# IBS diarrhea (severe weight loss)



## Guest (Aug 20, 2001)

I was very moved by reading the comments and suggestions people posted, and I hope somebody will be able to share his or her experience with me. My mother is suffering from the IBS-diarrhea (according to her physician/s), and she has been reduced to nothing over the years, due to repeated diarrhea (chronic), and when it starts she is unable to retain anything. She is 62 years old and very fragile, and now she is scared to step out of the house. Her doctor thinks she has intestinal hurry. I am wondering if you could offer some advice. She experiences high blood pressure, occasionally. Thank you!


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## Mike NoLomotil (Jun 6, 2000)

Has Mom had a complete workup by a Board Certified Gastroenterologist yet, or is the cae being handled by her primary care physician(s). Sometime very fine PCP's may miss something "reversible" (treatable) while doing the workup and she should be seen by a Board Certified GI doc. If she HAS, I recommend a second opinion beofe doing anything else. Typically patient with the symptom sets of IBS, even episodic diarrhea, do not have a loss-of-weight problem unless it is so severe and frequent and the transit time so chronically shortened that is effects complete digestion and absorption. This would be atypical, but not unheard of.Let us know a little more.ThanksMNL_____________ www.leapallergy.com


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## Mike NoLomotil (Jun 6, 2000)

Has Mom had a complete workup by a Board Certified Gastroenterologist yet, or is the cae being handled by her primary care physician(s). Sometime very fine PCP's may miss something "reversible" (treatable) while doing the workup and she should be seen by a Board Certified GI doc. If she HAS, I recommend a second opinion beofe doing anything else. Typically patient with the symptom sets of IBS, even episodic diarrhea, do not have a loss-of-weight problem unless it is so severe and frequent and the transit time so chronically shortened that is effects complete digestion and absorption. This would be atypical, but not unheard of.Let us know a little more.ThanksMNL_____________ www.leapallergy.com


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## Kathleen M. (Nov 16, 1999)

2nd the good work up by a good doctor.Can she take Ensure? It is a calorie dense nutritionally dense supplement that is for the most part easily digested and may help her supplement her diet.K.------------------I have worked for the government and at universities doing scientific research primarily in the area of the environment and the impact of environmental factors on human health, I have never done any independant clinical testing for the pharmaceutical industry, nor have I ever worked for a drug company. I have no financial, academic, or any other stake in any commercial, natural, or any other product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## Kathleen M. (Nov 16, 1999)

2nd the good work up by a good doctor.Can she take Ensure? It is a calorie dense nutritionally dense supplement that is for the most part easily digested and may help her supplement her diet.K.------------------I have worked for the government and at universities doing scientific research primarily in the area of the environment and the impact of environmental factors on human health, I have never done any independant clinical testing for the pharmaceutical industry, nor have I ever worked for a drug company. I have no financial, academic, or any other stake in any commercial, natural, or any other product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## LadyM (Feb 17, 2001)

Hi, I have been having a problem losing weight too. Last August I had my gallbladder taking out, in turn this cause my minor ibs to turned into major symptoms, and I have lost over 50 pounds. Every time I have a flare up of the D, I lose weight. Doctors got me eating alot of sweets to stop weight lost but some people are sensitive to sugar, I am not. This time around after this bad flare up, I lost four more pounds, but this time I manage to gain 2 back, first time I have gained since my surgery. Take ten more pounds off me and you won't be able to tell the difference in me and a pole. I am wearing size 16 in little girls clothes. Losing all this weight has caused me problems with my muscles, I am in a wellness program to strengthing back up. Might be something to consider for her too, they will help her get her muscle back to where they protect her bones better. I am 39 and a specialist told me that I had the muscle tone of a 75 year old woman were I lost weight so quickly and prio to my rapid weight lost I was a muscular person, could lift very heavy stuff, now it hard to pick up my fat cat







The meds I am on that seems to have helped my D is pepcid. I hope your mother gets to feeling better. I know how she feels about being fragile, been so afraid that I would break a bone, the doc told me that I could very easily when I went to him, but glad to say I have build my muscles back up some but still got a long ways to go. Now I am taking one day at a time and hope that I don't lose no more weight. Hugs to your mother, God Bless.


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## LadyM (Feb 17, 2001)

Hi, I have been having a problem losing weight too. Last August I had my gallbladder taking out, in turn this cause my minor ibs to turned into major symptoms, and I have lost over 50 pounds. Every time I have a flare up of the D, I lose weight. Doctors got me eating alot of sweets to stop weight lost but some people are sensitive to sugar, I am not. This time around after this bad flare up, I lost four more pounds, but this time I manage to gain 2 back, first time I have gained since my surgery. Take ten more pounds off me and you won't be able to tell the difference in me and a pole. I am wearing size 16 in little girls clothes. Losing all this weight has caused me problems with my muscles, I am in a wellness program to strengthing back up. Might be something to consider for her too, they will help her get her muscle back to where they protect her bones better. I am 39 and a specialist told me that I had the muscle tone of a 75 year old woman were I lost weight so quickly and prio to my rapid weight lost I was a muscular person, could lift very heavy stuff, now it hard to pick up my fat cat







The meds I am on that seems to have helped my D is pepcid. I hope your mother gets to feeling better. I know how she feels about being fragile, been so afraid that I would break a bone, the doc told me that I could very easily when I went to him, but glad to say I have build my muscles back up some but still got a long ways to go. Now I am taking one day at a time and hope that I don't lose no more weight. Hugs to your mother, God Bless.


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## NewBreedGirl (Aug 22, 2000)

when I started out on this board a year ago I was 5'7 and 97 pounds. Also suffering from IBS-DSince milk was an issue I would drink Ensure Plus for weight gain and also I was prescribed a light med for an anger disorder.....it didnt help with that but the side effects are constipation and weight gain. And man did it work. I am now at my recommended weight of 135. You may wanna look into it its light drug non-addictive its called Zyprexa.


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## NewBreedGirl (Aug 22, 2000)

when I started out on this board a year ago I was 5'7 and 97 pounds. Also suffering from IBS-DSince milk was an issue I would drink Ensure Plus for weight gain and also I was prescribed a light med for an anger disorder.....it didnt help with that but the side effects are constipation and weight gain. And man did it work. I am now at my recommended weight of 135. You may wanna look into it its light drug non-addictive its called Zyprexa.


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## Jeffrey Roberts (Apr 15, 1987)

I agree with a more thorough work-up. Weight loss is not typically an indication of IBS.Jeff


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## Jeffrey Roberts (Apr 15, 1987)

I agree with a more thorough work-up. Weight loss is not typically an indication of IBS.Jeff


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## LadyM (Feb 17, 2001)

I agree with Jeff on a more through work up. But I do have a question, why isn't weight lost part of ibs? When you have constant D, you are going to lose weight, I do and I read where others have too. Logical you would lose weight with D, and if it was bad enough you would dehydrate with it, I did that last time with the worst flare up with the D I ever had(due to milk, actually I ate the largest ice cream cone you ever saw







and paid for it severly, that is when it really soaked into my blonde brain that I was Lactose intollerate). I also have read post where people who have D want to lose weight and can't. It is perplexing about the weight loss but to me it could happen to a person who has ibs with alot of D. And logically with a person who has C, they really should have a hard time losing weight. But who said IBS was logical? Spock? lol, sorry, had to laugh at my own humor. God Bless.


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## LadyM (Feb 17, 2001)

I agree with Jeff on a more through work up. But I do have a question, why isn't weight lost part of ibs? When you have constant D, you are going to lose weight, I do and I read where others have too. Logical you would lose weight with D, and if it was bad enough you would dehydrate with it, I did that last time with the worst flare up with the D I ever had(due to milk, actually I ate the largest ice cream cone you ever saw







and paid for it severly, that is when it really soaked into my blonde brain that I was Lactose intollerate). I also have read post where people who have D want to lose weight and can't. It is perplexing about the weight loss but to me it could happen to a person who has ibs with alot of D. And logically with a person who has C, they really should have a hard time losing weight. But who said IBS was logical? Spock? lol, sorry, had to laugh at my own humor. God Bless.


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## coppin (Jul 17, 2001)

NewBreedGirl.. Zyprexa is not a good med to recommend..i was put on it by an idiot shrink..and ya i gained a lot of weight..but it caused me to self-mutilate(cutting yourself) for months..now im am permanently scarred because of it..i had no history of that before and have not cut myself since i took myself off it and told the doctor what he can do with it...now im on remeron for depression it helps for that but not my IBS-D type...Lately i have lost a lot of weight but im jumping for joy...i gained 40 pounds on the zyprexa and prozac..but my IBS has been really bad as of late...and im hardly eating anything but bananas and bread..------------------AussieDeb


> quote:In this world we all need humor


 aussiecoppin###aol.com


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## coppin (Jul 17, 2001)

NewBreedGirl.. Zyprexa is not a good med to recommend..i was put on it by an idiot shrink..and ya i gained a lot of weight..but it caused me to self-mutilate(cutting yourself) for months..now im am permanently scarred because of it..i had no history of that before and have not cut myself since i took myself off it and told the doctor what he can do with it...now im on remeron for depression it helps for that but not my IBS-D type...Lately i have lost a lot of weight but im jumping for joy...i gained 40 pounds on the zyprexa and prozac..but my IBS has been really bad as of late...and im hardly eating anything but bananas and bread..------------------AussieDeb


> quote:In this world we all need humor


 aussiecoppin###aol.com


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## Mike NoLomotil (Jun 6, 2000)

LADY M:The things you say are absolutely true in the context of loss of weight following an episode. This of course is fluid loss and is quickly replenished. The person who fails to thrive, so to speak, secondary to constant diarreah which so shortens the transit time chronically, and such derangment of the normal lumen-to-vasuclar interface structure and function is present that normal digestion and absorption of nutrients is impeded does also appear to occur clinically.Sometimes people with this problem are misdiagnosed and further investigation sometimes reveals a pathogenic basis for the symptoms. Many many times I have seen patients whith this chronic non-episodic diarrhea be "reworked up" and found pathogenic invlvement of one form or another and relief is achieved. Also, I have seen sometimes people like this have true food allergy or severe non-allergic reactivity (delayed hypersensitivity, intolerance whatever the term du jour, its irrelevant)which (when identified) causes the constant, nonepisodic diarrhea to diminish or even cease, whereupon weight is regained. There are other possibilities those are but 3.I think what folks are saying that in the patients who suffer the more typical episodic diarrhea and/or cyclic symtoms, without exception assessments of selected patient populations have shown no trend towards chronic weight loss in the more typical patients. They tend to be of normal weight when assessed in their normative state (not right after an attack), and there is another subpopulation which struggles with weight Gain.This second one is the most interesting, and the physicians and dieticians I work with see this very frequently: patients with comorbid weight difficulties and symptoms of IBS.Now a number of theories have been set forth as to the mechanism for this, and they can become as exotic as the effects of specific mediators on lypolisis. In a more practical sense gained from experience observing the clinical management of these patients during a recent 5 year period, these patients have a certain amount of excess water weight, which is shed when their provoking dietary components are identified and removed. This averages 6-10 pounds (I lost 6 pounds and I was s kinny guy...but my little 40+ front-corporation diminished). Fell, Sandberg and others have many times confirmed this phenomenon in food-sensitive patients over the years. It is basically an expected response.After the initial phase of a specific avoidance diet, patients find in retrospect that often they were suffering food cravings which corresponded to their reactive foods. Since very often this involves aberrant or excessive consumption of foods which are realtively high in caloric density (as some patients receive serotonergic and endorphinergic response benefits from these foods....also called "comfort foods") sometimes a prolonged phase of weight loss occurs merely as a result of ths subsidance of food cravings which resulted in overconsumption of more calorii-dense foods.There was a study published several years ago using older in vitro technology to identify the offending foods and then monitor weight loss during avoidance diets, which demonstrated not only scale weight loss but reduced fat ratio to body mass. So a postulate was set forth by some which linked this to enhanced lipolytic action. BUT this to me is highly specultaive at this stage since they did NOT track caloric intake as I recall nor check basal metabolic rate nor establish the patients caloric consumption at her homeostatic state (weight before the reactive foods were removed). So personally I am more inclined, having observed hundtreds of dietary intake logs during the avoidance phase and loaded the foods into one of several medically-accepted (ADA approved) nutrient analysis datatbase programs to suspect plain old ordinary reduced caloric intake. I have obsrved it first hand more often than not and quantified it.Anyway, in a nutshell, thats how much time I have today to talk about weight and IBS or anything else. Gotta go to work. But I have been priviliged to see alot of people with these symptoms undergo dietary therapy and seen the data points, and read other investigators finidings, so I base my editorializing on that.Eat well, think well, be well.MNL______________ www.leapallergy.com


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## Mike NoLomotil (Jun 6, 2000)

LADY M:The things you say are absolutely true in the context of loss of weight following an episode. This of course is fluid loss and is quickly replenished. The person who fails to thrive, so to speak, secondary to constant diarreah which so shortens the transit time chronically, and such derangment of the normal lumen-to-vasuclar interface structure and function is present that normal digestion and absorption of nutrients is impeded does also appear to occur clinically.Sometimes people with this problem are misdiagnosed and further investigation sometimes reveals a pathogenic basis for the symptoms. Many many times I have seen patients whith this chronic non-episodic diarrhea be "reworked up" and found pathogenic invlvement of one form or another and relief is achieved. Also, I have seen sometimes people like this have true food allergy or severe non-allergic reactivity (delayed hypersensitivity, intolerance whatever the term du jour, its irrelevant)which (when identified) causes the constant, nonepisodic diarrhea to diminish or even cease, whereupon weight is regained. There are other possibilities those are but 3.I think what folks are saying that in the patients who suffer the more typical episodic diarrhea and/or cyclic symtoms, without exception assessments of selected patient populations have shown no trend towards chronic weight loss in the more typical patients. They tend to be of normal weight when assessed in their normative state (not right after an attack), and there is another subpopulation which struggles with weight Gain.This second one is the most interesting, and the physicians and dieticians I work with see this very frequently: patients with comorbid weight difficulties and symptoms of IBS.Now a number of theories have been set forth as to the mechanism for this, and they can become as exotic as the effects of specific mediators on lypolisis. In a more practical sense gained from experience observing the clinical management of these patients during a recent 5 year period, these patients have a certain amount of excess water weight, which is shed when their provoking dietary components are identified and removed. This averages 6-10 pounds (I lost 6 pounds and I was s kinny guy...but my little 40+ front-corporation diminished). Fell, Sandberg and others have many times confirmed this phenomenon in food-sensitive patients over the years. It is basically an expected response.After the initial phase of a specific avoidance diet, patients find in retrospect that often they were suffering food cravings which corresponded to their reactive foods. Since very often this involves aberrant or excessive consumption of foods which are realtively high in caloric density (as some patients receive serotonergic and endorphinergic response benefits from these foods....also called "comfort foods") sometimes a prolonged phase of weight loss occurs merely as a result of ths subsidance of food cravings which resulted in overconsumption of more calorii-dense foods.There was a study published several years ago using older in vitro technology to identify the offending foods and then monitor weight loss during avoidance diets, which demonstrated not only scale weight loss but reduced fat ratio to body mass. So a postulate was set forth by some which linked this to enhanced lipolytic action. BUT this to me is highly specultaive at this stage since they did NOT track caloric intake as I recall nor check basal metabolic rate nor establish the patients caloric consumption at her homeostatic state (weight before the reactive foods were removed). So personally I am more inclined, having observed hundtreds of dietary intake logs during the avoidance phase and loaded the foods into one of several medically-accepted (ADA approved) nutrient analysis datatbase programs to suspect plain old ordinary reduced caloric intake. I have obsrved it first hand more often than not and quantified it.Anyway, in a nutshell, thats how much time I have today to talk about weight and IBS or anything else. Gotta go to work. But I have been priviliged to see alot of people with these symptoms undergo dietary therapy and seen the data points, and read other investigators finidings, so I base my editorializing on that.Eat well, think well, be well.MNL______________ www.leapallergy.com


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## Kathleen M. (Nov 16, 1999)

LadyM--The diarrhea in IBS seems to be mostly a colon problem and things not processing correctly there.You absorb zero nutrients from the colon. It doesn't matter if the food leaves you 30 minutes or 60 hours after it gets in the colon (and it takes ~ 3 hours to reach the colon) other than you aren't getting the water back out of the stool so you may have to watch for dehydration.In IBS the small intestine appears to be working just fine. That is where you get the nutrients and calories out of the food you eat. People who have problems with the small intestine that cannot absorb things are seriously and critically ill without treatment. IBSers are for the most part generally healthy and not on the verge of being hospitalized, so the small intestine seems to be working just fine.The stool you poop out right after you eat is from a previous meal that you have already rung the nutrients and calories out of, so it doesn't effect weight.What effects weight in IBSers is how much they eat and how active they are. It is very common for people to not eat to avoid symptoms. Normal people that don't eat enough have weight loss. IBSers that don't eat enough have weight loss. (and visa versa with eating too much and not enough exercise).If you are losing weight and having IBS symptoms right down everything you eat and the amounts and consult a calorie chart. If you are eating sufficiently to maintain weight (usually over 2000 calories a day) or gain weight and you are still losing weight that needs to be evaluated as that is a symptom of something other than IBS.K.------------------I have worked for the government and at universities doing scientific research primarily in the area of the environment and the impact of environmental factors on human health, I have never done any independant clinical testing for the pharmaceutical industry, nor have I ever worked for a drug company. I have no financial, academic, or any other stake in any commercial, natural, or any other product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## Kathleen M. (Nov 16, 1999)

LadyM--The diarrhea in IBS seems to be mostly a colon problem and things not processing correctly there.You absorb zero nutrients from the colon. It doesn't matter if the food leaves you 30 minutes or 60 hours after it gets in the colon (and it takes ~ 3 hours to reach the colon) other than you aren't getting the water back out of the stool so you may have to watch for dehydration.In IBS the small intestine appears to be working just fine. That is where you get the nutrients and calories out of the food you eat. People who have problems with the small intestine that cannot absorb things are seriously and critically ill without treatment. IBSers are for the most part generally healthy and not on the verge of being hospitalized, so the small intestine seems to be working just fine.The stool you poop out right after you eat is from a previous meal that you have already rung the nutrients and calories out of, so it doesn't effect weight.What effects weight in IBSers is how much they eat and how active they are. It is very common for people to not eat to avoid symptoms. Normal people that don't eat enough have weight loss. IBSers that don't eat enough have weight loss. (and visa versa with eating too much and not enough exercise).If you are losing weight and having IBS symptoms right down everything you eat and the amounts and consult a calorie chart. If you are eating sufficiently to maintain weight (usually over 2000 calories a day) or gain weight and you are still losing weight that needs to be evaluated as that is a symptom of something other than IBS.K.------------------I have worked for the government and at universities doing scientific research primarily in the area of the environment and the impact of environmental factors on human health, I have never done any independant clinical testing for the pharmaceutical industry, nor have I ever worked for a drug company. I have no financial, academic, or any other stake in any commercial, natural, or any other product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## LotronexLover (Jan 10, 2001)

I too have IBS D. I am 5'5 & weight 100 lbs forever. The ONLY time I ever gained weight was on Lotronex 13 lbs!!! Because I kept everything in. I then lost the 13 lbs when taken off of Lotronex ... I now gained 8 lbs back on Remeron. Again because everything is staying in.Has your mom ever had a test for celiac disease (blood test) or for osteoporosis?Fibracon pills or calcium pills may help her bind up a bit. Has she taken anything for her IBS?


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## LotronexLover (Jan 10, 2001)

I too have IBS D. I am 5'5 & weight 100 lbs forever. The ONLY time I ever gained weight was on Lotronex 13 lbs!!! Because I kept everything in. I then lost the 13 lbs when taken off of Lotronex ... I now gained 8 lbs back on Remeron. Again because everything is staying in.Has your mom ever had a test for celiac disease (blood test) or for osteoporosis?Fibracon pills or calcium pills may help her bind up a bit. Has she taken anything for her IBS?


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## HipJan (Apr 9, 1999)

I had a lot of weight loss. The doctors never officially figured it out. But I am next to positive my weight loss was due to 1) my prolonged H. Pylori infection, 2) my own body's reaction to too many acid reducers/inhibitors. Preceding all that, stress may have entered in a bit too. A doctor told me it sounded like I'd had a malabsorption problem.


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## HipJan (Apr 9, 1999)

I had a lot of weight loss. The doctors never officially figured it out. But I am next to positive my weight loss was due to 1) my prolonged H. Pylori infection, 2) my own body's reaction to too many acid reducers/inhibitors. Preceding all that, stress may have entered in a bit too. A doctor told me it sounded like I'd had a malabsorption problem.


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## genny (Jan 15, 2001)

Mike, I'm not the brightest light bulb in the box so would you please rephrase in terms I can understand? I honestly had to laugh (I sincerely apologize here) but I didn't understand a dang word you said. this ole Texas gal is a little slow today. LOL


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## genny (Jan 15, 2001)

Mike, I'm not the brightest light bulb in the box so would you please rephrase in terms I can understand? I honestly had to laugh (I sincerely apologize here) but I didn't understand a dang word you said. this ole Texas gal is a little slow today. LOL


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## Mike NoLomotil (Jun 6, 2000)

GENNY:"I didn't understand a dang word you said. "







...sorry...spend too much time around eggheads and you start blabbering like one yourself.







Without going over the whole line, when it comes to weight in IBS basically the typical IBS victim, correctly diagnosed, is of normal weight or even overweight. Unless you weigh her right after a bout of diarrhea in which case she will have some short term weight loss due to the water lost in the episode. This is soon recovered.From the studies of immunologists and allergists who have studied the d & cyclic symptoms of those IBS populations it become clear that the colon functions normally because it is not the site of the problem. It is simply getting abnormal signals from elsewhere, neurochemically, that effect its function. The shock organ is the small intestine. Errors are made by the immune cells in the mucosa, small blood vessels, or both.The normal function of certain small intestine structures is compromised and it results in abnormal release of chemicals from certain immune cells in the mucosa and in the tiny blood vessels that should not be released except in, say, infection. The chemicals have effects on many different body parts and the net effect IN GENERAL is to "overstimulate" them (smooth muscle, blood vessels, nerves, and other immune cells). Since everyone looks inthe colon they don't see this, except signs of it at the junction of the small bowel and large bowel. You have to look inside the small intestine and in the bloodstream, so those people doing this (looking there for specific things) do see these reactions. For whatever reason, and its not clear all the reasons why, some people as they age begin to lose tolerance to different foods or chemicals which then precipitate this abnormal chain of events this is separate and apart from enzymatic deficiencies, disruption of balance of the GI flora, and the like which can also cause bowel trouble).Usually it is episodic since the offending foods or additives are consumed episodically, so the digestive function of the small bowel is only interrupted intermittently, and therefore no chronic weight loss occurs. In between episodes, even though the mucosa may still function abnormally to a degree (takes time to recover) it is not enough to interfere with basic digestive function and nutrition/caloric uptake.The people who lose weight are people who have trouble so frequently that both the chyme (goop that food becomes when mixed with the digestive enzymes and liquid) goes through the small bowel and out the large so fast and so often the transit-time is so reduced that normal digestion and absorption are impaired. The mucosal function is also disrupted compounding the problem.This usually turns out to be something more than the "IB SYNDROME"...sometimes a severe disruption of the proper balance of bacteria in the gut exists, up to and including infection and even parasites, that was not looked for closely enough. Or sometimes the person has a real allergy or severe false-allergy to something they are consuming frequently. Sometimes they have developed a severe intolerance to something in the diet that is consumed frequently. This is a list that gets smaller and smaller the farther down we go.So when you see this "d" all the time and weight loss, and a patient has been dismissed with "IBS", it is time to seek another opinion from another doctor or two. Don't stop looking as this is not the typical (if there is such a thing) so called "IBS" victim. Sometimes it has been something as simple as person who had their gall bladder removed and "developed IBS". The you look into it and they did not get adeuqte dietary counselling and they are consuming the same fatty diet they did before and having all kinds of belly aches and pains and cramps and diarrhea...etc. Seen all kindsa odd stuff that was just missed by one doc but thought of by another. Sort of depends sometimes on each docs specialty area (Board certification). Like mechanics. A transmission guy thinks alot more about transmissions and tends to see cars functioning from that perspective. Then you have a guy who does auto electrics and vice versa. Sometimes you just need to switch mechanics (doctors) to a different specialty to get the full view.Then we said how some people, once the reactive foods or chemicals which provoke these reactons and trigger these symptoms, are removed from the diet, lose weight then.Most of the time its a few pounds of water weight. Then some people continue to lose weight significantly, and it is not just scale weight but can be analyzed to be actual fat loss.The reasons and mechansim have been studied to a very limited degree so far so I noted there are lots of theories, some of which make some sense, but are not substantiated yet as to why this happens.I personally have seen alot of people like this. And looking at their before-and-after dietary intake logs my casual observation (or quantified observation by inputting their intake logs into nutritional analysis software) has been that many times they are simply eating less calorie-dense foods in their new rotation-elimination diet than before (less fatty foods). So if you eat the same volume of food but it is less calorie dense you consume less calories than you are using and you lose weight.A 500 calorie per day gap will translate to about a pound a week. So in spite of all the postulates about lipolysis being effected, so far most of the time just to me and the dieticians I know it looks like a two-phase response of losing the water retention that is seen in patients with food sensitivity followed by a coincidental caloric reduction. Many patients with belly woes fromfood sensitivity tend to consume comfort foods, for example (foods which contain things which cause the body to release serotonin or endorphins). These foods being suagary fatty etc have more calories. I talk to alot of IBS patients who are just addicted to comfort foods, both physically and psychologically.When they feel better from removing reactive foods under certain guidelines, this pattern is often broken, they crave them less as their symptoms subside and they feel better so their caloric consumption drops.So they get a period of a gap betweeen intake and use of calories and lose some weight. Joy to the world for some. BUT if they do not also start workin out their metabolic rate slows down to adjust to the lowered caloric intake and the weight loss levels off.if we get them to work out, then the gap can be maintained and the person can actuallly get to a target weight. Some lose 40- even 60 pounds.BUT thats another story....Does that make a little more sense. If not say so and I will come back tomorrow and try again. I kinda had to rush it and left out a lout of stuff.Eat well, think well, be well.MNL______________ www.leapallergy.com


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## Mike NoLomotil (Jun 6, 2000)

GENNY:"I didn't understand a dang word you said. "







...sorry...spend too much time around eggheads and you start blabbering like one yourself.







Without going over the whole line, when it comes to weight in IBS basically the typical IBS victim, correctly diagnosed, is of normal weight or even overweight. Unless you weigh her right after a bout of diarrhea in which case she will have some short term weight loss due to the water lost in the episode. This is soon recovered.From the studies of immunologists and allergists who have studied the d & cyclic symptoms of those IBS populations it become clear that the colon functions normally because it is not the site of the problem. It is simply getting abnormal signals from elsewhere, neurochemically, that effect its function. The shock organ is the small intestine. Errors are made by the immune cells in the mucosa, small blood vessels, or both.The normal function of certain small intestine structures is compromised and it results in abnormal release of chemicals from certain immune cells in the mucosa and in the tiny blood vessels that should not be released except in, say, infection. The chemicals have effects on many different body parts and the net effect IN GENERAL is to "overstimulate" them (smooth muscle, blood vessels, nerves, and other immune cells). Since everyone looks inthe colon they don't see this, except signs of it at the junction of the small bowel and large bowel. You have to look inside the small intestine and in the bloodstream, so those people doing this (looking there for specific things) do see these reactions. For whatever reason, and its not clear all the reasons why, some people as they age begin to lose tolerance to different foods or chemicals which then precipitate this abnormal chain of events this is separate and apart from enzymatic deficiencies, disruption of balance of the GI flora, and the like which can also cause bowel trouble).Usually it is episodic since the offending foods or additives are consumed episodically, so the digestive function of the small bowel is only interrupted intermittently, and therefore no chronic weight loss occurs. In between episodes, even though the mucosa may still function abnormally to a degree (takes time to recover) it is not enough to interfere with basic digestive function and nutrition/caloric uptake.The people who lose weight are people who have trouble so frequently that both the chyme (goop that food becomes when mixed with the digestive enzymes and liquid) goes through the small bowel and out the large so fast and so often the transit-time is so reduced that normal digestion and absorption are impaired. The mucosal function is also disrupted compounding the problem.This usually turns out to be something more than the "IB SYNDROME"...sometimes a severe disruption of the proper balance of bacteria in the gut exists, up to and including infection and even parasites, that was not looked for closely enough. Or sometimes the person has a real allergy or severe false-allergy to something they are consuming frequently. Sometimes they have developed a severe intolerance to something in the diet that is consumed frequently. This is a list that gets smaller and smaller the farther down we go.So when you see this "d" all the time and weight loss, and a patient has been dismissed with "IBS", it is time to seek another opinion from another doctor or two. Don't stop looking as this is not the typical (if there is such a thing) so called "IBS" victim. Sometimes it has been something as simple as person who had their gall bladder removed and "developed IBS". The you look into it and they did not get adeuqte dietary counselling and they are consuming the same fatty diet they did before and having all kinds of belly aches and pains and cramps and diarrhea...etc. Seen all kindsa odd stuff that was just missed by one doc but thought of by another. Sort of depends sometimes on each docs specialty area (Board certification). Like mechanics. A transmission guy thinks alot more about transmissions and tends to see cars functioning from that perspective. Then you have a guy who does auto electrics and vice versa. Sometimes you just need to switch mechanics (doctors) to a different specialty to get the full view.Then we said how some people, once the reactive foods or chemicals which provoke these reactons and trigger these symptoms, are removed from the diet, lose weight then.Most of the time its a few pounds of water weight. Then some people continue to lose weight significantly, and it is not just scale weight but can be analyzed to be actual fat loss.The reasons and mechansim have been studied to a very limited degree so far so I noted there are lots of theories, some of which make some sense, but are not substantiated yet as to why this happens.I personally have seen alot of people like this. And looking at their before-and-after dietary intake logs my casual observation (or quantified observation by inputting their intake logs into nutritional analysis software) has been that many times they are simply eating less calorie-dense foods in their new rotation-elimination diet than before (less fatty foods). So if you eat the same volume of food but it is less calorie dense you consume less calories than you are using and you lose weight.A 500 calorie per day gap will translate to about a pound a week. So in spite of all the postulates about lipolysis being effected, so far most of the time just to me and the dieticians I know it looks like a two-phase response of losing the water retention that is seen in patients with food sensitivity followed by a coincidental caloric reduction. Many patients with belly woes fromfood sensitivity tend to consume comfort foods, for example (foods which contain things which cause the body to release serotonin or endorphins). These foods being suagary fatty etc have more calories. I talk to alot of IBS patients who are just addicted to comfort foods, both physically and psychologically.When they feel better from removing reactive foods under certain guidelines, this pattern is often broken, they crave them less as their symptoms subside and they feel better so their caloric consumption drops.So they get a period of a gap betweeen intake and use of calories and lose some weight. Joy to the world for some. BUT if they do not also start workin out their metabolic rate slows down to adjust to the lowered caloric intake and the weight loss levels off.if we get them to work out, then the gap can be maintained and the person can actuallly get to a target weight. Some lose 40- even 60 pounds.BUT thats another story....Does that make a little more sense. If not say so and I will come back tomorrow and try again. I kinda had to rush it and left out a lout of stuff.Eat well, think well, be well.MNL______________ www.leapallergy.com


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## genny (Jan 15, 2001)

Hey, got it this time. Thanks bunches!!! You're absolutely right about one thing. I've levelled off between 132 and 136 now but still can't seem to gain. But I admit I'm doing practically little to no fat due to gallbladder surgery. Guess I've just gotten used to it. I guess I'm consuming about 1,000 maybe 1,500 calories a day so I appear to be stable. Doctor is not worried as I'm 5 feet tall, in fact, he says I can get down to 125 but no lower.


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## genny (Jan 15, 2001)

Hey, got it this time. Thanks bunches!!! You're absolutely right about one thing. I've levelled off between 132 and 136 now but still can't seem to gain. But I admit I'm doing practically little to no fat due to gallbladder surgery. Guess I've just gotten used to it. I guess I'm consuming about 1,000 maybe 1,500 calories a day so I appear to be stable. Doctor is not worried as I'm 5 feet tall, in fact, he says I can get down to 125 but no lower.


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## ewink (May 17, 2001)

I wanted to post a short reply to this, even though I really don't have much time. I need to go to bed b/c I have to get early tomorrow morning.Anyhow, ever since my IBS started acting up again 4 years ago, I've been losing weight. I weighed about 107 lbs pre-IBS (I'm 5'2"), and slowly went down to 91.5 about 2 years ago, and stayed there until the most recent D-flare several months ago. I went down to 89.5 then! I am D/C type, and also get lots of gas problems.This most recent D-flare was the worst I've ever had, and as some of you may know from some of my previous posts on other threads, it took a lot of supplements to actually get over it. At this point I'm down to half the number of supplements (5 left), and am doing really well. No more D, also no C, just 1 normal BM each morning. I have also finally started gaining weight again, and now weigh about 95.5 lbs! That was my weight 3 years ago.I don't know why IBS-D people are not "supposed" to lose weight. But I guess I was losing weight even when I was C! I think that each of us should find their own regimen of supplements and tolerated foods, b/c we're all so different. It seems like I finally figured it out for my body at this time, but it took me almost 6 months! I also have to add that besides the supplements and lots of carbs (white bread and white rice), I am halfway thru Mike's tapes and they've been very helpful as well.Just my 2 cents.Edith


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## ewink (May 17, 2001)

I wanted to post a short reply to this, even though I really don't have much time. I need to go to bed b/c I have to get early tomorrow morning.Anyhow, ever since my IBS started acting up again 4 years ago, I've been losing weight. I weighed about 107 lbs pre-IBS (I'm 5'2"), and slowly went down to 91.5 about 2 years ago, and stayed there until the most recent D-flare several months ago. I went down to 89.5 then! I am D/C type, and also get lots of gas problems.This most recent D-flare was the worst I've ever had, and as some of you may know from some of my previous posts on other threads, it took a lot of supplements to actually get over it. At this point I'm down to half the number of supplements (5 left), and am doing really well. No more D, also no C, just 1 normal BM each morning. I have also finally started gaining weight again, and now weigh about 95.5 lbs! That was my weight 3 years ago.I don't know why IBS-D people are not "supposed" to lose weight. But I guess I was losing weight even when I was C! I think that each of us should find their own regimen of supplements and tolerated foods, b/c we're all so different. It seems like I finally figured it out for my body at this time, but it took me almost 6 months! I also have to add that besides the supplements and lots of carbs (white bread and white rice), I am halfway thru Mike's tapes and they've been very helpful as well.Just my 2 cents.Edith


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## Mike NoLomotil (Jun 6, 2000)

GENNY;If you are stable and otherwise basically healthy I would say congratulations and don't worry too much about what the chart says your weight should be. Now an exception to this would be, of course, someone lying on the sofa all day eating rice cakes and drinking bottled water watching the New Flintsones whose weight is steady. This person needs to get up and get busy so as to create the situation where their body, via metabolic activity, is going to demand more of everything nutritionally. The "hibernative state" is natural for bears not us people.I sense this does not describe your lifestyle







It is not unusual, especially for women, for that weight to bounce around like that within a narrow range for all the reasons we all know about. Toss in a few d-episodes and, well, to paraphrase a famous moustachioed comic, "A child of 5 would understand this. Quick! Send somebody to fetch me a child of 5!"







So if you are physically active and otherwise healthy I think weight probably does not need to be in your Top 10 List of Things to Fret About.Take CareEat well, Think well, Be well.MNL_____________ www.leapallergy.com [This message has been edited by Mike NoLomotil (edited 08-23-2001).]


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## Mike NoLomotil (Jun 6, 2000)

GENNY;If you are stable and otherwise basically healthy I would say congratulations and don't worry too much about what the chart says your weight should be. Now an exception to this would be, of course, someone lying on the sofa all day eating rice cakes and drinking bottled water watching the New Flintsones whose weight is steady. This person needs to get up and get busy so as to create the situation where their body, via metabolic activity, is going to demand more of everything nutritionally. The "hibernative state" is natural for bears not us people.I sense this does not describe your lifestyle







It is not unusual, especially for women, for that weight to bounce around like that within a narrow range for all the reasons we all know about. Toss in a few d-episodes and, well, to paraphrase a famous moustachioed comic, "A child of 5 would understand this. Quick! Send somebody to fetch me a child of 5!"







So if you are physically active and otherwise healthy I think weight probably does not need to be in your Top 10 List of Things to Fret About.Take CareEat well, Think well, Be well.MNL_____________ www.leapallergy.com [This message has been edited by Mike NoLomotil (edited 08-23-2001).]


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## genny (Jan 15, 2001)

Mike, you know what would be helpful is that doctors would go over the nutritional changes you need to make after gallbladder surgery. I went right back to old eating habits, McDonalds, lots of sugar, fried, heavy Mexican, etc. Ugh, big mistake. Finally caused this. Then I find out about 2 years later I will never be able to tolerate large amounts of fat again. I just wish they had explained the consequences of the surgery.


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## genny (Jan 15, 2001)

Mike, you know what would be helpful is that doctors would go over the nutritional changes you need to make after gallbladder surgery. I went right back to old eating habits, McDonalds, lots of sugar, fried, heavy Mexican, etc. Ugh, big mistake. Finally caused this. Then I find out about 2 years later I will never be able to tolerate large amounts of fat again. I just wish they had explained the consequences of the surgery.


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## Mike NoLomotil (Jun 6, 2000)

GENNY:I know, this is so common it is almost unbelievable to me even after threee decades in healthcare. I have met so many people who swear they have IBS or something and are in such terrible discomfort and you talk to em awhile and find out they have no gallbladder nor any idea how to eat without it. This situation where the provider did not provide even that amount of dietary guidance....it is no wonder there is so little understanding and education about diet in other conditions like IBS, and that so much bad info is passed around.Over the years docs I had look at me, even in some very respected medical centers...once the "eat more fiber" did not work, all that was left in thier toolkit was to just keep a prescription pad on the desk with my name on it.Very very little time and effort goes into things like nutritional management and dietary managment of specific conditions. Our basice medical training system is not set up to provide nor is the practitioner in the field faced with anyone sitting in his lobby waiting to meet with him who can provide it. Just the pharmaceutical detail rep.Pharmaceutical reps made 61.4 million visits to doctors offices last year. How much time do you figure gets spent on dietary management? The system does really not provide much in this area nor the motivation for it. In fact the doc whose practice is predominantly fully capitated HMO patients is disincentivized to spend time on things which require a lot of face time anyway....and dietary counselling fits that description.Sux but thats how it is. I am glad you got it figured out.MNL_____________ www.leapallergy.com


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## Mike NoLomotil (Jun 6, 2000)

GENNY:I know, this is so common it is almost unbelievable to me even after threee decades in healthcare. I have met so many people who swear they have IBS or something and are in such terrible discomfort and you talk to em awhile and find out they have no gallbladder nor any idea how to eat without it. This situation where the provider did not provide even that amount of dietary guidance....it is no wonder there is so little understanding and education about diet in other conditions like IBS, and that so much bad info is passed around.Over the years docs I had look at me, even in some very respected medical centers...once the "eat more fiber" did not work, all that was left in thier toolkit was to just keep a prescription pad on the desk with my name on it.Very very little time and effort goes into things like nutritional management and dietary managment of specific conditions. Our basice medical training system is not set up to provide nor is the practitioner in the field faced with anyone sitting in his lobby waiting to meet with him who can provide it. Just the pharmaceutical detail rep.Pharmaceutical reps made 61.4 million visits to doctors offices last year. How much time do you figure gets spent on dietary management? The system does really not provide much in this area nor the motivation for it. In fact the doc whose practice is predominantly fully capitated HMO patients is disincentivized to spend time on things which require a lot of face time anyway....and dietary counselling fits that description.Sux but thats how it is. I am glad you got it figured out.MNL_____________ www.leapallergy.com


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## JenL (Aug 23, 2001)

Genny,In agreement with you, I believe docs should give us a head up. I thought two weeks after my gallbladder surgery, which was only 3 months ago, I was dying. The heartburn and irritable bowel sent me through the roof. I thought I was having a gallbladder attack. I had myself so worked up about having a lodged stone. Well it took me doing my own investigation to find out what was going on. I had only a slight case of irritable bowel, just the D. Not much in stomach pain prior to surgery. NOW! Oh my word, the stomach is so loud sometimes you can hear it over my diesel truck, the pain, nausea and heartburn.I have lost 21lbs in two months. Some of that is due to the fact that after surgery my blood pressure went wild, so I was put on meds. I then decided it was time to cut fat, suger etc from my diet. Secondly, I have begun to panic when it is time to eat. All I've done according to my family is sit at this computer and search for answers. In my research I have found that IBS can be hereditary. My brother has had it for 30 years, and my sister has had it for 15 years. I've decided to go the holistic route. These past couple of days have been great. I only had 2 bouts of D today. What a mirable. Heartburn has been at a minimum today.Doctor told me that they ofter see indigestion and irritable bowel either after surgery or if present before surgery, a worsening period. Found that out this week.What are you doing for therapy? Diet? Supplements? OTC? Prescription?------------------Wasscared


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## JenL (Aug 23, 2001)

Genny,In agreement with you, I believe docs should give us a head up. I thought two weeks after my gallbladder surgery, which was only 3 months ago, I was dying. The heartburn and irritable bowel sent me through the roof. I thought I was having a gallbladder attack. I had myself so worked up about having a lodged stone. Well it took me doing my own investigation to find out what was going on. I had only a slight case of irritable bowel, just the D. Not much in stomach pain prior to surgery. NOW! Oh my word, the stomach is so loud sometimes you can hear it over my diesel truck, the pain, nausea and heartburn.I have lost 21lbs in two months. Some of that is due to the fact that after surgery my blood pressure went wild, so I was put on meds. I then decided it was time to cut fat, suger etc from my diet. Secondly, I have begun to panic when it is time to eat. All I've done according to my family is sit at this computer and search for answers. In my research I have found that IBS can be hereditary. My brother has had it for 30 years, and my sister has had it for 15 years. I've decided to go the holistic route. These past couple of days have been great. I only had 2 bouts of D today. What a mirable. Heartburn has been at a minimum today.Doctor told me that they ofter see indigestion and irritable bowel either after surgery or if present before surgery, a worsening period. Found that out this week.What are you doing for therapy? Diet? Supplements? OTC? Prescription?------------------Wasscared


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## LadyM (Feb 17, 2001)

When I really bad flare ups with the D, I always lose weight, this has been going on since Gallbladder surgery, I don't gain it back either except for this last time I have gained 2 pounds back, first weight gain in a year but I am in a wellness program building my muscles up too so some of that two pounds is muscle gain







Mike I agree the D causes me stomach distress so I eat less so that in turn might cause the weight loss. I don't have the D where it is just below the belly button, when it flares up, it from the mouth downward. I guess the reason I don't gain it back is that when I get to feeling better I get back to eating low to medium fat meals, I eat sugar to help maintain my weight(doctor's orders, which sugar don't seem to hurt me in the least if it is not too fattening), in other words I think I just eat enough to maintain my weight. I happy with my weight as it is, 122, 5'2, medium frame. But I can't afford to lose not one more pound, so I would like to put back on the last four I lost, two I have, so two more to go, that away I have insurance if another bad, bad flare up gets me. Right now I am doing fine since I started back on the precription pepcid, it actually has helped the D alot!!! Would you know medically why it helped? I seen a few answers to my post about it where it helped other people and someone else posted on it too. After my gallbladder surgery everything just went haywired in my digestive system and I started off with low fats right after surgery, had no choice. 50 pounds of me is gone, for good if I have my way, still haven't gotten use to the little me, or should I say mini me







God Bless thanks for the info and thank you Genny for asking him to retype it in plainer english..lol


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## LadyM (Feb 17, 2001)

When I really bad flare ups with the D, I always lose weight, this has been going on since Gallbladder surgery, I don't gain it back either except for this last time I have gained 2 pounds back, first weight gain in a year but I am in a wellness program building my muscles up too so some of that two pounds is muscle gain







Mike I agree the D causes me stomach distress so I eat less so that in turn might cause the weight loss. I don't have the D where it is just below the belly button, when it flares up, it from the mouth downward. I guess the reason I don't gain it back is that when I get to feeling better I get back to eating low to medium fat meals, I eat sugar to help maintain my weight(doctor's orders, which sugar don't seem to hurt me in the least if it is not too fattening), in other words I think I just eat enough to maintain my weight. I happy with my weight as it is, 122, 5'2, medium frame. But I can't afford to lose not one more pound, so I would like to put back on the last four I lost, two I have, so two more to go, that away I have insurance if another bad, bad flare up gets me. Right now I am doing fine since I started back on the precription pepcid, it actually has helped the D alot!!! Would you know medically why it helped? I seen a few answers to my post about it where it helped other people and someone else posted on it too. After my gallbladder surgery everything just went haywired in my digestive system and I started off with low fats right after surgery, had no choice. 50 pounds of me is gone, for good if I have my way, still haven't gotten use to the little me, or should I say mini me







God Bless thanks for the info and thank you Genny for asking him to retype it in plainer english..lol


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