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Discussion Starter · #21 ·
quote:Eric wrote:Because you have to be able to read the article carefully for one and not cherry pick what a person wants to hear or believe.becausethe conclusion was"CONCLUSION: There are intestinal flora disorders in IBS patients, which may be involved in triggering the IBS-like symptoms. IBS patients experience significant impairment in QoL, however, the impairment is not caused directly by enteric symptoms."I find it odd this is always left out when this abstarct is posted? Thats bias.
My, my Eric you really are confused, aren't you? There's no bias. The "Conclusion" you quoted above is simply the very basic summary from the study's Abstract. What I quoted is from the "Discussion" section of the complete article, which contains a much more detailed, in-depth and therefore more accurate explanation of the study's findings. There's no disagreement between the two. What I posted is simply more accurate. They say it all when they state:
quote:"Further studies are still needed. However, there was dysbacteriosis in IBS patients. Whether it is the effect or just cause of IBS remains unclear."
That says everything - They are stating that dysbacteriosis may be an effect of the IBS, OR it may actually be the "just cause" of the IBS - they just can't say for sure one way or the other. I don't see anywhere here where it says what you believe though, that dysbacteriosis DOES NOT cause IBS. Please show me where it clearly says that dysbacteriosis does not cause IBS, where they have unequivocally ruled it out - I just don't see it.The quality of life part in your quote above is also just a basic summary from the study's abstract. Here's a more complete discussion from the full article:
quote:In our study, we also found that IBS patients had significantly lower scores on all SF-36 scales with the exception of physical functioning, when compared with the age and sex-matched control group. Decrements in QoL were most pronounced in general health, role physical and vitality. However, there was no significant correlation between QoL and enteric symptoms, which might be due to the frequent presence of anxiety, depression, fatigue and anorexia in IBS patients.
You get the basic idea. But don't despair, Eric, because in the "Inflammation, Infection, and Irritable Bowel Syndrome (IBS): An Update" article which you posted earlier, there was a study described where IBS patients were given a Bifidobacterium probiotic which significantly improved many of their IBS symptoms, and - "The symptomatic response with Bifidobacterium was associated with parallel improvement in quality of life as assessed by using an IBS-specific instrument. A follow-up 4 weeks after discontinuation of the treatment (washout period) showed that both symptoms and quality of life returned to baseline."So, this shows that as the gut flora is improved with probiotics, the quality of life can go up too, probably in an indirect way, I'd think. As the patient feels better with less pain, the quality of life factors naturally improve due to the more positive mental state.ref.("A Role For Probiotics" section):Inflammation, Infection, and Irritable Bowel Syndrome (IBS): An Update
quote:Eric wrote:also what does this mean from the above study"There was no significant difference in gut flora between two subgroups"
I believe that means that the overall numbers of bacteria in the flora were about the same, but the numbers of some of the various specific strains of bacteria were different (different proportions).Now Eric, you have posted vast numbers of pages here from studies in a seeming attempt to try to convince me of something. But that's a complete waste of your time. Let me remind you that this thread isn't about what I believe. It's about what you believe, and why it differs from what the IBS experts concluded in the study you earlier posted. You do believe they are IBS experts, don't you? Of course you do, because you yourself say that you only post accurate medical information from the world's IBS experts here. So did you email them yet to inform them that they are wrong when they say dysbacteriosis MAY be the "just cause" of IBS? Do hurry, I just can't wait to see their reply! Suggestion - Maybe you could email them the studies you posted here to convince them how wrong they are.... Sincerely,Captain Colon
 

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Discussion Starter · #22 ·
quote:Talissa wrote:Sorry for butting in here Capt C
You're not butting in! Please go ahead and post all you want, I always enjoy and learn a lot from your posts. You're much better at research than I am.
Hey Kel, I trust your Brain-Gut Axis / Neurotransmitter system transplant is still working great and you continue to be pretty much free of IBS.
I agree though when you say it would be foolish to completely ignore the emotional aspect of illness. I'm a long time meditator myself, and find the practice indespensable for helping control the pain of IBS, and to help deal with the negative emotional impact of it. -Captain Colon
 

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Discussion Starter · #23 ·
quote:Talissa wrote:Sorry for butting in here Capt C
You're not butting in! Please go ahead and post all you want, I always enjoy and learn a lot from your posts. You're much better at research than I am.
Hey Kel, I trust your Brain-Gut Axis / Neurotransmitter system transplant is still working great and you continue to be pretty much free of IBS.
I agree though when you say it would be foolish to completely ignore the emotional aspect of illness. I'm a long time meditator myself, and find the practice indespensable for helping control the pain of IBS, and to help deal with the negative emotional impact of it. -Captain Colon
 

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quote:Why would you even raise this point? So what if there are some patients who might match the controls with respect to various bacteria.
This implies that having a difference in those bacteria is not clinically significant.
quote:If this were true, why use antibiotics or antifungals?
Who is trying to use antibiotics to treat dysbacteriosis?
quote: How could doctors use anything but broad spectrum if its all just guess-work?
You tell us.
quote:If that were true, how could they find the following in IBS patients? ~~
How do these findings have anything to do with the other 400 species of bacteria present? Are they less important if we can't count them?
quote: believe that means that the overall numbers of bacteria in the flora were about the same, but the numbers of some of the various specific strains of bacteria were different (different proportions).
But those are mean values. There could be patients would overlap. Wouldn't that negate the findings of difference?
 

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quote:Why would you even raise this point? So what if there are some patients who might match the controls with respect to various bacteria.
This implies that having a difference in those bacteria is not clinically significant.
quote:If this were true, why use antibiotics or antifungals?
Who is trying to use antibiotics to treat dysbacteriosis?
quote: How could doctors use anything but broad spectrum if its all just guess-work?
You tell us.
quote:If that were true, how could they find the following in IBS patients? ~~
How do these findings have anything to do with the other 400 species of bacteria present? Are they less important if we can't count them?
quote: believe that means that the overall numbers of bacteria in the flora were about the same, but the numbers of some of the various specific strains of bacteria were different (different proportions).
But those are mean values. There could be patients would overlap. Wouldn't that negate the findings of difference?
 

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"Flux, this is your lucky day! I just happen to know the perfect person to help you out with your confusion about dysbacteriosis. Amazingly, his name is also Flux! His email address is at the link below, you can contact him there. I'm sure you two will get along just fine. "
"Hey Kel, I trust your Brain-Gut Axis / Neurotransmitter system transplant is still working great and you continue to be pretty much free of IBS. "All I have to say is thank goodness that this horrible condition is reversible. I am living proof that if you really want to find a solution to this curse you can do it.Eric and his experts are wrong when they say that it is incurable and you have to just live with it. Of course flux will probably have to just live with it because he doesn't believe anything.
 

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"Flux, this is your lucky day! I just happen to know the perfect person to help you out with your confusion about dysbacteriosis. Amazingly, his name is also Flux! His email address is at the link below, you can contact him there. I'm sure you two will get along just fine. "
"Hey Kel, I trust your Brain-Gut Axis / Neurotransmitter system transplant is still working great and you continue to be pretty much free of IBS. "All I have to say is thank goodness that this horrible condition is reversible. I am living proof that if you really want to find a solution to this curse you can do it.Eric and his experts are wrong when they say that it is incurable and you have to just live with it. Of course flux will probably have to just live with it because he doesn't believe anything.
 

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Just because you don't have symptoms, does not mean a person is "cured."also the word is Chronic" "chronic" comes from the Greek word chronos, meaning time). "In order to fully "cure" something you have to know exactly what causes it, they do not yet fully understand the cause of IBS yet, although they are getting way better. In the four years I have been here a ton of research generated insights on IBS and functional disorders have come to light. Some things they have already found out, IBS is a brain gut axis dysfunction with abnormalities and dysregulation of the serotonin system, and immune system. Nor is this a competition of either the brain or the gut, both are operative to cause the symptoms! Symptoms can be generated from either the gut or the brain. It was twenty years you had IBS Kel, if I am not mistaken. Is that chronic?""Living with a long-lasting health condition (also called a chronic illness) presents a person with new challenges. Learning how to meet those challenges is a process - it doesn't happen right away. But understanding more about your condition, and doing your part to manage it, can help you take health challenges in stride. Many people find that taking an active part in the care of a chronic health condition can help them feel stronger and better equipped to deal with lots of life's trials and tribulations. What Are Chronic Illnesses?There are two types of illnesses: acute and chronic. Acute illnesses (like a cold or the flu) are usually over relatively quickly. Chronic illnesses, though, are long-lasting health conditions (the word "chronic" comes from the Greek word chronos, meaning time). Having a chronic condition doesn't necessarily mean an illness is critical or dangerous - although some chronic illnesses, such as cancer and AIDS, can be life threatening. But chronic illnesses can also include conditions like asthma, arthritis, and diabetes. Although the symptoms of a chronic illness might go away with medical care, usually a person still has the underlying condition - even though their treatments mean they may feel completely healthy and well much of the time.Each health condition has its own symptoms, treatment, and course. Aside from the fact that they are all relatively long lasting, chronic illnesses aren't necessarily alike in other ways. Most people who have a chronic illness don't think of themselves as "having a chronic illness," they think of themselves as having a specific condition - such as asthma, or arthritis, or diabetes, or lupus, or sickle cell anemia, or hemophilia, or leukemia, or whatever ongoing health condition they have. If you're living with a chronic illness, you may feel affected not just physically, but also emotionally, socially, and sometimes even financially. The way a person might be affected by a chronic illness depends on the particular illness and how it affects the body, how severe it is, and the kinds of treatments that might be involved. It takes time to adjust to and accept the realities of a long-term illness, but teens who are willing to learn, seek support from others, and participate actively in the care of their bodies usually get through the coping process.The Coping ProcessMost people go through stages in learning to cope with a chronic illness. A person who has just been diagnosed with a particular health condition may feel a lot of things. Some people feel vulnerable, confused, and worried about their health and the future. Others feel sad or disappointed in their bodies. For some, the situation seems unfair, causing them to feel angry at themselves and the people they love. These feelings are the start of the coping process. Everyone's reaction is different, but they're all completely normal. The next stage in the coping process is learning. Most people living with a long-term illness find that knowledge is power - the more they find out about their condition, the more they feel in control and the less frightening it is. The third stage in coping with a chronic illness is all about taking it in stride. At this stage, people feel comfortable with their treatments and with the tools (like inhalers or shots) they need to use to live a normal life. So a person with diabetes, for example, may feel a range of emotions when his or her condition is first diagnosed. The person may believe he or she will never be able to go through the skin prick tests or injections that may be necessary to manage the condition. But after working with doctors and understanding more about the condition, that person will grow to be more practiced at monitoring and managing insulin levels - and it will stop feeling like such a big deal. Over time, managing diabetes will become second nature to that person. The steps involved will seem like just another way to care for one's body, in much the same way as daily teeth brushing or showering help people stay healthy. There's no definite time limit on the coping process - everybody's process of coming to terms with and accepting a chronic illness is different. In fact, most people will find that emotions surface at all stages in the process. Even if treatments go well, it's natural to feel sad or worried from time to time. Recognizing and being aware of these emotions as they surface is all part of the coping process.Tools for Taking ControlPeople living with chronic illnesses often find that the following actions can help them take control and work through the coping process:Acknowledge feelings. Emotions may not be easy to identify. For example, sleeping or crying a lot or grouchiness may be signs of sadness or depression. It's also very common for people with chronic illnesses to feel stress as they balance the realities of dealing with a health condition and coping with schoolwork, social events, and other aspects of everyday life. Many people living with chronic illnesses find that it helps to line up sources of support to deal with the stress and emotions. Some people choose to talk to a therapist or join a support group specifically for people with their condition. It's also important to confide in those you trust, like close friends and family members. The most important factor when seeking help isn't necessarily finding someone who knows a lot about your illness, but finding someone who is willing to listen when you're depressed, angry, frustrated - or even just plain old happy. Noticing the emotions you have, accepting them as a natural part of what you're going through, and expressing or sharing your emotions in a way that feels comfortable can help you feel better about things.Play an active role in your health care. The best way to learn about your condition and put yourself in control is to ask questions. There's usually a lot of information to absorb when visiting a doctor. You may need to go over specifics more than once or ask a doctor or nurse to repeat things to be sure you understand everything. This may sound basic, but lots of people hesitate to say, "Hey, can you say that again?" because they don't want to sound stupid. But it takes doctors years of medical school and practice to learn the information they're passing on to you in one office visit!If you've just been diagnosed with a particular condition, you may want to write down some questions to ask your doctor. For example, some of the things you might want to know are:How will this condition affect me? What kind of treatment is involved? Will it be painful? How many treatments will I get? Will I miss any school? Will I be able to play sports, play a musical instrument, try out for the school play, or participate in other activities I love? What can I expect - will my condition be cured? Will my symptoms go away? What are the side effects of the treatments and how long will they last? Will these treatments make me sleepy, grumpy, or weak? What happens if I miss a treatment or forget to take my medicine? What if the treatments don't work?Even though your doctor can't exactly predict how you'll respond to treatment because it varies greatly from one person to the next, knowing how some people react may help you prepare yourself mentally, emotionally, and physically. The more you learn about your illness, the more you'll understand about your treatments, your emotions, and the best ways to create a healthy lifestyle based on your individual needs.Understand other people's reactions. You may not be the only one who feels emotional about your illness. Parents often struggle with seeing their children sick because they want to prevent anything bad from happening to their children. Some parents feel guilty or think they've failed their child, others may get mad about how unfair it seems. Everyone else's emotions can seem like an extra burden on people who are sick, when of course it's not their fault. Sometimes it helps to explain to a parent that, when you express anger or fear, you're simply asking for their support - not for them to cure you. Tell your parents you don't expect them to have all the answers, but that it helps if they just listen to how you feel and let you know they understand.Because the teen years are all about fitting in, it can be hard to feel different around friends and classmates. Many people with chronic illnesses are tempted to try to keep their condition secret. Sometimes, though, trying to hide a condition can cause its own troubles as Melissa, who has Crohn's disease, discovered. Some of Melissa's medications made her look puffy, and her classmates started teasing her about gaining weight. When Melissa explained her condition, she was surprised at how accepting her classmates were. When talking to friends about your health condition, it can sometimes help to explain that everyone is made differently. For the same reason some people have blue eyes and others brown, some of us are more vulnerable to certain conditions than others. Depending on the severity of your illness, you may find yourself constantly surrounded by well-meaning adults. Teachers, coaches, and school counselors may all try to help you - perhaps causing you to feel dependent, frustrated, or angry. Talk to these people and explain how you feel. Educating and explaining the facts of your condition can help them understand what you're capable of and allow them to see you as a student or an athlete - not a patient.Keep things in perspective. It's easy for a health condition to become the main focus of a person's life - especially when they first learn about and start dealing with the condition. Many people find that reminding themselves that their condition is only a part of who they are can help put things back in perspective. Keeping up with friends, favorite activities, and everyday things helps a lot. Living With a Health Condition There's no doubt the teen years can be a more challenging time to deal with a health condition. In addition to the social pressures to fit in, it's a time of learning about and understanding our bodies. At a time when it's natural to be concerned with body image, it can seem hard to feel different. It's understandable that people can feel just plain sick and tired of dealing with a chronic illness once in a while.Even teens who have lived with an illness since childhood can feel the pull of wanting to lead a "normal" life in which they don't need medicine, have any limitations, or have to care for themselves in any special way. This is a perfectly natural reaction. Sometimes teens who have learned to manage their illness feel so healthy and strong that they wonder whether they need to keep following their disease management program. A person with diabetes, for example, may wonder if he or she can skip a meal when at the mall or check his or her blood sugar after the game instead of before. Unfortunately, easing up on taking care of yourself can have disastrous results. The best approach is to tell your doctor how you feel. Talk to him or her about what you'd like to be doing and can't - see if there's anything you can work out. This is all part of taking more control and becoming a player in your own medical care. When you're living with a chronic health condition, it can feel hard at times to love your body. But you don't have to have a perfect body to have a great body image. Body image can improve when you care for your body, appreciate its capabilities, and accept its limitations - a fact that's true for everyone, whether they're living with a chronic condition or not. Voicing any frustration or sadness to an understanding ear can help when a person feels sick of being sick. At times like this it's important to think of ways others could help and ask for what you'd like. Some people find they can ease their own sense of loss by reaching out and offering to help someone in need. Lending a hand to someone else can help one's own troubles seem easier to manage.Adjusting to living with a chronic illness takes a little time, patience, support - and willingness to learn and participate. People who deal with unexpected challenges often find an inner resilience they might not have known was there before. Many say that they learn more about themselves through dealing with these challenges and feel they grow to be stronger and more self-aware than they would if they'd never faced their particular challenge. People living with chronic illnesses find that when they take an active role in taking care of their body, they grow to understand and appreciate their strengths - and adapt to their weaknesses - as never before. Reviewed by: D'Arcy Lyness, PhDDate reviewed: January 2004"Next this has been replicated in more studies now."In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship." Perceptions of colonic activity Patients with IBS may perceive colonic sensations in a way that is different. For example, they may have a feeling of incomplete evacuation even though the rectum is empty. They also may feel that they are distended with gas though there is no sign of increased gas when it is measured. A number of studies have shown that IBS patients have a limited tolerance to distension of a balloon inserted into the rectum. They feel pain at a lower degree of distension of the balloon and also feel greater pain at the same degree of distension as normals. This may relate to a heightened sensitivity of the nerves that go from the colon to the spinal cord, known as visceral hypersensitivity. In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship. Example In addition to pain sensation, motility of the colon has been measured. IBS patients have an abnormal muscular response to a number of stimuli including stress and eating a fatty meal. This is important in terms of diarrhea and constipation patterns in IBS. Brain scanning in IBS One study used a functional scanning technique called Positron Emission Tomography (PET scan) comparing IBS patients to controls. Using this method, it is possible to map certain areas of the brain that respond to specific stimuli elsewhere in the body. When this technique was applied to IBS patients during balloon distension in the rectum, the pre-frontal cortex was activated. This area of the brain is part of the limbic system, involved in emotional feelings. In contrast, a different area of the brain, possibly more involved in pain control, was activated in controls. Even more interesting was the observation that anticipation of rectal stimulation in IBS also activated the pre-frontal cortex. The last finding indicates a direct connection between emotional stimuli and colonic function. http://www.mindbodydigestive.com/ Nor is that the message from researchers that IBS is untreatable, in fact their message is it is treatable for the majority of IBSers.There is also a big overlap of functional dyspepsia and IBS and FD patients show altered motility and viceral hypersensitvity of the esophagus. Do these patients have gut flora dysbiosis of the esophagus?Is non cardiac chest pain from altered gut flora?There is also a big overlap of FM and CFIS, which in part has to do with autonomic dysfunction and the HPA axis.It is also known now that both parasites and bacteria may lead to PI IBS and very possibly a virus. Food poisoning can lead to PI IBS.I also believe probiotics can have a role in managing some peoples IBS. I have not however seen they have "Cured" anyone yet in control trials, I have seen inconsitent results and the experts saying they need to study them more and find out what each specific strain does. I have also seen a lot of people get better without taking them with IBS.Why do IBSers have specific impairment of certain brain centers that are different then controls and different then people with Inflammatory bowel Disease, who certainly have active overt inflammation in the colon?Also how do we know gut flora issues in IBSers are not from medications, stress, fiber, or envirnmental factors? Maybe its even a comborbid problem or a result of altered transit and motility, that result in food residue trapped in the colon which can alter gut flora?Also how does gut flora signal information to the brain? Nor does intestinal permeability of any pathogens show up in any positive blood samples? It also does not seem to be causing overt inflammation in IBS or alarm symtoms, nor is it out of control like in C Dif, where the symptoms then would rule out IBS. They also know that anxiety is a major factor in generating symptoms and their severity.Anxiety increases IBS severity Anxiety-related hyperactivity of the brain may increase the severity and duration of irritable bowel syndrome, say researchers. Given that IBS severity is highly influenced by psychiatric comorbidity, they suggest that phobic anxiety in IBS patients may influence processing in the frontal brain and visceral sensitivity. Svein Blomhoff, from the National Hospital, Oslo, Norway, and colleagues recruited 11 female patients with IBS and comorbid phobic anxiety and compared them with 22 age-matched female patients with IBS but no comorbidity. The patients' event-related potentials (ERPs) were recorded, along with their reaction to hearing words with emotional significance, barostat-assessed visceral sensitivity thresholds, and symptom thresholds. Patients with comorbid phobic anxiety had a significantly increased first negative (N1) ERP wave to all stimuli, compared with the noncomorbid group, the researchers report. This, they say, indicates an increased use of brain attentional resources. The comorbid group also had an increased visceral threshold for the sensation of gas, and a reduced gas-stool and gas-discomfort tolerance. Examining the data closely, the researchers found that enhanced N1 amplitude and reduced gas-stool tolerance were significantly correlated with subjective gas complaints, which accounted for 47% of the variation in symptoms. The researchers conclude: 'The study suggests an association between information processing in the frontal brain and visceral sensitivity characteristics in IBS patients, and indicates that subjective disease-related symptomatology is predicted by brain perceptual characteristics. 'The findings indicate that an interaction between IBS-related and anxiety-related hyperreactivity in the frontal brain may constitute a psychophysiological mechanism for the contribution of psychiatric comorbidity to severity and duration of the irritable bowel syndrome.' The study is published in Psychosomatic Medicine.Psychosom Med 2001; 63: 959�965 http://www.psychiatrymatters.md/internatio...381678328819444 This isn't because its all in the head either, it is due to very real processes of psychoneuroimmunology.Psychophysiological processes can also alter gut flora?Nor is anyone's gut flora the same as anyone elses.
 

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Just because you don't have symptoms, does not mean a person is "cured."also the word is Chronic" "chronic" comes from the Greek word chronos, meaning time). "In order to fully "cure" something you have to know exactly what causes it, they do not yet fully understand the cause of IBS yet, although they are getting way better. In the four years I have been here a ton of research generated insights on IBS and functional disorders have come to light. Some things they have already found out, IBS is a brain gut axis dysfunction with abnormalities and dysregulation of the serotonin system, and immune system. Nor is this a competition of either the brain or the gut, both are operative to cause the symptoms! Symptoms can be generated from either the gut or the brain. It was twenty years you had IBS Kel, if I am not mistaken. Is that chronic?""Living with a long-lasting health condition (also called a chronic illness) presents a person with new challenges. Learning how to meet those challenges is a process - it doesn't happen right away. But understanding more about your condition, and doing your part to manage it, can help you take health challenges in stride. Many people find that taking an active part in the care of a chronic health condition can help them feel stronger and better equipped to deal with lots of life's trials and tribulations. What Are Chronic Illnesses?There are two types of illnesses: acute and chronic. Acute illnesses (like a cold or the flu) are usually over relatively quickly. Chronic illnesses, though, are long-lasting health conditions (the word "chronic" comes from the Greek word chronos, meaning time). Having a chronic condition doesn't necessarily mean an illness is critical or dangerous - although some chronic illnesses, such as cancer and AIDS, can be life threatening. But chronic illnesses can also include conditions like asthma, arthritis, and diabetes. Although the symptoms of a chronic illness might go away with medical care, usually a person still has the underlying condition - even though their treatments mean they may feel completely healthy and well much of the time.Each health condition has its own symptoms, treatment, and course. Aside from the fact that they are all relatively long lasting, chronic illnesses aren't necessarily alike in other ways. Most people who have a chronic illness don't think of themselves as "having a chronic illness," they think of themselves as having a specific condition - such as asthma, or arthritis, or diabetes, or lupus, or sickle cell anemia, or hemophilia, or leukemia, or whatever ongoing health condition they have. If you're living with a chronic illness, you may feel affected not just physically, but also emotionally, socially, and sometimes even financially. The way a person might be affected by a chronic illness depends on the particular illness and how it affects the body, how severe it is, and the kinds of treatments that might be involved. It takes time to adjust to and accept the realities of a long-term illness, but teens who are willing to learn, seek support from others, and participate actively in the care of their bodies usually get through the coping process.The Coping ProcessMost people go through stages in learning to cope with a chronic illness. A person who has just been diagnosed with a particular health condition may feel a lot of things. Some people feel vulnerable, confused, and worried about their health and the future. Others feel sad or disappointed in their bodies. For some, the situation seems unfair, causing them to feel angry at themselves and the people they love. These feelings are the start of the coping process. Everyone's reaction is different, but they're all completely normal. The next stage in the coping process is learning. Most people living with a long-term illness find that knowledge is power - the more they find out about their condition, the more they feel in control and the less frightening it is. The third stage in coping with a chronic illness is all about taking it in stride. At this stage, people feel comfortable with their treatments and with the tools (like inhalers or shots) they need to use to live a normal life. So a person with diabetes, for example, may feel a range of emotions when his or her condition is first diagnosed. The person may believe he or she will never be able to go through the skin prick tests or injections that may be necessary to manage the condition. But after working with doctors and understanding more about the condition, that person will grow to be more practiced at monitoring and managing insulin levels - and it will stop feeling like such a big deal. Over time, managing diabetes will become second nature to that person. The steps involved will seem like just another way to care for one's body, in much the same way as daily teeth brushing or showering help people stay healthy. There's no definite time limit on the coping process - everybody's process of coming to terms with and accepting a chronic illness is different. In fact, most people will find that emotions surface at all stages in the process. Even if treatments go well, it's natural to feel sad or worried from time to time. Recognizing and being aware of these emotions as they surface is all part of the coping process.Tools for Taking ControlPeople living with chronic illnesses often find that the following actions can help them take control and work through the coping process:Acknowledge feelings. Emotions may not be easy to identify. For example, sleeping or crying a lot or grouchiness may be signs of sadness or depression. It's also very common for people with chronic illnesses to feel stress as they balance the realities of dealing with a health condition and coping with schoolwork, social events, and other aspects of everyday life. Many people living with chronic illnesses find that it helps to line up sources of support to deal with the stress and emotions. Some people choose to talk to a therapist or join a support group specifically for people with their condition. It's also important to confide in those you trust, like close friends and family members. The most important factor when seeking help isn't necessarily finding someone who knows a lot about your illness, but finding someone who is willing to listen when you're depressed, angry, frustrated - or even just plain old happy. Noticing the emotions you have, accepting them as a natural part of what you're going through, and expressing or sharing your emotions in a way that feels comfortable can help you feel better about things.Play an active role in your health care. The best way to learn about your condition and put yourself in control is to ask questions. There's usually a lot of information to absorb when visiting a doctor. You may need to go over specifics more than once or ask a doctor or nurse to repeat things to be sure you understand everything. This may sound basic, but lots of people hesitate to say, "Hey, can you say that again?" because they don't want to sound stupid. But it takes doctors years of medical school and practice to learn the information they're passing on to you in one office visit!If you've just been diagnosed with a particular condition, you may want to write down some questions to ask your doctor. For example, some of the things you might want to know are:How will this condition affect me? What kind of treatment is involved? Will it be painful? How many treatments will I get? Will I miss any school? Will I be able to play sports, play a musical instrument, try out for the school play, or participate in other activities I love? What can I expect - will my condition be cured? Will my symptoms go away? What are the side effects of the treatments and how long will they last? Will these treatments make me sleepy, grumpy, or weak? What happens if I miss a treatment or forget to take my medicine? What if the treatments don't work?Even though your doctor can't exactly predict how you'll respond to treatment because it varies greatly from one person to the next, knowing how some people react may help you prepare yourself mentally, emotionally, and physically. The more you learn about your illness, the more you'll understand about your treatments, your emotions, and the best ways to create a healthy lifestyle based on your individual needs.Understand other people's reactions. You may not be the only one who feels emotional about your illness. Parents often struggle with seeing their children sick because they want to prevent anything bad from happening to their children. Some parents feel guilty or think they've failed their child, others may get mad about how unfair it seems. Everyone else's emotions can seem like an extra burden on people who are sick, when of course it's not their fault. Sometimes it helps to explain to a parent that, when you express anger or fear, you're simply asking for their support - not for them to cure you. Tell your parents you don't expect them to have all the answers, but that it helps if they just listen to how you feel and let you know they understand.Because the teen years are all about fitting in, it can be hard to feel different around friends and classmates. Many people with chronic illnesses are tempted to try to keep their condition secret. Sometimes, though, trying to hide a condition can cause its own troubles as Melissa, who has Crohn's disease, discovered. Some of Melissa's medications made her look puffy, and her classmates started teasing her about gaining weight. When Melissa explained her condition, she was surprised at how accepting her classmates were. When talking to friends about your health condition, it can sometimes help to explain that everyone is made differently. For the same reason some people have blue eyes and others brown, some of us are more vulnerable to certain conditions than others. Depending on the severity of your illness, you may find yourself constantly surrounded by well-meaning adults. Teachers, coaches, and school counselors may all try to help you - perhaps causing you to feel dependent, frustrated, or angry. Talk to these people and explain how you feel. Educating and explaining the facts of your condition can help them understand what you're capable of and allow them to see you as a student or an athlete - not a patient.Keep things in perspective. It's easy for a health condition to become the main focus of a person's life - especially when they first learn about and start dealing with the condition. Many people find that reminding themselves that their condition is only a part of who they are can help put things back in perspective. Keeping up with friends, favorite activities, and everyday things helps a lot. Living With a Health Condition There's no doubt the teen years can be a more challenging time to deal with a health condition. In addition to the social pressures to fit in, it's a time of learning about and understanding our bodies. At a time when it's natural to be concerned with body image, it can seem hard to feel different. It's understandable that people can feel just plain sick and tired of dealing with a chronic illness once in a while.Even teens who have lived with an illness since childhood can feel the pull of wanting to lead a "normal" life in which they don't need medicine, have any limitations, or have to care for themselves in any special way. This is a perfectly natural reaction. Sometimes teens who have learned to manage their illness feel so healthy and strong that they wonder whether they need to keep following their disease management program. A person with diabetes, for example, may wonder if he or she can skip a meal when at the mall or check his or her blood sugar after the game instead of before. Unfortunately, easing up on taking care of yourself can have disastrous results. The best approach is to tell your doctor how you feel. Talk to him or her about what you'd like to be doing and can't - see if there's anything you can work out. This is all part of taking more control and becoming a player in your own medical care. When you're living with a chronic health condition, it can feel hard at times to love your body. But you don't have to have a perfect body to have a great body image. Body image can improve when you care for your body, appreciate its capabilities, and accept its limitations - a fact that's true for everyone, whether they're living with a chronic condition or not. Voicing any frustration or sadness to an understanding ear can help when a person feels sick of being sick. At times like this it's important to think of ways others could help and ask for what you'd like. Some people find they can ease their own sense of loss by reaching out and offering to help someone in need. Lending a hand to someone else can help one's own troubles seem easier to manage.Adjusting to living with a chronic illness takes a little time, patience, support - and willingness to learn and participate. People who deal with unexpected challenges often find an inner resilience they might not have known was there before. Many say that they learn more about themselves through dealing with these challenges and feel they grow to be stronger and more self-aware than they would if they'd never faced their particular challenge. People living with chronic illnesses find that when they take an active role in taking care of their body, they grow to understand and appreciate their strengths - and adapt to their weaknesses - as never before. Reviewed by: D'Arcy Lyness, PhDDate reviewed: January 2004"Next this has been replicated in more studies now."In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship." Perceptions of colonic activity Patients with IBS may perceive colonic sensations in a way that is different. For example, they may have a feeling of incomplete evacuation even though the rectum is empty. They also may feel that they are distended with gas though there is no sign of increased gas when it is measured. A number of studies have shown that IBS patients have a limited tolerance to distension of a balloon inserted into the rectum. They feel pain at a lower degree of distension of the balloon and also feel greater pain at the same degree of distension as normals. This may relate to a heightened sensitivity of the nerves that go from the colon to the spinal cord, known as visceral hypersensitivity. In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship. Example In addition to pain sensation, motility of the colon has been measured. IBS patients have an abnormal muscular response to a number of stimuli including stress and eating a fatty meal. This is important in terms of diarrhea and constipation patterns in IBS. Brain scanning in IBS One study used a functional scanning technique called Positron Emission Tomography (PET scan) comparing IBS patients to controls. Using this method, it is possible to map certain areas of the brain that respond to specific stimuli elsewhere in the body. When this technique was applied to IBS patients during balloon distension in the rectum, the pre-frontal cortex was activated. This area of the brain is part of the limbic system, involved in emotional feelings. In contrast, a different area of the brain, possibly more involved in pain control, was activated in controls. Even more interesting was the observation that anticipation of rectal stimulation in IBS also activated the pre-frontal cortex. The last finding indicates a direct connection between emotional stimuli and colonic function. http://www.mindbodydigestive.com/ Nor is that the message from researchers that IBS is untreatable, in fact their message is it is treatable for the majority of IBSers.There is also a big overlap of functional dyspepsia and IBS and FD patients show altered motility and viceral hypersensitvity of the esophagus. Do these patients have gut flora dysbiosis of the esophagus?Is non cardiac chest pain from altered gut flora?There is also a big overlap of FM and CFIS, which in part has to do with autonomic dysfunction and the HPA axis.It is also known now that both parasites and bacteria may lead to PI IBS and very possibly a virus. Food poisoning can lead to PI IBS.I also believe probiotics can have a role in managing some peoples IBS. I have not however seen they have "Cured" anyone yet in control trials, I have seen inconsitent results and the experts saying they need to study them more and find out what each specific strain does. I have also seen a lot of people get better without taking them with IBS.Why do IBSers have specific impairment of certain brain centers that are different then controls and different then people with Inflammatory bowel Disease, who certainly have active overt inflammation in the colon?Also how do we know gut flora issues in IBSers are not from medications, stress, fiber, or envirnmental factors? Maybe its even a comborbid problem or a result of altered transit and motility, that result in food residue trapped in the colon which can alter gut flora?Also how does gut flora signal information to the brain? Nor does intestinal permeability of any pathogens show up in any positive blood samples? It also does not seem to be causing overt inflammation in IBS or alarm symtoms, nor is it out of control like in C Dif, where the symptoms then would rule out IBS. They also know that anxiety is a major factor in generating symptoms and their severity.Anxiety increases IBS severity Anxiety-related hyperactivity of the brain may increase the severity and duration of irritable bowel syndrome, say researchers. Given that IBS severity is highly influenced by psychiatric comorbidity, they suggest that phobic anxiety in IBS patients may influence processing in the frontal brain and visceral sensitivity. Svein Blomhoff, from the National Hospital, Oslo, Norway, and colleagues recruited 11 female patients with IBS and comorbid phobic anxiety and compared them with 22 age-matched female patients with IBS but no comorbidity. The patients' event-related potentials (ERPs) were recorded, along with their reaction to hearing words with emotional significance, barostat-assessed visceral sensitivity thresholds, and symptom thresholds. Patients with comorbid phobic anxiety had a significantly increased first negative (N1) ERP wave to all stimuli, compared with the noncomorbid group, the researchers report. This, they say, indicates an increased use of brain attentional resources. The comorbid group also had an increased visceral threshold for the sensation of gas, and a reduced gas-stool and gas-discomfort tolerance. Examining the data closely, the researchers found that enhanced N1 amplitude and reduced gas-stool tolerance were significantly correlated with subjective gas complaints, which accounted for 47% of the variation in symptoms. The researchers conclude: 'The study suggests an association between information processing in the frontal brain and visceral sensitivity characteristics in IBS patients, and indicates that subjective disease-related symptomatology is predicted by brain perceptual characteristics. 'The findings indicate that an interaction between IBS-related and anxiety-related hyperreactivity in the frontal brain may constitute a psychophysiological mechanism for the contribution of psychiatric comorbidity to severity and duration of the irritable bowel syndrome.' The study is published in Psychosomatic Medicine.Psychosom Med 2001; 63: 959�965 http://www.psychiatrymatters.md/internatio...381678328819444 This isn't because its all in the head either, it is due to very real processes of psychoneuroimmunology.Psychophysiological processes can also alter gut flora?Nor is anyone's gut flora the same as anyone elses.
 

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Let me ask something else, in the world of IBS treatments are there any treatments through numerous clinical and hopefully controlled studies shown to be more effective then probiotics in indivdual symptoms and global symptom relief?
 

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Let me ask something else, in the world of IBS treatments are there any treatments through numerous clinical and hopefully controlled studies shown to be more effective then probiotics in indivdual symptoms and global symptom relief?
 

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quote:But those are mean values. There could be patients would overlap. Wouldn't that negate the findings of difference?
Unfortunately not. That is statistics for you. The means of patients falling outside the confidence intervals of the normals with p<0.05 means that the sample of the patients came from a different population than the samples of the normals. If you calculated confidence intervals for many samples of normals 95% of those confidence intervals will not contain the mean of the patients.
 

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quote:But those are mean values. There could be patients would overlap. Wouldn't that negate the findings of difference?
Unfortunately not. That is statistics for you. The means of patients falling outside the confidence intervals of the normals with p<0.05 means that the sample of the patients came from a different population than the samples of the normals. If you calculated confidence intervals for many samples of normals 95% of those confidence intervals will not contain the mean of the patients.
 

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This is old now, because they have done a ton more research on PI IBS and in IBS in general, however, No single bacteric or virus or parasite has been shown to directly cause IBS. In Fact with newer research, it has been found that a bacterial enteritis or parasite can lead to the clinical full blown expression of IBS, After the resolution of the infection. And newer research has implicated viruses as well, but the studies are not conclusive yet. There has also been a ton of research that stress at the time of infection is the highest predictor of who gets IBS after an enteric infection. Which is why some people fully recover from the intial infection and some later go on to PI IBS and still later to IBS.Some however, maybe predisposed to it from birth as a congential birth defect perhaps and there are studying that also.Some others may even get it from surgeries or from shock to the digestive system, they are studying that also."Bacteria and IBSMany have wondered if IBS is caused by an infection. To date, no virus, bacteria, or parasite has been found to directly cause IBS. It has, however, been hypothesized that these microbes may indirectly cause IBS or at least exacerbate its symptoms. Some researchers question whether IBS begins with a common bacterial gastroenteritis. Gastroenteritis is an inflammation of the lining of the stomach and intestinal tract often caused by a bacterial infection. Symptoms may include vomiting, abdominal pain, and diarrhea. Other investigators question whether the number or type of bacteria that normally live in the colon affects symptoms.Some individuals with IBS recall that their symptoms began with a gastroenteritis. The first theory of a "post-infection diarrhea" as a possible link has been explored in greater depth this past year. A post-infection diarrhea is a common, temporary phenomenon resulting from the destruction of intestinal digestive enzymes during an infection. Even after the infection has cleared, certain foods will cause the persistence of loose stools for several weeks until the intestine rebuilds its digestive enzymes.One recent Canadian study looked at the occurrence of IBS in people who travel overseas and acquire a "traveler's diarrhea." These investigators found that 10% of travelers who acquired an infectious gastroenteritis subsequently developed IBS. Those who did develop a traveler's diarrhea, compared to those who did not, had an approximate 6-fold increased risk of developing IBS.Another study from England found that 23% of their patients hospitalized for an infectious gastroenteritis went on to develop IBS. Regardless of whether these individuals developed IBS, they all had increased rectal sensitivity and increased colon movements several weeks after their infection had cleared. However, the researchers also found that the individuals who developed IBS reported more life events suggesting that that there may have been a psychological component to their symptoms in addition to the infectious component.Can bacteria cause IBS without a preceding infection? There are trillions of bacteria that normally reside in the gastrointestinal tract where they help digest nutrients. [Fermentation and intestinal gas are a byproduct of this digestive process.] Some investigators have questioned whether the number or type of bacteria normally present is different in individuals with IBS. A group of German investigators found that the tissue taken from the colons in people with IBS had higher bacterial concentrations than the tissue from individuals without IBS. The researchers believe that this finding suggests that the colons of some people with IBS are colonized by a greater number of bacteria than those without IBS. This may alter how nutrients are fermented in the colons of IBS patients.A group of British investigators also believe that colonic fermentation (gas production) is different in some people with IBS. They confirmed this in one study, which may explain why some individuals respond to dietary restriction and why some do not. The investigators went on to measure gas production in IBS patients before and after antibiotic treatment. The antibiotics appeared to reduce the total volume and rate of hydrogen gas production in the people studied. The investigators felt that this second study provided additional evidence of the role of colonic fermentation in IBS symptoms and supported the use of dietary modification or antibiotics to reduce gas production and improve symptoms in people with IBS.These findings are promising. It is too early however, to say conclusively that bacteria and antibiotics have a role in the development of IBS symptoms and in effective treatment.""Where is the Problem in IBS?The definition of IBS suggests that all routine investigations such as blood tests, endoscopy, and radiological imaging should be normal. The condition is diagnosed on the basis of symptoms, elicited through history and physical examination, in the absence of obvious gut abnormality. So what is the problem?Much work has been done to explain the underlying pathology (disease characteristics or cause) in IBS in the hope that treatment could be directly targeted to an abnormality. This approach could be hugely beneficial compared to available treatments that work symptomatically. In IBS, we know the problem is not only in the gut but is also in the brain-gut axis and the autonomic nervous system. Is the problem in the gut? Increased perception of sensations in the gut, or visceral hypersensitivity, has consistently been observed in IBS. Mertz and colleagues from California checked the discomfort threshold in IBS patients and in a control group. In response to balloon distention of the rectum, almost all (94%) of IBS patients showed lowered pain thresholds. The investigators proposed that increased rectal perception could be used as a reliable biological marker for IBS.Is the problem in the brain?Silverman and colleagues from UCLA used a special brain imaging technique, positron emission tomography (PET), to measure the changes in the pattern of blood flow in the brains IBS patients and a control group in response to balloon distention of the rectum. They found that different areas of the brain were activated in IBS patients when rectal stimuli were delivered. This suggests that the brains of people with IBS process signals from the gut differently.Is the problem in the general autonomic nervous system?Monga and colleagues from London checked bladder and esophageal perception and pain thresholds and found that women with IBS have both lower bladder and esophageal sensory thresholds. They suggested that IBS is part of a generalized disorder of smooth muscles. These women also had "irritable bladders." Francis and colleagues from Manchester, UK found that a higher proportion of patients who are seen in the urology clinic have IBS compared to patients seen in other clinics (dermatology; and ear, nose, and throat). There seems to be increasing evidence that the pathology in IBS is not limited to the gut, brain, or autonomic nervous system only. Rather there may be an involvement of all three systems. Therefore, any potential new therapy should be aiming at this widespread pathology." http://www.aboutibs.org/Publications/resea...ml#anchor143049
 

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This is old now, because they have done a ton more research on PI IBS and in IBS in general, however, No single bacteric or virus or parasite has been shown to directly cause IBS. In Fact with newer research, it has been found that a bacterial enteritis or parasite can lead to the clinical full blown expression of IBS, After the resolution of the infection. And newer research has implicated viruses as well, but the studies are not conclusive yet. There has also been a ton of research that stress at the time of infection is the highest predictor of who gets IBS after an enteric infection. Which is why some people fully recover from the intial infection and some later go on to PI IBS and still later to IBS.Some however, maybe predisposed to it from birth as a congential birth defect perhaps and there are studying that also.Some others may even get it from surgeries or from shock to the digestive system, they are studying that also."Bacteria and IBSMany have wondered if IBS is caused by an infection. To date, no virus, bacteria, or parasite has been found to directly cause IBS. It has, however, been hypothesized that these microbes may indirectly cause IBS or at least exacerbate its symptoms. Some researchers question whether IBS begins with a common bacterial gastroenteritis. Gastroenteritis is an inflammation of the lining of the stomach and intestinal tract often caused by a bacterial infection. Symptoms may include vomiting, abdominal pain, and diarrhea. Other investigators question whether the number or type of bacteria that normally live in the colon affects symptoms.Some individuals with IBS recall that their symptoms began with a gastroenteritis. The first theory of a "post-infection diarrhea" as a possible link has been explored in greater depth this past year. A post-infection diarrhea is a common, temporary phenomenon resulting from the destruction of intestinal digestive enzymes during an infection. Even after the infection has cleared, certain foods will cause the persistence of loose stools for several weeks until the intestine rebuilds its digestive enzymes.One recent Canadian study looked at the occurrence of IBS in people who travel overseas and acquire a "traveler's diarrhea." These investigators found that 10% of travelers who acquired an infectious gastroenteritis subsequently developed IBS. Those who did develop a traveler's diarrhea, compared to those who did not, had an approximate 6-fold increased risk of developing IBS.Another study from England found that 23% of their patients hospitalized for an infectious gastroenteritis went on to develop IBS. Regardless of whether these individuals developed IBS, they all had increased rectal sensitivity and increased colon movements several weeks after their infection had cleared. However, the researchers also found that the individuals who developed IBS reported more life events suggesting that that there may have been a psychological component to their symptoms in addition to the infectious component.Can bacteria cause IBS without a preceding infection? There are trillions of bacteria that normally reside in the gastrointestinal tract where they help digest nutrients. [Fermentation and intestinal gas are a byproduct of this digestive process.] Some investigators have questioned whether the number or type of bacteria normally present is different in individuals with IBS. A group of German investigators found that the tissue taken from the colons in people with IBS had higher bacterial concentrations than the tissue from individuals without IBS. The researchers believe that this finding suggests that the colons of some people with IBS are colonized by a greater number of bacteria than those without IBS. This may alter how nutrients are fermented in the colons of IBS patients.A group of British investigators also believe that colonic fermentation (gas production) is different in some people with IBS. They confirmed this in one study, which may explain why some individuals respond to dietary restriction and why some do not. The investigators went on to measure gas production in IBS patients before and after antibiotic treatment. The antibiotics appeared to reduce the total volume and rate of hydrogen gas production in the people studied. The investigators felt that this second study provided additional evidence of the role of colonic fermentation in IBS symptoms and supported the use of dietary modification or antibiotics to reduce gas production and improve symptoms in people with IBS.These findings are promising. It is too early however, to say conclusively that bacteria and antibiotics have a role in the development of IBS symptoms and in effective treatment.""Where is the Problem in IBS?The definition of IBS suggests that all routine investigations such as blood tests, endoscopy, and radiological imaging should be normal. The condition is diagnosed on the basis of symptoms, elicited through history and physical examination, in the absence of obvious gut abnormality. So what is the problem?Much work has been done to explain the underlying pathology (disease characteristics or cause) in IBS in the hope that treatment could be directly targeted to an abnormality. This approach could be hugely beneficial compared to available treatments that work symptomatically. In IBS, we know the problem is not only in the gut but is also in the brain-gut axis and the autonomic nervous system. Is the problem in the gut? Increased perception of sensations in the gut, or visceral hypersensitivity, has consistently been observed in IBS. Mertz and colleagues from California checked the discomfort threshold in IBS patients and in a control group. In response to balloon distention of the rectum, almost all (94%) of IBS patients showed lowered pain thresholds. The investigators proposed that increased rectal perception could be used as a reliable biological marker for IBS.Is the problem in the brain?Silverman and colleagues from UCLA used a special brain imaging technique, positron emission tomography (PET), to measure the changes in the pattern of blood flow in the brains IBS patients and a control group in response to balloon distention of the rectum. They found that different areas of the brain were activated in IBS patients when rectal stimuli were delivered. This suggests that the brains of people with IBS process signals from the gut differently.Is the problem in the general autonomic nervous system?Monga and colleagues from London checked bladder and esophageal perception and pain thresholds and found that women with IBS have both lower bladder and esophageal sensory thresholds. They suggested that IBS is part of a generalized disorder of smooth muscles. These women also had "irritable bladders." Francis and colleagues from Manchester, UK found that a higher proportion of patients who are seen in the urology clinic have IBS compared to patients seen in other clinics (dermatology; and ear, nose, and throat). There seems to be increasing evidence that the pathology in IBS is not limited to the gut, brain, or autonomic nervous system only. Rather there may be an involvement of all three systems. Therefore, any potential new therapy should be aiming at this widespread pathology." http://www.aboutibs.org/Publications/resea...ml#anchor143049
 

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Why is it also that a pain attack can come on so fast and sometimes last a 1/2 hour or sometimes last a couple hours or even the whole day or even a couple days, but the pain can also go away as quickly as it came on?Also why is it sometimes described as a charlie horse in the gut?Why is it when some people go an lay down and calm the body and mind the pain can go away?Again why do more women then men have it?Why is it there is mild moderate and svere IBS?Why is it that it can wax and wane for years?Why is it that for some, certain times of the year are when its at its worse? For some it maybe winter and for others it maybe summer or anytime of the year?Why is it for some they can get pain with out a d or c or alternating attack to go with the pain?Why is it that some people have functional d with no pain?or functional c with no pain?Or chronic abnominal pain syndrome with no c or d or c/d?
 

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Why is it also that a pain attack can come on so fast and sometimes last a 1/2 hour or sometimes last a couple hours or even the whole day or even a couple days, but the pain can also go away as quickly as it came on?Also why is it sometimes described as a charlie horse in the gut?Why is it when some people go an lay down and calm the body and mind the pain can go away?Again why do more women then men have it?Why is it there is mild moderate and svere IBS?Why is it that it can wax and wane for years?Why is it that for some, certain times of the year are when its at its worse? For some it maybe winter and for others it maybe summer or anytime of the year?Why is it for some they can get pain with out a d or c or alternating attack to go with the pain?Why is it that some people have functional d with no pain?or functional c with no pain?Or chronic abnominal pain syndrome with no c or d or c/d?
 

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Why is it for some people applying heat to the abdomen makes the pain better or go away?Why is it for some people wearing tight pants triggers an attack?Why is it not just bad stress but good stress can trigger an attack?Why is it cold water for some can trigger an attack?Also the symptoms of the "sensation of incomplete evacuation is not needed for and IBS diagnoses, but helps confirm it, because it is not a symptom consistent with a pathogen or enteric infection.IBS is also not contagious, nor does it do more damage to the gi tract?The symptoms in Most IBSers are consitenty the same for many years. Also when using the rome ll diagnoses the diagnoses IS stable and less then five percent are found years later to have an organic condition or major changes in symptoms or red flag or alarm symptoms.
 
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