# Gut feelings/ Brainstorms



## eric (Jul 8, 1999)

Brainstorms is a monthly section of The Journal of Clinical PsychiatryGut Feelings About Irritable Bowel Syndrome http://www.psychiatrist.com/pcc/brainstorm/br6208.htm


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## Mike NoLomotil (Jun 6, 2000)

From the essay: _____________________________________"Psychiatrist to gastroenterologist: "Isn't it surprising how many brain neurotransmitters are also in the gut?" Gastroenterologist to psychiatrist: "Not at all, but it sure is interesting how many gut neurotransmitters are in the brain." _____________________________________addendum, from the endocrinologist to both:"...and isn't it interesting how specific hormones affect, among other things, the ENS, CNS and GI function as well?"then from the immunologist to all:"...and isn't it interesting aberrant immune responses release of proinflmmatory mediators from mucosal immunocytes and circulating immunocytes affecting the enteric nervous system, central nervous system, enteric smooth muscle and endocrine systems all interractively?"The attached essay is a very good essay from the perspective of the psychiatrist approach to IBS. If that perspective could be integrated fully with the perspectives of each of the other specialties and thier views on the etiology of IBS, then some day this quote, also from the article, could be eradicated from the literature: ______________________________________"Although the cause of IBS is unknown,..." ______________________________________At least everyone agrees with the material in the essay as far as it goes, and with this assessment from the essay...: ______________________________________"... it is known to be associated with increased sensitivity and activity of the GI tract, which lead to abnormal sensations of pain and motor activity, i.e., IBS patients feel more pain and discomfort with rectal distention than do normal volunteers." ______________________________________It is also apparent that "how" this end game of upregulation occurs is just beginning to be understood, but the multiple pathways that lead to the end result described remain to be fully elucidated. These need to be integrated into a complete working model of all the interractive systems, any of which can serve as a primary source of insult leading to activation of the others.This essay does make it easier for lay people to understand the single modality perspectives of psychopharmacotherapies. It is not, though, the approach which produces the best possible outcomes. An integrative approach is not described. As is usually the case in these essays, one area or another of integrative therapy is given short-shrift, depebding upon the the background, area of expertise, and thus perspective of the author.Eat well. Think well. be well.MNL


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## LML (Jul 17, 2001)

Mike You seem like a very kind, intellegent and humorous person. These qualities make me enjoy reading and learning from your posts. But since your focus is primarily on integrating food intolerance into IBS treatment, and I'm one of the unfortunate ones who don't match the criteria for this aspect of IBS, I do get frustrated when you sometimes make it sound as though this is a major part of the/my solution to IBS symptoms.I know you advocate looking at all parts of the issue and I'm happy for those who find relief by learning to deal with their food issues. But for that evident minority of us for which food doesn't play any significant role, it's just as frustrating to hear that we must always include the food issue as it seems to be for you when other information that we need to understand is presented without food!I agree that a balanced approach is the best, but if we're to find real solutions, it's important to remember that the presentation of IBS is greatly individual. I do so wish dealing with foods could be my solution, but it's not. And I think we as individuals should be able to balance the information ourselves we find here without someone always feeling some particular aspect is being given short shrift. Make sense? I hope so!


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