# Treating symptoms vs. eliminating causes



## the doc (Feb 8, 2005)

I want to open dialogue on the notion of working towards a protocol that helps us better discover and eliminate the causative factors that contribute to our problems. Immodium, peptoB, calcium, and almost all the other 'remedies' discussed in this forum do little or nothing to help us discover and understand the underlying causes for our condition. I refuse to accept that there are not specific causes. It's fascinating for example that many of us first began our symptoms after a bout of food poisoning, a foreign trip, or some other parasitic, bacterial or fungal impact on our digestive systems. This cannot be insignificant and of course leads one to supsect that whatever caused the initial bout of digestive disorder (whether it be a specific pathogen or an imbalance) is still present in our system. I am also fascinated by the role that the liver plays in our equation of chronic symptoms and of course stress factors. I have been reading the information at wellatlast.com recently and find his discussions of the complex chemical functions of the liver to be eye opening. We certainly ask it to do a lot and I wonder how much we take care of it along the way.What I do understand is that western medical practice has not found any definitive causes and has no treatments except to lessen the symptoms - many of which ultimately only add to the problem over time. My theory is that nature gives us the cure for everything on the planet if we can discover it. I think that each of us can find a cure if we begin to first at least look at causative factors within our unique experiences.


----------



## cat crazy (Jan 28, 2002)

yay to the above post. My sentiments exactly. Sometimes I think it is a psychosis of the bowels as gi functions also have a lot to do with the serotonin malfunctioning. Just like the psychosis experienced by humans on the mental level when the serotonin in the brain or brain chemicals go off balance, perhaps the serotonin imbalance in the gi tract cause the bowels to go haywire. Perhaps a specific pathogen has caused the damage to the something in the gi tract. If this pathogen is unknown to science then it would not be something they would even look for in the tests. Just my theory anyway.


----------



## bonniei (Jan 25, 2001)

Cause is a very interesting word in illness and health. When a pathogen enters the body it "causes" symptoms. But not in all. Some with a strong immune system don't develop symptoms to the same pathogen. Is the pathogen the cause or a weakened immune system the cause.Al;so serotinin dysregulation seems to cause iBS. But why is there serotonin dysregulation. It is sort of like a child asking "Why is the sky blue?" and who keeps asking why to every answer you give him. So doc, what exactly do you mean by cause?


----------



## Kathleen M. (Nov 16, 1999)

Standard model is the bacteria or parasite is LONG gone, not still lurking totally undetectable by any means.Standard model runs like this. Bacteria comes along. Immune system goes into full kill it mode. Full kill it mode in addition to whacking out the bacteira (or whatever) also damages the body (why sometimes you feel like heck for days/weeks after the flu for instance, you killed off the bug, but with collateral damage).The damage that is important for IBS is any damage to the nerves that control the gut's sensory nerves, or alters how the nervous system reacts to stimuli.If you use a chemical to inflame the colon of a rat (I think they did this in rats) the nerves in the gut wall get damaged by the immune system. People with inflamatory bowel disease get IBS-like issues from this as well (symptoms that persist when the disease is fully under control).Most of the newer treatments for IBS focus on treating the problems with the nervous system.K.


----------



## 21286 (May 7, 2005)

I am always looking for the culprit.


----------



## eric (Jul 8, 1999)

Doc, read thishttp://www.ibshope.com/viewtopic.php?t=687"It's fascinating for example that many of us first began our symptoms after a bout of food poisoning, a foreign trip, or some other parasitic, bacterial or fungal impact on our digestive systems. This cannot be insignificant and of course leads one to supsect that whatever caused the initial bout of digestive disorder (whether it be a specific pathogen or an imbalance) is still present in our system. ""Post-infectious IBS. Symptoms suggestive of IBS occur in approximately 7-30% of patients following acute GI infections, often persisting for years following complete resolution of the infection. A large cohort study identified a self-reported history of acute gastroenteritis as a major risk factor for the development of IBS. Reported risk factors for the development of post-infectious IBS include female sex, the duration of the acute diarrheal illness and the presence of sustained psychosocial stressors around the time of infection. Post-infectious IBS is not restricted to a particular organism and has been documented with a variety of bacterial infections (Salmonella, Campylobacter and E. coli) as well as parasitic infection. However, the role of acute viral gastroenteritis in this condition is unknown. In post-infectious IBS, low grade GI inflammation or immune activation may be a basis for altered motility, and/or nerve and mucosal (lining of bowel) function of the gut in IBS. Recent studies have also shown that in a subset of unselected IBS patients (no documented history of a preceding gut infection), there is evidence of increased inflammatory cells in the colon mucosa. It remains to be determined if altered gut immune function is a general characteristic of IBS patients. The implication of stressful life events in the development of post-infectious IBS suggests a convergence of central (brain) and peripheral (gut) mechanisms in the clinical presentation of this syndrome. "


----------



## eric (Jul 8, 1999)

PS its not just inflammation though, because inflammation does not always cause pain."Altered brain-gut communication in IBS. A unifying hypothesis to explain the functional bowel disorders is that they result from a dysregulation of the brain-gut axis. An evolving theory is that normal gastrointestinal function results from an integration of intestinal motor, sensory, autonomic and CNS activity and GI symptoms may relate to dysregulation of these systems. Brain imaging studies such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have been performed in IBS patients to measure brain activation patterns to visceral stimuli. These studies suggest that brain activation responses to visceral stimuli are distinctly different in IBS patients compared to healthy individuals. IBS patients may have different emotional and cognitive processing of sensory information from the gut compared to healthy individuals."


----------



## overitnow (Nov 25, 2001)

I think I have gone further up the tree as far as controlling the cause of my bowel and digestive disorders with the flavonoid supplementation that I take; however, the "cause" is surely not a shortage of red wine in my diet, rather something that those extracts do within my wounded system.I have now talked a fourth person into using it for his GERD. Another ex-smoker (and co-worker) with a chronic problem of indigestion, he has now gone a month without pain, which is delightful for both of us. I am open to any theory as to why red grape seed and skin and ginko would do this.Any ideas out there?Mark


----------



## jeanne2 (Jul 19, 2004)

This dialogue kind of sums up the issues with IBS in general...and although I am glad to see it on this BB, am not conviced we will come up with anything new.Just my opinion for my own battle-it truly is mostly a psycho-social problem. The first GI I saw summed it up in a very oversimplified way, but it does make sense. In someone like me (not all of you) when I get stressed, or confronted by a situation that I fear, my body reacts by making me want to defecate. In some people their hands get sweaty, others hands tremble, some feel like they are going to vomit, faint, or urinate...and so on. Us IBS-D poeple, translate it to our bowels-for whatever reason!I think we all like to underplay the mental part of this disease, because we don't want to feel like we have no control-or admit it.Having written that, I can say that I have had bouts of D in very calm times at home..but they are rare, and likely caused by something I ate, like in a "normal" person.Also not implying we should not continue our quest to help make this disease tolerable, but for one, I am convinced that our mind-gut connections just go haywire in certain situations. Those that had food poisoning, etc etc probably had an embarrassing experience with urgency at the same time, and it set off a trigger that continued into their next social experience, even after the food poisoning, traumatic events, etc were long in the past.Their minds just keep remembering and dwelling on the bad experience, with the resulting effect that for us, goes to our GI tract.I am always amazed at the level of "mind power" and research that the individuals on the site have dedicated to IBS. I have never one time read a post or reply from a medical person. I have told three doctors that I have been to-including one from the University of Michigan Medical Center- that any med students looking at becoming a GI specialist, should be given an assignment to spend even one hour on the different boards of this website. I doubt a one of them thought it was a worthwhile suggestion!Anyhow...good thread, but for me, I just keep trying different things to help me lead a more normal life. I can't wait on medical research, if a pill or supplement helps me-I'm going to go with it.Jeanne


----------



## miranda (Apr 16, 2004)

I too have had symptoms while in a 'calm' state and this scared me alot b/c I was sure my D was caused/aggravated by situational stress and anxiety.I realize now that brain triggers are not just the situation at hand. Stress and anxiety, for me, can be caused by something immediate like a meeting at work, having to meet someone at a certain time, having to go to a party or going somewhere where bathrooms aren't plentiful etc... But I've also learned thru therapeutic sessions that stress and anxiety can be caused by worries and thoughts we carry around with us each day.I don't know a general term to cover what I am trying to explain but some examples are - holding grudges against family or friends, long standing feuds, guilt - say you broke the office copier and never owned up to it.My point is that if you hold these negative feelings inside you, they will eat away at your emotional health. You could be carrying a baseline of worry and mental anguish which can affect you at anytime not just when faced with a nerve wracking situation.I looked at all parts of my life, I felt guilty and awful after gossiping at work so I stopped, I tried making peace with friends and family who I have feuded with, I owned up to lies I've told... We all make mistakes in life, let us not carry them around with us.I am not saying if you have anxiety you are a low down, lying, cheating awful person. The point is to look at see if there are any dark clouds hanging over your life that you could brighten up!!


----------



## jeanne2 (Jul 19, 2004)

You're right Miranda..the general anxiety disorder is just what you described.I hate to keep referring to my husband, but he's the person I can most identify with because I've been with him so long, and around him in many situations. But- he's an example of the many people out there that can just blow off things us anxiety prone people cannot.We can have a big argument, and he can go to bed and fall right to sleep...Im up for hours worrying....same thing if something went bad with the kids....I wake up worrying and thinking with my mind racing...or things at work...he just doesn't let it get to him.He will put off things he knows he has to do, and it doesn't bother him at all...outwardly.I feel bad if I let someone down or don't own up to something I know I should have,etc.Doesn't mean we are better people than others..it's just how we are. I would love to be more calm and "type B' about my life. So, maybe the calm times when my gut acts up, are really just from anxiety. Somehow I don't think so though..it's a whole different feeling than days when my whole body just feels "nervous".Jeanne


----------



## eric (Jul 8, 1999)

One thiing about psychological stressors, they can have a delayed reaction.However,"Comment from Emeran A. Mayer, M.D. -- In contrast to the common interpretation of the term "stress" as a psychological phenomenon, it should be understood as any real or perceived perturbation of an organism's homeostasis, or state of harmony or balance. For example, in this viewpoint a severe hemorrhage, starvation, extreme temperature, or worry about the unpredictable onset of abdominal pain all qualify as stressors -- some as "physical" stressors, others as "psychological" stressors. The fear to leave the house in the morning without knowing if one can make it to work without having to stop on the freeway because of an uncontrollable bowel movement, or the fear of experiencing uncontrollable abdominal discomfort during an important business meeting are sufficient stressors to activate the central stress system. The central stress system involves the release of chemical stress mediators in the brain (such as corticotropin releasing factor), which in turn orchestrate an integrated autonomic, behavioral, neuroendocrine, and pain modulatory response. This biological response in turn will alter the way the brain and the viscera interact, and this altered brain-gut interaction can result in worsening of IBS symptoms. Thus, pain and discomfort, fear of these symptoms, activation of the stress response, and modulation of the brain-gut interactions by stress mediators are part of a vicious cycle which need to be interrupted to produce symptom relief. "http://www.aboutibs.org/Publications/StressDefined.html


----------



## jeanne2 (Jul 19, 2004)

Interesting....I still maintain that I have many "times" actually days or stretches of days, where I feel in "homeostasis" did I spell that right?My mind feels OK, my gut feels calm, I feel kind of invinceable-I notice it when I am on vacation or away from home a lot..which is nice, but also just some regular old days.Then other days for no reason, I get up in the morning and my stomach is just churning.It may be hormones, it may be seritonin, but whatever it is, I don't seem to have much control over my anxiety level. Of course before any big public thing..like a talk I have to do, etc. I will be nervous and probably have D a couple of times, but in those cases it is self limiting.This is Tuesday. Monday morning I had a usual sevreral BMS as my work day started...usually that means a calm afternoon and Tuesday.Well, this morning I have been to the john 5 times..and now feel OK. None were real urgent or too runny-but nonetheless, this is usually one of my good days, and it is a calm day at work ...who knows?Jeanne


----------



## the doc (Feb 8, 2005)

> quote:Originally posted by Kath M.:Standard model is the bacteria or parasite is LONG gone, not still lurking totally undetectable by any means.Standard model runs like this. Bacteria comes along. Immune system goes into full kill it mode. Full kill it mode in addition to whacking out the bacteira (or whatever) also damages the body (why sometimes you feel like heck for days/weeks after the flu for instance, you killed off the bug, but with collateral damage).The damage that is important for IBS is any damage to the nerves that control the gut's sensory nerves, or alters how the nervous system reacts to stimuli.Most of the newer treatments for IBS focus on treating the problems with the nervous system.K.


This is obviously the current belief regarding causation and uncovering treatments. But I'm not sure that I am quick to accept it.Step back from it all and ask the simple question, what is IBS? These are words grouped together over the last few decades by health practitioners to label a set of symptoms that cannot be fully explained regarding their causative factors.Go back ten years before we had the term IBS, without the concept, what did they call our symptoms then?While I certainly accept the idea that nerves in our gut are acting out to deal with our problems, are they in themselves the problem? And I don't know if I accept that the stimuli is indeed "long gone."Case in point: H. Pylori. Recently my own personal endoscopy found mild gastritis, after five weeks of D that I could not get to stop (and refused to take immodium to do so). My colonoscopy results were normal. So, now I go back to Japan in 1995 when I acquired my first D symptoms. Ten years later is the bacteria still there and am I still having problems because it was never fully eradicated? There is a wealth of findings that H. Pylori can stay around for a lifetime if not dealt with.Recent studies of Gambian children have connected chronic diarrhea with H. Pylori (when conventional medical wisdom has previously confined H. Pylori to the stomach). I am equally fascinated that there is a vitamin B12 deficiency connected to H. Pylori conditions and that so far the typical three pronged western medical protocol for H. Pylori eradication has usually only been shown to be effective while being administered. That is, once you stop trying to eradicate H. Pylori, it returns. They are only now discovering that this bacteria burrows itself much deeper into the mucosa tissues than was previously thought.Ok so indulge my oversimplification, but why can I not at least suspect that I acquired an H. Pylori problem, it was never really eradicated and now during times of surpressed immune system function, my body reacts to its continued presence? And when it does, my digestive system starts to act up. Or should I just believe conventional wisdom that my colon has now become misguided and is just acting out through memory of previously dealing with it or some other suspected cause? Maybe we are just making it too complicated? Sure we can respect and accept that our colons have their own "brain" and nervous system, but maybe in their wisdom they know more than our tests show. Perhaps undetected bacteria or some other specific cause still exists and our system knows it. It's worth thinking about. It's worth investigating, if we want to be responsible for our own well being.


----------



## jeanne2 (Jul 19, 2004)

Doc-You bring up some thought provoking questions. No physician I have seen has ever brought up the pylori "issue".Have you talked with a doctor about your ideas?How do they test and/or treat for it?Like you wrote, it seems to simple to be right-but have you pursued it further with a medical person?Just curious..as we are all looking for "why"Jeanne


----------



## the doc (Feb 8, 2005)

jeannei have pursured it with many medical people with mixed results. the problem with medical people generally is they tend to only believe and accept what they were taught or have learned. there is usually just not time to investigate or research unproven and speculative new options. they leave that up to the pharmaceutical companies! the conventional wisdom regarding h. pylori in medical school has been that it only effects the tissues of the stomach, but i am of the belief, and i think evidence is beginning to show that this bacteria can be present in the colon as well.Rather than expect them to know, approve or suggest any alternative means of treatment, I have taken it upon myself to investigate curative options. Some of which involve grapefruit seed extract, oregano leaf extract, mastic gum and glutamine, along with vitamin B12 shots. These are just underway so time will tell.If you do some searches for "h. pylori" on google you will find out the typical treatment regimens used today. They usually involve antibiotics in a combination of threes. Something I would likely not be open to.


----------



## phillipm2 (Sep 24, 2004)

Some very good information in this discussion. I too have found there are lots of variables when deciding on a path to take in treating IBS. Its how you go about it, the "what works, and what doesnt." The brain is connected to all parts of the body. So, if something is offset in the mind like stress or extra hormones then the colon tends to act up, as some of us know. If bacteria are invading the colon usually discomfort or pain is associated with the culprit. Trying to decipher all of these things is a real headache. I have heard of certain types of bacteria that casue harm staying in your system, without you knowing its still there. Surely medical doctors have found something that will attack these bacteria and get them flushed from the system. I think this is the main cause of people getting IBS in the first place. If they were to have had food poisoning or came in contact with any type of fungus or even antibiotic their bowl habits have changed. Undoing the damage is really nerve wrecking to do since you have to go through the process of elimination. I believe thats why some peoples chemistry responds differently to treatments for IBS..??


----------



## jeanne2 (Jul 19, 2004)

It's complex all right..an understatement.I still contend the mind-gut relatioship is the culprit (for whatever reason) for most of us.Hundreds of thousands (or whatever the number might be....I'm just trying to make a point) of people every year get food poisoning, bacterial infections that effect the GI tract..not to mention just the stress of day to day life, and other traumatic events that have been mentioned on this BB as being the "time their IBS started"(death in the family, divorce, etc)If these were absolute beginning points for IBS-why would most people just eventually go back to "normal" after these events...when others with mixed up mind-gut chemistry, fall into what will likely be a life-long pattern of IBS?I'm not discounting the pylori theory..and will look into it...I am always curious. The longer I go with this, the more things I read and try, the more jaded I get. But-we have to keep on trying to live with as much quality as we can, and tell ourselves there are far worse disabilities.Jeanne


----------



## eric (Jul 8, 1999)

As far as Post infectious IBS is concerned, both bacteria and viruses have been found to lead to IBS. There is a lot of research already done on this and a lot more being done.There are also some 25 or more functional gi disorders.Functional dfunctional cfunctional chronic abdominal painIBS functional dyspepsiaand more.A huge amount of research has been done lately on IBS.This is worth readingFYIwith permission from the UNC"History of Functional DisordersDouglas A. Drossman, MDCenter-Co-DirectorMelissa SwantkowskiNew York UniversityTHE PASTHISTORICAL PRECEDENTShttp://ibsgroup.org/eve/forums/a/tpc/f/71210261/m/19710974They also know serotonin is not regulating right in IBS. They just don't know why.They also have really good evidence for impairment of certain brain centers in IBS.This is a good article on state of the art in IBS.http://www.ibshope.com/viewtopic.php?t=687In your case also they have found organic issues. When that is the case it isn't ibs any longer, unless a person has IBS and other organic disorders, which can happen. People can have IBS and say gerd for example. In IBS also more women then men have it, there is mild, moderate, and severe IBS.There is also this.Report on the 5th International Symposium on Functional Gastrointestinal DisordersApril 4, 2003 to April 7, 2003 Milwaukee, WisconsinCopyright Â© 2003 by the International Foundation for Functional Gastrointestinal Disorders (IFFGD). All rights reserved. By: Douglas A. Drossman, M.D., UNC Center for Functional GI and Motility Disorders at Chapel Hill, and William F. Norton, IFFGDClick on Titles to View TopicsOutcomes of Pediatric Functional GI Disorders Epidemiology/Genetic/Behavioral Factors Basic Principles -- Brain-Gut Brain Imaging Emerging Techniques to Evaluate and Treat Functional GI and Motility Disorders Clinical Applications of Diagnosis and Treatment Functional GI DisordersGeneral Principles of TreatmentPharmacological Treatment Psychological Treatment IFFGD Research Awards http://www.iffgd.org/symposium2003report.htmlThere was a new one of these recently and that information will be published to the net soon.


----------



## jeanne2 (Jul 19, 2004)

Eric- I have seen your posts over the years and know you do a tremendous amount of research...it is appreciated.My feeling is that the research doesn't get to the doctors in the field, for the most part.The GI I have spent the most time with-and I am done with, by the way....is in his early 60's.He truly seems to have no clue what to do with me, except the same things they've been doing for the past 20 years to treat "diarrhea".It's unbelievable...and he is with a big, well respected group of GI specialists.They seem to like the testing, surgery and treating cancer. We are just too time consuming for them!Just venting.Jeanne


----------



## cat crazy (Jan 28, 2002)

There is interesting info on http://www.luminet.net~wenonah/new/ulcer.htm


----------



## eric (Jul 8, 1999)

Thanks jeanne.I agree more of the research, such as even using rome ll to diagnose should be more prevalent to regular docs.This is new from the new ddwDDW: Post-infectious IBS outbreaks probed for clues to long-term effects Study of two Canadian outbreaks to help MDs better counsel patientshttp://www.medicalpost.com/mpcontent/artic...613_201531_1348


----------



## the doc (Feb 8, 2005)

interesting. viral causes appear to be less of a likely culprit with chronic condtions, given intestinal virus's apparent shorter lifespans. why do i keep suspecting that it's bacteria that we cannot wipe out?and what about the anxiety connection? why do so many sufferers also start having anxiety issues after the symptoms start manifesting?any of you prolific posters know of any research on the IBS/Anxiety connection?


----------



## cat crazy (Jan 28, 2002)

> quote:Maybe we are just making it too complicated? Sure we can respect and accept that our colons have their own "brain" and nervous system, but maybe in their wisdom they know more than our tests show. Perhaps undetected bacteria or some other specific cause still exists and our system knows it. It's worth thinking about. It's worth investigating, if we want to be responsible for our own well being.


I tend to agree with this. Maybe the infecting bacteria does not get completely eradicated with the antiboitic treatment following the infection. Perhaps the bacteria goes into a dormant state and rears its ugly head when the body is stressed or immune functions are overloaded. But I also have this question, If the bacteria is still residing in the gut would then we not have other symptoms like fever, flu like feelings and other associated symptoms that go with an infection? Also would not our own immune system still be attacking the bacteria again when it becomes active in the gi tract. There is definitely a real need for more research.


----------



## jeanne2 (Jul 19, 2004)

Hanna-Your last paragraph were my questions exactly..you just wrote them better, lol. Infections that go on for year, surely must have some other manifestations. Then another post asked "why does the IBS anxiety start after these episodes"...another of my questions from my post. And again, over- simplification but I think we end up with IBS because of the way our minds work...we dwell on it and create our own hell so to speak. Everybody gets diarrhea, Everybody will have a bout with food posioning, bad water, GI infection in their lives....most never experience anything like we do afterwards. We are just programmed that way, and find anyway we can to try to break the mind-gut cycle.(always fearing an embarrassing social event)Jeanne


----------



## cat crazy (Jan 28, 2002)

Just another thought and question. With the mind/body/gut connection to post infectious diseases then what happens in cases of infection when the infection is not in the gut? Suppose there was an infection in the kidneys or bladder or other parts of the body then would those people not have continued symptoms after their infection cleared up and exhibit chronic symptoms? Anxiety factor would be there in anyone with an infection in any part of the body. Or maybe the pathogens that infect the gi tract are much harder to eradicate than the ones that infect other parts of the body?


----------



## jeanne2 (Jul 19, 2004)

Maybe those people would...but I've had bladder infections (maybe 3 in my life) and when they cleared up, I didn't fear I'd not be able to control it.I have rarely thrown up in my whole adult life, but I will bet there are cases of people who fear that after a bout of GI infection where vomiting is the main symptom. I didn't though.(I think I've even read of a phobia where people will not eat in front of someone, or do things after they eat for fear they will vomitin public-of course even that is more accetable than what we thinkg we will do)I think bowel habits are just the worst, most embarrassing, most often joked about body function..and as I wrote before, when we have a episode(s) totally caused by something else, where we have a close call...or actually have an accident..it is just so engrained in our minds, we cannot let it go. It is the ultimate humiliation in our society, and those of us that are hyper sensitive to it, just can't get over it.Ah, my theories...Jeanne


----------



## cat crazy (Jan 28, 2002)

Only one gi doctor said to me I have post infectious ibs. He said there is nothing that can be done other than take fibre. He also said the infection left an imprint on my cells. I did not ask him to elaborate not knowing what to ask. Did he mean the mind-gut connection I wonder?


----------



## phillipm2 (Sep 24, 2004)

It seems to me, when I am sick the body protects itself from harmful bacteria or viruses by inducing vomiting or generating heat. This is so that everything in the system is out. Now, when it comes to IBS some bacteria are either still there or something was left behind. Most IBS suffers dont vomit or get "other" side effects from harmful bacteria besides the unpredictable colon phenomena. The brain-gut is going to take awhile to progress since science is not quite up to speed on understanding how to stop the gut from being so receptive to the brain(anxiety). I would be willing to take classes to better understand all of the functional influences the brain has over the gut but I dont think I could sit through class.


----------



## eric (Jul 8, 1999)

The majority of treatments that help IBS and global symptoms, are not treatments that work on bacteria. Transient bacteria such as eating some leftovers out of the firdge could trigger an attack possibly.There is no major inflammation found in IBS, but in some people there is Macroscopic inflammation of specific cells.There is no weight loss, malabsorbtion, fever, all these things are red flags for a diagnoses of IBS.There is no eveidence of continued bacterial infection, or any single bacterial infection in IBS, on the contrary, both viruses and bacteria may lead to the development of IBS after the resolution of the intial infection.Some people like myself have had IBS for over thirty years, with it not leading to anything else or with any bacteria issues after the intial infection, which has been resolved. The inflamattion of the intial infection however, can cause changes is the cell makeup of the gut.Specifically EC cells, 9which release serotonin) and mast cells which release histimine.There is however serotonin dysregulation in IBSers in the brain gut axis. A couple good things to read."What would be an example of new understanding?Well one example is that we're starting to understand how the brain is responding to the pain in IBS. There have been some studies done where they've artificially created a kind of an irritable bowel by placing a balloon to stretch the bowel, and that produces pain. Then they've compared people with IBS to non-IBS, or "normal" individuals. And what they've found is that when you stretch the bowel-and use PET scans to monitor the response-in normal individuals, certain areas of the brain that register pain respond and release chemicals called neurotransmitters that suppress and lower the pain. But it seems that doesn't happen as well in people with IBS."In fact, in people with IBS another area of the brain responds that is associated with anxiety. So what we find is that people with IBS, aside from having a bowel problem, may have some difficulty in terms of the way their brain is regulating the pain."http://www.aboutibs.org/Publications/clinicalIssues.html"Visceral Sensations and Brain-Gut MechanismsBy: Emeran A. Mayer, M.D., Professor of Medicine, Physiology and Psychiatry; Director, Center for Neurovisceral Sciences & Women's Health, David Geffen School of Medicine at UCLAIntroduction Over the past several years, different mechanisms located within the gut, or gut wall have been implicated as possible pathophysiologic mechanisms underlying the characteristic IBS symptoms of abdominal pain and discomfort. The list ranges from altered transit of intestinal gas, alterations in the colonic flora, immune cell activation in the gut mucosa, and alterations in serotonin containing enterochromaffin cells lining the gut. For those investigators with a good memory, these novel mechanisms can be added to an older list of proposed pathomechanisms, including altered gut motility ("spastic colitis") and alterations in mucus secretion. While the jury on any of these novel mechanisms is still out, one unique aspect about the gut and its connection to the brain are often forgotten: Our brain-gut axis is not designed to generate conscious perceptions of every alteration in gut homeostasis and internal environment, in particular when these changes are chronic, and when there is no adaptive behavioral response an affected organism could generate. "http://www.aboutibs.org/Publications/VisceralSensations.htmlIf you have not watched this, its pretty good.Informative public television broadcast on IBShttp://www.itvisus.com/programs/hbhm/episode_ibs.aspThis is one more indepth good one.http://www.ibshope.com/viewtopic.php?t=687


----------



## AngelGlow (Jun 16, 2003)

H. Pylori can be diagnosed using a simple blood test. Treatment is a two week regimen called Helidac Therapy. It contains a few different meds including tetracycline. My daughter had that, and the doctor had her use Prilosec for the two weeks as well as Helidac Therapy. H. Pylori is the bacteria that causes Peptic Ulcer.


----------



## 21918 (May 16, 2005)

Over the years (I've had IBS for 37 wonderful years







), I've had several courses of antibiotics of all kinds and classes(penicillins, sulfa drugs, tetracyclines, macrolides, flagyl, and cephalosporins) for various things such as tonsillitis, sinus infections, skin infections, and colon surgery. I still have IBS and if anything, most antibiotics cause diarrhea unless one replaces the normal gut flora with acidophilus. I have also been on a few antifungal meds for other problems.I don't ever remember having a significant GI infection that started the whole thing. My first memories of IBS were of riding in the car as a child and having diarrhea and hoping my dad could find a place to stop without being mad at me. My next memories were of being 14 and sitting in class and having a very nervous stomach. This is when I feel my history of IBS began. I do remember that I always had a very nervous stomach. What my mom explained were butterflies in my stomach seemed so much worse to me--to the point of not involving myself in activities that caused those feelings.The one thing I did notice in one of the links was a mention of cortisol as a contributing factor. I was given cortisone shots several times as a kid for very inflammatory cases of poison oak. Other than that, I can't find a physical cause for my IBS and vote on the side of IBS (at least mine) being more of an anxiety by-product.


----------



## the doc (Feb 8, 2005)

forgive me for mentioning again something that treats the symptoms more than the cause, but i do think that this is worth a heads up! it's - especially good for those taking peptoB: GastroMycin. it's useful for at least a couple of months, after that it's suggested to have the bismuth (a naturally occurring metal/element and the active ingredient in pepto bismo) level checked in your blood regularly. this stuff is like pepto without all the gunk they add to it and i think that 2 capsules three times a day would probably help most folks with D! i can testify that it helps end the D and would guess that it's both better for you and safer long term than peptoB. note that they recommend that it can be used with mastic gum which is known to kill h. pylori. http://organicpharmacy.org/products/Gastro...n/SKU:71030-arg


----------



## cat crazy (Jan 28, 2002)

> Rather than expect them to know, approve or suggest any alternative means of treatment, I have taken it upon myself to investigate curative options. Some of which involve grapefruit seed extract, oregano leaf extract, mastic gum and glutamine, along with vitamin B12 shots. These are just underway so time will tell.the doc, I am interested in how you are doing on this treatment. Please post on your progress. I am especially interested in the mastic gum and the gastromycin, (sp). Any more info on these 2 meds?


----------



## the doc (Feb 8, 2005)

the D is over now and it's because of the GastroMycin. i'm into my holistic MD tomorrow for the B12 drip and since my Life Enhancement ByeLori mastic gum just ran out i'm gonna see what my doc uses in that regard. i have an appointment for further discussions this week with my GI also to hear what he will say can cause mild stomach inflamation if there is no h. pylori detected. i'm starting a series of colonics this week too and some lymphatic-drains to help my body stay cleaned out.


----------



## cat crazy (Jan 28, 2002)

the docWhat are lymphatic-drains? I know about colonics as I had taken a series few years ago. It helped wean me off immodium as my body had become addicted or built up a tolerance. Was on immodium daily for a few years and the effective had worn off. What do lymphatic-drains do for the body and how it is done and by what kind of health care provider?


----------



## the doc (Feb 8, 2005)

Electro-lymphatic therapy is explained here pretty well: http://www.livingwaterrejuvenation.com/Electro_Lymphatic.htmapparently our bodies contain more lymphatic fluid than blood. the protocol is to have the ELT and then the colonic immediately afterward to help clear the system.Here's more about the importance of keeping the lymphatic system working properly: http://www.northwestwoman.com/vitality.htmlyou might also want to check into rebounders - small trampolines that you jump on in your house to help the lymph system flow stay active.


----------



## eric (Jul 8, 1999)

FYIThis is free but you need to register and supply a password. http://www.medscape.com/viewarticle/506599They are getting somewhere. "Commentary Evidence is emerging that there are definable abnormalities in those patients previously categorized as having "functional" disease. These study findings not only lend further support to the involvement of nociceptive abnormalities, but also nicely and scientifically define a treatment response to a therapy. It will be interesting to evaluate the crossover application of these physiologic assessments of the nociceptive abnormalities in other disease states, such as chronic constipation. Additionally, definition of prevalence and treatment response for these abnormalities will need to be further explored across sex and IBS subgroups."


----------



## phillipm2 (Sep 24, 2004)

Thanks for the info eric it seems to be really helpful


----------



## cat crazy (Jan 28, 2002)

> quote:Originally posted by the doc:the D is over now and it's because of the GastroMycin. i'm into my holistic MD tomorrow for the B12 drip and since my Life Enhancement ByeLori mastic gum just ran out i'm gonna see what my doc uses in that regard. i have an appointment for further discussions this week with my GI also to hear what he will say can cause mild stomach inflamation if there is no h. pylori detected. i'm starting a series of colonics this week too and some lymphatic-drains to help my body stay cleaned out.


I was just browsing on google and came upon an intersting article on Fibromyalgia and Infection connection. This article also mentions ibs in their range of symptoms. Hmmmm, infection causing fibro/cfs and ibs among other things like arthritis etc etc. Before H/pylori was detected doctors or researchers always thought ulcers were caused by stress and then came along discovery of h/pylori. Now maybe there is aspecific bug proven to cause fibro/cfs. I have also posted this info on the fibromyalgia forum


----------



## paul762 (Jan 4, 2004)

> quote:Originally posted by bonniei:serotinin dysregulation seems to cause iBS. But why is there serotonin dysregulation.


In my case I think it was fluoxetine.


----------



## the doc (Feb 8, 2005)

just an update on things for anyone interested. after five weeks of D and the requiste round of tests my GI basically told me "we don't know why you had mild inflammation in the stomach and colon and the colonoscopy, endoscopy and the biopsys came back negative for h. pylori and everything else, so you are good to go..."my holistic MD gave me a 90 minute B12 and other nutrient IV drip and had me do one final stool test (all previous ones have been negative for anything they look for). The IV infusion was very beneficial and helped replace the nutrients that were lost through the weeks of D.no more D for quite a while now and probably the most encouraging thing from last saturday was the electro-lymphatic cleanse and colonic. the hygenist told me that D is the ultimate C! Think about it. I will probably start another thread on this but the reasoning is: D is not your colon freaking out to what you are taking in as much as what is still around and won't come out. Fascinating!


----------



## flux (Dec 13, 1998)

> quote:Electro-lymphatic therapy is explained here pretty well: http://www.livingwaterrejuvenation.com/Electro_Lymphatic.htmapparently our bodies contain more lymphatic fluid than blood. the protocol is to have the ELT and then the colonic immediately afterward to help clear the system.


This stuff is science fiction.









> quote:my holistic MD gave me a 90 minute B12 and other nutrient IV drip





> quote:The IV infusion was very beneficial and helped replace the nutrients that were lost through the weeks of D.


People with IBS do *not* lose nutrients. I'm not so sure what the circumstances there could that anyone would require nutrients replaced in this fashion. If you had severe diarrhea, you'd be dehydrated (also, this is not generally caused by IBS either) and you'd need an IV, but that's for fluids and electrolytes and where you'd be hospitalized for.


----------



## the doc (Feb 8, 2005)

to suggest that during the process of longterm, chronic D and the dehydration that occurs as the result of it, there is not some level of corresponding nutrient depletion, is just plain silly.


----------



## flux (Dec 13, 1998)

> quote:to suggest that during the process of longterm, chronic D and the dehydration that occurs as the result of it, there is not some level of corresponding nutrient depletion, is just plain silly.


No, it's fact. Longterm, chronic D from IBS does *not* cause any kind of nutrient depletion whatsoever.


----------



## the doc (Feb 8, 2005)

> quote:Originally posted by flux:No, it's fact. Longterm, chronic D from IBS does *not* cause any kind of nutrient depletion whatsoever.


source? D by nature is malabsorption. electrolytes, carbohydrates, salts, water, calories, proteins (the list goes on) are plainly not being adequately absorbed and thus over time are depleted in the body.adding the phrase 'ibs' to an opinion isn't some sort of magic confirming qualifier, either. whatever the cause of chronic D, over time, it most definitely *will* cause depletion of key nutrients (defined as any substance that can be metabolized by an organism to give energy and build tissue) in the system.http://gastroresource.com/GITextbook/En/Chapter7/7-11.htmit's common knowledge that the primary role of nutrition in both chronic and acute D is to prevent depletion of fluid, sodium, potassium and calories.


----------



## 23584 (Jul 6, 2005)

Help, I am getting desperate. I started suffering from this miserable way of life about 2 years ago. I have tried everything - specific diets, drugs (including Lomotil as prescribed by my doctor) with very little lasting effect. Calcium as suggested on some of the web's bulletin boards does not work. The strange thing is that I can eat a specific food one day and it won't have any effect on me, then a month later eat it again and wham!! I am currently suffering thru a bout that started with eating a handful of fresh Bing cherries last Thursday & Friday - and I mean literally just a handful, maybe about 6 one day and 8 the next. Yet over the past year I have eaten many cherries on many occasions with no effect whatsoever. The only food I know for certain to keep away from is whole nuts of any kind - they always set it off, no matter how many I eat. (But, I can eat peanut butter with no problem...) Codiene no longer helps to bind me at all. Both my doctor and I are at the end of our ropes as to what to do next. Any suggestions to make it stop? Any new drugs in the marketplace that I can try?


----------



## Kathleen M. (Nov 16, 1999)

If you are in the US there is Lotronex.Foods sometimes trigger symptoms, but a lot of people find that likely trigger foods (cherries are a known likely problem because they are high in sorbitol) are often only a problem when the IBS is acting up for other reasons, rather than consistantly every time they eat the food.Have you tried any of the tricyclic antidepressants? Those sometimes work very well for diarrhea predominate IBS.K.


----------



## paul762 (Jan 4, 2004)

Kath - I was given amitriptyline but im a bit worried to take them because of the fluoxetine experience, I am the same , one day a food wont bother me and the next time I eat it I have a blowout, my bowels seem to go into overdrive if I know I have to go out somewhere, but I still can get loose stools even at home, I took 1 immodium plus tablet and havent been to the loo for 3 days but did have a feeling a lot of the time, I am wondering whether to take them regularly or not? which do you think I should try amitriptyline or the immodium, although ther has been times when even immodium has failed me.


----------



## Kathleen M. (Nov 16, 1999)

Depending on what the problem was with the SSRI antidepressant that may or may not counterindicate a tricyclic (you need to talk that over with the doctor to see what the risks may be)With Imodium if you take regularly you need a dose that doesn't back you up. If you get backed up you have to stop until things start moving again.People who are more consistant in symptoms are usually better candidates for daily treatment with things like anti-diarrheals as they can usually find a dose that controls things most of the time.Even when you have good control if you eat something that would set anyone off (if it is bad food even non-IBSers get severe diarrhea from it, for example), you may not get control with IBS meds.You don't want to medicate to the absolute worse case scenario as that tends to cause problems the other way. What you want is what controls things most of the time fairly well. It is a balancing act and can be a pain.edit to add...For the diarrhea must in every single case deplete you thing....in most IBSers unless they got something additional going on transit throught the small intestine where the majority of stuff is absorbed (nutrients and pretty much everything but water) is completely and totally normal. This is why nutrient deficiencies and uncontrollable weight loss (small intestine is messed up signs) are BIG RED FLAGS that something other than IBS is going on.For most IBSers the diarrhea is also not a case where the colon walls are dumping large amounts of water and electrolytes into the colon (although sometimes certain things will trigger watery diarrhea in IBSers) which is where the losing water and electrolytes with diarrhea causing diseases cause problems. IBSers do not routinely need to be admitted to the hospital for IV fluids which would be the case if they lost huge amounts of water and electrolytes every day.Usually with IBS diarrhea stool gets to the end before your body has enough time to reabsorb all the normal levels of water it dumped into the GI tract for digestion. You aren't losing much more water than an average person, and drinking when you are thirsty like any other human should keep you hydrated just fine. K.


----------



## eric (Jul 8, 1999)

FYIhttp://www.ibs-research-update.org.uk/ibs/digestion1ie4.htmlandThis is just one, of many research centers around the world saying this."In IBS, digestion and absorption of nutrients is not disturbed. "http://www.uoflhealthcare.org/pp_ad_bowelsyndrome.htmlI could find many more.Some people however, might have more then one thing going on as Kath has mentioned.Doc you should read this.http://www.ibshope.com/viewtopic.php?t=687


----------



## the doc (Feb 8, 2005)

this thread has come full circle. and readers have a clear choice. continue to believe that you are fine with your D and take the latest fashionable pharmaceutical that the 'experts' here are quick to endorse - with little corresponding regard for understanding and dealing with the reasons for taking it, or try to look at yourself and remedy the causative factors that are the basis for your unacceptable health conditions. earlier i talked about keeping it simple. the experts here with thousands of posts however are so wrapped up in their expertise that they've lost sight of the simple fact that IBS is not a causative factor, it's a man made description of unexplained conditions. it's the trash bin where western medicine dumps its lack of ability to deal with it. in that regard the prolific posters are correct. IBS doesn't cause anything, it doesn't deplete anything, how can the result be the cause? Their learned oversight parallels that of most western medicine and the _only for profit_, worn out road it always travels down. we'll trade you your liver for lowered blood pressure, your kidneys for lower cholesterol, an erection on cue for your ability to see ... and life goes on. eric you site one sentence describing IBS which encompasses D, C and whatever else the author has in mind and you call this proof? anyone who wishes to believe that your system does not become depleted with chronic D can't see the forest for the trees and is baffled by their BS.


----------



## Jeffrey Roberts (Apr 15, 1987)

I haven't been following this thread very closely so excuse me for jumping right in. I posted this note back in April and you might find useful for this discussion.http://ibsgroup.org/eve/forums/a/tpc/f/78210261/m/765102251Hypothesis for mode of action for ischemic colitis with 5-HT3 medicationsAt the IFFGD conference (April 2005) there was a roundtable panel discussion about the prevalance of ischemic colitis (IC) in patients while taking 5-HT3 medications. IC is described and presented as a lack of blood flow to the intestines. It seems to naturally reverse itself if you stop taking the medication, hence the interest in the action of the 5-HT3 serotonin antagonist.The panel agreed that there is a correlation between a diagnosis of IBS and development of IC. This seems very probable; however, the occurence of IC is very much a rare event. Dr. Michael Gershon presented a hypothesis for the mode of action. He rationalized that IBS most likely involves the disruption of the serotonin uptake (SERT).


> quote:Although serotonin generally is recognized as a chemical in the brain, only five percent of this naturally occurring neurotransmitter is found in the brain and central nervous system. The remaining 95 percent of serotonin resides in the cells lining the GI tract. In the gut, serotonin binds to 5-HT receptors on nerve cells, initiating intestinal movement. SERT (serotonin transporter), also found in cells lining the GI tract, initiate the uptake of serotonin by deactivating it when appropriate. Without this natural regulation, the mechanisms of digestion cannot function properly. In this study, patients with IBS were found to have decreased expression of SERT, which could lead to either over-stimulation of the gut (IBS with diarrhea) or receptor desensitization (IBS with constipation or IBS-C).


(Taken from http://www.pharma.us.novartis.com/newsroom...=1266&checked=y )Dr. Gershon suggested that drugs which *slow bowel transit* increase the risk of IC. This includes 5-HT3 and anti-depressants. Note that 5-HT4 medications are not included since they speed-up transit. The slow bowel transit in turn may cause constipation which may cause increased pressure in the bowel. This causes inflammation in the cell membranes and on blood vessels. This change in physiology likely gives the appearance of IC when examined. Whether it is truly IC in the classical sense was up for debate. Dr. Gershon suggested the reason that their is so little data about IC development from all medications which slow bowel transit is that nobody has been specifically looking for it.The next step is to study this in the lab.Jeff


----------



## eric (Jul 8, 1999)

Jeff, thanks for posting that, its very interesting information."The slow bowel transit in turn may cause constipation which may cause increased pressure in the bowel. This causes inflammation in the cell membranes and on blood vessels. This change in physiology likely gives the appearance of IC when examined. Whether it is truly IC in the classical sense was up for debate. Dr. Gershon suggested the reason that their is so little data about IC development from all medications which slow bowel transit is that nobody has been specifically looking for it."Very interesting.Doc, "'experts' here are quick to endorse "experts are endorsing natural treatments and education and more as well in IBS, but your not mentioning that."with little corresponding regard for understanding and dealing with the reasons for taking it"Not true. Anyone can learn why they are taking lotronex for example and they should."IBS which encompasses D, C "IBS does encompass d and c, it also incompasses pain and discomfort.D and c and alternating d/c are SYMPTOMS of a IBS. There is a bigger picture to IBS.IBS right know encompasses.1. altered motility2. viceral hypersensitvity3. Brain gut axis dysfunctionThese things lead to the symptoms of IBS.IBS is one of thirty functional GI disorders."anyone who wishes to believe that your system does not become depleted with chronic D "You haven't studied the basic science of IBS yet or digestion. Also centers around the world are saying that.They have already found abnormalities in IBS.


----------



## eric (Jul 8, 1999)

FYIRole of serotonin in the pathophysiology of the IBShttp://www.nature.com/bjp/journal/v141/n8/full/0705762a.html


----------



## jeanne2 (Jul 19, 2004)

I think there should be a new bulletin board for people that are interested in reading lengthy, often conflicting medical studies, using words that perhaps 10% of the readers on this site understand, or have time to investigate.I am not saying that the work of the what I call the "research folks" on here provide is not helpful to some....but most of us on here, in my opinion just want to share, get practical suggestions, share what our doctors have told-or not told us, etc.Meantime, all the complicated and technical research goes on-not filtering down to doctors who-from reading on here-basically don't give a damn-nor do THEY even keep up with it themselves..and like it or not THEY are our door to freedom (doctors)- but those of us suffering on a day to day basis with IBS have the right and desperate need to try what has helped others while we wait for some magic cure that is not likely to happen in my lifetime anyways.Just an editorial..for us working folks-wading through post after post of medical research links is not useful, nor understandable..and perhaps should be on a board for people looking for that.ThanksJeanne


----------



## eric (Jul 8, 1999)

Like, all things, in order to learn you have to take the time to study the problem.If not your personally in the dark.IBS is very complex, no question about it.Some of the treatments involve learning about the complexities.Many here have taken that time. Because of that they may recommend things that work on IBS.Many who don't learn about their condition, may suffer a whole lot more.There are some very basic information about IBS, doctors rarely ever tell people.I learn here there was a "brain in the gut" for example and about serotonin.


----------



## the doc (Feb 8, 2005)

> quote:Originally posted by jeanne2:I think there should be a new bulletin board for people that are interested in reading lengthy, often conflicting medical studies, using words that perhaps 10% of the readers on this site understand, or have time to investigate.I am not saying that the work of the what I call the "research folks" on here provide is not helpful to some....but most of us on here, in my opinion just want to share, get practical suggestions, share what our doctors have told-or not told us, etc.Meantime, all the complicated and technical research goes on-not filtering down to doctors who-from reading on here-basically don't give a damn-nor do THEY even keep up with it themselves..and like it or not THEY are our door to freedom (doctors)- but those of us suffering on a day to day basis with IBS have the right and desperate need to try what has helped others while we wait for some magic cure that is not likely to happen in my lifetime anyways.Just an editorial..for us working folks-wading through post after post of medical research links is not useful, nor understandable..and perhaps should be on a board for people looking for that.ThanksJeanne


absolutely! see my new thread on the value of colonics - a simple and safe way to help remedy both D and C. it worked for me (despite all the _experts_ here to the contrary)!


----------

