I HAVE TRIED TO FIND OUT SOME CAUSES OF IBSAlthough IBS is the most common diagnosis given by gastroenterologists (gut doctors), the causes of the illness aren't clear. Much research shows that IBS patients have a colon that is much more sensitive to stimuli than healthy subjects. These stimuli could be foods and drinks or emotional stimuli like stress and anxiety. Some research has also shown that the immune system may be involved somehow. This could be an indication that the bacteria in the gut play a part, whether the immune system is having an abnormal response to the normal bacteria or whether dysbiosis or a specific bacterial infection is present.Factors that may have a role in IBS include:1) Neurological Dysfunction2) Stress3) Food Sensitivities/Intolerances4) Gut Dysbiosis5) Leaky Gut Syndrome Neurological Dysfunction In IBS:What is unique about perception of visceral events in the GI tract?There are several features which are unique to the perception of sensory stimuli arising from the gastrointestinal tract and which differ from those coming from the rest of the body. These differences may explain many of the symptom characteristics present in FBD patients.Even though the events within the GI tract such as the composition of food, the concentration of acid, or the strength of contractions are continuously monitored by sensory nerve fibers, only a small fraction of this sensory information ever reaches consciousness. The majority of sensory signals play a role in reflex regulation of the digestive process and presumably in the very basic regulation of states like hunger or well being. The only sensory signals which are consciously perceived are those which result in a beneficial behavioral response, such as: the sensation of being "full" following a big meal so that we stop eating, the sensation of rectal fullness and urgency preceding a bowel movement, and the sensation of gas which will result in an attempt to expel the gas from the upper or lower GI tract.The brain has developed mechanisms, which prevent the conscious perception of all visceral information that is not essential for the individual to respond to. However, in patients with FBD, this inhibitory mechanism appears to be compromised. For example, people with IBS commonly experience a persistent sensation of excessive gas, even though carefully designed studies have failed to demonstrate alterations in the gas content of the bowel which correlate with symptoms of bloating. A sensation of incomplete evacuation will make a person try to go to the bathroom many times during the day, even though the rectum is virtually empty. Persons with functional heartburn experience a burning sensation in the esophagus, without abnormal amounts of refluxed acid, and persons with dyspepsia will experience a constant sensation of gastric fullness even though their stomachs are nearly empty.An additional problem for FBD patients is that they have no sensory "back-up" system to verify if the perceived gut sensations are appropriate. For example, if I have a sensation that my face feels swollen, I can look in the mirror, touch my face, feel the temperature, etc. If these checks fail to confirm my sensory experience, I will likely not be concerned about the sensation in my face and forget about it. In contrast, if my belly feels full of food, gas, or stool, I have no way of verifying if this sensation actually is due to an excessive amount of food, gas, or stool. Even more so, if I experience belly pain, I have no way of verifying what may be responsible for the pain or any way of determining if it is a life threatening problem or a simple spasm. This sole reliance on our visceral sensory apparatus (without being able to use our other senses for verification) makes us highly vulnerable to even small alterations in its sensitivity and reliability. Furthermore, the system is prone to generate symptom-related anxiety and fears: if there is no easy way to verify if a particular sensation is a warning signal or an innocuous event, worries and fears about this sensation are likely to develop, in particular in an individual prone to anxiety.Source Site FOR ABOVE INFORMATION and also more info regarding this is here:http://www.aboutibs.org/Publications/VisceralSensations.html---------------------------------------------------------------------------------What is GUT DYSBIOSIS?The state of a disordered microbial ecology that causes disease. It may exist in the oral cavity, gastrointestinal tract or vaginal cavity. In dysbiosis, normally harmless bacteria, yeasts, and protozoa trigger disease by altering the nutrition or immune responses of their host.Recognition that intestinal flora have a major impact on human health first developed with the birth of microbiology in the late nineteenth century. It is generally accepted that our relationship with indigenous gut flora is "Eu-symbiotic," meaning a state of living together that is beneficial. Metchinkoff popularized the idea of "Dys-symbiosis, or Dysbiosis," a state of living with intestinal flora thathas harmful effects. He postulated that toxic amines produced by bacterial putrefaction of food were the cause of degenerative diseases, and that ingestion of fermented foods containing Lactobacilli could prolong life by decreasing gut putrefaction(1). Although Metchnikoff's ideas have been largely ignored in the United States, they have influenced four generations of European physicians. The notion that dysbiotic relationships with gut microflora may influence the development of inflammatory diseases and cancer has received considerable experimental support over the past two decades, but the mechanisms involved are far more diverse than Metchnikoff imagined.Source Site:http://www.ei-resource.org/Articles/candida-art03.asp---------------------------------------------------------------------------what is GUT PERMEABILITY ?The property of something that can be pervaded by a liquid ( as by osmosis or diffusion)-------------------------------------------------------------------What is LEAKY GUT SYNDROME?The purpose of the gastro-intestinal tract, or gut, is multi-fold. Basically, it:i) Digests foods,ii) Absorbs small food particles to be converted into energy.iii) Carries nutrients like vitamins and minerals attached to carrier proteins across the gut lining into the bloodstream.iv) Contains a major part of the chemical detoxification system of the body, andv) Contains immunoglobulins or antibodies that act as the first line of defence against infection.The leaky gut (or LGS) is a poorly recognised but extremely common problem. It is rarely tested for. Essentially, it represents a hyperpermeable intestinal lining. In other words, large spaces develop between the cells of the gut wall, and bacteria, toxins and food leak in.The official definition is an increase in permeability of the intestinal mucosa to luminal macromolecules, antigens and toxins associated with inflammatory degenerative and/or atrophic mucosal damage.If the gut is not healthy, neither is the rest of the body. It is the point of fuel and nutrient entry. If healing is at a standstill look at the gut to see if this is the block. Chemical sensitivity, fibromyalgia and escalating food allergies are among the many problems caused by the leaky gut.If gas, bloating, abdominal pain, indigestion, alternating constipation and diarrhoea are symptoms, irritable bowel syndrome may not be all that's going on.The Mucosal BarrierThe barrier posed by the intestinal mucosa is, even in normal subjects, an incomplete one. Small quantities of molecules of different sizes and characteristics cross the intact epithelium by both active and passive mechanisms. The route by which such transfer occurs is, at least in part, dependent on molecular size. Molecules up to about 5000 Daltons in size cross the epithelial membrane of the microvilli. Larger molecules may utilise an intercellular pathway or depend on being taken up by endocytosis entering the cell at the base of the microvilli.How Does The Gut Become Leaky?Once the gut lining becomes inflamed or damaged, this disrupts the functioning of the system. The spaces open up and allow large food antigens, for example, to be absorbed into the body. Normally the body sees only tiny food antigens. When it sees these new, larger ones, they are foreign to the body's defence system. So the attack results in the production of antibodies against once harmless, innocuous foods.The 7 stages of the 'inflamed’ gut.1 . When the gut is inflamed, it does not absorb nutrients and foods properly and so fatigue and bloating can occur.2. As mentioned previously, when large food particles are absorbed there is the creation of food allergies and new symptoms with target organs, such as arthritis or fibromyalgia.3. When the gut is inflamed the carrier proteins are damaged so nutrient deficiencies occur which can also cause any symptom, like magnesium deficiency induced muscle spasm or copper deficiency induced high cholesterol.4. Likewise when the detox pathways that line the gut are compromised, chemical sensitivity can arise. Furthermore the leakage of toxins overburdens the liver so that the body is less able to handle everyday chemicals.5. When the gut lining is inflamed the protective coating of lgA (immunoglobulin A) is adversely affected and the body is not able to ward off protozoa, bacteria, viruses and yeast’s like candida.5. When the gut lining is inflamed the protective coating of lgA (immunoglobulin A) is adversely affected and the body is not able to ward off protozoa, bacteria, viruses and yeast’s like candida.6. When the intestinal lining is inflamed, bacteria and yeast’s are able to translocate. This means that they are able to pass from the gut lumen or cavity, into the bloodstream and set up infection anywhere else in the body.7. The worst symptom is the formation of antibodies. Sometimes these leak across and look similar to antigens on our own tissues. Consequently, when an antibody is made to attack it, it also attacks our tissue. This is probably how autoimmune disease s tart. Rheumatoid arthritis, lupus, multiple sclerosis, thyroiditis and many others are members of this ever-growing category of ‘incurable’ diseases.Source Site:http://osiris.sunderland.ac.uk/autism/gut.htmIBS Health Advice from CNN:http://www.cnn.com/HEALTH/library/DS/00106.htmlIBS Discussed in detail here:http://www.medicinenet.com/irritable_bowel...ome/article.htm
WHAT IS THE CAUSE FOR IBS???
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India, some links for you.However,"The lining of the colon (epithelium), which is affected by the immune and nervous systems, regulates the passage of fluids in and out of the colon. In IBS, the epithelium appears to work properly."http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/a caveat to that is in PI IBS.more links for you.Report on the 5th International Symposium on Functional Gastrointestinal Disordershttp://www.iffgd.org/symposium2003report.htmlpast Symposiumshttp://www.aboutibs.org/Publications/symposium.htmlThis you should really look at though.American Gastroenterological Association Teaching project slides IBS Originally posted on May 15, 2003 https://www.gastroslides.org/Main/browse_deck.asp?tpc=4 Irritable Bowel Syndrome 2004 Update Originally posted on May 15, 2003 https://www.gastroslides.org/Main/browse_deck.asp?tpc=9and last but not leastVisceral Sensations and Brain-Gut MechanismsBy: Emeran A. Mayer, M.D., Professor of Medicine, Physiology and Psychiatry; Director, Center for Neurovisceral Sciences & Women's Health, David Geffen School of Medicine at UCLAhttp://www.aboutibs.org/Publications/VisceralSensations.html
THANKS ERIC .......... I will have a lookMORE Recognised CAUSES of IBS ::::ABNORMAL CONTRACTION AND EXPANSIONOne theory suggests that IBS is caused by abnormal contractions of the colon and intestines (hence the term "spastic bowel," which has sometimes been used to describe IBS). Vigorous contractions of the intestines can cause severe cramps, providing the rationale for some of the treatments of IBS, such as antispasmodics and fiber (both of which help to regulate the contractions of the colon). However, abnormal intestinal motility does not seem to explain IBS in all patients, and it is unclear whether it is a symptom or cause of the disorder.FROM OTHER ILLNESSThe development of IBS following severe gastrointestinal infections (such as those caused by Salmonella or Campylobacter) has been well recognized for many years. The mechanisms by which the infections trigger the development of IBS are not well understood. Most patients with IBS do not have a history of having had one of these infections.ROLE OF ANXIETYPeople with IBS in the general community have the same psychological makeup as those without IBS. However, people with IBS who seek medical help are more likely to suffer from anxiety and stress than those who do not seek medical advice. It is known that stress and anxiety have a number of effects on the intestine; thus, it is likely that anxiety and stress worsen symptoms, but they are probably not the cause of symptoms. Some studies have suggested that IBS is more common in people who have a history of physical, verbal, or sexual abuse.FOOD INTOLERANCESFood intolerances are common in patients with IBS, raising the possibility that IBS is caused by food sensitivity or allergy. This theory has been difficult to prove, although it continues to be studied. The best way to detect an association between symptoms of IBS and food sensitivity is to eliminate certain food groups systematically (a process called an elimination diet), which is usually best accomplished under the supervision of a doctor or nutritionist. The danger in eliminating foods in a nonsystematic way is that it can erroneously lead people to eliminate important sources of nutrition from their diet. In addition, unnecessary dietary restrictions can further worsen the quality of life in patients who already have enough to cope with.HYPER SENSITIVITYMany researchers believe that IBS may be caused by heightened sensitivity of the intestines to normal sensations (so-called "visceral hyperalgesia"). This theory proposes that nerves carrying sensory messages from the bowel are overactive in people with IBS, so that normal amounts of gas or movement in the gastrointestinal tract are perceived as excessive and painful. In support of this theory is the observation that some patients with severe IBS feel better when treated with medications (such as low doses of imipramine or nortriptyline) that decrease the sensations coming from the intestine.Many studies have shown that in patients with IBS, both awareness and pain caused by balloon distention in the large and small bowel are experienced at significantly lower balloon volumes than those reported by healthy subjects.10-12 However, It is not known at what level of pain signal transmission (starting at the receptor in the gut wall, through the spinal cord to the brain) this increased sensitivity is expressed, but it is selective to visceral stimuli, as patients with IBS have normal or even decreased sensitivity to somatic stimuli.ABNORMAL GUT MOTILITYThe changes in gut motility observed in IBS are qualitative, with no distinct pattern that can distinguish patients from healthy subjects. Two major changes are observed: (1) enhanced gut transit in some patients with diarrhea-predominant IBS and decreased gut transit in some patients with constipation-predominant IBS; and (2) increased motility compared with healthy subjects in response to various stimuli, such as psychological stress, meals, and balloon inflation in the gut.PSYCHOSOCIAL FACTORSIBS has long been dismissed as a psychosomatic condition, since it has no clear etiology or pathophysiology. Psychological stress and emotional events, eg, physical or sexual abuse, can result in GI symptoms in healthy subjects, but they affect patients with IBS to a greater degree. The common psychological symptoms associated with IBS are depression, somatization, anxiety, hostility, phobia, and paranoia. Up to 50% of patients with IBS meet criteria for a psychiatric diagnosis as compared with an average of 20% with organic GI disorders and 15% of control subjects.6 Although there are no psychological or psychiatric disorders specific to IBS, identification of such disorders may help in planning psychological or psychopharmacologic treatment.NEUROTRANSMITTER IMBALANCENinety-five percent of serotonin is in the GI tract, within enterochromaffin cells, neurons, mast cells, and smooth muscle cells. When released by enterochromaffin cells, serotonin stimulates extrinsic vagal afferent nerve fibers and intrinsic enteric afferent nerve fibers, resulting in such physiologic responses as intestinal secretion and the peristaltic reflex and in such symptoms as nausea, vomiting, abdominal pain, and bloating.15 Preliminary evidence suggests that patients with IBS have increased serotonin levels in plasma and in the rectosigmoid colon.16,17 Other neurotransmitters that may play a role in IBS include calcitonin gene-related peptide, nitric oxide, and vasoactive intestinal peptideLATENT OR POTENTIAL CELIAC DISEASE The concept of latent/potential celiac disease has recently been introduced into the pathogenesis of IBS. Abdominal symptoms in the absence of mucosal abnormalities are features of both IBS and latent or potential celiac disease.18 In a study of genetic, serologic, and histologic markers of celiac disease in 102 patients with diarrhea-predominant IBS, 35% of the patients had positive findings for HLA-DQ2, 23% had increased intraepithelial lymphocyte counts, and 30% had increased celiac disease-associated antibodies in the duodenal aspirates, including antibodies against gliadin, tissue tranglutaminase, ß-lactoglobulin, and ovalbumin.18 Stool frequency and intestinal IgA level decreased significantly under a gluten-free diet in a subgroup of IBS patients with positive HLA-DQ2 and positive intestinal celiac disease-associated antibodies when compared with IBS patients without these markers.18WHAT IS CELIAC DISEASE?inability to digest and absorb gliadin, the protein found in wheat. Undigested gliadin causes damage to the lining of the small intestine, which prevents absorption of nutrients from other foods. Celiac disease is also called celiac sprue, gluten intolerance, and nontropical sprue.A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, and barley. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine, specifically the villi.INFECTION AND INFLAMMATIONClinical, epidemiologic, and physiologic studies have shown that acute, transient GI infection is associated with a syndrome that, in many instances, meets diagnostic criteria for the diagnosis of IBS. In a subgroup of patients with IBS, their condition appeared to be preceded by an enteric infection, such as Campylobacter jejuni, with increased inflammatory cell response.19,20 IBS and small-intestinal bacterial overgrowth may share similar symptoms. In a study of 202 patients with IBS, 157 (78%) had small-intestinal bacterial overgrowth. Eradication of bacterial overgrowth improved patients' abdominal symptoms.21 Intraepithelial lymphocytes, lamina propria CD3 cells and CD25 cells, neutrophils, and mast cells are increased in patients with IBS.20 Exact mechanisms by which the inflammatory changes cause the symptomatology are not clear. The inflammatory response may be associated with activating enterochromaffin cells to produce 5-hydroxytryptamine (5-HT) and CD3 cells to produce cytokines, which in turn leads to enhanced motility, increased intestinal permeability, and lowered visceral sensation thresholds.19,20,22 In one prospective study of postinfectious IBS, it was found that patients whose symptoms remained 3 months after an enteric infection had not only increased mucosal cellularity but also had had increased psychosocial distress at the time of the infection. Lowered visceral sensation thresholds and increased motility were present after the infection regardless of whether or not the symptoms remained.23 Therefore, the microscopic inflammation and its physiologic effects on motility and sensation contribute to, but are not always sufficient for, the clinical explanation of IBS pain.24SIGNS AND SYMPTOMSPatients with IBS can present with a wide variety of GI and extraintestinal symptoms. However, the symptom complex of chronic abdominal pain and altered bowel habits that cannot be explained by identifiable structural or biochemical abnormalities is the main clinical pattern of IBS.Chronic abdominal pain in IBS is usually described as a crampy sensation with varying intensity and periodic exacerbation. The pain is generally located in the lower abdomen, although the location and character of the pain can also vary. Emotional stress and eating may exacerbate the pain, whereas defecation often provides some relief. Progressive pain that awakens the patient from sleep or prevents sleep should prompt a search for causes other than IBS.Since the range of normal bowel habits is broad, a careful history should include the volume, frequency, and consistency of the patient's stool. The frequency of bowel movements in normal individuals is variable, and it can range from three times a day to three times per week. Patients with IBS complain of diarrhea, constipation, alternating diarrhea and constipation, or normal bowel habits alternating with either diarrhea or constipation.DIARREADiarrhea is generally characterized as a condition of frequent loose stools of small and moderate volume. Bowel movement generally occurs during waking hours, most often in the morning or after meals. Most bowel movements are preceded by urgency and may be followed by a feeling of incomplete evacuation. Nocturnal diarrhea, bloody stools, dehydration, or weight loss are not features of IBS.CONSTIPATIONConstipation may last from days to months, with interludes of diarrhea or normal bowel function. Stools are often hard and may be described as pellet-shaped. Patients may also experience a sense of incomplete evacuation even when the rectum is empty. This can lead to straining with defecation, prolonged time on the toilet, and inappropriate use of enemas or laxatives.OTHER GASTROINTESTINAL SYMPTOMSUpper GI symptoms are not uncommon in patients with IBS. These include symptoms of heartburn, dysphagia, nonulcer dyspepsia, nausea, and noncardiac chest pain.25 Patients with IBS often complain of abdominal bloating and increased gas production in the form of flatulence or belching. However, these symptoms occur despite normal volumes of gas in the GI tract and no significant colonic distention.OTHER SYMPTOMSPatients with IBS have a high frequency of non-GI symptoms, including rheumatologic symptoms, headache, genitourinary symptoms such as urinary frequency and urgency, dyspareunia, sexual dysfunction, and sleep-related disturbances.Abdominal pain â€" Abdominal pain is typically crampy, varying in intensity, and located in the lower left abdomen. However, the nature, severity, and location of pain can vary considerably from person to person. Some people notice that emotional stress and eating worsen the pain, and that defecation relieves the pain. Some women with IBS notice an association between pain episodes and their menstrual cycle.WHAT IS COLITIS?IT IS INFLAMMATION OF THE LINING OF LARGE INTESTINE.WHAT IS DYSPEPSIA?digestive type problems such as indigestion or upset stomach.SORRY HERE ...... I HAVE LOST THE SITE LINK FROMWHICH I COLLECTED ALL THE INFORMATION
Current state of the art video on IBSwindows media playerhttp://www.itvisus.com/programs/hbhm/episode_ibs.aspandNo Link Found Between Celiac Disease and Irritable Bowel Syndrome http://ibsgroup.org/eve/forums/a/tpc/f/71210261/m/891102261Role of serotonin in the pathophysiology of the irritable bowel syndromehttp://www.nature.com/bjp/journal/v141/n8/full/0705762a.htmlThe Other Brain Also Deals With Many Woeshttp://ibsgroup.org/eve/forums/a/tpc/f/71210261/m/369100861"The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug "http://www.ibshealth.com/ibs_foods_2.htmThis part"as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation."is based on serotonin dysregulation. It also helps to explain alternating d/c in IBS.
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·Hi, I'm brand new today to this site and fascinated in the IBS debate.I am 47 and have suffered from stomach problems since birth. I was interested to see Eric's link that there is no link between Coeliac disease and IBS. I was hospitalised in 1962 (aged 4) for eight weeks with a badly swollen stomach, cramps etc and was subsequently diagnosed with Coeliac disease. I was put on a gluten free/fruit free diet. It never solved any problem and I was continually in pain.When I was 28, my son was born and I informed the medical staff at the time that I had Coeliac disease and was worried if it may be hereditary. The doctor took one look at me and told me I couldn't be a Coeliac sufferer because of my physique (I was a weighlifter) and general well-being. He said I should be thin and gaunt looking.I had various hospital tests on the advice of the medical staff who diagnosed IBS.I had spent 24 years on a wasted diet!I have since that time encountered continual numerous problems with my gut (all the usual symptoms) and have tried different diets galore.Either on the Coeliac diet or IBS (intolerance diets) I have had continual pain and problems.I believe IBS has no firm solution and that sufferers have to achieve relief through trial and error. A good friend and fellow weightlifter gave me the best advice on nutrition. He said "If it tastes good it's bad for you" LOL Strangely I have found that to be more fact that fiction.I have found certain 'triggers' that certainly cause and upset stomach on a regular basis over the years - the main culprit being stress. Follow that with coffee, wheat, alcohol and fruit and vegaetables. I have recently moved to an Organic' lifestyle and my improvement has been immense. It's early days and I have been fine with very little bloating/disorder. Perhaps all the 'c**p they throw at us nowadays in food causes or irritates IBS more - who knows.Thanks for letting a 'newbie' with 47 years experience rant on and thanks for a great informative site.
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·Thanks Joolie,I hope I can be of help and learn from the site too.mikey
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·Hello Mikey - welcome from the sunny (ha ha) North West - whats it like in Cornwall (you lucky bugger - fav place on earth)? Flooding? Typical half term weather here in South Manc.Thanks India? (sorry can't see who posted this lot originally) very interesting.I'd stake my life 90% of my probbos are stress-related. My wee lad was flying off to Italy this am and now he's there feel alot better.Sue
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IT is indeed disturbing.Flux, I will like to mention here that before objecting to another person's remark you should verify whether you are telling right or not.food sensitivity, abnormal contraction of intestinal muscles are really both symptoms of IBS.Dysbiosis is observed in many IBS patients.I don't know whether leaky gut syndrome is a symptom for IBS but I have mentioned here the site to from where i have found that.Flux, Please stop objecting to other's comment, or if you are objecting ....... give valid proofs.Simply saying a big "NO" and believing everybody is going to hold on that is not a perfect thinking.Thanks
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·Hi Sue,I am from South Manc until 4 years ago when I moved to Cornwall. My son is still there.I have fantastic beaches to roam on and the scenery is spectactular!I have found stress really causes a problem in IBS. I am rubbish at keeping to a diet so don't do myself any favours.I once decided to keep to an alcohol only diet. It was terrible for me but I was so pi**ded I couldn't remember what my bad tum was for!!! LOLA fellow manc. Ace!Mikey
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·Oh India - without getting into a HUGE debate - Flux always does this and I don't think will ever change!!Sorry, but I appreciated your article and I know alot of other peeps will/did too so keep posting - live and learn I say.Sue
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