# Spasms



## Guest (Dec 19, 2006)

HI All, I just found this site although I've been dealing with IBS-C (sometimes D too) for oh about 20 yrs if not longer. Just wanted to see what y'all do for your spasms? I seem to get symptoms starting the week before my cycle, ending shortly after the cycle begins. I'm on 10 mg Bentyl 2 times a day for the spasms, but sometimes that just isn't enough. I also use a handy heating pad (the kind that canm be heated in the microwave, making it portable for work etc)on the actual spasm spot (which for me is directly in the center of my belly) when the spasms are real bad, consistant spasming. Sometimes a hot bath helps too. Are there any other self help remedies y'all do to stop the spasms? Any advice is greatly appreciated.


----------



## 23376 (Jul 31, 2006)

Hey Sammyprint;I also experience severe spasm, although my spams on on my left side and range from just under my rib cage to to top of my hip bone.I currently take Dicetel (100 mg) three times daily (with food) to help cope with the spasms.When it is real bad (mostly at night) I too tend to use a heating pad.Jack


----------



## 14416 (Jun 21, 2005)

I experience extreme cramping - I think I would liken it to a contraction? It's when I'm getting diarrhea and for awhile I won't be able to go during these contractions, but then when the contractions start to get closer and closer I will experience "D", like I am today, unfortunately.Perhaps I am just more aware/sensitive to these contractions? Or maybe IBS sufferers have exaggerated or more frequent "contractions" in their intestines?


----------



## Popp (May 31, 2004)

Not the dreaded "S" word!Use that word with caution around here


----------



## flux (Dec 13, 1998)

I'm afraid that is that word again.









> quoteerhaps I am just more aware/sensitive to these contractions? Or maybe IBS sufferers have exaggerated or more frequent "contractions" in their intestines?


For those new to the study of the IBS, I encourage people to avoid using the term because it makes everyone think something abnormal is occurring in the intestine.The "spasms" of IBS is just pain; it isn't caused by any contractions in the gut. Contractions in the gut are normal and involuntary all the time. There may be more of them and they may occur when they shouldn't occur, and they be more exaggerated than what would otherwise occur in a normal person, but they are not responsible for the discomfort per se.


----------



## 14473 (Mar 20, 2006)

Hey flux and othersI guess we use the word spasms because there are so many anti spasmodics on the market.I can neally always feel my intestines moving (peristalsis) and I do think they are out of whack (this could be spasms). When I put my hand on where I can feel the movement I feel a vibration phenomenon and this can be quite noisy and embarrasing. I tried to explain this to the gastro and he gave it some name - forgot what - and said that it was the bowel contracting very tightly forcing contents and air to quickly get squashed through causing the feeling and noise. Does anyone else have this - I have no pain, get lots of gas and have IBS - A, mainly C.Flux what do you think? Wouldn't you say that my bowel is everyow and then going through a spasm where it is tightning too much causing my problem? If I could get throught this noisy vibration like problem life would be a whole lot better - at least my work life anyway!Cheers


----------



## 16229 (Jan 28, 2006)

Sammy,You may want to try relaxation techniques. Some controlled breathing along with the hot bath can really help out those cramps.At work, I use, well, I don't remember the name of it. Basically, I keep myself busy and focused. I will usually do a small puzzle or game etc along with my work. Not let my mind wander to the pain. Think of it like this. If you twisted your ankle it would hurt, yes? Now, if we were to break your other leg you'd probably forget that your ankle hurt pretty quickly. That's because your head becomes focused on the broken leg.The idea is to have things you can immerse yourself in. To focus on completely. Like just watching tv does not work for me because it does not require my complete attention, whereas video games usually hit the spot. If I'm doing something that doesn't require my full attention, then I do something else along with it.


----------



## 13375 (Aug 9, 2006)

The term was barborgmy.I get that it sounds like popping?I can hear it when I first wake up in the morning.IBS sucks......I wonder if there is someone on this planet that likes IBS?


----------



## Janet Robinson (Sep 21, 2006)

To me sorry they are spasms as I can feel them and it feels like my colon is coming thru my skin and lots of time it trapes gas..


----------



## flux (Dec 13, 1998)

> quote:I can neally always feel my intestines moving (peristalsis) and I do think they are out of whack (this could be spasms). When I put my hand on where I can feel the movement I feel a vibration phenomenon and this can be quite noisy and embarrasing. I tried to explain this to the gastro and he gave it some name - forgot what - and said that it was the bowel contracting very tightly forcing contents and air to quickly get squashed through causing the feeling and noise.


What you are describing is a strange phenomenon that a few posters have described. We don't know what it is, but only what it is not. It's not pain, of course, and IBSer's don't have it (which means whatever you have, it ain't IBS). It can't be a "spasm" because that has no meaning physiologically in the gut. I have no idea what the doctor could have called it unless he was calling you a Martian


----------



## Guest (Dec 20, 2006)

Please forgive my ignorance, but the colon in a muscle right? Muscles spasm, right? What's wrong with a colon spasm? Why do you feel it doesn't exist?


----------



## 14473 (Mar 20, 2006)

quote------------------------------------What you are describing is a strange phenomenon that a few posters have described. We don't know what it is, but only what it is not. It's not pain, of course, and IBSer's don't have it (which means whatever you have, it ain't IBS). It can't be a "spasm" because that has no meaning physiologically in the gut. I have no idea what the doctor could have called it unless he was calling you a Martian ---------------------------------------Interesting ....You are right there is no pain. I was always under the impression that a lot of IBSers had this sort of feeling. I definately have symptoms of IBS (gas, constipation and a little D) And is started out of the blue about 3 years ago. Whatever these feelings are I can't seem to get rid of it and it sux.As for the word describing this - the gastro said barborgmy as snookman suggested.Regarding spasms - I am with sammyprint all muscles spasm occasionally for certain reasons. Sometimes I get a twitch on the eyelid or bicep. Why would the colon be any different. And also if one was constipated wouldn't the peristaltic (spelling!) waves get a little messed up trying like hell to clear the pipes?Flux do you think that these noises and vibration I feel could be from a buid up of gas in my system - I know that there is some research that suggest that IBSers don't have any more gas BUT for me it is a constant problem and has only started when all these other symptoms started. I am getting a little of topic here but there was one night that I think I must have woken up 20 times to pass wind and I had so much gas that I was in pain? Any feedback on this would be great!Cheers - bring on christmas ( tiem to party with all my martian friends!


----------



## Kathleen M. (Nov 16, 1999)

Smooth muscle in the intestines and bladder and such is physiologically different from the skelatal muscle so I don't know that you can assume that because skelatal muscle does it the exact same thing must be happening to your colon.Most of what IBSers experience as pain is the normal colon doing normal things but being sensed abnormally. So there isn't some misbehavior leading to the pain.IBS pain is usually treated with the probably badly named antispasmodics which I think are supposed to relax the smooth muscles or antidepressants that stop the nerves from abnormally sensing the colon and sending pain signals to the brain.K.


----------



## 14473 (Mar 20, 2006)

Thanks KathleenIts great to hear other people's views on the subject.The only thing is if my bowel is functioning normally then how would one explain that I can actually feel this vibration phenomena (almost always to the right side of my abdomen). Not only can I feel it I can hear it - I guess contents being squeased through.I guess it is more complicated then we imagine. I was wondering also what causes stomach hunger noises - is this smooth muscle and is it undergoign spasms or contracting in anticipation or is it too much secretion of the stomach enzymes. Would love to know because it is a little like what happens in my bowels - that growling sound??My doc just put me on prozac but if I have no pain how could it help? Crazy times ....


----------



## Kathleen M. (Nov 16, 1999)

If there is any nerve misbehavior it may modulate that.The gut is always making noise and moving things around. I don't know if what you have is abnormal awareness of a normal process or not. When we feel something funny we as humans tend to get hyperaware of it even if that same thing has been going on all along. If your gut is totally silent that means it is obstructed and it is a medical emergency. Now usually you have to stick the stethoscope on it like you would to hear the heart beat, but it should make noise.A gut doing normal gut things can be very loud. I'm not sure we know why the noise gets loud enough to be heard, but it doesn't as far as I can tell when it happens to me to be associated that well with other issues that would say something funny is going on (like diarrhea or constipation, etc.)K.


----------



## Guest (Dec 20, 2006)

Question on me. I recently went through a Radiofrequescy ablation for a heart condition called Tacycardia. I was on Beta blockers, which not only reduce the heart rate but the anxiety level also. I stopped taking them about a week ago, and starting on Monday I started the um, unusual sensations in my stomach so severe they take my breath away and I bend over slightly. Has anyone else used beta blockers as opposed to antidepressents? And did it help your IBS symptoms?


----------



## Kathleen M. (Nov 16, 1999)

Not sure about beta-blockers but a fair number of people take anti-anxiety medication.I've used Buspar for IBS even though I don't have anxiety. It works on a different serotonin receptor than antidepressants so works for anxiety, but isn't sedating like the benzos.K.


----------



## eric (Jul 8, 1999)

I asked the experts at the UNC a while back about this as some know and technically they are not spasms but contractions.Flux, I still need to ask them about the other question, which I will do soon.A couple things, one is how the bowel actually works, it has to distend like a ballon you feel with air in order to feel anything, because it doesn't release neurotransmitters until that happens.But"Pain and BloatingNormal, Relaxed Bowel Bowel With IrregularContractions The well-functioning bowel has regular, rhythmic contractions, which in IBS, become disrupted. Depending on the strength of bowel contractions and the amount of intestinal gas, painful abdominal cramps may be experienced. Variations in intestinal contractions, which may cause material in one section of the intestine to be passing slowly while material in another section is passing quickly, and when these actions occur simultaneously, painful cramps result as well as the characteristic alternating between constipation and diarrhea. Also, prolonged contractions of the bowel may prevent the normal passage of air through the bowel, triggering bloating, belching, and flatulence. Bloating can become so severe that clothing needs to be adjusted and abdominal swelling becomes visible to others.Pain is varied among individuals with IBS. It may be ongoing or it may resolve very quickly. It can occur occasionally or frequently, and it can move around from one location in the bowel to another. Digestive pain often occurs following a meal and can last for hours."http://www.badgut.com/index.php?contentFil...+Bowel+Syndrome














You might want to read this alsoVisceral 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 UCLAThe most common symptoms of IBS patients are related to altered perception of sensations arising from the GI tract, and frequently from sites outside the GI tract, such as the genitourinary system or the musculoskeletal system. Sensations of bloating, fullness, gas, incomplete rectal evacuation and crampy abdominal pain are the most common symptoms patients experience. Numerous reports have demonstrated that a significant percentage of FBD patients (about 60%) rate experimental distensions of the colon as uncomfortable at lower distension volumes or pressures when compared to healthy control subjects. This finding of an increased perception of visceral signals ("visceral hypersensitivity") has been demonstrated during balloon distension tests of the respective part of the GI tract regardless of where their primary symptoms are â€" the esophagus, the stomach, or the lower abdomen. In contrast to the current emphasis on mechanisms that may result in sensitization of visceral afferent pathways in the gut, it may well be that alterations in the way the nervous system normally suppresses the perception of the great majority of sensory activity arising from our viscera are essential for the typical symptom constellation of IBS and other functional GI disorders to develop.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. http://www.aboutibs.org/Publications/VisceralSensations.htmlIt has been known now for a while that the "gate" for sensory information arising from the gut to the brain is lost in IBS, so all sensory information gets through.This is also a newer study about it. Study shows link between IBS and pain"Thus, people with IBS have a lower pain threshold because their pain filters appear to malfunction, amplifying rather than dampening the nervous input from the gut to the brain - resulting in a propensity for both abdominal pain, and an increased sensitivity to somatic (skin or surface) pain. "Compared to healthy subjects, IBS patients tend to have a more sensitive bowel. This can be explained by the finding that IBS sufferers have a lower pain threshold for perceiving abdominal pain, when compared to individuals who don't have IBS. "So, IBS patients may feel pain even when the intensity of a stimulation they receive is within a normal range," explained Prof Ho. "http://www.channelnewsasia.com/stories/hea.../239806/1/.htmlThere have been a lot of studies related to this discussion. Some of them are fmri studies and pet scans studies of the brain and IBS. The brain scans are different then normal controls as well as IBD conditions.There maybe a problem and they are looking into this for quite some time now for the brains anterior cinculate cortex to signal the release of endorphines back down to the gut for pain. However that is just one part of it all.You can get pain from normal gut functioning however in IBS. Not only that but the signal arising from the gut may activate the prefrontal cortex, which is associated with anxiety, as opposed to the ACC which is associated with pain and emotions.


----------



## flux (Dec 13, 1998)

> quote:but the colon in a muscle right? Muscles spasm, right? What's wrong with a colon spasm?


The term spasm is probably most useful when describing a condition like nocturnal leg cramps. In this condition, a muscle under normal voluntary control suddenly and violently contracts on its own and this contraction is accompanied by severe pain.The smooth muscle of the gut is always under involuntary control and the way it is innervated and controlled is very different from skeletal muscle. It probably could get out of control on its own, but that would probably under very specific circumstances (i.e, severe electrolyte imbalance).


> quote:The only thing is if my bowel is functioning normally then how would one explain that I can actually feel this vibration phenomena (almost always to the right side of my abdomen). Not only can I feel it I can hear it - I guess contents being squeased through.


That you can feel vibration indicates that it is *not* a hyperawareness because vibrations like that do not normally occur in the gut. In addition, the sensation of vibration is not transmitted by the visceral pain nerves which are sensitized in IBS. So this is clearly not normal nor is is related IBS. You could confirm this by putting your hand on your abdomen. If you can feel it there, then it cannot be due to hypersensitivity (of any kind).


> quote:I guess it is more complicated then we imagine. I was wondering also what causes stomach hunger noises - is this smooth muscle and is it undergoign spasms or contracting in anticipation or is it too much secretion of the stomach enzymes. Would love to know because it is a little like what happens in my bowels - that growling sound??


Hunger stomach noises are probably not related to hunger, but are most likely the result of the gut's normal contractive cycle between meals. Most likely, phase III of the migrating motor complex. What's actually going to make the noise and why is it these noises don't result in "vibrations" is probably complicated. We are only just beginning to study the motions of the gut in realtime, so right now, I'm not sure we have good answers.


----------



## 14856 (Apr 17, 2006)

Very good thread Guys and GalsVery infomativeI have an image of the Bowel kinda like an inside out snake, Would this be an accurate metaphor? I feel that instead of a nice smooth, snake like, motion We unfortunate IBS suffers have a juddering or a skipped beat somewhere along the line, which then knocks the entire system out of balance.


----------



## Janet Robinson (Sep 21, 2006)

MUSCLE SPASMS ARE REAL..RIGHT AFTER MY COLONOSCOPY I WENT INTO A BIG SPASM FROM IT, THE DOCTOR KNEW IT, (SPASTIC COLON) I WAS LIKE THAT FOR TWO DAYS. AFTER MY INFECTION FROM DIVER I WAS IN SPASM ON MY LEFT SIDE FOR 6 MONTHS, ONCE GAS RELEASE'S THE SPASM EASE'S IT HAS 100 PER CENT TO DO WITH THE COLON AND WHAT DETERMINE'S WHAT KIND OF BOWEL MOVEMENTS. IF YOU CAN'T LIFT YOUR LEG TO TIE YOUR SHOE THERE IS A KNOT OF MUSCLES THERE. I HAVE IT MANY TIMES I KNOW WHAT IT IS ALL ABOUT AND MY DOCTOR WHO IS A PROFESSOR HAS CONFIRMED IT.


----------



## eric (Jul 8, 1999)

Dieselengine "I have an image of the Bowel kinda like an inside out snake, Would this be an accurate metaphor? "It can seem to feel that way sometimes. It should be nice wave motions moving from the top out, but in IBS there can be altered contractions anywhere along the lenght as the pictures above demonstrate.This is related. It is a question from a 13 year old with functional recurrent abdominal pain. Another functional disorder. However there are connections to IBS. I am sure some of the IBSers here have noticed a slight twinge or something before an attack. This makes you conciously aware of that feeling down there. A normal reaction will be a stress reaction, this is a threat to me. Worry may set in if the pain will be bad or you will have to go out and have d ect..But"Recent studies point to an increased sensitivity of the sensory nerves in the intestines. Normal movements of your intestines may be perceived as cramps or other discomfort. The intestines share nerve pathways with the brain. In many situations, when the brain reacts to something -- like the sound of a dentist's drill -- the intestines, or gut, pick up the same signals and react. The majority of people will ultimately have some kind of gastrointestinal (GI) symptom when exposed to stressful situations. If your GI system is a bit too reactive, you will experience symptoms in more types of stressful situations than someone else will whose gut is not quite as reactive. What is stressful for one person may not be stressful to another, and lots of people don't even realize it when they get stressed -- they just feel sick. Finally, there is the "gate theory" of how pain is experienced. When pain originates at some point, nerve messages pass through something like a gate on their way to the brain. The wider open the gate is, the more pain that is experienced. By thinking about and focusing on the pain site, we open the gate. Plus, feelings of anger or worry or sadness can open the gate. However, we can also help close the gate. Turning attention away from the site or feeling of pain, through relaxation or focusing on some other activity, can help close the gate and lessen or even eliminate pain. A well-known phenomenon that demonstrates this is that of the athlete who plays a game while injured, oblivious to the pain. The athlete is completely focused on the game and does not feel pain. Then, after the game is over, the athlete turns attention to the injury and feels pain. Whatever the cause, you can do something about it! It takes some effort but there a number of ways that you can help yourself. First, think about this example. Have you ever experienced a muscle cramp or a side-ache during strenuous running or exercise? You feel real pain in muscles that are not diseased. But they have been stressed beyond some point that in you causes discomfort. What do you do to avoid it in the future? You might think about what you were doing that resulted in the muscle pain. Maybe next time you do more warm-up exercises, or start out slower, or don't run as far. The first time you felt a side-ache, you might have felt concerned and stopped running. After you learned that it was nothing to be concerned about, you may have barely taken notice the next time it happened, perhaps slowed down a bit, but then kept right on going. This is the same type of thing that happens with functional recurrent abdominal pain. Your intestinal muscles may be causing you to feel pain. To get it under control, try this: 1) While the pain you feel is very real, do not worry that you are sick. You are not. Your body is reacting to events in a way that is causing you discomfort but is not cause for alarm. 2) Try to figure out if your symptoms are connected with anything else that may be triggering them. Do symptoms flare at certain times, before certain events, on weekdays, on weekends, etc? If you can identify triggering factors (like certain foods or activities) you can try to avoid them, or if that is not possible, try to deal with them in different ways. 3) Are you missing school because of this? Worry over missing school can make symptoms worse. Try to keep going. 4) Are you doing too much-school plus lots of outside activities? If so, take some time off to relax. Too much of anything can be stressful. 5) The next time you feel the pain, don't let it stop you. Keep on going. Practice focusing your thoughts on what it is you want to do next and then go ahead and do it. Don't let pain take your awareness hostage."http://www.aboutkidsgi.org/questionsandanswers.html#fap


----------



## Twocups424 (Mar 26, 2002)

> quote:Most of what IBSers experience as pain is the normal colon doing normal things but being sensed abnormally. So there isn't some misbehavior leading to the pain.


 I think this statemnet is totally wrong. If everything is so normal WHY THE HELL DO i FEEL SO BAD. I say that since CBT worked for you that doesn't prove everyone else is sensing things abnormally. That's baloney. I sense things abnormally BECAUSE WHAT IS HAPPENING IN MY COLON 'IS NOT NORMAL".THE END.


----------



## flux (Dec 13, 1998)

> quote:I WENT INTO A BIG SPASM FROM IT, THE DOCTOR KNEW IT, (SPASTIC COLON) I WAS LIKE THAT FOR TWO DAYS. AFTER MY INFECTION FROM DIVER I WAS IN SPASM ON MY LEFT SIDE FOR 6 MONTHS


Contractions in the gut last on the order of *seconds*.


> quote:If everything is so normal WHY THE HELL DO i FEEL SO BAD. I say that since CBT worked for you that doesn't prove everyone else is sensing things abnormally. That's baloney. I sense things abnormally BECAUSE WHAT IS HAPPENING IN MY COLON 'IS NOT NORMAL".


It's because the nerves are sending the wrong signals to the brain and because the brain is processing signals wrong. There may be abnormal contractions in the gut to create diarrhea, but they are not 'sensed" because they are abnormal.


----------



## Kathleen M. (Nov 16, 1999)

> quote:. I say that since CBT worked for you that doesn't prove everyone else is sensing things abnormally


It isn't just me. This is the theory that has lead to most of the new medicines and treatments for IBS.A big part of what is going wrong in IBS is in the nervous system, not the muscles of the colon or the lining of the colon. The nervous system controls every single thing the gut does and how you sense it. I'm sorry that upsets you.I guess all the other people helped in the CBT study I did (some 70% of those in the treatment group and it was a very large study) don't count at all. You say that like I am the ONLY person in the world that CBT ever helped in any way with IBS, ever, and there is NO data and NO research that would ever agree with me at all, I mean they CAN'T be directing all the drug research at the nerves of the gut because they just want to find something that can't possibly ever work for anyone and I am just blowing smoke out my butt.I don't base what I say solely on my own personal experience, but whatever.I also was NEVER implying that this was the ONE AND ONLY thing going on like you are trying to say I was. REALLY! However, it is a very big part of what goes on for a lot of people and there isn't always a lot of benefit trying to make it be something bad going on when for a lot of us most of the time it's just the nerves that are the "accelerator pedal" or the "brake pedal" or the "sensors that tell it what it needs to know to run smoothly" are screwed up. It may not be the "engine" of the car that needs to be fixed but the stuck accelerator pedal, or stuck brakes or one of the sensors. No matter what is the problem the car ain't gonna run right.I do not know why I cannot ever say anything like that without getting blasted for it by you.







I'm sorry if I've hurt you in the past and I request that if my posts cause you so much pain and problems that you click on my name and put me on your ignore list so you never ever have to be bothered by my opinion ever again.Do you really believe I say things like that to make life worse for other IBSers, because sometimes it seems based on how you react to me that you really do believe I'm here to hurt as many people as possible.*sigh*K.


----------



## hope* (Aug 1, 2005)

I am one of the many people that CBT is helping, i am on my 9th session of 12 and am slowly getting my life back thanks to CBT. Before my sessions i never left my house and had ibs pain daily.I still have my ibs flare up's but they are a lot less now and i feel like i'm in control now not ibs.I feel so sad that you feel you have to attack someone's belief in something that has helped that person and continues to help others. We are all here to help one and other and show support in what they try even if they fail or succeed, after all we all want the same thing to get rid of IBS forever and live our lives.


----------



## Kathleen M. (Nov 16, 1999)

I'm glad it is working for you, that sounds pretty similar to my experience.I do want to acknowlege that no one approach works for everyone, even when one can prove to a certainty that the exact same mechanism is causing the problem.When there is less certainty about the cause it can be harder to find what works for oneself. I have that with allergies. Most of the normal treatments just don't work for me. Pollen/dust and histamine release are still the heart of the problem, I just can't control the symptoms with things that work so well for everyone else even though the exact same thing is going on. I know it is histamine because they can do a positive control with histamine and get a reaction. Just things like Claritin don't do anything to block the histamine reaction in me. It is extra frustrating because since Claritin went OTC the insurance doesn't like to cover other drugs as they expect me to do what everyone else does and just buy this OTC at the drug store.There is some variation between people and that can be why something works for one person and not another. Our fundamental biology is all the same, but there are enough small differneces that we always need to find the treatment approach that works for us. It can be very frustrating when what "should" work doesn't.I also want to say that I know some people think the pain isn't "real" if it is generated by the nervous system rather than some other cause that can be identified. Usually the conditions that have the most pain and the hardest to treat pain is when there isn't a "real" cause for it. When the nervous system for whatever reason goes haywire. The pain is as bad or worse than pain from an injury, what makes it especially difficult is there is nothing you can do to make that pain go away. It isn't like you can remove the diseased part or set the bone and do something that will lead to the pain ending. I want to make sure that I don't think that anyone is making up their IBS symptoms. Even if the nervous system is to blame for a lot of us it doen't mean there is something we did to make ourselves have IBS, or that our suffering is any less than someone where there is an obvious problem you can see like in ulcerative colitis. Other than IBS some of the worst pain I ever had was when a nerve that was cut to a fingertip regrew. It took a couple of days for it to learn what was appropriate and what wasn't. No one was holding my hand on an anvil and pounding the finger with a sledgehammer, but it sure did feel that way. Luckily that nerve got reset on it's own, sometimes they need a little help and that is where things like CBT or drugs that target nerve function can work for a lot of us. I feel sorry for people with phantom limb syndrome where that same sort of nerve thing I went through happens to them, but they don't have the body part phsyically present to help get the nerves reset so they just go off like that forever.K.


----------



## hope* (Aug 1, 2005)

Kathleen i hope you didn't feel my post was directed at you, it was in response to the other persons attack on you, which i felt was harsh.


----------



## Kathleen M. (Nov 16, 1999)

I know that







I just wanted to say something about that response I got in a calmer manner and make sure my position is clear in case anyone was wondering


----------



## eric (Jul 8, 1999)

Janet RobinsonI hope your reading all the material on this thread. They use the term spasms frequently because its way easier for patients to understand it that way. But technically they are really gut contractions. A part of this which some people might not understand is how the bowel actually works. It works by pressure sensitive cells, that sense pressure from the act of eating or from distension. When it distends it releases chemicals, without that happening a person would not feel pain.There is a ton of research on viceral hypersensivity and it is very complex. It should be totally understood here though that the pain is not made up. There are problems and that is why there is pain. However ALL pain is process in the brain.IBSer have lower pain thresholds then normal people. They know this by ballon distension of the rectum and colon and studies using fmri and pet scan studies. A very important chemical for pain transmission from the gut to the brain is serotonin. That has been confirmed. It is also very important in gut contractions, it is released from those pressure sensitive cells to intiate contractions.CBT and Hypnotherapy are successful treatments for IBS and while they don't work for absolutely everyone, both are recommend by IBS experts and have been studies. In the case of HT for IBS for the last twenty years of research. There is more info on sensoryhttp://ibs.med.ucla.edu/Articles/PatientArticleSp97Sens.htmhttp://ibs.med.ucla.edu/Articles/PatientAr...eakthroughs.htmhttp://ibs.med.ucla.edu/Articles/PatientAr...Sp97Looking.htmhttp://www.iffgd.org/symposium2003brain-gut.htmlhttp://www.iffgd.org/symposium2003imaging.html


----------



## eric (Jul 8, 1999)

FYIThe History of functional gi disordersPRESENT PATHOPHYSIOLOGICAL OBSERVATIONS Despite differences among the functional gastrointestinal disorders, in location and symptom features, common characteristics are shared with regard to: o motor and sensory physiology, o central nervous system relationships, o approach to patient care. What follows are the general observations and guidelines.MOTILITY In healthy subjects, stress can increase motility in the esophagus, stomach, small and large intestine and colon. Abnormal motility can generate a variety of GI symptoms including vomiting, diarrhea, constipation, acute abdominal pain, and fecal incontinence. Functional GI patients have even greater increased motility in response to stressors in comparison to normal subjects. *While abnormal motility plays a vital role in understanding many of the functional GI disorders and their symptoms, it is not sufficient to explain reports of chronic or recurrent pain * VISCERAL HYPERSENSITIVITYVisceral hypersensitivity helps to account for disorders associated with chronic or recurrent pain, which are not well correlated with changes in gastrointestinal motility, and in some cases, where motility disturbances do not exist. Patients suffering from visceral hypersensitivity have a lower pain threshold with balloon distension of the bowel or have increased sensitivity to even normal intestinal function. Additionally, there may be an increased or unusual area of somatic referral of visceral pain. Recently it has been concluded that visceral hypersensitivity may be induced in response to rectal or colonic distension in normal subjects, and to a greater degree, in persons with IBS. Therefore, it is possible that the pain of functional GI disorders may relate to sensitization resulting from chronic abnormal motor hyperactivity, GI infection, or trauma/injury to the viscera. BRAIN-GUT AXISThe concept of brain-gut interactions brings together observations relating to motility and visceral hypersensitivity and their modulation by psychosocial factors. By integrating intestinal and CNS central nervous system activity, the brain-gut axis explains the symptoms relating to functional GI disorders. In other words, senses such as vision and smell, as well as enteroceptive information (i.e. emotion and thought) have the capability to affect gastrointestinal sensation, motility, secretion, and inflammation. Conversely, viscerotopic effects reciprocally affect central pain perception, mood, and behavior. For example, spontaneously induced contractions of the colon in rats leads to activation of the locus coeruleus in the pons, an area closely connected to pain and emotional centers in the brain. Jointly, the increased arousal or anxiety is associated with a decrease in the frequency of MMC activity of the small bowel possibly mediated by stress hormones in the brain. Based on these observations, it is no longer rational to try to discriminate whether physiological or psychological factors produce pain or other bowel symptoms. Instead, the Functional GI disorders are understood in terms of dysregulation of brain-gut function, and the task is to determine to what degree each is remediable. Therefore, a treatment approach consistent with the concept of brain-gut dysfunction may focus on the neuropeptides and receptors that are present in both enteric and central nervous systems. THE ROLE FOR PSYCHOLOGICAL FACTORSAlthough psychological factors do not define these disorders and are not required for diagnosis, they are important modulators of the patient's experience and ultimately, the clinical outcome. Research on the psychosocial aspects of patients with functional GI disorders yields three general observations: o Psychological stress exacerbates gastrointestinal symptoms in patients with functional GI disorders and can even produce symptoms in healthy patients (but to a lesser degree).o Psychological disturbances modify the experience of illness and illness behaviors such as health care seeking. For example, a history of major psychological trauma (e.g. sexual or physical abuse) is more common among patients seen in referral centers than in primary care and is associated with a more severe disorder and a poorer clinical outcome. Additionally, psychological trauma may increase pain-reporting tendency. o Having a functional GI disorder has psychological consequences in terms of one's general well-being, daily functional status, concerns relating to control over symptoms, and future implications of the illness (e.g. functioning at work and home). http://216.109.125.130/search/cache?p=hist...&icp=1&.intl=us


----------



## 16229 (Jan 28, 2006)

CBT is not a cure, it's a tool to help you deal. It, and other forms of therapy like it, are used to treat many different disorders. In those with anxiety driven IBS it sure can help limit attacks. In others it's about lessening the impact of the pain on your life, and coping with the additional stress that that pain puts on you.CBT hasn't cured me, not in the least. But it has helped me deal with my life. To stay active and alive. Cut down on anxiety related attacks.And you don't have to go to a specialized cbt therapist, persay. Many good therapists use a lot of the concepts of cbt in their normal practice when dealing with those who have chronic pain or anxiety.


----------



## 19149 (Dec 17, 2006)

Spasms or contractions...it hurts all the same!


----------



## Twocups424 (Mar 26, 2002)

I still don't agree whatsoever. What about people who have had a gastro infection , girardia etc.and then seem to have IBS-D for life. YOu mean to tell me their perception is in their brain??????????? when it was clearly germs that started it all.


----------



## Twocups424 (Mar 26, 2002)

and this incessant talk about what is a spasm and what is a contraction????????? And you all think I"m nuts. I think all those big long explanations have effected your heads


----------



## flux (Dec 13, 1998)

> quote:YOu mean to tell me their perception is in their brain??????????? when it was clearly germs that started it all.


Yes. The cause involves a number of factors. Germs is but one factor.


----------



## Kathleen M. (Nov 16, 1999)

It is how the brain interacts with the damaged nerves in the gut, at least in my case, after all my IBS is post infectious.There was a study awhile ago demonstrating just how much damage the gut nerves that are in the wall of the colon when the colon is inflamed.You can't do anything about the germs that are long gone, you can only try to deal with the damage caused by the inflamation. The basis of most mind-body medicine is that how the brain interprets and responds to the body effects the course of the disease, no matter what caused the disease in the first place.K.


----------



## eric (Jul 8, 1999)

IN PI IBS the intial infection gets RESOLVED and changes are left in the gut.All Perception is in the brain.The brain and the gut brain are constantly communicating with each other. All pain is processed in the brain. Serotonin is an important neurotransmitter for signaling to the brain pain in the gut. PI IBSers have more EC cells in the gut which store serotonin as well as an increase in mast cells. The mast cells are embedded in the gut wall and can contribute to pain by releasing histimine unto the smooth muscle. The release and dysregulation of serotonin is believed to cause the c or d or d/c of which there is strong evidence.Not just bacteria cause PI IBS, but other things as well.Post-infectious irritable bowel syndrome. A review based on current evidence][Article in Spanish]Gomez-Escudero O, Schmulson-Wasserman MJ, Valdovinos-Diaz MA. Departamento de Gastroenterologia, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Tlalpan, C.P. 14000 Mexico, D.F.INTRODUCTION: Pathophysiology of irritable bowel syndrome (IBS) is multifactorial. Recent investigations have associated episodes of infectious gastroenteritis with development of IBS. This condition is named post-infectious IBS (PI-IBS). The role of inflammation-infection in IBS pathogenesis is not well understood. AIM: To review published scientific evidence on PI-IBS regarding risk factors, causal agents, histopathological changes, and treatment. MATERIALS AND METHODS: An electronic search in MEDLINE and abstracts presented at national and international GI meetings was performed, looking for information published in the past 50 years including animal studies, cohort studies, case-control studies, and series of cases and case reports, using the key words post-infectious enteritis, post-dysenteric or post-infectious irritable bowel syndrome (PI-IBS), and post-infectious colitis. RESULTS: Fifty one papers were included. These studies were classified according to pathophysiologic mechanisms, infectious agents involved, animal or human studies, and treatment. CONCLUSIONS: Current evidence shows a strong association between colonic infection and inflammation with development of IBS. Approximately 25% of patients with IBS have a history of infectious enteritis. Microbial agents related with PI-IBS include bacteria (Campylobacter, Salmonella) and parasites (Trichinella spiralis). Increased number of enteroendocrine cells, CD3 lymphocytes and mast cells within the colonic muscle wall, release of pro-inflammatory substances, and increased number of inflammatory cells with intestinal nervous endings are the most common histopathologic findings. Patients developing PI-IBS have a higher frequency of psychological disorders and stressful events prior to the gastroenteritis episode. Therapeutic interventions with steroids, COX-2 inhibitors, antibiotics and probiotics require further investigation.PMID: 12940101So bacteria or even parasites could cause the intial gastroenteritis and once resolved a person may develop IBS, but not everyone with gastroenteritis develop IBS, there are risk factors involved. Why do you believe persception has nothing to do with IBS? Or that nerve singaling is not a problem?


----------



## eric (Jul 8, 1999)

FYIOn the right side of this page shows the sensory pathways for pain in IBS. Serotonin is involved in sending that signal from the gut to the brain.http://hopkins-gi.nts.jhu.edu/pages/latin/...se=43&lang_id=1


----------



## eric (Jul 8, 1999)

This is brand new*Neuromuscular Dysfunction* and IBS: Clinical Implications"Classically, the pathophysiology of IBS has been thought to involve an interplay between psychosocial stressors and abnormalities in gut motility and visceral sensation. A variety of motility abnormalities have been described in IBS, including more frequent and prominent colonic contractions in response to meals in patients with IBS and diarrhea (IBS-D), and delayed colonic motility or abnormal colonic propulsive activity in patients with IBS and constipation (IBS-C).[1] Additionally, disorders of evacuation, as seen with puborectalis dysfunction or a rectocele, may also play a role, either alone or in conjunction with abnormal motility, in some IBS patients.Visceral hypersensitivity has long been accepted as an important feature in a subset of IBS patients and has even been suggested by some to be a biological marker of the condition.[2] Until recently, the concept of visceral hypersensitivity was based largely upon studies that identified differences in patient pain response or cortical activation measured by brain imaging techniques following painful visceral distention. An interesting recent study using functional magnetic resonance imaging (fMRI) found that subliminal rectal distention resulted in a greater volume of cortical activation in IBS patients than in controls. By eliminating the effects of stimulus-related cognitive processes through the use of subliminal stimuli, *this study more definitively established the hypersensitivity of neural circuitry involved in visceral sensation in IBS patients*.[3]The enteric nervous system (ENS) regulates motor, secretory, and sensory functions through an extensive neural network contained within the GI tract. It functions semiautonomously, but is influenced by bidirectional communication with the central nervous system (CNS) through the autonomic nervous system (ANS). Numerous neurotransmitters and neuropeptides have been identified in the ENS, including calcitonin-gene receptor protein, substance P (SP), vasoactive intestinal peptide, nitric oxide, adenosine triphosphate, acetylcholine, and serotonin (5-hydroxytryptamine [5-HT]). Current understanding of the compex interaction between the nerves and muscles of the GI tract with the various neurohormones and peptides serves as the basis for much of the discussion on emerging therapeutic options for IBS."http://www.medscape.com/viewarticle/548600_2


----------



## eric (Jul 8, 1999)

In some ways you can view pain in IBS as a kind of headache or migrane in the "gut brain" where the pain is processed in the brain.


----------



## 20784 (Feb 6, 2006)

hi...have read this post with interest. I too get the vibration feeling in my intestines that the initial post described. Its a bizarre feeling...like I have swallowed a mobile phone set on vibrate........if I have understood the posts correctly, is it thought that this is NOT a festure of IBS??? Do msot IBS sufferers not experince this?What is causing this?


----------



## 14473 (Mar 20, 2006)

hi kimstaIs this vibration feeling mornally in the same place? I get this feeling that I can feel with my hands (can last up to half hour and then can stop for a while). Might get it a couple of times a day. For me it is mainly on the righ side of my abdomen. Have no idea what it is - would love to know.


----------



## 20784 (Feb 6, 2006)

hello,I feel my vibrations all along my abdomen under my belly button.....so lower abdomen really......I too can at times feel it with my hands or even without........my gastro said it was just me bing hypersensitive to colonic movement......and was baffled about the vibrations


----------



## flux (Dec 13, 1998)

> quote:I too get the vibration feeling in my intestines that the initial post described. Its a bizarre feeling...like I have swallowed a mobile phone set on vibrate........if I have understood the posts correctly, is it thought that this is NOT a festure of IBS??? Do msot IBS sufferers not experince this?


No, it is not a symptom of IBS. It's actually unknown to medical science. And it's suddenly becoming oddly common as if there is a new disease out there.







Whatever it is you have, it ain't IBS.


> quote:t........my gastro said it was just me bing hypersensitive to colonic movement.....


That's clearly *not* the case. Hypersensitivity applies only to the visceral nerves, which cannot sense vibration, and that fact that you feel it with your hands prove it is a physical phenomenon.


----------



## 14416 (Jun 21, 2005)

What would actually be causing the extreme cramping pain in my intestines? Feels like my colon is being wrung out like a washrag full of water. Are they involuntary, normal contractions that, as an IBS sufferer, I'm just more sensitive to? Or is that cramping pain caused by something completely different?Is visceral hypersensitivity meaning as IBS sufferers we're hyper-aware of certain actions of the nerves that we interpret as painful when most (non-IBS sufferer) would not?


----------



## Kathleen M. (Nov 16, 1999)

While the allergy shots bothered my IBS before it was under control, I don't seem to have IBS problems from my respiratory allergies at this time.I did think about the Gastrocrom, but that doesn't seem to be what my problem with the IBS was. More pain from the nervous system than diarrhea from the mast cells.K.


----------



## flux (Dec 13, 1998)

> quote:What would actually be causing the extreme cramping pain in my intestines? Feels like my colon is being wrung out like a washrag full of water.Are they involuntary, normal contractions that, as an IBS sufferer, I'm just more sensitive to? Or is that cramping pain caused by something completely different?


Visceral hypersensitivity (along dysfunctional pain processing in the brain) is primarily responsible. There may be diffferences in motility such as more frequent contractions, but these contractions wouldn't cause pain in a healthy person, but they do in IBS, so the combination of two makes just results in more pain.


> quote:I think it is possible these changes in muscle composition and movement could account for the feeling that some people describe as 'spasms'.


In IBS, no. Even in diverticular disease, it appears that visceral hypersensitivity and altered motility as I described above is primarily responsible for the pain.However, none of this is related to the "vibration" phenomenon.


----------



## Kathleen M. (Nov 16, 1999)

I'm wondering if the vibrational might be in the muscle wall rather than the colon?I get a "tic" in my eyelids once in awhile that may be stress/lack of sleep related and that feels a bit vibrational more than anything I had from the IBS.http://www.nlm.nih.gov/medlineplus/ency/article/000756.htm describes it pretty well.My understanding, mostly from experience (IBS and the time I had a nerve cut to a finger tip that regrew) is that when the pain nerves are sending signals inappropriately it is like the "volume knob" is uncoupled from the amount of stimulus that should set it. Sometimes it is like the volume is on full blast all the time, no matter what stimulates the nerve. When the nerve grew back to the end of the finger anything touching the fingertip no matter how gentle was hugely painful. I didn't really notice much difference between a very light touch or a hard bump. Eveything was at full "volume" pain wise.I think that is one of the thing that can be frustrating about IBS. Surely if something hurts that darn much something really bad must be happening. Sometimes it's like putting on a soft sweater when my fingertip nerve was fresh, lots of "noise" for no good reason.K.


----------



## Janet Robinson (Sep 21, 2006)

yes they are spasms, my gi doctor and I have discussed this matter, yes by muscles and trapped gas.when you can't life your leg to tie your shoe thats a knot which is a spasm. i am sure


----------



## Twocups424 (Mar 26, 2002)

Absolutely they are!!!!!!!!!


----------



## Kathleen M. (Nov 16, 1999)

I don't think there is a way to test for the composition of the muscles of the colon wall.I mean you might be able to do a biopsy of the muscles but I think the risk of perforating the colon by doing that might make it really unusual to check what is going on with the muscle fibers (if that is what you meant?) They do for some diseases of the muscular system take samples of the muscle to look at it and figure out what is going on. Taking a little bit of a bicep isn't that much of a big deal. Taking some of the wall of the colon out you might make a problem where you have to surgically repair the hole you made in the wall (or hope you didn't take too much because once that perforates the risk of dying from sepsis is pretty high)They usually look at the lining of the colon for signs of inflamation. There are a few tests where they look at the functioning of muscles but that is much rarer than looking at the lining or for macroscopic anatomical issues like prolapses or diverticuli, things you see in a barium enema.A colonoscopy wouldn't tell you anything about the functioning or the composition of the muscle wall of the colon, you may see some of the anatomy of the colon over all but they mostly look at and sample the lining.They do sitz marker testing and manometry in some cases to see if the problem is just stool consistancy rather than the colon can't move things along properly, or can't relax the anus properly to pass stool, but they really don't look at what is wrong with the muscles, just check the function of them.Also altered motility doesn't mean that the muscles aren't working right. Look at something like parkinson's disease, the muscles of the body will work but the signals telling them what to do aren't right and you get tremors. The involuntary muscles of the GI tract also get signals telling them when to do their thing, so you could have a lot of problems if the signalling is messed up. Think of traffic when the power is out compared to when the traffic lights are all working. The cars run the same in both situations, but they don't have the structure telling them when to stop and go in an efficient manner. Drugs like Lotronex and Zelnorm target the nerves and can correct the motility issues without in anyway being able to restructure the muscles back to normal.Also, the vast majority of people with diverticuli (if you live long enough most people will get them, the issues in your post might be the people that get a lot of them at an unusually early age) never know they have them. They have no symptoms at all until of them until one of them gets infected. Some people do, but is the pain from the muscles or the pouches or do they just serve as a trigger for visceral sensitivity??K.


----------



## Kathleen M. (Nov 16, 1999)

I don't think CT scans get down to the microscopic level. That the wall is thick may not tell you much as to they why. Inflamation can do that. The more detailed you want the scan the more X-rays you have to take. (warning, geeky side of work coming through here) The amount of detail you can see is partly based on the reconstruction algorithms, but mostly due to the density of rays you take. To see something microscopic like how thick a bowel wall is takes a heck of a lot of rays (the more rays the more expensive the device is), to see the fine structure of the muscles would probably be outside the range of what they do with those instruments. Usually if you want to see the microscopic structure taking a sample and running it under a microscope is what they'd do. I mean with a tumor they may see it in the CT scan or MRI or other scan, but to know if it is cancer, or what stage of cancer they usually need to take some out and look at it, so I don't think they can do cellular structure.Back to the rays (and the geekiness) if you want to see something well you need to get several intersecting rays going through it. So at the cellular level you'd need several rays per cell and that just gets really hard to do. To see how thick the wall is you need several rays going through that part of the wall which may have thousands or millions of cells depending on how big a piece you are looking at.CT scans speaking in the theoretical case may be safer than some other tests if you think there is severe enough diverticular disease that you risk perforation. It becomes one of those cost/benefit decisions. How much risk is there that doing the test that is many times more expensive really needed.Zelnorm tends to speed up the bowel so is for constipation. Lotronex is the one for diarrhea.Many diseases have GI symptoms, I don't know if hypothalmus isues do.K.


----------



## eric (Jul 8, 1999)

Zelnorm works on serotonin receptors and the release of serotonin, its not really a sedative.Auburn, there is a lot of research in IBS on mast cells and on the HPA axis. The HPA axis is the bodies stress system, but it also helps fight infection. The mast cells can be triggered by chronic stressors. There is a lot on all this in regards to IBS, it is part of the picture.


----------



## 21198 (Dec 10, 2006)

You are becoming very informed on IBS very fast for being so new here ,you should consider a career in treatment of IBS -internist/colonic therapy tech/proctologist/nutritionist , most the people in those fields (colonic therapy tech )were problem IBS patients and thrugh researching cures for their own IBS ,they became so well versed in treating it ,its a small step to be on the other end of the problem . Spasms are a very common symptom of IBS ,as the intestines are trying to move along wastes thru 20 feet of twisting turning narrow passages ,and are having to readjust their normal rythm to a new snhedule from not eating right/poop in pubic phobia /stress ,etc..So try to set a private quiet time to go potty every day or 2 to get the intestines back to a normal pattern again , good luck


----------



## Kathleen M. (Nov 16, 1999)

> quote:I realise gut wall muscle is smooth muscle, different to other muscles in our bodies. So maybe different rules apply, and maybe that blows my hypothesis out of the water anyway


However there is still the brain-gut interactions that may be very similar, and after all the % of people with FM that have IBS is very high and some of the same medications that work for FM pain work for IBS pain so I think there may be something that works with that idea







K.


----------



## Kathleen M. (Nov 16, 1999)

Oh, also one doctor here did an article for the health magazine the hospital puts out that had basically that as an overarching theory of all of these functional disorders and a lot of post-trauma chronic pain syndromes.The part has nerves that normally get feedback from other body parts or the brain to function correctly. If the part gets cut off from the proper feedback it does the best it can on it's own. Most of the parts can do things on their own they just get them coordinated so they are "in sync" with the whole. So with an injury or illness it gets disconnected and then it still does all it's functions right, it just doesn't do them when or how it is supposed to do them. So this can cause pain or other disruptions that don't show up on most medical tests. It can do everything it should it just isn't doing it when or to the amplitude it should. So if you test for "can it" the answer is yes. Finding out is it getting the right information is a lot harder to test for.This is why sometimes mind-body medicine can work for a lot of these things. Using various techniques you find another path to get the part so it gets the feedback it needs so it functions at the right time and place and amount most of the time rather than just doing it's own thing until it hears that it should do otherwise.K.


----------



## 21198 (Dec 10, 2006)

Oh #### ,I didnt realize you werent knew , Im the newbie thats why I didnt recognize your name ,my bad for not lookin at your sign up date right at the bottonm of your post,I deserve to be whipped with an enema hose here , a thousand pardons please Im sorry , I should read before opening my mouth


----------



## flux (Dec 13, 1998)

> quote:I'm wondering if the vibrational might be in the muscle wall rather than the colon?


No, these are are skeletal muscle fasiculations.And please, don't anybody mention...butterflies.







Uh-oh.Now we're look how many different things are being talking about and _confused_ in a single thread again.There are now 1) Spasms2) IBS3) Butterflies4) Fasiculations6) The "vibration" thingI consider 1 and 2 to be the same thing and solely a product of sensation and does not imply any abnormal contraction in the gut. That's why the term "spasm" should be abandoned because it implies something that ain't.Butterflies is also a strange phenonemon, the mechanism of which is unknown, but at least it appears to be universal and everyone knows what it is and what's it's not. Hint: it's not related to any of the other things in the list. Fasiculations are like the eyelid "tic" as K described.The "vibration" thing is a very strange phenonemon that we know that is *not* related to any of the other things in the list. It's clearly coming from _inside the lumen of the intestine_, but beyond that we don't know much. It appears rare enough that there is no report of it in the medical literature.


> quote:Surely 'altered motility' could be caused by changes in the muscle wall of the colon.


Well, there are two kinds of changes that you could be talking about. There are large scale changes such as strictures. These can be picked up by CT scan. And there disease states of the muscle that occur on a microscopic scale, which certain rare diseases that include bodywide mitochondrial myopathies and specific intestinal myopathies such as myopathic pseudoobstruction.


----------



## 21198 (Dec 10, 2006)

Tha/n/ks for explaining some of the mental aspects of IBS , but no one mentioned my phobia the "cant poop in public syndrome/' is there a s/cienti/fic term for thAt ?Im sure there must be,as a lot of others have told me of the same phobia ,(it seems to effect more women than men by a long shot ),is there a psych reason that can be the root of this problem ?? Are there any courses of therapy/hypnosis for it ??I know that was 50 % of the reason i GOT ibs AT 14 ,when I started high school I was afraid of some upperclassman walkin i on me while I was trying to squeeze out a Lincoln Log and Id clog the toilet and he would tell the whole school.My cousin did a short time before , wher I was staying at my cuzs with my mom I went pottyand didnt flush it ( I had to show my mom proof I went in those days ),and my cousin Rose went in and seen it ,and came out laughing and hshouted to everyone Pat just pooped a brick ,go look at it ,and all my cousins and aunts looked and bustedup in tears they laughed so hard !!I was so embarrassed I wanted to die


----------



## 21198 (Dec 10, 2006)

Wel at 13 in front of my cuz it was embarrassing,now I dont care though .But my point was the public poop phobia ,that started from that and continues today even.I know from asking girls I dated that most girls all have that cant poop in pubic bathroom problem, why is that ,why are women more uptight aqbout pooping in a park or gas staion bathroom ??After all its just you girls in bathroom together ,no guys are in there ,why uptight to poop , is it the unsanitary conditions of public loos ?


----------



## Kathleen M. (Nov 16, 1999)

I've never had that particular phobia, but I do think some people can feel as if they aren't supposed to have bodily functions, and if they haven't figured out how to survive like that they definitely cannot let anyone else know that still happens to them.For some reason "everyone does it" can't over-rule that. Girls are actually harder on other girls than they are guys so I could see where being around other girls doing a bodily function you are supposed to pretend NEVER happens to you may cause one to be even more uptight than one would be around guys. Like with farting, guys may kid about it when it happens, but it tends to be good natured. Other girls may use the fact you actually still have bodily functions in nasty little jokes. If you can't admit you do it, you can't do it around other people, especially if the other people might be catty about it later.Some people do have cleanliness issues, but I think the "don't let anyone else know you poop" thing tends to be the bigger issue for a lot of people.Usually the woman in pairs is more about the preping to get back out in the world than the sharing of bodily functions. Guys sometimes like to share their bodily functions, but woman don't.K.


----------



## flux (Dec 13, 1998)

> quote:no one mentioned my phobia the "cant poop in public syndrome/' is there a s/cienti/fic term for thAt ?


parcopresisYou can get more information about it at http://home.freeuk.net/parcopresis/


----------



## eric (Jul 8, 1999)

This is a new study on children and IBS and FD.J Pediatr. 2007 Jan;150(1):66-71.Somatic Referral of Visceral Sensations and Rectal Sensory Threshold for Pain in Children with Functional Gastrointestinal Disorders.Faure C, Wieckowska A. Department of Pediatrics, Division of Pediatric Gastroenterology, Hopital Sainte-Justine, Universite de Montreal, Montreal, Quebec, Canada.OBJECTIVE: To test the hypothesis that abdominal pain related to functional gastrointestinal disorders is associated with visceral hypersensitivity and abnormal perception of visceral sensations. STUDY DESIGN: We examined 35 children (10-17.6 years old) fulfilling the Rome II criteria with irritable bowel syndrome (IBS; n = 21), functional abdominal pain (FAP; n = 8) or functional dyspepsia (FD; n = 6) compared with 10 control subjects (10.2-16.1 years). All underwent a rectal barostat examination. Painful sensations were reported on a human body diagram. The projections of sensations induced by rectal distension, the rectal sensory threshold for pain (RSTP) and the diagnostic value of RSTP measurements were measured. RESULTS: Rectal distension induced sensations that projected to the S3 dermatome in the control subjects and FD and to aberrant sites in children with IBS and FAP. The RSTP was decreased in children with IBS and FAP compared with control subjects (P <.002) and was not different in children with FD compared with control subjects. At 30.8 mm Hg, the 5th percentile for the control subjects, the RSTP had a sensitivity rate of 89% and a specificity rate of 83% for IBS and FAP diagnosis. CONCLUSION: Children with IBS and FAP are characterized by the association of rectal hypersensitivity and abnormal pain referral after rectal distension.PMID: 17188617


----------



## eric (Jul 8, 1999)

Auburn, as you probably already know I have done a ton of research on IBS.I am not sure how much you have read up on the role of chronic stressors and mast cells.Most people are more familar with mast cells and allergies, but they are also very important in stress reactions. There is a lot of info on mast cells and IBS and chronic stress. The stress can reinflame previous inflammation, cause gut permeabiltiy, and through stress activate the HPA axis, which in turn degradulates mast cells in the gut that then release a variety of mediators, but importantly histimine, which is "toxic" to the smooth musle and it then reacts. This all can contribute to pain in IBS, but its not the whole picture. Serotonin is very important because it is the chemical that sends the message from the gut through nerve fibers to the brain. It also intiates contractions of the gut. A lot of evidence points to a problem with serotonin, which by the way mast cells can release as well.I don't personally believe drugs are the only answer to IBS either, although you have comorbid problems. I do feel there is a role for them and if one works great. In all the years I had IBS drugs for me never really helped, or helped slightly or helped for a little bit then stopped. There is one new one being tested for a chemical called CRF a stress chemical that I am interested in perhaps in the future after its really been tested and out there for a bit.How long were you on the Amitryptiline for out of curiousity.I can tell you I was d/c and had very very severe pain and a lot of other symptoms including non gi symptoms. I have to say out of all the things I have studied in regards to IBS treatments, HT has the highest statistical success rates on IBS and this is important, global symptoms. It has a high success rate and a high success rate for pain and it can work long term, up to five years in one study of 250 people.It was personally the best thing I have ever done in 35 plus years of IBS and numerous drugs and otc's etc.. To me it was fantastic I had so much success with it and in my case listening to a tape. I never would have thought it and more then thrilled I did it and then here many many others have as well. Most of them left the bb.Have you ever read this thread.http://ibsgroup.org/groupee/forums/a/tpc/f...0261/m/10210344 It is very safe and has virtually no side effects. If it was called something else it would be posted all over the place, but a lot of people I think don't take it as serious well researched treatment, which is a real shame really.I know it works psychophysiologically, both on the gut and the brain and both mentally and physically. There is also new preliminary evidence that it may help the brain downregulate endorphines to the gut, as well as a tool to calm the gut and calm stress and calm anxiety and decrease gastric acid to the gut and works on an area of the brain called the ACC which is also highly implicated in IBS, but there even more then that in the research.I highly recommend it and I am pretty sure it would help mast cells at the very least from stress degrandulation.A couple years ago I was at an IBS support group and they had a hypnotherapist for IBS and he was taking people and having them imagine they were in a beautiful garden and to smell the flowers and use all the senses and one ladies allergy acted up and she started sneezing and her eyes got watery ect..Mast cells are one player though another cell called an ec cell which releases serotonin is also another player. This is another area HT can work on in regards to relaxation and serotonin and different states of the parasymathetic and symnpathetic nervous systems.1 in 3 are helped with antidepressants and IBS, 8 out of 10 with HT and IBS and on global symptoms, not just a couple of symptoms.It also somehow has a way of breaking the vicious cycle and IBS, because a side effect of it is less anxiety and less stress. I personally think more people should try it and more doctors are using it and its recommened by the rome experts and has 20 years of research on it and IBS.However its not a "cure" and it does not help 100% of IBSers. It may not also be the only thing a person needs to do or use, but it is very relaxing and enjoyable for most people. I hope this helps. I think there is always something for a person to try.


----------



## eric (Jul 8, 1999)

This is slighly dated because they mention rome two and were on rome three now but, this is in part and in regards to whats going wrong in IBS.http://www.acponline.org/journals/news/sep03/ibs.htm#body


----------



## eric (Jul 8, 1999)

Auburn, have you ever heard of Neurogenic Inflammation?There are some interesting things about it.Stress in the sense of IBS or basically in any sense is a "Threat to the organism" You might find this interesting.Neurogenic Inflammation in Chronic Pain Conditionshttp://216.109.125.130/search/cache?p=neur...&icp=1&.intl=us


----------



## eric (Jul 8, 1999)

Auburn, out of curiosity what were you doing the HT for?You might try Mike's tapes at home, as they are a different approach to IBS with Gut specific suggestions and a longer course, 100 days with rest days. A major plus is being able to do it at home. It sounds like you could obtain deep relaxation from it. Of course as you said some are not as responsive, but I wouldn't rule it out quite yet. "I found the therapy very pleasant, and enjoyed the deep relaxation I felt during a session, but I felt no different the next day or subsequent days, not even after completing 12 sessions. "That deep relaxation is a major plus and sometimes it takes longer for results. I can tell you more if you like. I personally think it is worth a shoot at his method of HT for IBS.I am not familar with reverse therapy. If it worked thatwould be good and anything that helps to "restore homeostatis." is a good thing.I do know about CBT for IBS, but have not done actual therapy, more my own. It has shown to be effective though. It can be a longer process then the HT usally. But it can also work on some specifics of the person on a concious level.A side effect of Amitryptiline is basically C, which is why its used in D IBSers. If you also have diver are you c predominate? Although that may not have been long enough, and that is something to tell the doc.So you don't take antibiotics for the Diver?Your probably right about being better off without a drug route or try some other methods and see if they help. Have you read this also?The Neurobiology of Stress and EmotionsBy: Emeran A. Mayer, M.D., UCLA Mind Body Collaborative Research Center, UCLA School of Medicine, California http://www.aboutibs.org/Publications/stress.htmlDo you feel you have a good doctor?


----------



## eric (Jul 8, 1999)

Auburn, don't know where you live but perhaps we could find a doctor that might no more about mast cewlls. Its good you have the doctors however.This is some more and I want to make a comment later on it. Have you ever heard of DR Wood?"You have two brains: one in your head and another in your gut. Dr. Jackie D. Wood is a renowned physiologist at The Ohio State University. He calls the second brain, "the-little-brain-in-the-gut." This enteric nervous system is part of the autonomic nervous system and contains over one hundred million neurons, which is as many as are in the spinal cord. This complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. This little brain in the gut is connected to the big brain by the vagus nerves, bundles of nerve fibers running from the GI tract to the head. All neurotransmitters, such as serotonin that are found in the brain are also present in the gut.Dr Wood has discovered that this little-brain-in-the-gut has programs that are designed for our protection and which are very much like computer programs. *They respond to perceived threats in the same way that the limbic system or the emotional brain does. So the threat of a gastrointestinal infection can activate the program that increases gut contractions in order to get rid of the infection. The symptoms are abdominal cramping and diarrhea. * Dr. Wood has determined that a type of cell found in the body and the gut, called the mast cell, is a key to understanding the connection of the big brain in the head with the little-brain-in-the-gut. Mast cells are involved in defense of the body. In response to certain threats or triggers, such as pollen or infection, mast cells release chemicals, such as histamine, that help to fight off the invader. Histamine is one of the chemicals that causes the symptoms of an allergy or a cold. When an infection of the gut occurs, such as food poisoning or gastroenteritis, the mast cells of the gut release histamine. The little-brain-in-the-gut interprets the mast cell signal of histamine release as a threat and calls up a protective program designed to remove the threat â€" at the expense of symptoms: abdominal pain and diarrhea. The brain to mast cell connection has a direct clinical relevance for irritable bowel syndrome and other functional gastrointestinal syndromes. It implies a mechanism for linking allostasis and the good stress response to irritable states (e.g., abdominal pain and diarrhea) of the gut. *Mast cells can be activated to release histamine in response to perceived psychological stress, whether the stressor or trigger is consciously perceived or not. So the end result is the same as if an infection activated the program in the-little-brain-in-the-gut: abdominal pain and diarrhea."*http://www.parkviewpub.com/nuggets/n5.html


----------



## eric (Jul 8, 1999)

Let me know how the therapy works for you.The HPA axis as mentioned before is the bodies "stress system." However it also helps in fighting infections.Have you ever read this?Complex and Hidden Brain in Gut Makes Bellyaches and Butterflies"The two brains may influence each other while in this state. Dr. Wingate said. Patients with bowel problems have been shown to have abnormal REM sleep. This finding is not inconsistent with the folk wisdom that indigestion can produce nightmare. As light is shed oA the circuitly between the two brains, researchers are beginning to understand why people act and feel the way they do. When the central brain encounters a frightening situation, it releases stress hormones that prepare the body to fight or flee. Dr. Gershon said. The stomach contains many sensory nerves that are stimulated by this chemical surge - hence the "butterflies". On the battlefield, the higher brain tells the gut brain to shut down. Dr. Gershon said. "A frightened, running animal does not stop to defecate", he said. Fear also causes the vagus nerve to "turn up the volume" on serotonin circuits in the gut. Dr. Gershon said. Thus overstimulated, the gut goes into higher gear and diarrhea results. Similarly, people sometimes "choke" with emotion. When nerves in the oesophagus are highly stimulated, people have trouble swallowing. Even the so-called "Maalox moment" of advertising fame can be explained by the two brains interacting, said Dr. Jackie D. Wood, chairman of the department of physiology at Ohio State University in Columbus. Stress signals from the head's brain can alter nerve function between the stomach and oesophagus, resulting in heartburn.In cases of extreme stress. Dr. Wood said, *the higher brain seems to protect the gut by sending signals to immunological mast cells in the plexus. The mast cells secrete histamine, prostaglandin and other agents that help produce inflammation, he said. "This is protective. If an animal is in danger and subject to trauma, dirty stuff in the intestines is only a few cells away from the rest of the body. By inflaming the gut, the brain is priming the gut for surveillance. If the barrier breaks, the gut is ready to do repairs". Dr. Wood said. Unfortunately, the chemicals that get released also cause diarrhea and cramping. "*So the flight or flight and the HPA axis and stress and infection and serotonin are all conected.Also on the fight or flight a person can be sacred enough to make them go right away. Hence the term "**** scared out of you."Fear, worry, anger, negative emotions and antisipatory anxiety among others all effect homeostasis (a threat to the organism) and chemical and electrical signalling between the CNS and the ENS or brain gut axis.


----------



## eric (Jul 8, 1999)

This is a really good videoIntegrated Approach to Irritable Bowel Syndromehttp://www.ja-online.com/dukeibs/#


----------



## eric (Jul 8, 1999)

This is brand new an excellent info"Stress and Irritable Bowel Syndrome: Unraveling the CodeBy: Yvette TachÃ©, Ph.D., Center for Neurovisceral Sciences and Women Health, Digestive Diseases Center, Department of Medicine, Digestive Diseases Division, University of California at Los Angeles and VA Greater Los Angeles Health Care System, CaliforniaDr. TachÃ© was the recipient of the IFFGD 2005 Research Award to Senior Investigator, Basic Science. Her early publications put the "brain-gut axis" on the map. Since then, she has been one of the pioneers in this field. In many ways, it has been her energy and enthusiasm that has ensured the continued vibrancy of the field. Her identification of the role of corticotrophin-releasing factor (CRF) signaling pathways in stress-related alterations of gut motor function and visceral pain are of major and lasting importance."http://www.giresearch.org/Tache.html


----------



## eric (Jul 8, 1999)

Auburn, it might be the antidepressants cause constipation in regards to another cell. The EC cell or enterochromaffin cell. This cell stores the majority of serotonin in the gut and releases it to initiate the peristaltic reflexes or gut contractions, along with other key functions. There is quite a bit of evidence something is wrong with the system.However, it is also know that chronic stress and anxiety can contribute to C long term because it uts a person in sympathetic nervous system mode, as opposed to parasympathetic nervous system mode. The first is fight or flight and basically slows down digestion, the other rest and digest.While the mast cells are important so are the ec cells for sure.IBS -- Review and What's NewPosted 07/26/2006Amy Foxx-Orenstein, DO, FACG, FACP Abstract and Introduction"Serotonin SignalingOf the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. The effect of serotonergic mechanisms in the manifestation of IBS symptoms has led to development of a new drug class for the treatment of IBS patients: the GI serotonergic agents.Normal GI function relies on a properly functioning brain-gut axis, which involves the coordinated interplay of the GI musculature, the CNS, the autonomic nervous system, and the enteric nervous system (ENS). The ENS contains millions of neurons embedded in the wall of the digestive tract and functions, at least in part, independently of the CNS. The size, complexity, and independent function of the ENS has resulted in application of the terms "the second brain" and "the mini-brain."[81] Impaired function or coordination of any of these systems, or the communication between these systems and the GI musculature, can lead to symptoms of dysmotility and altered sensory perception, which are characteristic of IBS and select other GI motility disorders.[82]The neurotransmitter serotonin (5-hydroxytryptamine [5-HT]) is a predominant signaling molecule in the ENS. Most (90% to 95%) of the body's serotonin is found in the gut, and smaller amounts are found in the brain (about 3%) and in platelets (about 2%).[83] In the GI tract, serotonin facilitates communication between the ENS and its effector systems (muscles, secretory endothelium, endocrine cells, and vasculature of the GI tract), thus playing a key role in normal GI tract functioning.[84] In addition, serotonin plays a role in the communication between the ENS and the CNS.In the gut, serotonin is synthesized by and stored in the enterochromaffin cells, which are located within the mucosa of the intestinal wall. When material passes through the lumen and the mucosa is stimulated, enterochromaffin cells release serotonin, which then binds to its receptors (primarily 5-HT1P receptors) on intrinsic primary afferent neurons, initiating peristalsis and secretion. Serotonin also binds to 5-HT4 receptors on interneurons, which augments the transmission of signals to motor neurons, resulting in enhanced peristaltic activity. In transgenic mice lacking 5-HT4 receptors, colonic motility is abnormally slow, confirming the role of these receptors in facilitating normal colonic motility.[85] By binding to 5-HT3 receptors on efferent sensory innervations coming from the vagus and the spinal nerves, serotonin mediates signaling between the ENS and the CNS and, thus, modulates pain perception.To regulate the signaling process, excess serotonin must be removed; this is accomplished by the SERT molecule expressed by intestinal epithelial cells.[86] Human studies have shown that defects in serotonin signaling contribute to the pathophysiology of IBS and, potentially, other GI motility disorders. In a recent study by Coates and colleagues,[87] biopsy specimens from patients with IBS showed significantly lower mucosal serotonin concentrations than those from healthy controls, potentially the result of lower mRNA levels for tryptophan hydroxylase (the rate-limiting enzyme in serotonin synthesis), which were also significantly lower in patients with inflammatory bowel disease.[87] There was no significant difference in the number of enterochromaffin cells or in the capacity of these cells to release serotonin under stimulated conditions. In another study, higher serotonin levels were observed in mucosal biopsy samples from patients with IBS with constipation (IBS-C) than in patients with IBS-D or in healthy volunteers.[88]Serotonin levels may also be affected by altering the amount or function of SERT. The study by Coates and colleagues[87] showed a significant decrease in the level of SERT mRNA and SERT protein expressed in the intestinal epithelial cells of IBS patients compared with that of healthy volunteers. In another study,[89] SERT expression and binding capacity in platelets were decreased in women with IBS-D compared with expression and binding capacity in healthy controls. Furthermore, Chen and colleagues[90] showed that mice with a SERT gene deletion had altered colonic motility. It is interesting to note that the mice thrived in laboratory housing conditions, indicating that other transporters could compensate for the lack of SERT. Additional studies have focused on SERT polymorphisms. Yeo and colleagues[91] showed an association between patients with IBS-D and the homozygous short polymorphism of the SERT gene promoter. This mutation results in lower levels of SERT gene transcription and reduced amounts of SERT protein available for reuptake of serotonin. In addition, Camilleri and colleagues[92] showed a possible link between the long promoter polymorphism and patient response to therapy.Thus, a substantially large body of work shows that normal gut physiology is predicated on the interplay between the GI musculature and the ENS, autonomic nervous system, and CNS. One of the central mediators of this complex interplay is the neurotransmitter serotonin. Impairment or imbalance in serotonergic signaling, which can affect GI motility, secretion, and visceral sensitivity, may be affected by defects or deficiencies in serotonin production, specific serotonin receptors, or proteins such as SERT. These changes can manifest in symptoms associated with IBS, including abdominal pain, altered bowel habits (constipation, diarrhea, or alternation between these 2 states), and bloating."http://www.medscape.com/viewarticle/532089_3


----------

