the like make people feel crazy and wierd. i think ibs and these other disorders are far more complex than just seratonin. the whole serotonin craze reminds me of how they used to give lobotomies to people and then thought it was the cure for mental disorders b/c it produced a response, any response. when i see people who are messing with their serotonin levels i can tell there is someting wrong with them-infact, they seem lobotomized. i know that is just observation but is has to mean point is-i believe in things like hypnotherapy, but i don't think serotonin changes are at the heart of hypnotherapy success or any other ibs successes.
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I think you're right about the serotonin and hypnotherapy connection, I think Joanofarc. It's more likely that hypnotherapy changes the immune system. tom
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