# eric and other vets need to help a newbie



## BryterLayter (Dec 15, 2007)

Hello all,I'm a new guy here and I just wanted to post my story. I'm hoping that some veterans here can answer some questions and make some suggestions.I have not been labeled as having IBS by a doctor yet because I have not had an appointment with a GI doctor yet to rule things out. I have been to a regular GP (family doctor) that has just referred me to a GI doctor at the end of January. But first read my story please.In September I was travelling around Europe for a few weeks. The first days were fine there but then I kept on experiencing some stomach virus that kept on going on. The virus seemed to calm down but then I began to experience serious bouts of morning D attacks. It was so bad that I was losing weight and getting dehydrated. So, I ended the rest of my travels and came home early back to the USA.In the USA I quickly went to the a doctor who dismissed my case and just called it a travel virus that should go away. All she told me was to take was Imodium. Obviously my gut did not heal and the morning attacks kept on going and I became sensitive to things like soda and heavy meals.I changed my diet and started to eat yogurt. The attacks sort of died down the D switch to multiple soft BM's instead. I went back to this same doctor again and she did not do anything except give me Paxil. I urged her to give me the Rifax antibiotic but she did not, she just gave me a couple of Cipro which did not help to cure anything and just made me feel more sick.By November, I began to just do self-care of myself. I was taking vitamins, probiotics, calcium, peppermint oil, calming tea, enzymes, Imodium, gas-x and so on. I read almost every book I could find at the library about IBS and digestive disorders. Since the end of November, this IBS-A pattern of mine has switch to mainly like a IBS-C way. But the thing is I have BM every day, it involves lots of straining but I am still glad I am able to evacuate myself. I'm sure I'm still in the IBS-A class that was started by PI-IBS but it's all confusing to me. I guess it's confusing to doctors too because they don't know the cause or the cure of anything.So, for the past two weeks I have been getting the pellet type BM, which are talked on GI-IBS website:http://www.gicare.com/pated/ecdgs03.htmWith an alternating pattern, I feel irritable all day, a feeling that feels like I have a sensitive D-oriented type stomach with lots of trapped gas but then when I actually go try a BM, it's only the hard straining pelletsThe pains have died down a bit. The pain on the upper left ab only comes now after a BM or eating a very large meal.I currently still take a Paxil, vitamins, enzymes, lots of water, calcium, peppermint oil, and lots of water. It seems that I'm far off from a cure, especially with this confusing alternating pattern.I'm going to quit this Paxil after I see the GI, I never knew why I was given it to me in the first place. Anybody who is having digestion, stomach, and colon problems is going to be frustrated and a little stressed out. I have not tried fiber supplements because I'm afraid things will get worse.I never had any stomach, colon, and digestion problems in my life. So yes, I will see what the GI suspects when I visit him at the end of January. But as for right now I'm chalking it up as IBS-A that was set on by some travel virus or food virus.So, here are my questions for you veterans (survivors) and other more experienced people:-Is it true that IBS-A is mostly associated with PI-IBS?-What majority of your guys/girls have been tested for food allergies and intolerance? -Do people get cured after they have found SIBO? -Would you say that people who got IBS as adults because of some infection, allergy, intolerance or surgery experience IBS differently than IBSers who have had it since childhood and are facing more psychological issues of childhood trauma? In other words is the cause of adult-onset-IBS mainly a bacteria-allergy-intolerance-surgery-psychical caused issue?-And this serotonin issue. Some books say that serotonin is lacking in people who have IBS-C and that IBS-D people have too much serotonin. What do you think about this? And what about IBS-A people then, do they lack, have too much, or are just have totally mixed up serotonin issues? I don't get it and I sort of don't believe this serotonin issue with IBS because I never heard anybody getting cured from taking an anti-depressant. Sure, there is 98% of serotonin in your gut but taking a pill that has the side effects of D, C, nausea, ulcers and so on is not really going to help any digestion or colon issue. It might knock out some pain in your brain signals but it's not going to cure IBS.-Would some of the veterans mind posting some of their daily (or better yet weekly) routine of supplements and foods that are working for you&#8230;please.


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## SpAsMaN* (May 11, 2002)

I haven't found people with SIBO yet.


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## overitnow (Nov 25, 2001)

I had only IBS-D for 10 years. Since 1998 I have been taking a flavonoid supplement called Provex CV daily for my cholesterol issues. Since September of 1998 I have had no digestive problems and since the end of 1999 no bowel problems. It has helped others with pain problems.Mark


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## eric (Jul 8, 1999)

I have to come back to this, but its good your going to see a gi doctor. It maybe you have not fully recovered from the gi infection yet.So it would be good first to do blood work and stool work and see a gi doc."Is it true that IBS-A is mostly associated with PI-IBS?"IBS D is mostly associated with PI IBS, but alternating is possible as well. "What majority of your guys/girls have been tested for food allergies and intolerance?"Food allergies or intolerences don't cause IBS but in some people can contribute to the symptoms or they can have more then one condition going on at once."Do people get cured after they have found SIBO? "Sibo is another functional issue, so it might depend on what causes the sibo in the first place. The speculation that sibo causes IBS is not working out so well. So this is a seperate issue some people have along with IBS. I will come back with the rest of your questions but you might want to read this also.altered serotonin signaling and ibs compilationhttp://www.ibsgroup.org/forums/index.php?showtopic=80198There are two cells in IBS that seem to be very important, ec cells and mast cells.


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## BryterLayter (Dec 15, 2007)

thanks for your help so far. and thanks for taking the time out to answer some questions. I would still like to hear from other vets and see what things which worked for them. The bad thing is that most of the people who have cured their IBS completely are probably not an active member of these forums any longer.On this GI website, this doctor explains just a brief description of IBS and how IBS-D can alternate mysteriously to a straining BM phase. It just confuses me that if IBS cases are the most frequent cases that GI doctors see each day, why in the year 2007 has there not been an effective treatment or even some exact causes. It seems to me that the IBSers and the doctors are just here in 2007 still guessing about everything.thanks again.


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## eric (Jul 8, 1999)

"thanks for your help so far. and thanks for taking the time out to answer some questions"No problemIts important to understand IBS is a chronic condition. There are not a bunch of "cured" IBSers running around. Managed better and some almost symptom free perhaps, but "cured" isn't a word used in IBS. Also about ten percent for some reason just get better.There seems to be different cell pathologies for one in different groups of IBSers. For example there are important cellular changes in Post infection IBS after the resolution of the intial infection.Some of these changes are also seen in IBS and some of the problems are also seem connected.like migranes are chronicThe digestive system is extremely complex and the connections to digestion and the brain are extremly complex.you might want to watch all these.At IFFGD's 7th International Symposium on Functional Gastrointestinal Disorders in April 2007, we had the opportunity to talk to some of the international experts in functional GI disorders. Our discussions covered some of the most recent developments in this field. Click the topic titles below to go to the video interviews!http://www.aboutibs.org/site/learning-center/video-corner/


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## 16229 (Jan 28, 2006)

> -Is it true that IBS-A is mostly associated with PI-IBS?


As Eric said, D, but it can develop over time. I think in the next few years, doctors will start to treat the d from GI infections more aggressively, and that may help in the reduction of occurrence or length of PI-IBS. I think once we get out of whack down there it is hard for the body to get back to normal. Obviously some of us are better at rebounding from these things than others.


> -What majority of your guys/girls have been tested for food allergies and intolerance?


Probably not very many. Since 95% of those with IBS gain improvement by either diet or medication, that would leave only the last 5% that would be tested for more than the basic intolerances, like Celiac. But, on the flip side, that 5% is much more likely to be on the boards here. Research indicates that food allergies or intolerance don't cause IBS, so not many doctors are very inclined to send people for testing for it.


> -Do people get cured after they have found SIBO?


People can get better (don't know if you'd go as far as cured) and in some cases SIBO can be more manageable. But there are a lot of things that can cause the SIBO (motility disorders, IBD, etc), so it would be hard to say what one could expect from SIBO treatment. There are a couple good antibiotics that act locally that are effective with dealing with the bacterial part of the problem. Beyond that, it is much more individual.


> -Would you say that people who got IBS as adults because of some infection, allergy, intolerance or surgery experience IBS differently than IBSers who have had it since childhood and are facing more psychological issues of childhood trauma? In other words is the cause of adult-onset-IBS mainly a bacteria-allergy-intolerance-surgery-psychical caused issue?


I don't know that it has anything to do with child vs. adult, but IBS is almost certainly a series of closely related disorders that have not been defined enough yet to fully separate them, with the exception being PI-IBS. I don't think it breaks down on the c, d and a lines either. Your gut is tied to your "fight or flight" nervous system and one's psychological reactions cannot be predicted, nor can they be tied exclusively to an age. So yes, I think there are quite a few different groups of us. But we still may be a bit away from understanding how the subgroups of IBS really differ from each other.


> -And this serotonin issue. Some books say that serotonin is lacking in people who have IBS-C and that IBS-D people have too much serotonin. What do you think about this? And what about IBS-A people then, do they lack, have too much, or are just have totally mixed up serotonin issues? I don't get it and I sort of don't believe this serotonin issue with IBS because I never heard anybody getting cured from taking an anti-depressant. Sure, there is 98% of serotonin in your gut but taking a pill that has the side effects of D, C, nausea, ulcers and so on is not really going to help any digestion or colon issue. It might knock out some pain in your brain signals but it's not going to cure IBS.


A pretty good case has been made in regards to seratonin. Personally, I think it's a little over-hyped, but that is different from saying it doesn't exist. That, and we're not very good at controlling seratonin levels. There are so many choices, but not much of a clue as to what will work for who or if it will help someone specifically at all. So a lot of people go from med to med with terrible side effects and no help with the original problem. But, there are others who find relief with one of these drugs. Perhaps this could play a more prominent role in one of the subgroups?


> Would some of the veterans mind posting some of their daily (or better yet weekly) routine of supplements and foods that are working for you&#8230;please.


It's tough for anyone to tell anyone what to take. Ask 100 IBS'ers and you're likely to get 90 different answers. With my other conditions, it's kind of hard for me to say with much accuracy to that either.Did you start taking all of these supplements at the same time? Just wondering how much you can measure how much any one thing is helping or hurting if you go on a bunch of things together. Dosage can be important, too. Like taking too much calcium may stop you up. A lower dosage may still relieve d without causing c.Any supplement I take, I usually start at half the recommended dosage. After a couple of weeks or a month, I'll up the dosage to a fuller level if I'm not having bad side effects. But with some things, I have ended up coming back down in dosage and achieved what I consider to be better results. One example of that for me is probiotics. I kept taking these mega pills that had 10,15,50 or more billions of bacteria and they would all make me nuts. But when I switched to a much milder probiotic and dosage (1 billion) it actually started to help some with my cramps and firm up my bowel movements.Unfortunately for too many on this board, the process is all trial and error. And for some of us, actual therapy may be better than any supplement. Even for some of us that feel we have it all together, sometimes we just try to be so strong all the time, and we all need a good way to vent. Behavioral therapies have also proven pretty effective with certain people with IBS and there's plenty here that will attest to hypnotherapy as well. Then there is biofeedback, or as I say, the X-therapy. That seems to help more with people who have c, but can also help people visualize bodily responses if behavioral therapy isn't enough.


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## Guest (Dec 18, 2007)

Very well said ArtJunky and Eric!You both are an asset to our website. Your replies to BryterLayter's posting... a new member, are terrific! I wish some others would simplify their messages thus, easily understanding in laymen's terms what they mean. I was irked by one reply that I received, that even my doctor was puzzled with, ha ha.BryterLayter, I too, am new to this wonderful site. Think, I logged onto it during this summer... time flies! There are quite a number of loving and compassionate people who "walked our walk" and I've learned so much about my IBS-D. I understand that "C" is for constipation and "D" for diarrhea, but do not know the other acronyms are i.e. "A", etc. In time, I'll learn more plus get better at navigating.I recently was diagnosed with C. Difficile... a bad bacteria infection in my colon and stomach that is highly contagious via fecal matter. I posted it on the BB (bulletin board) and someone linked me to a sister site that I did not know existed and I found quite a few postings for C. Diff. though, most of the comments were a few years old. Most likely, because of the C. Diff. outbreak a few years in hospitals and nursing homes that killed 28 people in the Province of Quebec, Canada. Also, 1,742 died from it worldwide in 2003. If you have taken a lot of antibiotics recently or within a few years, have "D" and abdominal pain, then get tested for it. It's a very simple test consisting of 3 stool samples. First line of defense is Flagyl (metronizole) 500mg x's @ day for 14 days (what I was prescribed) and it is very inexpensive, cost me $14.27 for 84 pills & pharmacist's fee. This sounds crazy, "prescribed an antibiotic to fix what antibiotics did"!!!Re: Supplements and Food that helps:For me, the following seems to help... if not, at least I'm eating well, ha ha. I've been taking Lactobacillus Acidophilus for about 3 months but, suspended it when I got C. Diff. on Dec. 1st. I did not notice any changes with my "D". My disability health consultant said that I was throwing my money away buying probiotics at a supermarket or drug store i.e. OTC Jamieson products (2 billion active cells). She suggested a health food store but, the 25-35 billion active cell probiotics found in their cooler are very expensive... too rich for me. Also, I was taking a multi-vitamin, Salmon & Fish Oil 1,000 mg (Omega 3) every other day, and Halibut Liver Oil (Vitamin A - 10,000 IU & Vitamin D - 400 IU) the day not taking Salmon & Fish Oil.Plus, I'm taking fibre i.e. Metamucil & BeneFibre, eating All Bran or Raisin Bran for breakfast and I grind some flaxseed that my neighbour gives me from his Organic farm. I rarely eat full meals. Mini meals 4-6 per day help a lot. I make often my own soup, eat Hutterite raised chicken... best chicken I've ever tasted though, very big 6-8 lbs! I get them for only $1.50 lb. I did ask if they were organic but they replied, "they're fed good food", ha ha. A few months ago, I came home from grocery shopping with one of those "meal deals" whole chicken, salad & breadstick. The chicken tasted horrible! Not what I am used too. Believe it or not, I took the half eaten chicken back and got a full refund! ha ha. The package did say, "best chicken you've ever tasted with a 100% money-back guarantee". I still enjoy red meats but, nearly everything is broiled. I enjoy broiled fish too. I rarely eat at restaurants, and if needing to travel (IBSer's nightmare), I usually eat a submarine sandwich or at selective good restaurants.I do not drink colas, egg nog and alcohol but, I drink milk, juice, coffee... yes coffee! Usually 2 cups when I wake up, and a lot of bottled water. Personally, I do not like tea though, there's a lot of benefits with green tea I hear. My doctor thinks that bottle water is a scam! Some days, I believe a glass of milk triggers "D" but some days I have no trouble. I was exasperated with recording all my food intake trying to determine what foods are triggers. Think it was just an exercise or something to do to make you feel that the doctor was interested, ha ha. I share with people that I never had any problems like this before I was married... I've been married now 19 years! ha ha.Well my fellow sufferer, I must sign off now. I do have a blog "adhregina". I trust that our unofficial greeter "Cherrie", who is also one of the site's moderater's welcomed you. If not, I know that she needed a little timeout... sometimes, we get overwhelmed always focused on our disease(s). My social life has suffered as many do not want to hear about bms (bowel movements) all the time or the lack of washrooms in stores, etc. Take care, keep the faith!Tony (nice guy living in rural Saskatchewan, Canada).


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## eric (Jul 8, 1999)

Thanks Tony, hope you can get the C-Diff under control soon.This is some excellent up to date Post Infectious IBS info.Post-infectious Irritable Bowel SyndromeRobin Spiller; Eugene Campbell"Recent Findings: Recent studies have overthrown the dogma that irritable bowel syndrome is characterized by no abnormality of structure by demonstrating low-grade lymphocytic infiltration in the gut mucosa, increased permeability and increases in other inflammatory components including *enterochromaffin and mast cells.* Furthermore, increased inflammatory cytokines in both mucosa and blood have been demonstrated in irritable bowel syndrome. While steroid treatment has proved ineffective, preliminary studies with probiotics exerting an anti-inflammatory effect have shown benefit.Summary: The study of post-infectious irritable bowel syndrome has revealed the importance of low-grade inflammation in causing irritable bowel syndrome symptoms. It has suggested novel approaches to irritable bowel syndrome including studies of serotonin and histamine metabolism which may be relevant to other subtypes of of the disease."http://www.medscape.com/viewarticle/518355_printenterochromaffin or EC cells store the majority of serotonin in the gut. They are pressure sensitive and release serotonin to start gut contractions. Mast cells release histimine.Here is a picture of where those cells are located.







The 5ht3 receptors are involved in D IBS and the 5ht4 receptors C IBS.I will post more on the mast cells because they are also very important.


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## Heva (Dec 9, 2007)

Thanks guys, this has been so useful to me being a newbie also. I now understand the d and c which confused me. I have IBS_C.I have found keeping food diaries a pain but now quite happy with what I found that sort of works for me. As you all have said different foods effect different people. I cannot eat large meals which is good for my weight-lost 10kgs this year. But will have to keep an eye on this as I do not want to lose too much more.I have Elivate-yoghurt for gas and bloating-every morning and this helps get me through the day-not so many cramps and nausea . Also take Phloe which is for IBS and C. Found that I could not take these daily but every two to three days and I would have a BM though small everyday.Never thought I would get excited by BM but there you are, this is IBS does to you.I thought my extreme fatigue was mainly caused from arthritis which I am taking drugs for. But now I think the combination of that and IBS is making it harder. I have given up my full time job this year and work two to three days a week. A pain but has saved my santity.Thanks again


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## BryterLayter (Dec 15, 2007)

Thanks for more responses. The mast cell theory is interesting. It's a little bit hard for me to totally understand because I have only read a few things about it and most of the readings were just complex study reports with no summary.I know the mast cell studies have been going on since like 1999 but since then there has been no cause or cure of IBS that has come out it. This seems to happen in almost every IBS study I read about, the doctors make a new theory but there is no big cure or cause discovered.Yes, I tried to space out the supplements as much as I could. But I admit that I frantic to find something to help me and cure me so I might have taken the supplements too closely in order to correctly judge which ones were working and which were not. I know Dr. Weil said that you should give 90 days to any kind of supplement in order to judge if it's giving you good or bad results.I know IBDs are suppose to be to IBS. But it seems that new studies by some doctors are saying that IBS is just a low-inflammatory bowel disease. And even on Wikipedia it says "A 3-year study found that patients diagnosed with IBS were 16.3 times more likely to develop IBD during the study period". That kind of freaks me out because I'm still in the age range of where something like UC can strike. Even in the book "IBS For Dummies", which was printed in 2006, in most pages of the book it says the typical thing about how IBS does not lead to a IBD. But there is one small section in the book where they talk about the IBD activist Jini Patel Thompson and how she believes that IBS and IBDs are more closely related than people think and that IBSers could benefit from some of the same diet and treatments that IBDers use.And do any of you guys really not drink anything while eating your meals? Do you really wait for one hour after to drink anything?thanks!


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## eric (Jul 8, 1999)

Heva, are you purposely trying to lose weight?More on the enterochromaffin cells and IBS and serotoninAliment Pharmacol Ther. 2006 Apr 15;23(8):1067-76. LinksReview article: intestinal serotonin signalling in irritable bowel syndrome.Mawe GM, Coates MD, Moses PL.Department of Anatomy and Neurobiology, University of Vermont College of Medicine, Burlington, VT 05405, USA. [email protected] in motility, secretion and visceral sensation are hallmarks of irritable bowel syndrome. *As all of these aspects of gastrointestinal function involve serotonin signalling between enterochromaffin cells and sensory nerve fibres in the mucosal layer of the gut, potential alterations in mucosal serotonin signalling have been explored as a possible mechanism of altered function and sensation in irritable bowel syndrome.* Literature related to intestinal serotonin signalling in normal and pathophysiological conditions has been searched and summarized. Elements of serotonin signalling that are altered in irritable bowel syndrome include: enterochromaffin cell numbers, serotonin content, tryptophan hydroxylase message levels, 5-hydroxyindoleacedic acid levels, serum serotonin levels and expression of the serotonin-selective reuptake transporter. Both genetic and epigenetic factors could contribute to decreased serotonin-selective reuptake transporter in irritable bowel syndrome. A serotonin-selective reuptake transporter gene promoter polymorphism may cause a genetic predisposition, and inflammatory mediators can induce serotonin-selective reuptake transporter downregulation. While a psychiatric co-morbidity exists with IBS, changes in mucosal serotonin handling support the concept that there is a gastrointestinal component to the aetiology of irritable bowel syndrome. Additional studies will be required to gain a more complete understanding of changes in serotonin signalling that are occurring, their cause and effect relationship, and which of these changes have pathophysiological consequences.PMID: 16611266 Neurogastroenterol Motil. 2007 Aug;19 Suppl 2:25-31. LinksRecent advances in understanding the role of serotonin in gastrointestinal motility in functional bowel disorders: alterations in 5-HT signalling and metabolism in human disease.Spiller R.Professor of Gastroenterology, Wolfson Digestive Diseases Centre, Nottingham, UK. [email protected] (5-hydroxytryptamine, 5-HT) is present in abundance within the gut, most stored in enterochromaffin cell granules. It is released by a range of stimuli, most potently by mucosal stroking. Released 5-HT stimulates local enteric nervous reflexes to initiate secretion and propulsive motility. It also acts on vagal afferents altering motility and in large amounts induces nausea. Rapid reuptake by a specific transporter (serotonin transporter, SERT) limits its diffusion and actions. Abnormally increased 5-HT is found in a range of gastrointestinal disorders including chemotherapy-induced nausea and vomiting, carcinoid syndrome, coeliac disease, inflammatory bowel disease and irritable bowel syndrome (IBS) with diarrhoea (IBS-D), especially that developing following enteric infection. Impaired SERT has been described in IBS-D and might account for some of the increase in mucosal 5-HT availability. 5-HT(3) receptor antagonists inhibit chemotherapy-induced nausea and diarrhoea associated with both carcinoid syndrome and IBS. While IBS-D is associated with increased 5-HT postprandially, IBS with constipation (IBS-C) is associated with impaired 5-HT response and responds to 5-HT(4) agonists such as Prucalopride and 5-HT(4) partial agonists such as Tegaserod.PMID: 17620085


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## eric (Jul 8, 1999)

Another very important cell in IBS is the mast cell. You can see where that is located in the picture, they are embedded in the gut wall.Mast cells are involved in fighting infections, allergies and the fight or flight stress responce. They can be activated by the HPA axis or Hypothalamic-pituitary-adrenal axis. The HPA axis has importnt roles in bodily functions, but is also the bodies stress system. The mast cells can degrandulate and release histimine from the mast cells embedded in the gut and this can contribute to pain and D.DR Wood is an expert on food lallergies, but importantly the enteric nervous system and IBS.First from Dr Drossman though.Dr Drossman's comments on foods for IBS Health.Shawn,To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Futhermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse. However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature. The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug http://www.ibshealth.com/ibs_foods_2.htmhttp://www.ibshealth.com/ibsfoodsinfo.htmDr Wood's comments for me"Dr. Jack Wood, a renowned physiologist at The Ohio State University calls the ENS the little-brain-in-the-gut."Dear Shawn:Sorry for the delayed reply to your question. I generally agree with Dr. Drosssmans response. A subgroup of individuals when they become sensitized to specific molecules in certain foods respond to ingestion of the molecules with symptoms of cramping abdominal pain, fecal urgency and explosive watery diarrhea. These are also the primary symptoms of diarrhea-predominant IBS. Enteric mast cells, by mechanisms we don't understand, become sensitized to the food molecule and respond to its presence by releasing a signal to the brain-in-the-gut (ENS) which is interpreted as a threat. The ENS responds by running a program which organizes secretion and motility into a behavior pattern of the bowel, which rapidly clears the threat from the lumen. *Because to be effective secretion occurs in large volumes and the contractions that accomplish rapid propulsion are strong, running of the program has the side effects of diarrhea and cramping pain. Big brain input to mast cells during stress activates the mast cells to evoke the symptoms resulting from exposure of the mast cells to sensitizing food antigens. *Aside from food allergens and mast cells, certain chemicals such as those in hot peppers, stimulate sensory nerves in the ENS and we are beginning to understand how this can also lead to food-related symptoms that might mimic or exacerbate IBS.Hope this helps,Jackie (Jack) D. Wood " FYI"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 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 This is also very important" whether the stressor or trigger is consciously perceived or not"


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## eric (Jul 8, 1999)

The inflammation seen in some IBSers is MACROSCOPIC and not 'overt inflammation" which is seen in IBD conditions. Normal testing with IBS will not reveal this, until more powerful microscopes are used on specific cells and tissue.Inflammation CONTRIBUTES to the symptoms.There is another issue with inflammation and IBS however. "*But microscopic inflammation cannot be a diagnostic marker for IBS because it does nor typically produce pain in those who have it. *All patients with active celiac disease have microscopic inflammation, but a large proportion do not have abdominal pain, and patients with ulcerative colitis who also have microscopic inflammation when compared with patients with IBS seem to have higher pain thresholds."http://www.ibsgroup.org/forums/index.php?showtopic=91184 Its important in your case that you still might not have fully recovered from your intial infection yet which can take sometimes for some people. Also people might develop PI IBS and then possible "classic" IBS.There is more to IBS then just inflammation, but inflammation is important.


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## eric (Jul 8, 1999)

FYIThe whole paper is worth reading.What Patients Know About Irritable Bowel Syndrome (IBS) and What They Would Like to KnowNational Survey on Patient Educational Needs in IBS and Development and Validation of the Patient Educational"The most prevalent IBS misconceptions included (% of subjects agreeing with the statement): IBS is caused by lack of digestive enzymes (52%), is a form of colitis (42.8%), will worsen with age (47.9%), and can develop into colitis (43%) or malnutrition (37.7%) or cancer (21.4%). IBS patients were interested in learning about (% of subjects choosing an item): (1) foods to avoid (63.3%), (2) causes of IBS (62%), (3) coping strategies (59.4%), (4) medications (55.2%), (5) will they have to live with IBS for life (51.6%), and (6) research studies (48.6%). Patients using the Web were better informed about IBS.Conclusion: (1) Many patients hold misconceptions about IBS being caused by dietary habits, developing into cancer, colitis, causing malnutrition, or worsening with age; (2) patients most often seek information about dietary changes; and (3) educational needs may be different for persons using the internet for medical information."http://www.ibsgroup.org/forums/index.php?showtopic=90774


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## Heva (Dec 9, 2007)

No ,I was not purposely trying to lose weight. I started losing weight because I find I cannot eat a lot of food at one time and cut down the sugars in my diet-no fruit etc to see if this would help with gas and nausea. It does help a little. This is my story.I got campylobacter 10 years ago and was ill. I suppose since then I had problems but did not affect my life so much. Two years ago I was put on methotrexate to help with pain in my joints. This is a very toxic drug and was unhappy being on it so they tried other drugs to help but nothing did. Then last year had pulse therapy treatment for my arthritis and had extreme pain for 48 hours in my stomach. It was from this day that my real problems began. I had so many tests it was not funny as it played with my head. I stopped taking all the drugs to see if this helped but the pain in my joints was affecting my life and it did not help my stomach. So back on the drugs and coping with IBS.A question I have always asked is: If it is IBS why do I get really sick at nighttime-I have read other peoples stories and they find it hard to cope all day. I have asked my GI Dr if it was the gallbladder but CT scan showed up nothing. I get so ill at 4pm and I am taking sleeping pills to get me through the night. I feel fine most days-for me this does not make sense. All the symptoms on this site point to IBS so am trying except it. I believe the Pulse threaphy treatment I had has caused some sort of reaction in my gut.Thanks


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## emky12 (Dec 18, 2007)

adhregina, if I may ask, where do you get your chickens from? I live very close to you - only 45 mins from Regina.


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## BryterLayter (Dec 15, 2007)

Heva, I understand about your diet habits. It's been a change for me too. Sticking to 5 or 6 smallers meals rather than 3/4 largers seems to help a little. But this can be sometimes hard to do when you are living with or hanging around other people who don't have IBS or other related digestive issues. What brand of sleeping pill are you taking? How long have you been taking this sleeping pill? Are you taking it on an empty stomach? I know you are suppose to take those types of pills on an empty stomach so that your sleep can come on quicker and the pill can be more effective, but maybe this pill is burning your stomach a bit during the night. I don't know, it depends on what brand you are taking and what are the side effects of it.


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## eric (Jul 8, 1999)

HevaEating smaller meals puts less physical stress on digestion.Campylobacter jejuni has been implicated in Post infectious IBS.after resolution of the intial infection, " a small percentage of patients go on to develop chronic IBS symptoms, as documented in several studies""InfectionBacterial infection has recently been recognized as an important cause of IBS. Infections such as Campylobacter jejuni, Salmonella enteritidisand Shigella flexneri produce diarrhoea and abdominal pain which usually resolves rapidly. However, a small percentage of patients go on to develop chronic IBS symptoms, as documented in several studies. Patients with post-infectious IBS account for 6-17% of the IBS population,24 and typically have the diarrhoea-predominant subtype (D-IBS)."http://bmb.oxfordjournals.org/cgi/content/full/72/1/15It is perhaps true that you had IBS from the Campylobacter infection before and the pulse therapy somehow brought it out more. I am not familar with pulse therapy though. are you still on the methotrexate?Losing weight if your eating right is a red flag. But that doesn't sound like that is the case with you although you might ask the doctor about it. Rapid weight loss is an issue.When you say "I get so ill at 4pm " what are those symptoms exactly?"I feel fine most days-for me this does not make sense."IBS can be like that and in some ways that points more to IBS. Other health issues can certainly make things much harder as well and contribute to problems.


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## Heva (Dec 9, 2007)

Eric Thanks for reply.I think you are right, my husband has said my stomach has not been the same since the Campylobacter. I have had terrible bouts of diarrhoea and then go into constipation Yes I am still on methotrexate-this I know is a cause of stomach problems but my bloods are monitored monthly and when I ceased taking them for a few months this did not make a difference. My white cell count was high for a year and had a lot of tests done. My liver etc is healthy and all the bloods recently show excellent levels.At 4pm most days I get a nausea and my stomach starts gurgling-, feel bloated and so much gas. I am exhausted. If I am working I feel ok-not my usual self but a lot better than where I was at the beginning of the year where I was ill all day and in so much pain. To me it’s like the food is just digesting after lunch?? My colon ( I think) feels hard and I was getting reflux.At night my stomach makes terrible noises and I cannot get comfortable-so many sleepless nights but now taking sleeping pills to help me cope.That’s why I am now eating smaller meals and found that too much sugar or food makes me ill.I am taking Prozac because I got so down with all the problems with my health and the Dr thought that they might help relax my stomach-this has not been the case as yet but feel not so down about everything. I am going through menopause as well so a lot to contend with at present and having been in good health for a long timePulse therapy is steroids pumped into your system through an IV. This is meant to help with the type of arthritis I apparently have. Attacks my tendons in Achilles and joints. I will never have this again no matter what the pain.I am aware of the weight loss and keeping a close eye on this as is my DR, I think it is just eating less so I do not feel so sick.Have a good Xmas


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## Heva (Dec 9, 2007)

The sleeping pills I am taking are zopiclone. I use to wait till it was midnight before taking a half but now take a half or whole (if I have a really bad attack) before getting into bed because I was getting so down from being over tired and sick.I know it has hard being around other people but I learn everytime I eat something new or too much. Xmas is not going to be fun but I would rather eat what I know than be miserable for the holidays as it is out summer here in NZ and a time to be at the beach.Thanks-have a good xmas


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## eric (Jul 8, 1999)

Heva, have you heard or seen on here anything about Mike's tapes? It sounds like they could possibly be something that may help you out here with sleep and IBS and pain.


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## Guest (Dec 29, 2007)

Emky12,We get them from a Hutterite Colony (South of Moose Jaw). They come here to Caronport (15 minutes West of Moose Jaw along the #1). There's a lady in our village (chicken lady) who takes orders for chickens... sometimes turkeys, etc. and every 5-6 weeks we get them in the post office parking lot. Reminds me of a major drug deal going down, ha ha.Do not believe they are organic... most likely freerange. I did ask one of the Hutterites if the chickens were organic? He replied, they're fed good, lol. Sometimes, they are frozen and sometimes fresh... depends on when they're killed. $1.50 @ lb, you cannot go wrong!So where are you located? If you want to get in touch with me... [email protected] or a PM.Tony (nice guy in rural Saskatchewan, Canada... between Alberta & Manitoba, ha ha)


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## Heva (Dec 9, 2007)

Hi EricNo I have not heard of mikes tapes, where do I find the information? and can I get them sent overseas? Thnks for all your help


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## 20334 (Apr 14, 2006)

Heva,I have used Michael Mahoney's CDs and they are fabulous. They helped me return to a more stable state after my IBS D got very bad after my 2nd son was born.I bought mine from ...com ( or .org, I can't remember







) or you can google Michael's name or "IBS Audio 100".It's well worth the cost and at the very least it will help you relax at night....his program is amazingly relaxing and even helped with my chronic nausea and anxiety. Bonus!







Good Luck!


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## eric (Jul 8, 1999)

Hevasome info and there is a lot more on the HT forum.http://www.ibsaudioprogram.com/alsoHT and CBT successeshttp://www.ibsgroup.org/forums/index.php?showtopic=5373If you have any questions let me know.


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## Heva (Dec 9, 2007)

Thanks eric and kiiri I have now order these. Will let you know how it goes.I was interested in reading about palpitations, I did not think it was worth mentioning as was told it was not a part of IBS but since found on this support others have experinced the same. Thankyou for that I will be taking this info to my drs as I asked and thought it was connected to my stomach as when I get a bad episode i get palps. Infrequent now thank goodness-I suppose because I am not worring so much.Thanks


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## eric (Jul 8, 1999)

Heva, Its good to hear your trying the tapes. If they work and in order to find that out you have to try them and they work for the majority of people who do them 80% or more, they will help with your sleep as well as your IBS. I think you will also enjoy them. FYI"Question: I have suffered with IBS for 24 years. My question is what causes the following symptoms: Out of nowhere I start feeling very nauseated, then I start to sweat, feel faint, have heart palpitations, and have terrible stomach pains. Usually a bowel movement or just passing gas helps. Does the bowel pain bring this on? I've heard of many people that have the same symptoms. Answer: If a bowel movement relieves the discomfort, it is consistent with IBS. The likelihood is that at her age it would be IBS. However, if this is an acute, or short-lived, intense type of pain, it might also be an intestinal infection. If it's been going on for several weeks or months, then it's likely IBS or another type of intestinal disease, such as Crohn's disease, or if there is blood in the stool it could be ulcerative colitis. But in young people those disorders have perhaps one-hundredth to one-thousandth the frequency of IBS. The key element is that if it has been going on for a while without blood in stool or weight loss and you experience relief after passing gas or a bowel movement, it's most likely IBS. *Symptoms, such as pain, sweating, heart palpitations, and feeling faint are related to the exaggerated nervous system response to eating that occurs in people with IBS.* -- Douglas Drossman, professor of medicine and psychiatry at the University of North Carolina, Chapel Hill and co-director of the UNC Center for Functional GI and Utility Disorders. "http://www.webmd.com/content/article/65/79521.htmIts not just eating which can effect this, just the exaggerated nervous system can.Have you read all that brand new IBS information?


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