# Tape 5 ?



## Patsy (Feb 11, 2000)

I have listened to tape 5 for two nights now. The problem is I can only stay awake for the first few minutes. I try to reflect about the tape after it is over and have no clue what it is about. I even tried sitting up while listening last night and I still fell asleep!How can I stay awake?


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## BQ (May 22, 2000)

Patsy, Not to worry....Here's the best part of hypnotherapy....It works whether you are actually alert & listening or not..







So don't try to stay awake or anything, if ya clock out, ........ ya clock out. No big deal. If you want to, you could always give another listen during the day, like early in the day, LOL, if you wanted to consciously hear what is going on. Your subconscious is still working even if your conscious isn't. So you are still getting the benefit of the tape, whether or not you are aware & alert. I'm sure somebody else will pop in here.. but truly, don't worry. You don't even have to reflect after for it to work, it is nice to though, I imagine, but it isn't required for effectiveness, just so you know. Hang in there.







BQ


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## wanderingstar (Dec 1, 1999)

Patsy, please look at Marilyn's thread on 'Mike's Informational Postings' - or something like that. It contains a number of helpful references to sleeping whilst listening to the tapes. When you get onto that thread, if you don't want to read the whole thing, use your browser software: Edit>Find (on this page) then type in 'sleep'. Keep on asking it to find until you get to the bottom of the page. You probably know how to do that!


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## cookies4marilyn (Jun 30, 2000)

Thanks BQ and Susan... I will bump up that thread for Patsy. And, Susan, thanks for that tip about the edit/find on this page info. Never knew that, and now I do! Boy, will that save me some time from now on! Thanks!







Yes, and Patsy, BQ is right. No problems about sleeping at all! Take care.


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## Guest (Dec 5, 2001)

I'm at the final days now. One or two days to go and I can tell you that there is not one night that I stayed awake.It's funny sometimes. For example on side five (I think), Mike talks about that blanket of safety in the beginning and I thought to myself: Blanket, what blanket is he talking about ? It seems he talked about it on another tape (don't know which one) but I always fell asleep before I reached that part of the tape.







People talk about a wheel on the BB. I think I heard it once on a session but I'm not sure what they are talking about...







But my symptoms have improved so much since I started the sessions, it is amazing...Regards,Peter...(C&D type)


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## eric (Jul 8, 1999)

Peter, thats great to hear.I recommend conciously reviewing the tapes after your done also if you finnished and continue for the added reinforcement try listening at a different time to them and you can pick up on imagery and such as that can help.


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## Guest (Dec 6, 2001)

Eric,I'm going to continue listening on a daily basis to the tapes because they help met with another mayor problem, insommnia. Before I bought the tapes, I spent hours thinking and being awake in bed before I fell to sleep. From the first day I listened to the tapes, I fall asleep within 15 minutes.







But perhaps I should also listen to the tapes during the day to pick up the imaginary like you say. I'm afraid I will fall asleep also, no matter what time of the day it is. Although I fall asleep soon, the quality of my sleep is bad and I feel tired all day. That's another problem to work on...







Regards,Peter...(C&D type)


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## eric (Jul 8, 1999)

Peter, it will help to get some of the imagery off them and you may just need to find the right time to listen while awake. Glad they are helping the insomnia though, it helped mine for sure.There is also some research in sleep and IBS." IBS Research What's new? Adapted from the Winter 1998 and Winter1999 issues of Participate, this article reviews a number of recent research findings. By: G. Richard Locke III, MD, Consultant, Division of Gastroenterology and Internal Medicine, Assistant Professor of Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN; Jamshid S. Kalantar, MD, GI Motility Fellow, and Yuri A. Saito, MD, MPH, Gastroenterology NIH Research Fellow, Mayo Clinic, Rochester, MN ï¿½2000 by IFFGD. This article may be printed for your own personal use. Except as otherwise permitted under the copyright law of the United States (Title 17, United States Code), no part of this article may be reproduced, transmitted, or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of IFFGD. How is IBS Defined Bacteria and IBS What Makes People with IBS Seek Medical Attention Where is the Problem in IBS In the gut? In the brain? In the general autonomic nervous system? Food and IBS Travel and IBS Sleep and IBS The Nervous System and IBS Gender Differences Are There Any New IBS Treatments? Serotonin Cognitive therapy Acupuncture Hypnotherapy Chinese herbal Summary Irritable Bowel Syndrome (IBS) is a common condition. Depending on the criteria used to define the disease, it occurs in tens of millions of people; estimates range from 10% to 25% of the general population. It is the most common ailment seen by gastroenterologists and comprises about 30% of their work. Research is increasing our understanding of how common the condition is, where in the body the problem may be, and what new treatment options are available. We all wish for and expect periodic breakthroughs in medical research. Progress in medical science, however, is usually comprised of small, rather than giant, steps forward. Taken  together, these advances increase our understanding and ultimately help towards development of a cure. This article highlights the results of studies published in scientific journals or presented at conferences during 1998 and 1999. Many of the findings are preliminary and should be interpreted cautiously. Nonetheless, they may also be viewed with optimism towards a better understanding of the disorder. back to top How is IBS Defined? One problem in medical research is to define a condition so that all the investigators in that field describe the same type of patient. Diagnostic criteria applied to IBS were developed for research purposes first by means of a study in a patient group (Manning criteria) and later by a consensus meeting (Rome criteria). These criteria consist of sets of symptoms that, in the absence of other gastrointestinal diagnoses, are consistent with IBS. With the Rome criteria, we can make a positive diagnosis of IBS, along with limited tests to rule out other disease factors, rather than a negative diagnosis based solely on exclusion of other possible abnormalities Agreus and colleagues from Sweden conducted a study to compare the prevalence of IBS diagnosis in the general population by means of the Manning criteria, the Rome criteria, and a newer simple definition based on abdominal pain or discomfort combined with self-reported diarrhea and/or constipation. They found a good correlation between these new criteria and the previous ones. This may make it possible to use the simpler definition for future surveys or even in clinical practice. back to top Bacteria and IBS Many have wondered if IBS is caused by an infection. To date, no virus, bacteria, or parasite has been found to directly cause IBS. It has, however, been hypothesized that these microbes may indirectly cause IBS or at least exacerbate its symptoms. Some researchers question whether IBS begins with a common bacterial gastroenteritis. [Gastroenteritis is an inflammation of the lining of the stomach and intestinal tract often caused by a bacterial infection. Symptoms may include vomiting, abdominal pain, and diarrhea.] Other investigators question whether the number or type of bacteria that normally live in the colon affects symptoms. Some individuals with IBS recall that their symptoms began with a gastroenteritis. The first theory of a "post-infection diarrhea" as a possible link has been explored in greater depth this past year. A post-infection diarrhea is a common, temporary phenomenon resulting from the destruction of intestinal digestive enzymes during an infection. Even after the infection has cleared, certain foods will cause the persistence of loose stools for several weeks until the intestine rebuilds its digestive enzymes. One recent Canadian study looked at the occurrence of IBS in people who travel overseas and acquire a "traveler's diarrhea." These investigators found that 10% of travelers who acquired an infectious gastroenteritis subsequently developed IBS. Those who did develop a traveler's diarrhea, compared to those who did not, had an approximate 6-fold increased risk of developing IBS. Another study from England found that 23% of their patients hospitalized for an infectious gastroenteritis went on to develop IBS. Regardless of whether these individuals developed IBS, they all had increased rectal sensitivity and increased colon movements several weeks after their infection had cleared. However, the researchers also found that the individuals who developed IBS reported more life events suggesting that that there may have been a psychological component to their symptoms in addition to the infectious component. Can bacteria cause IBS without a preceding infection? There are trillions of bacteria that normally reside in the gastrointestinal tract where they help digest nutrients. [Fermentation and intestinal gas are a byproduct of this digestive process.] Some investigators have questioned whether the number or type of bacteria normally present is different in individuals with IBS. A group of German investigators found that the tissue taken from the colons in people with IBS had higher bacterial concentrations than the tissue from individuals without IBS. The researchers believe that this finding suggests that the colons of some people with IBS are colonized by a greater number of bacteria than those without IBS. This may alter how nutrients are fermented in the colons of IBS patients. A group of British investigators also believe that colonic fermentation (gas production) is different in some people with IBS. They confirmed this in one study, which may explain why some individuals respond to dietary restriction and why some do not. The investigators went on to measure gas production in IBS patients before and after antibiotic treatment. The antibiotics appeared to reduce the total volume and rate of hydrogen gas production in the people studied. The investigators felt that this second study provided additional evidence of the role of colonic fermentation in IBS symptoms and supported the use of dietary modification or antibiotics to reduce gas production and improve symptoms in people with IBS. These findings are promising. It is too early however, to say conclusively that bacteria and antibiotics have a role in the development of IBS symptoms and in effective treatment. back to top What Makes People with IBS Seek Medical Attention? Although many people have IBS symptoms, only a small portion (around 30%) ever seek medical attention. It has been suggested that psychological factors rather than symptoms drive IBS sufferers to seek medical advice. Talley and colleagues from Australia surveyed local residents for IBS and looked at the factors predicting health care-seeking behavior. They found that duration and severity of the abdominal pain were among the factors that prompted IBS patients to seek medical attention. Psychological problems or abuse history did not increase the chance of IBS patients to seek medical attention. Thus, psychological problems in this population were not associated with more visits to the doctor. People read IFFGD publications to be better informed about IBS and other disorders. Researchers in London looked at the role the media and other sources play in providing the general public with information about IBS. Employees who were attending a health-screening program about IBS symptoms were asked to describe their understanding of IBS and where they obtained their information about IBS. Surprisingly only one fifth of IBS patients who had seen a doctor reported that they obtained IBS information from their doctor. Even after seeing a doctor, two thirds did not know whether IBS would progress to a more serious disease. Women's magazines, family, and friends were the main sources of IBS information. Poor and inaccurate knowledge of IBS may lead to unnecessary health worries and disease fears. Medical care providers and the media must provide better education and more accurate information about IBS. back to top Where is the Problem in IBS? The definition of IBS suggests that all routine investigations such as blood tests, endoscopy, and radiological imaging should be normal. The condition is diagnosed on the basis of symptoms, elicited through history and physical examination, in the absence of obvious gut abnormality. So what is the problem? Much work has been done to explain the underlying pathology (disease characteristics or cause) in IBS in the hope that treatment could be directly targeted to an abnormality. This approach could be hugely beneficial compared to available treatments that work symptomatically. In IBS, we know the problem is not only in the gut but is also in the brain-gut axis and the autonomic nervous system. Is the problem in the gut? Increased perception of sensations in the gut, or visceral hypersensitivity, has consistently been observed in IBS. Mertz and colleagues from California checked the discomfort threshold in IBS patients and in a control group. In response to balloon distention of the rectum, almost all (94%) of IBS patients showed lowered pain thresholds. The investigators proposed that increased rectal perception could be used as a reliable biological marker for IBS. Is the problem in the brain? Silverman and colleagues from UCLA used a special brain imaging technique, positron emission tomography (PET), to measure the changes in the pattern of blood flow in the brains IBS patients and a control group in response to balloon distention of the rectum. They found that different areas of the brain were activated in IBS patients when rectal stimuli were delivered. This suggests that the brains of people with IBS process signals from the gut differently. Is the problem in the general autonomic nervous system? Monga and colleagues from London checked bladder and esophageal perception and pain thresholds and found that women with IBS have both lower bladder and esophageal sensory thresholds. They suggested that IBS is part of a generalized disorder of smooth muscles. These women also had "irritable bladders." Francis and colleagues from Manchester, UK found that a higher proportion of patients who are seen in the urology clinic have IBS compared to patients seen in other clinics (dermatology; and ear, nose, and throat). There seems to be increasing evidence that the pathology in IBS is not limited to the gut, brain, or autonomic nervous system only. Rather there may be an involvement of all three systems. Therefore, any potential new therapy should be aiming at this widespread pathology. back to top Food and IBS Many people with IBS notice an association between eating and their symptoms. This could be due to abnormal digestion caused by a dietary intolerance (e.g., lactose intolerance, sorbitol malabsorption, inability to digest fructose or bean sugars). In these instances, the undigested food causes looser stools and provides a source of food to bacteria, which then produce more gas. Much is already known about this link between food and IBS symptoms, but investigators are exploring whether the act of eating may also trigger abnormal gastrointestinal movement or enhance bowel sensation in the absence of food intolerance. One group of investigators from Spain studied healthy volunteers to see if food consumption affects the way intestinal gas is processed. When gas alone was infused into the small intestine, the volunteers reported no discomfort, and the investigators did not detect any increase in anal gas retention or increase in girth (measurement around the waist). However, if they distended the stomach and then infused the gas into the small intestine, the subjects reported discomfort and significant nausea. Furthermore, when the investigators infused food into the small intestine with the gas, increases in gas retention and girth were seen. This study suggested the act of eating may cause changes in intestinal motor activity, which could be a mechanism for the bloating and gas symptoms experienced by individuals with IBS. A separate study performed in Sweden also looked at whether or not food intake affects colonic sensation. A pressure-gauge balloon was inserted into the colon, and then a fat solution was infused into the small intestine to simulate food. The researchers recorded pressure readings before and after the fat solution was infused. They discovered that when food intake was simulated, individuals with IBS had lower colonic pain thresholds than individuals without IBS. The investigators hypothesized that this alteration in colon sensation may explain why IBS sufferers experience more symptoms after they eat. However, another group of investigators in the U.S. performed a similar experiment and found no change in rectal sensation with consumption of real food. They did find that subjects with constipation-predominant IBS have a lower colonic discomfort threshold in general, compared with subjects with diarrhea-predominant IBS or those without IBS. Thus, the interaction of food and colonic sensation is still unclear. back to top Travel and IBS Does traveling away from home upset your bowels? This is a frequent occurrence for many IBS patients. The deviation from a regular schedule, the changes in diet, and the stress of travel all contribute to increased symptoms. However, it appears that altitude changes associated with airplane travel may also contribute to gastrointestinal distress. [Lower pressure may increase gas volume and bloating.] Several German investigators looked to see if high-altitude flying affected the stomach's movements. They placed a group of healthy volunteers in a low-pressure chamber to simulate a high-altitude flight and found: 1) All volunteers had fast heart rates suggesting a stressed state, and 2) All volunteers reported symptoms of bloating. Furthermore, they found that high-fiber diets slowed down the emptying of the stomach into the small intestines, but normal stomach emptying rates were seen in low-fiber diets. This study suggests that a small-volume, low-fiber meal may be better for you when you travel on a plane. However, this study was performed in individuals without IBS, so you may want to experiment on your own when traveling. back to top Sleep and IBS The restorative quality of sleep has been reported to be altered in some people with IBS. One study of individuals with IBS objectively measured brain wave activity and found a decrease in stage 4 sleep [a phase important for rest and restoration of the physical body]. They also found alterations in REM sleep [a phase important for organizational restoration of the mind]. Another study compared subjective (self-reported) and objective (brain wave activity during sleep) measures of sleep quality in a group of 15 people with IBS and in a group of 15 healthy controls. They found a change in the perception of sleep by the IBS group, in the absence of objective sleep abnormalities. Studies like these suggest that multiple areas of brain function may be involved in the development of IBS symptoms." http://www.aboutibs.org/Publications/resea...ml#anchor155572 There are some more studies on sleep and ibs in pubmed so you know.


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## BQ (May 22, 2000)

Eric, Forgive my ignorance or (brain damage, it's been quite a day & will be tomorrow too...LOL I can't think....) Could you give some examples of smooth muscles and what is the other type of muscle called? LOL I can't believe I can't remember this!!! LOL Sorry.This is interesting to me because I once had a chiropracter complain about my muscles. (He should try living with them, right? LOL) BQ


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## *Luna* (Nov 19, 2001)

BQ, I think the other kind of muscle is striated muscle...I could be wrong though. I remember others mentioning the bladder and uterus as smooth muscles.


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## eric (Jul 8, 1999)

Here is the information your looking for BQ, but I will warn you know its pretty complicated stuff. http://www.ultranet.com/~jkimball/BiologyP.../M/Muscles.html


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