# Is IBS real?



## 16085 (Feb 3, 2007)

Many people tell me that IBS is something a Dr diagnosis you with when they have NO clue whats wrong with you. Do you all believe this too?


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## Kathleen M. (Nov 16, 1999)

I do not believe that is the case for most doctors.They have done a lot of research into IBS and which symptoms you have to have are very well defined. They have a fair idea of what is wrong with people.Most people say this because there is no test that specifically proves you have IBS.It is not something IBS patients make up. It is real. They have real pain and real problems with bowel habit.There are enough people who all have the exact same set of symptoms that it is hard to believe that everyone has something different and random wrong with them that is competely undetectable by every medical test known to man.Some doctors do diagnose it in ways that make people feel like it isn't a real thing, but that doesn't mean a whole lot. Some doctors aren't very good and don't keep up with the latest knowledge. Don't judge the whole syndrome on bad doctors.K.


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## Nanobug (Nov 7, 2006)

> quote:Many people tell me that IBS is something a Dr diagnosis you with when they have NO clue whats wrong with you.


I agree with those people. IBS is just a collection of symptoms. IBS is not a disease. When you go to the doctor and the doctor has no clue about what causes those symptoms, the doctor tells you that those symptoms have a label called IBS.


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## 16085 (Feb 3, 2007)

Wow even on the IBS board you have one for and one against.This isn't encouraging.


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## Kathleen M. (Nov 16, 1999)

Yep that's the way it goes.I don't believe syndrome is the same as totally imaginary and only things that could be classified as a "disease" are real and worth-while treating or researching.There are a number of syndromes. Each has its own specific pattern of symptoms. They don't call any symptom in any organ system IBS. At some point most of what any person would define as a "disease" was a "syndrome" because that's where it starts. You don't find a cause and then look for the symptoms. You find the symptoms first, and then look to see what patterns exist and eventually for most things you do eventually find a cause.I mean Acquired Immunodeficiency Syndrome still has the name syndrome from when it was just a collection of symptoms. Even before HIV was discovered people didn't say AIDS was not real and just something they diagnose people with when they don't want to bother with them.K.


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## Kathleen M. (Nov 16, 1999)

> quote:synÂ·drome (siË˜n'droÂ¯m') n.1.	A group of symptoms that collectively indicate or characterize a disease, psychological disorder, or other abnormal condition.2.	a.	A complex of symptoms indicating the existence of an undesirable condition or quality.b.	A distinctive or characteristic pattern of behavior: the syndrome of conspicuous consumption in wealthy suburbs.disÂ·ease (diË˜-zeÂ¯z') n.1.	A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.2.	A condition or tendency, as of society, regarded as abnormal and harmful.3.	Obsolete. Lack of ease; trouble.


Every disease is a syndrome, after all.Nowhere does it ever say Syndrome = not real and Disese = real *shrug*Doesn't change that people suffer and need treatment. Doctors that think IBS is no big deal and all imaginary anyway need to be fired.


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## eric (Jul 8, 1999)

Lisa here is some info for you.The diagnoses of IBS has come a long way. It is also a specific cluster of symptoms.http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/316101372andTHE JOHNS HOPKINS UNIVERSITY Gastroenterology and Hepatologyhttp://hopkins-gi.nts.jhu.edu/pages/latin/...se=43&lang_id=1and http://www.aboutibs.org/"Irritable bowel syndrome (IBS) has been described as a â€œfunctionalâ€ disorder, which is a â€œdiagnosis of exclusion.â€ Thus, many physicians still think IBS has no demonstrable pathophysiologic defects and that it can only be diagnosed after other â€œorganicâ€ disorders have been ruled out with multiple diagnostic tests.Recent data demonstrate the fallacy of this assumption. Irritable bowel syndrome IS characterized by multiple pathophysiologic defects:Altered gastrointestinal motility (1-2) Visceral hypersensitivity (1-2) Abnormal IL-10/IL-12 ratios consistent with pro-inflammatory Th-1 state (3) Infiltration of lymphocytes and neuronal degeneration in the myenteric plexus (4) Defects in serotonergic signaling mechanisms in the enteric nervous system of the GI tract (5) Unfortunately, these pathophysiologic defects cannot be identified by conventional laboratory testing. Therefore, we rely on the symptom-based IBS diagnostic criteria of the ROME committee (i.e., the presence of abdominal discomfort for at least 12 weeks in the past 12 months associated with a change in the consistency/frequency of stool or relief of discomfort with passage of stool) or the American College of Gastroenterology (i.e., IBS is defined as abdominal discomfort associated with altered bowel habits) (1-2). However, the reliance on symptom-based criteria to diagnose IBS should not de-emphasize the pathophysiologic defects expressed by IBS patients."


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## SophieUK (Dec 18, 2000)

Just because people don't know what causes IBS doesn't mean that it's not real or is not a valid diagnosis - doctors often don't have a clue what causes cancers. We don't need to know the cause to enable us to name the disorder. IBS is a recognised diagnosis - the Rome III criteria are pretty strict, and doctors agree that IBS is characterised by visceral hypersensitivity and a brain-gut dysfunction. There are also recognised starting points for IBS, such as food poisoning, surgery, or a time of extreme stress such as a bereavement.


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## 21723 (Aug 19, 2005)

In my field of Physical Therapy we see a condition called Reflex Sympathetic Dystrophy. It basically is the same as IBS but affects the peripheral nerves of a body part. Most people get it after severe trauma. Unfortunately there is no cure. Fibromyalgia is also a very similar condition. Simply put IBS is a sort circuit of the visceral nervous system.


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## Nanobug (Nov 7, 2006)

> quote:Simply put IBS is a sort circuit of the visceral nervous system.


Unless, of course, one takes antibiotics and the IBS disappears, even if temporarily.


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## Nanobug (Nov 7, 2006)

> quote:Wow even on the IBS board you have one for and one against. This isn't encouraging.


Truth is, no one knows for sure what is the cause or what are the causes of the symptoms labeled IBS. There are several hypothesis (ex: colonic dysbiosis, small intestine bacterial overgrowth, Hypothalamic-pituitary-adrenal axis disfucntion) and, at the end of the day, they may all explain a certain percentage of cases. This does not mean in any way shape or form that the symptoms labeled IBS are not real. After all, having diarrhea 3 times a day is quite objective.


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## 16085 (Feb 3, 2007)

Except for this pain that Ive had for 5 weeks, my stool is pretty normal.Only time I have "d" is when Im upset or overly anxious. Somehow after reading the Rome III criteria I really don't fit the profile.I always knew I had a nervous stomache, never felt the need to see a Dr. The abdominal pain (or discomfort) was the reason for the ER trip and the Dr visit.I have fibro and was tested well to rule out other things first, I just don't want a colonoscopy and sonogram and get well umm you must have IBS then. I want to know how and why they come to this conclusion.Lisa


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## Kathleen M. (Nov 16, 1999)

Some doctors use IBS for EVERY ONE of the functional bowel disorders.It doesn't matter much in the clinic as they treat based on symptoms rather than which label they stick on it. There are several functional bowel problems, IBS is the most common and most of the others are IBS - a symptom of IBS.If every stool was always normal, ("pretty normal" can still fit a change in stool consistancy or frequency, you don't need full blown diarrhea several times a day every time you go, just a change from normal) then it generally fits Chronic Functional Abdominal Pain. Which is basically all the pain and discomfort of IBS but normal bowel habit.That you have D that is triggered by emotions fits with IBS. Some IBS triggers are physical, others are emotional.It may be a bit early to label you IBS as the diagnositic criteria usually say wait 6 months to see if it goes away, first.How they come to the conclusion? Similar to Fibro, actually, you seem to think that is real, even though a lot of people think it is a "fake" diagnosis when they don't know what is wrong, really, it has a lot of the same diagnositic issues. There has been a lot of problems getting doctors to believe it actually exists over the last couple of decades. Patient has specific symptoms, Patient doesn't have other problems that explain the symptoms. I'm not sure what you are seeing as not at all what Rome criteria says IBS is?1.Patient complains of stool consistancy and/or frequency changes.2. Patient complains of abdominal pain and discomfort. (usually 1 and 2 go together, and often the pain goes away after a BM, but it doesn't have to)3. Patient does not exhibit any of the red flag symptoms that mean it is probably not IBS. (Are you losing weight all out of proportion to what you are eating? Starving yourself and losing weight is normal weight loss, this is abnormal weight loss. Do you have bloody stools? Do you have pain that wakes you from a deep sleep in the middle of the night? Do you have anemia? Do you have an elevated sedimentation rate? Do you have a pathogen in your stool? Do you have repeated bouts of watery diarrhea at night?)Red flag symptoms tend to point disorders that are not functional. Having some but not all of the IBS symptoms usually means one of the other functional disorders.4. Medical tests based on what needs to be ruled in or out are done. Different doctors have different ideas of how much testing you need. Typically in clinical studies if the patient ONLY has symptoms of IBS and has no red flag symptoms at all no matter how many tests you run the tests are normal and the patient ends up with an IBS diagnosis. Only a few % of patients have anything, and some of those have anatomical variations that do not explain the IBS as other people with them are normal.Some people will with repeated and extensive testing have their IBS get worse. The stress of the tests and being told over and over again that the results are normal can really do a number on some people. Some people will not believe it could be IBS unless they have every test known to man.How many tests you need to believe it is IBS is up to you, and it may not match what your doctor needs to make the diagnosis.Usually they run at least some blood tests to see if you have inflamation in the body. Mostly because that is one of the big red flags as well as anemia that something else may be going on.If you symptoms are really typical they tend to do fewer tests. If you have some red flags they tend to do more tests.FWIW that you have a diagnosis of Fibromyalgia may factor into getting an IBS diagnosis as that is common for people to have both problems.Woman may also want to do a check with the OBGYN as some reproductive organ issues can cause pain, bloating, and other GI symptoms.It really is not any or all symptoms we can't explain no matter what the symptoms are even if the patient has obvious symptoms of something else.K.


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## eric (Jul 8, 1999)

There is also mild, moderate and severe IBS.There are also things that HELP support an IBS diagnoses that are not part of the rome critieria. Incomplete evacuation, bloating, mucus in the stools, rectal hypersensivity, relief after defication, not waking you up at night, its a bigger picture, minus red flag symptoms. Pooman, I understand what you were saying for the most part but there really isn't a viceral nervous system. There is the Central nervous system, the autonomic nervous system and the enteric nervous system (brain in the gut.)Viceral hypersensivity is a term for feeling pain from viceral organs. Autonomic nerous system runs breathing digestion, the herat etc..all of these systems communicate to each other. That is the brain gut axis."Truth is, no one knows for sure what is the cause or what are the causes of the symptoms labeled IBS. "The strongest evidence is in the role serotonin plays at gut receptors levels embbeded in the gut wall that helps explain d, d/c and c as well as its importantce in Brain gut communication and viceral hypersensivity. It is an important neurotransmitter for sensations arising from the gut. Gut permeability is a factor in some IBSers, but not likely a cause.SIBO is a different condition then IBS.Hypothalamic-pituitary-adrenal axis disfucntion is seen in IBS and this is also part a big part of the bodies stress system and is connected to the fight or flight. Again this is a part of the brain gut axis dysfunction.which is why"Only time I have "d" is when Im upset or overly anxious." The anxious activates the fight or flight and causes d.Modern research understands IBS as"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 Drossman chairman of the Rome committe for gi disorders of function. "http://www.ibshealth.com/ibs_foods_2.htm They have also recently demonstrated""Demonstration of post-infectious IBS as a brain-gut disorder"http://www.iffgd.org/symposium2005report.htmlThey have also found STRUCTUAL abnormailites in PI IBSers as well as subgroups of IBSers.""Serotonin Signaling*Of the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. "*"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"http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/906107392


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## eric (Jul 8, 1999)

PS Lisa are you seeing and woring with a doctor now? Its very important.Also they don't always have to do a colonoscopy to diagnose IBS. take these question to the doctor with you and they can helphttp://www.medicinenet.com/script/main/art...rticlekey=13683


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## Nanobug (Nov 7, 2006)

> quote:Modern research understands IBS as"The cause of IBS is yet to be determined."


Thanks, eric, you summarized it well.


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## Nanobug (Nov 7, 2006)

> quote:Except for this pain that Ive had for 5 weeks, my stool is pretty normal.


Inflammation? Does Pepto-Bismol work?When you were diagnosed with fibromyalgia, did your doctor check your cortisol levels? People with fibro tend to have low cortisol levels and low cortisol levels result in increased immune system activity, aka, inflammation.


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## Nanobug (Nov 7, 2006)

> quote:Some doctors use IBS for EVERY ONE of the functional bowel disorders.


Indeed! This is yet another example of why people cannot trust doctors in general.


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## Kathleen M. (Nov 16, 1999)

Because a few doctors are bad, or heaven forfend use one particular label too broadly, doesn't mean vitually all of them are bad.It does pay to be an informed consumer when it comes to medicine just like one does for anything else. The "damage" done from calling it IBS instead of functional {fill in the name of the symptom} is pretty minimal. They treat based on the symptoms regardless of which functional bowel problem it is. It would be different if functional constipation had to be treated with completely different drugs than IBS-C and medicating with the wrong one would cause serious problems. As long as they can figure out functional vs organic they've done their job. I don't know that alternative medical people or herb store sales people are really any more reliable, FWIW.For any service you purchase there are good practioners and bad ones. Knowing enough to know the difference is the battle. Don't avoid all doctors or refuse to take the treatments they give out because some of them are bad. I wouldn't tell you to avoid all plumbers if your pipes need fixing because some of them are less than trustworthy.K.


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## 16085 (Feb 3, 2007)

Hi ericYes I am working with my Dr now....I started at the ER 2 weeks after lower right ab pain, blood tests were fine. I went to my Dr 3 days later. My discomfort/pain doesnt go away after a bowel movement. This pain comes and goes all day no rhyme or reason to it.He wants the colonoscopy, he also wanted a CT scan of my pelvis and stomach but insurance denied it because they said a sonogram had to be done first. So I have that on the 15th and colonoscopy on the 13th.As for my fibro they ran normal blood work, for lupus/RA and some others, also did xrays which showed oesteoarthritis in my spine. It took awhile for me to believe fibro was real....after 6yrs I got worse this past year and finally accepted it and saw a Rheumy.I do not want extensive tests, I prefer not to have any. On the other hand I don't want a dr to spend 5 min with me and say oooo you have IBS. This is why I agree'd to the colonoscopy.Thanks for everyones inputLisa


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## 16229 (Jan 28, 2006)

Some doctors do a good job and dx IBS correctly, as it is a proven syndrome at this point. But, too many doctors allay too many things to be IBS or use it as a defacto dx when they don't know what is wrong.More of a reason to take your time and find a good doctor(s).


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## 21857 (Aug 15, 2006)

I spose that is true if your going to a bad doctor, some doctors who cant be bothered to find out what is wrong with you, go through all the tests and stuff, will just say you have IBS. If a GP tells you that you have IBS they usually say there is nothing you can do about it, but there are lots of things you can do!You should always see a specialist and get all the tests done just to make sure nothing more serious is going on!


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## eric (Jul 8, 1999)

Lisa, does the pain wake you at night.Some spine problems can cause bowel problems, not IBS, but there own problems.also this is not written is stone, although it can help support the diagnoses."My discomfort/pain doesnt go away after a bowel movement."They have noticed an association in that quite a few people with IBS have fibro as well.Did they do stool tests? One stool test can help if there is inflammation and can help seperate IBS from IBD conditions.If they diagnose you with IBS ask if they used Rome criteria to do so?"I do not want extensive tests, I prefer not to have any. On the other hand I don't want a dr to spend 5 min with me and say oooo you have IBS. This is why I agree'd to the colonoscopy."Really you want a gi doc and you want to know what's going on with you. If they say IBS its a legitimate diagnoses. They might not be able to tell you exactly why, but its a legitimate diagnoses. It is also very common in gi practices. More so then some other problems.The colonoscopy is helpful to both the person and the diagnoses. But they don't dianose you by that, but by a cluster of symptoms. However they can help rule things out.Naobug, since everyone in IBS research in all the fields agree a good doctor patient relationship in IBS can and is very important how does one go about learning to trust and work with a doctor? Instead of making blanket statements like that which might make people distrust their doctor and their diagnoses?


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## eric (Jul 8, 1999)

FYIHistory of Functional Disordershttp://ibsgroup.org/groupee/forums/a/tpc/f...710974#19710974


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## 16085 (Feb 3, 2007)

I haven't had any stool tested, just normal blood cbc, wbc, and kidney/pancreas/liver test. Which were all fine ( did think cbc included the WBC though)Like I said I still have the sonogram and MAYBE the CTscan, depends what my dr thinks and if my insurance will ok it then.I'm also having another odd symptom, I will get what feels like a ball in the upper part of my stomach, like a knot, when this happens I get nauseated and start burping alot. Nerves or indegestion from all this worry I have no idea.Maylox relieves the ball and the nausea...the pain isnt there all day long just comes and goes so Im not sure if thats helping with that.Lisa


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## Nanobug (Nov 7, 2006)

> quote:It does pay to be an informed consumer when it comes to medicine just like one does for anything else.


Absolutely!


> quote:I don't know that alternative medical people or herb store sales people are really any more reliable, FWIW.


I'm pretty sure they aren't reliable at all.


> quote:For any service you purchase there are good practioners and bad ones.


My experience with assembly-line doctors is that they are generally too busy trying to make a buck or two to bother too much with their patients. And, unfortunately, most doctors fall into the assembly-line category. In my experience, good doctors are the exception, not the rule.


> quote:I wouldn't tell you to avoid all plumbers if your pipes need fixing because some of them are less than trustworthy.


Incidentally, my opinion of plumbers isn't any better than that of doctors.Now, would you like to know what my opinion of car mechanics is?


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## Nanobug (Nov 7, 2006)

> quote:They have noticed an association in that quite a few people with IBS have fibro as well.


Pimentel did a study to assess whether there is a link between small intestine bacterial overgrowth and fibromyalgia.Here's the conclusion (from the link above):"An abnormal lactulose breath test is more common in fibromyalgia than IBS. In contrast with IBS, *the degree of abnormality on breath test is greater in subjects with fibromyalgia and correlates with somatic pain.*"So, maybe a lactulose breath test is in order? Given that SIBO also causes bowel problems, you may be able to kill two birds with a single shot.


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## eric (Jul 8, 1999)

Lisa, someone for sure should be doing stool testing. 3 of them hopefully. There is also a stool fecal caleprotein test that helps seperate IBS from inflammatory conditions, which can greatly help in supporting a diagnoses.1: Clin Lab. 2005;51(3-4):117-26. Links Fecal leukocyte proteins in inflammatory bowel disease and irritable bowel syndrome.Silberer H, Kuppers B, Mickisch O, Baniewicz W, Drescher M, Traber L, Kempf A, Schmidt-Gayk H. University of Heidelberg, Germany.The aim of this prospective study was to compare five different leukocyte proteins in feces of patients with chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and healthy persons who underwent prophylactic colonoscopy. METHODS: The leukocyte proteins calprotectin, lactoferrin, lysozyme, myeloperoxidase, and PMN-elastase were determined with immunoassays in fecal samples of three consecutive feces (e.g. three days) in 40 healthy persons, 39 patients with chronic IBD (of these 21 with Crohn's disease and 18 with ulcerative colitis), and 40 patients with IBS. RESULTS: ROC curves calculated for healthy persons and patients with IBD yielded the following areas under the curves (AUCs): PMN-elastase 0.916, calprotectin 0.872, myeloperoxidase 0.750, lysozyme 0.726, and lactoferrin 0.693. The AUCs of PMN-elastase and calprotectin were not significantly different (p = 0.327), whereas PMN-elastase or calprotectin vs. the other proteins were significantly different (p < 0.001). PMN-elastase and calprotectin correlated with the endoscopically classified severity of inflammation. All fecal leukocyte markers in IBS were found in the range of the healthy persons. Data on storage stability of leukocyte proteins in fecal supernatants are given. *CONCLUSION: Fecal PMN-elastase and calprotectin support the differentiation of chronic IBD from IBS and correlate with the severity of inflammation.*PMID: 15819166 Is the doc a regular doctor or gastro doc? Do you live in the US?"The lactolose breath test is not a very accurate testing method."


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## 16085 (Feb 3, 2007)

I forgot to answer one of your questions, you asked if my pains wake me at night...the answer is no. I only had an episode 2months ago where I was waken up by cramps and I had diahera, but I think I was taking an over the counter laxative.I live in the US, Im seeing my regular Dr, but he is sending me to a GI Dr for the colonoscopy. I also see my Rheumy every 6 months.Lisa


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## eric (Jul 8, 1999)

That it doesn't awake you is more an IBS diagnoses verses and organic disease.Its good your going to see a gi doc.also just fyi 1: Am J Gastroenterol. 2003 Jun;98(6):1309-14. Links Fecal lactoferrin is a sensitive and specific marker in identifying intestinal inflammation.Kane SV, Sandborn WJ, Rufo PA, Zholudev A, Boone J, Lyerly D, Camilleri M, Hanauer SB. University of Chicago, Chicago, Illinois 60637, USA.OBJECTIVE: Lactoferrin is a glycoprotein expressed by activated neutrophils. The aim of this study was to determine the sensitivity and specificity of fecal lactoferrin concentrations for inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS) versus healthy controls. METHODS: Fresh stool samples were collected from outpatients with ulcerative colitis (UC), Crohn's disease (CD), or IBS. Clinical disease activity for IBD was assessed using a modified Harvey-Bradshaw Activity Index. Fecal lactoferrin concentrations were determined using a polyclonal antibody-based enzyme linked immunoassay. Mean fecal lactoferrin concentrations for each group and sensitivity and specificity of the assay were determined. RESULTS: One hundred-four CD patients, 80 UC patients, 31 IBS patients, and 56 healthy controls were recruited. The mean +/- SE fecal lactoferrin concentration (microg/g fecal weight) was 440 +/- 128 for CD patients, 1125 +/- 498 for UC patients, 1.27 +/- 0.29 for IBS patients, and 1.45 +/- 0.4 for healthy controls. Fecal lactoferrin was 90% specific for identifying inflammation in patients with active IBD. Elevated fecal lactoferrin was 100% specific in ruling out IBS. CONCLUSIONS: Fecal lactoferrin is sensitive and specific for detecting inflammation in chronic IBD. This noninvasive test may prove useful in screening for inflammation in patients presenting with abdominal pain and diarrhea.PMID: 12818275


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## 17890 (Mar 11, 2007)

Lisa-I have also heard that IBS is what doctors say you have if they don't know what is going on. However, people who have been diagnosed with IBS share similar symptoms. It is a functional disorder because there is nothing "physically" wrong they can see. Hang in there, things will be alright!


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## 23715 (Mar 10, 2007)

My big problem is needing reassurance that something else isn't being overlooked because they assume it's all IBS. It just makes the pain worse to have to worry that something else might be happening and they will never seriously look for it.I have a history of being overlooked so it bothers me. I had lower right abdominal pain recurring from 1979 to 1983 - all drs. saying it wasn't the appendix - until finally I had an acute attack, and the appendix was removed and the surgeon said it was the worst he had ever seen. I never had pain from that moment on, for another 20 yrs until I got diagnosed with IBS, which is not following typical patterns lately.


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## 16885 (Oct 10, 2006)

http://www.diseasesdatabase.com/result.asp...ClassSort=False according to this website IBS is a psychatric condition. So it is real in some ways.


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## SophieUK (Dec 18, 2000)

IBS definitely isn't a psychiatric condition - I don't know who runs that website but they've obviously made a mistake or not bothered to do their homework.


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## eric (Jul 8, 1999)

FYI"Latest From the Literature in IBS""Lawal A, Kern M, Sidhu H, Hofmann C, Shaker R. Novel evidence for hypersensitivity of visceral sensory neural circuitry in irritable bowel syndrome patients. Gastroenterology. 2006;130:26-33.The pathophysiology of IBS *involves multiple underlying factors, including abnormalities in visceral sensation, disturbances in gut motility, and differences in the central nervous system (CNS) processing of visceral pain"**"In addition, patients with IBS demonstrated a maximum response to subliminal distention, as compared with the graded response seen in healthy volunteers. These findings are important for a number of reasons. One, it confirms the now widely accepted view that the brain-gut axis is a critical component in IBS. Two, it emphasizes that hypersensitivity is a key underlying pathophysiologic mechanism in the generation of symptoms in IBS patients. And finally, although not evaluated in this study, these findings point out that therapeutic options for patients with IBS should focus on treating both the hypersensitive gut and the hypersensitive CNS."*http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/906107392


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## David LA (Dec 21, 2005)

Lisa---That's EXACTLY right. "IBS" is simple a catch-all term. Its just something to write on your chart after they've completed all their tests & haven't found anything. Since "IBS" is a catch-all term...this basically means their could be many different reason's why your having symptoms. My personal feeling is that Dr. Mark Pimentel--The Director of the GI Motility Program at Cedars-Sinai Medical Center is probably the closest Dr. to really understanding the Root Cause of the majority of cases. Overgrowth of Bacteria in the Small Intestines. The good news is Dr. Pimentel has several more studies/research/data coming out this year....and more GI's will try his protocol on their patients.Trying a 10 Day Course of Rifaximin---along with the Diet Changes has helped 1000's of patients already. Unfortunately some people have to repeat the protocol 2 or 3 times before they see results. Others still, will see results only by experimenting with different supplements/and or diet changes. Remember, since IBS is a Catch-All term---Your "IBS" could be caused by eating ice cream/Hotdogs every morning----And then the bloating/upset Stomach follows-- Getting a handle on your symptoms is very Possible- But, you first have to be willing to take responsibility--You have to realize that the Best Dr. for you is YOU. You know your own body. And if you don't, you may want to introduce yourself. Most Drs. today are still following One Protocol(Drossman) this is a road going to NO Where Land!I really feel sorry for anyone following this path. This is why more people are suffering from "IBS" today.I can't believe why anyone wouldn't prefer to try a 10 Day Course of Rifaximin before starting up with Anti-Depresants and Anti-Anxiety Meds Or trying different combinations of supplements/diet changes FIRST. Good Luck!


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## 18907 (Mar 8, 2007)

It is real for me.


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## eric (Jul 8, 1999)

FYI"Gut Bacteria and Irritable Bowel Syndrome By: Eamonn, M. M. Quigley M.D., Alimentary Pharmabiotic Centre, University College Cork, Cork, IrelandBacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These "normal" bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the flora and its host, and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article presents a discussion of the possible role of bacteria in IBS and various treatment approaches."Do bacteria play a role in IBS?The possibility that gut bacteria could have a role Irritable Bowel Syndrome (IBS) may surprize some; there is indeed, now quite substantial evidence to support the idea that distrubances in the bacteria that populate the intestines may have a role in at least some patients with IBS. What is this evidence? It can be summarized as follows:1. surveys which found that antibiotic use, well known to distrub flora, may predispose individuals to IBS.2. The observation that some individuals may develop IBS suddenly, and for the first time, following an episode of stomach or intestinal infection (gatroenteritis) caused by a bacterial infection.3. recent evidence that a very low level of inflammation may be present in the bowel wall of some IBS patients, a degree of inflammation that could well have resulted from abnormal interactions with bacteria in the gut.4. The Suggestion that IBS maybe Associated with the abnormal presents, , in the small intestines, of types and numbers; a condition termed small bacterial overgrowth (SIBO)>5. Accumaliting evidence to indicate that altering the bacteria in the gut, by antibiotics or probiotics, may improve symptoms in IBS.For some time, various studies have suggested the presence of changes in the kind of colonic flora in IBS patients. The most consistent finding is a relative decrease in the population of one species of 'good' bacteria, bifidobacteria.However, the methods employed in these studies have been subject to question and other studies have not always reproduced these finding. Nevertheless, these changes in the flora, maybe primary or secondary, could lead to the increase of bacterial species that produce more gas and other products of their metabolism. These could CONTRIBUTE to symptoms such as gas, bloating and diarrhea.""We still don't know the exact role bacteria has in IBS. More research is needed."http://www.aboutibs.org/Publications/currentParticipate.htmlIts important to read the above article as a whole to get the full picture however.Already they can see strutural changes in PI IBS that matter and very important problems in IBS.


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## 22282 (Jan 31, 2007)

Hi I get upset every time someone tells me that IBS is not real. Because it is causing me (and million of people) problems in my (and their) life and just because DRs don't know what it is, they just say it is all in head. This is what 2 docs told me.To the victim, the pain, the gas buildup, stomach cramps, constipation, diarrhea, flatulence and other symptoms are very real.I have done all sorts of test endoscopy, colonscopy, various ultrasound scans and then the DR says it is in my head. It is painful to the self-esteem and the pocket as well







I have now opted for alternative methods and it seems to help me get my life back although it took quite a bit of time. I still do rely on some medication (esp laxatives like dulcolax) but I try to minimize them.I guess I had the misfortune of meeting DR who may not have "appropriate" bedside manners.I guess my take is that if it is real to the victim, then it is real. I am just glad I have found this forum.Now I collect stories and alternative remedies and put them in a blog so that others can read them.terence


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## Nanobug (Nov 7, 2006)

> quote:I have done all sorts of test endoscopy, colonscopy, various ultrasound scans and then the DR says it is in my head.


Many doctors don't like to admit their ignorance. Instead of telling patients that they don't know what causes symptoms labeled as IBS, they resort to that last refuge of "it's in your head". These same doctors would probably tell you you'd need to be exorcised if they could get away with it.


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## eric (Jul 8, 1999)

If any doctor does not take you seriously and tell you "its all in the head" Then its really time to find a new doctor who knows about IBS.However its also really important to understand the brain plays a major role in IBS. This should be confused with a doctor telling you its all in the head, but the connections between the back and forth constant communication the "gut brain" has with the brain. The brain is also constantly monitoring the gut. "Report from the 6th International Symposium on Functional Gastrointestinal DisordersBy: Douglas A. Drossman, MD and William F. Norton, IFFGDThe 6th International Symposium on Functional Gastrointestinal Disorders was hosted by IFFGD on April 7-10, 2005. The biennial meeting was jointly sponsored by the Office of Continuing Medical Education, University of Wisconsin Medical School and the International Foundation for Functional Gastrointestinal Disorders (IFFGD) in cooperation with the Functional Brain-Gut Research Group (FBG). The program, a culmination of two years planning was both stimulating and informative. In fact, our knowledge of the functional gastrointestinal (GI) disorders continues to evolve, and these symposia are in many ways a barometer of the many changes occurring in the field. Nearly 400 persons from around the world attended representing a variety of health care disciplines. Over 80 experts in the field of functional GI disorders presented their work in general sessions, multiple symposia directed toward specialties, and mini-workshops. The attendees included gastroenterologists, other medical physicians, nurses, physician assistants, lab technicians, and related allied health personnel, as well as representatives from the U.S. National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA), and the pharmaceutical and medical device industry. The summary that follows highlights several of the important aspects presented in the general sessions, including:http://www.iffgd.org/symposium2005report.html


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## 17409 (Jun 6, 2006)

I was diagnosed with IBS for 10 years until my symptoms got really bad, in that time a doctor actually said to me 'we only diagnose IBS when we are not aware of what is causing the discomfort'Eventually I went from 9 stone to 7 and a half stone. I had a colonoscopy which the NHS consultant replyed saying eveything was normal, in the back of my mind I did not belive him as I was in agony ( you just know don't you). I eventually paid for a private consultant who had the same test results and he said that I had definatly got UC and does not know why the other doctor did not treat me and was really annoyed! he even said that he would help me claim compensation if I wanted (which I did not). Since my diagnosis I have had a bad flare up in which put me in hospital for 2 days, I was vomiting and losing blood, What I am trying to say is if I had accepted the original diagnosis of IBS when I had my flare up of UC I could of been in a really bad way now.Do accept first opinions when it comes to IBS or digestive disorders, my experience proves that!


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## 22282 (Jan 31, 2007)

Hi allThank you guys







I read you posting and I feel good that "It is not in my head". Thank you IBSgroup forum.. I am so glad I found this place.It took me a long time to finally say to myself, "Get on with my life and ignored what the doc said to me". It took a lot of determination. Fortunately, my wife supported me so much.But mostly thanks to this forum.terence


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