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Hello,im doing a project for college on Irritable Bowel Syndrome.I need to know what the outcomes of the treatment are.If anyone can help me it would be much appreciated.Or if anyone has a website where i can get the outcomes from,it would be very helpful.Thank you.
 

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MANDY:I would agree with the following explanation given by Eric: "mainly there are three ways to treat IBS.Dietmedicationspsychological treatments like CBT and HT "with one small modification.The (3) are not treatments which are mutually exclusive, in fact they should be viewed as INclusive.Experience has shonw over the last 25 years that the best outcomes, defined as reduced or eliminated symptoms with improved quality of life up to and including remission, are achieved with a Disease Management Program approach that integrates all (3) of these modalities together, in a way that is as specific as possible to the specific patients needs.IBS being a syndrome of overlapping multiple symptom sets, there is a wide range of variance as to the needs of each patient in each of these (3) areas, and the better they are analyzed, matched, and managed the more positive and enduring (lowest recidivism) the outcomes.So I would agree that the integrated therapy program which will work best includes1. effective assessment of dietary influences upon symptoms (reactivities of all types not just the more obvious allergenic or pseudoallergenic but the more prevalent non-allergenic classes of food and chemical intolerances as well) for elimination and establishement of a nutritionally sound rotation-elimination diet2. needs assessment of the patients psychosocial consequences, stress an/or anxiety responses, any learned behaviors, and selection of a modality that is best suited to the patient. Certain attenuative therapies that are more passive, such as hypnotherapy, are more effective for some people than proactive therapies like CBT [just an example] as the recidivism tends to be lower the less procative the patient has to be in her therapy. On the other hand strongly self-directed individuals can and do enjoy succes with CBT protocols (ask KMOTTUS, as she is a well known CBT beneficiary in the comminity, as Eric is a well know HT beneficiary...I guess I would be called a well-known dietary manipulation beneficiary in this community).3. a program of supportive-attenuative pharmacotherapy to help manage symptoms temporarily while #1 and #2 are developed, implemented and have their "affect" over time. The goal of a DMP should be not to create a patient who is reliant solely upon pharmacotherapy for symptomatic relief, but to find and remove anything which provokes the symptoms, and isolate any underlying causal conditions wherever they may exist...in other words prophylaxis...it has no side effects.Two other key elements are also adjunctive, one is essential and often we forget how important it is, and the other is emerging as an adjunctive therapy based upon a better understanding of the dysfunction within the small bowel which results in diet being an important provocateur of symptoms.4. DOCTOR PATIENT RELATIONSHIP. This is essential. How to describe the best doctor-patient relationship for the IBS victim? Not the one I hear offhand so often when talking to some physicians about IBS ("these patients are a pain, no matter what we do they do not get better, they are all head-cases, they are their own worst enemy because they must not be following instructions, they are too obsesed with their bowel function, etc"), but the doctor who beleives in what the famed Williona Osler,MD once said:"If you talk to the patient long enough [she] will tell you exactly what is wrong with [her]."5. Ever since it was discovered back in the 1980's, but has gone largely ignored in this country for various but specific reasons, that the immunocytes of the gut (primarily small bowel) and the systemic immuncytes are implicated, especially in the "d predominant" and "cyclic" symptom sets, various attempts have been made to stabilize them with known pharmaceuticals created for that purpose (primarily sodium cromoglycate)or some herbal preparations which, while effective for pathogenic diarrhea, do not address the correct mechanism of that seen in IBS. Unfortunately the effectiveess of SC for example, while pronounced in over 3/4 of the subjects, has been temporary due to tachyphylaxis. Many other preparations have seen limited usefulness sd they are addressing the wrong aspect of the problem, rather just one of the ofetr-the fact mechansisms involved {misapplied therapy}.In recent years more experimentation has been done with specific types of plant extracts and herbs which have been suspected of having properties which reduce the reactivity of specific immunocyte classes (immunomodulation). This are is now emerging as very promising, especially since technology has been created which can document their effectiveness, and in vivo discoveries have been made, especially in Sweden, which prove quantitatively, the aberrant function of the immune system of the small bowel.The consequences of specific provocation by the proinflammatory mediators released by immunocytes upon the the gut muscle, nerve, and vascular structures as well as the other parts of the nervous system and endocrine system affected when these mediators are released inappropriately is already known, and has been quantified that this occurs and it occurs as result of partial loss of oral tolerance for certain foods or additives or both. WHY oral tolerance is comprimised still eludes thorough elucidation, but at least it can be avoided, or possiblty attenuated, or both.You may visit the website below my name to see a little about this approach (addressing specific immunodysfunction) if you wish as well.I like to sum up the process as Eat well. Think well. Be well.MNL______________www.leapallergy.com
 

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MANDY:I would agree with the following explanation given by Eric: "mainly there are three ways to treat IBS.Dietmedicationspsychological treatments like CBT and HT "with one small modification.The (3) are not treatments which are mutually exclusive, in fact they should be viewed as INclusive.Experience has shonw over the last 25 years that the best outcomes, defined as reduced or eliminated symptoms with improved quality of life up to and including remission, are achieved with a Disease Management Program approach that integrates all (3) of these modalities together, in a way that is as specific as possible to the specific patients needs.IBS being a syndrome of overlapping multiple symptom sets, there is a wide range of variance as to the needs of each patient in each of these (3) areas, and the better they are analyzed, matched, and managed the more positive and enduring (lowest recidivism) the outcomes.So I would agree that the integrated therapy program which will work best includes1. effective assessment of dietary influences upon symptoms (reactivities of all types not just the more obvious allergenic or pseudoallergenic but the more prevalent non-allergenic classes of food and chemical intolerances as well) for elimination and establishement of a nutritionally sound rotation-elimination diet2. needs assessment of the patients psychosocial consequences, stress an/or anxiety responses, any learned behaviors, and selection of a modality that is best suited to the patient. Certain attenuative therapies that are more passive, such as hypnotherapy, are more effective for some people than proactive therapies like CBT [just an example] as the recidivism tends to be lower the less procative the patient has to be in her therapy. On the other hand strongly self-directed individuals can and do enjoy succes with CBT protocols (ask KMOTTUS, as she is a well known CBT beneficiary in the comminity, as Eric is a well know HT beneficiary...I guess I would be called a well-known dietary manipulation beneficiary in this community).3. a program of supportive-attenuative pharmacotherapy to help manage symptoms temporarily while #1 and #2 are developed, implemented and have their "affect" over time. The goal of a DMP should be not to create a patient who is reliant solely upon pharmacotherapy for symptomatic relief, but to find and remove anything which provokes the symptoms, and isolate any underlying causal conditions wherever they may exist...in other words prophylaxis...it has no side effects.Two other key elements are also adjunctive, one is essential and often we forget how important it is, and the other is emerging as an adjunctive therapy based upon a better understanding of the dysfunction within the small bowel which results in diet being an important provocateur of symptoms.4. DOCTOR PATIENT RELATIONSHIP. This is essential. How to describe the best doctor-patient relationship for the IBS victim? Not the one I hear offhand so often when talking to some physicians about IBS ("these patients are a pain, no matter what we do they do not get better, they are all head-cases, they are their own worst enemy because they must not be following instructions, they are too obsesed with their bowel function, etc"), but the doctor who beleives in what the famed Williona Osler,MD once said:"If you talk to the patient long enough [she] will tell you exactly what is wrong with [her]."5. Ever since it was discovered back in the 1980's, but has gone largely ignored in this country for various but specific reasons, that the immunocytes of the gut (primarily small bowel) and the systemic immuncytes are implicated, especially in the "d predominant" and "cyclic" symptom sets, various attempts have been made to stabilize them with known pharmaceuticals created for that purpose (primarily sodium cromoglycate)or some herbal preparations which, while effective for pathogenic diarrhea, do not address the correct mechanism of that seen in IBS. Unfortunately the effectiveess of SC for example, while pronounced in over 3/4 of the subjects, has been temporary due to tachyphylaxis. Many other preparations have seen limited usefulness sd they are addressing the wrong aspect of the problem, rather just one of the ofetr-the fact mechansisms involved {misapplied therapy}.In recent years more experimentation has been done with specific types of plant extracts and herbs which have been suspected of having properties which reduce the reactivity of specific immunocyte classes (immunomodulation). This are is now emerging as very promising, especially since technology has been created which can document their effectiveness, and in vivo discoveries have been made, especially in Sweden, which prove quantitatively, the aberrant function of the immune system of the small bowel.The consequences of specific provocation by the proinflammatory mediators released by immunocytes upon the the gut muscle, nerve, and vascular structures as well as the other parts of the nervous system and endocrine system affected when these mediators are released inappropriately is already known, and has been quantified that this occurs and it occurs as result of partial loss of oral tolerance for certain foods or additives or both. WHY oral tolerance is comprimised still eludes thorough elucidation, but at least it can be avoided, or possiblty attenuated, or both.You may visit the website below my name to see a little about this approach (addressing specific immunodysfunction) if you wish as well.I like to sum up the process as Eat well. Think well. Be well.MNL______________www.leapallergy.com
 
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