# Sexual and physical abuse are not associated with rectal hypersensitivity in patients



## Mike NoLomotil (Jun 6, 2000)

Another widespread beleif, dogma, bites the dust...Gut. 2004 Jun;53(6):838-42.Sexual and physical abuse are not associated with rectal hypersensitivity in patients with irritable bowel syndrome.Ringel Y, Whitehead WE, Toner BB, Diamant NE, Hu Y, Jia H, Bangdiwala SI, Drossman DA.Department of Medicine, Division of Digestive Diseases and Nutrition, and the UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, 27599-7080, USA. ringel###med.unc.eduBACKGROUND: Patients with irritable bowel syndrome (IBS) have reduced pain thresholds for rectal distension. In addition, the prevalence of sexual/physical abuse in referred IBS patients is high and is associated with greater pain reporting, poorer health status, and poorer outcome. This lead to a hypothesis that abuse history may sensitise patients to report pain at a lower threshold. AIM: To compare rectal pain thresholds in women with IBS who had a history of severe abuse to IBS women with no history of abuse. METHODS: We studied 74 IBS patients with a history of severe physical and/or sexual abuse and 85 patients with no history of abuse. Abuse history was assessed by a previously validated self-report abuse screening questionnaire. Rectal sensory thresholds were assessed using an electronic barostat and determined by the ascending method of limit (AML) and by the tracking technique. RESULTS: IBS patients with a history of severe abuse had significantly higher rectal pain thresholds, as measured by AML (F (1, 111) = 6.06; p = 0.015) and the tracking technique (F (1, 109) = 5.21; p = 0.024). Patients with a history of severe abuse also reported a significantly higher threshold for urgency to defecate (F (1, 113) = 11.23; p =.001). CONCLUSION: Severe sexual/physical abuse is associated with higher urge and pain thresholds for rectal distension in IBS patients. This suggests that the greater pain reporting and poorer health status in IBS patients with abuse history are not related to increased rectal pain sensitivity. Further studies are needed to determine the causes of these findings.___________________________________________Perhaps logic is all that is needed....if one can learn to tolerate physical and sexual abuse, a widely under reported problem due to stigma and other associated penalties, I would suspect one would learn to have greater pain and discomfort tolerance rather than reduced tolerance. I know from 40 years with IBS that pain and discomfort tolerance absolutley increased out of necessity...avoidance of insanity. So another popular misconception is debunked.MNL


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## SpAsMaN* (May 11, 2002)

Cure by LEAP?40 years?You are strong...


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## Mike NoLomotil (Jun 6, 2000)

Yo Spas....







Cure and remission not synonymous...if only! With LEAP we simply isolate the patient specific oligoantigenic diet plan which will, if followed, reduce or eliminate symptoms for that specific person. Just eliminates a ton of guesswork and trial and error and frustration.Now what is interesting is that, over time, oral tolerance can be restored to some degree. Why this is, in one way, is as difficult to assess as the oral tolerance mechanisms are difficult to understand...how t cell types drive adaptive immune response to antigens.But we do know that the lower the frequency and severity of provocation, the lower the net repsonse when provocation is represented.We also know, from at least one half way decent study, that subjects whose loss of oral tolerance has been lonked to dysbiosis, when an elemental diet is used their abnormal LBT results normalize...when retested the results return to normal range many times (correspondent with symptom reduction). Suggests that avoidance of provocation, which disurpts the lumenal and mucosal environment, for some reason seems to facilitate recolonization with commensul flora. Since this has to all be surmised from indirect studies like LBT analaysis (who's blowing hydrogen? who's blowing methane?)we are all still stuck with "inference" in interpreting the data and ther outcomes. For the moment.The biochemical mediators involved in there are wide ranging enough in their variance and in each ones specific effects it is not surprising it is exceedingly difficult to come up with some method of modelling what is occurring in the mid gut and distal gut with the flora.On the other matter...Luckily, yes, after 40 years with IBS (and having been in remission the last few years as long as I follow my friggin diet) the combination of increased tolerance for the symptomology and the reduction in severity of the net symptoms when I do udnergo an inadvertent "antigen challenge" (eat something I am reactive to...or "intolerant of") the symptoms are much less severe and of much shorter duriation when it does occur.I am about to experiment on myself with a particular herbal preparation from Europe which several studies suggest have sufficient anti-inflammatory properties that it may restore some additional tolerance.SInce I now have acces to a means of doing a quantitative assay of an array of proinflammatory cytokines, not just a screening for mediator release, I will have the ability to quantify if the funny herbs are actually effective or not.I'll let ya know if they work so you can rush out and get some!MNL


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## eric (Jul 8, 1999)

Emotional Abuse and IBSStudy found link to severity -- but not causality By: Douglas A. Drossman, M.D., Co-Director, Center for Functional GI & Motility Disorders Center; Professor of Medicine and Psychiatry, University of North Carolina, Chapel Hill http://www.aboutibs.org/Publications/abuse.html


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## SpAsMaN* (May 11, 2002)

Mike.Do you have a Lomotility or a Nolomotility?







Sorry if it is you real name,i had to put that in.Also,you can ask me question about herbs and products,i have tried many products.


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