# Abdominal Gas is Trapped in Colon



## Davis 2002 (Jan 6, 2002)

My IBS doctor says abdominal gas is trapped in my colon and causing my chronic bloating He said I just have to live with it Has anyone tried anything that works? I watch my diet Phazyme won't hep abdominal gas


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## flux (Dec 13, 1998)

How did the doctor determine this? Did you have an x-ray at the time of the bloating?


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## flux (Dec 13, 1998)

How did the doctor determine this? Did you have an x-ray at the time of the bloating?


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## Stace (Sep 20, 2000)

Yes, I too have suffered with trapped gas. Ask for a prescription anti-spasmodic (like Librax, Bentyl or Levsin). The gas gets trapped because of the spasms of the colon. Anti-spasmodic drugs (also known as anti-cholinergics) relax the smooth muscle, allowing the gas to pass. I have used both Bentyl and Librax and within an hour of taking 1 pill, I can pass the gas and the pain is gone.Stacey


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## Stace (Sep 20, 2000)

Yes, I too have suffered with trapped gas. Ask for a prescription anti-spasmodic (like Librax, Bentyl or Levsin). The gas gets trapped because of the spasms of the colon. Anti-spasmodic drugs (also known as anti-cholinergics) relax the smooth muscle, allowing the gas to pass. I have used both Bentyl and Librax and within an hour of taking 1 pill, I can pass the gas and the pain is gone.Stacey


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## Homebound (Jan 27, 2000)

I get this all the time too. It can really hurt, and make you bloated. I wish I knew how to get rid of it, I usually just have to lay down for a while when I get it.Jennifer


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## Homebound (Jan 27, 2000)

I get this all the time too. It can really hurt, and make you bloated. I wish I knew how to get rid of it, I usually just have to lay down for a while when I get it.Jennifer


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## Kaos0100 (Jul 16, 1999)

I believe some of the pain I have is from trapped gas. It doesn't happen very often, but when it does, it hurts! I find that massaging my abdomen and stomach helps the gas release...


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## Kaos0100 (Jul 16, 1999)

I believe some of the pain I have is from trapped gas. It doesn't happen very often, but when it does, it hurts! I find that massaging my abdomen and stomach helps the gas release...


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## Mike NoLomotil (Jun 6, 2000)

Hi Davis....Like Flux I am a little curious, also, how this diagnosis was arrived at. What procedure did he use to "visualize" te "trapped gas", do you remember? Not saying anything one way or the other, just curious how he made the assessment.MNL


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## Mike NoLomotil (Jun 6, 2000)

Hi Davis....Like Flux I am a little curious, also, how this diagnosis was arrived at. What procedure did he use to "visualize" te "trapped gas", do you remember? Not saying anything one way or the other, just curious how he made the assessment.MNL


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## sunnybobo (Mar 16, 2002)

Guess I'm with the others in saying, I wonder how your doctor arrived at this conclusion. ??But one thing I find that helps me when I have gas and need help passing it...drink _lots_ of water. And when the gas wants to expel...let it. Don't hold it in cause it might be socially unacceptable, that just makes it worse.I guess I should add why I use water. I've found out that most times when I use OTC gas medications...I immediately have diarrhea...and then seem to be bound up the following day. No fun there.


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## sunnybobo (Mar 16, 2002)

Guess I'm with the others in saying, I wonder how your doctor arrived at this conclusion. ??But one thing I find that helps me when I have gas and need help passing it...drink _lots_ of water. And when the gas wants to expel...let it. Don't hold it in cause it might be socially unacceptable, that just makes it worse.I guess I should add why I use water. I've found out that most times when I use OTC gas medications...I immediately have diarrhea...and then seem to be bound up the following day. No fun there.


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## justjeni (Feb 20, 2002)

I don't pretend to know the ins and outs of medical pro's at all, but my doctor told me they can tell a lot just by poking around on your abdomen - he always does this when I see him. Maybe this doctor could "feel" the bloating. I was curious when I was diagnosed with IBS because the first time I was told I have it the doctor did just that - poked around. He then told me it's amazing what they can all tell just be feeling in certain areas on the abdomen. He said just from doing that he could "feel" spasm's, gas and irritation. I believe him because about ten years prior I was having trouble with diahrrea, pain an bloating and was seeing a different doctor at that time. He poked around and said the same thing this one did - the lining of my stomach was irritated and he could feel spasm's. Check with your own doctor's - they can explain it much better than I ever could!


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## justjeni (Feb 20, 2002)

I don't pretend to know the ins and outs of medical pro's at all, but my doctor told me they can tell a lot just by poking around on your abdomen - he always does this when I see him. Maybe this doctor could "feel" the bloating. I was curious when I was diagnosed with IBS because the first time I was told I have it the doctor did just that - poked around. He then told me it's amazing what they can all tell just be feeling in certain areas on the abdomen. He said just from doing that he could "feel" spasm's, gas and irritation. I believe him because about ten years prior I was having trouble with diahrrea, pain an bloating and was seeing a different doctor at that time. He poked around and said the same thing this one did - the lining of my stomach was irritated and he could feel spasm's. Check with your own doctor's - they can explain it much better than I ever could!


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## Jammer (Jan 29, 2001)

I had it so bad that I could not walk.To check for gas, the doctor tapped me just above the colon.If it sound hollow like a drum, it is full of gas.







The doc also says that it will go away if you eat a gas free diet.(no beans, onions,softdrinks, etc..)My gas did go away, but very slowly.I still have gas, but not so much.







JAMMER


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## Jammer (Jan 29, 2001)

I had it so bad that I could not walk.To check for gas, the doctor tapped me just above the colon.If it sound hollow like a drum, it is full of gas.







The doc also says that it will go away if you eat a gas free diet.(no beans, onions,softdrinks, etc..)My gas did go away, but very slowly.I still have gas, but not so much.







JAMMER


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## DogsAreFun (Apr 5, 2002)

My doctor saw and felt the severe spasming during a colonoscopy. Then when I had abdominal surgery recently, the surgeon could see the gas trapped there in my colon. That's how I knew for sure the gas was there. But my doctor, like the others, always palpates my abdomen and can feel how much gas is in there. Perhaps that's how your doctor knew this.


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## DogsAreFun (Apr 5, 2002)

My doctor saw and felt the severe spasming during a colonoscopy. Then when I had abdominal surgery recently, the surgeon could see the gas trapped there in my colon. That's how I knew for sure the gas was there. But my doctor, like the others, always palpates my abdomen and can feel how much gas is in there. Perhaps that's how your doctor knew this.


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## bonniei (Jan 25, 2001)

Maybe the infamous percussion technique?


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## bonniei (Jan 25, 2001)

Maybe the infamous percussion technique?


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## carolauren (Mar 14, 2002)

Yes, they can use percussion, but it is really very easy to palpate gas and spasm just by feeling around. I'm a licensed massage therapist and have a couple clients with constipation and trapped gas that I do abdominal work on. I used to do it on myself, but it's too hard on my wrists.


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## carolauren (Mar 14, 2002)

Yes, they can use percussion, but it is really very easy to palpate gas and spasm just by feeling around. I'm a licensed massage therapist and have a couple clients with constipation and trapped gas that I do abdominal work on. I used to do it on myself, but it's too hard on my wrists.


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## scrappy1997 (Feb 21, 2002)

Phazyme seems to help me when I have trapped gas.


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## scrappy1997 (Feb 21, 2002)

Phazyme seems to help me when I have trapped gas.


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## Mike NoLomotil (Jun 6, 2000)

Jeez now I have this picture of JAMMER with a big drum for a belly...now I will have nightmares of this Edward Scissorhands genetic freak variant...







Oh, yeah, it is true you can palpate spasm and palpate globs of goo (chyme) and gas, but what is palpated is transient, otherwise we would eventually perforate...like I did..in 7 places...peritonitis..coma...death resuscitation...brain dead [know you know why]So it is true that people with IBS of course are prone to spasm, sometimes severe when segmentatin runs wild, so this will produce transient accumulations of chyme and gas in various areas....but a permanent stricture would be more characteristic of an adhesion or other anatomical defect, the Merck Manual can give you an education on all that...but the smooth muscle spasms do come and go.The palpation-auscultation-percussion approach to abdominal viscera assessment is a very old and standard and useful technique. Hey this is in part what originally gave rise to the term "spastic colon" for IBS since you can palpate it and then see it on certin GI x-rays with contrast material. (good ol' fashioned Barium enema and barium swallow with time-lapse shots anyone? yuck)Dr. Welby lives.







MNL


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## Mike NoLomotil (Jun 6, 2000)

Jeez now I have this picture of JAMMER with a big drum for a belly...now I will have nightmares of this Edward Scissorhands genetic freak variant...







Oh, yeah, it is true you can palpate spasm and palpate globs of goo (chyme) and gas, but what is palpated is transient, otherwise we would eventually perforate...like I did..in 7 places...peritonitis..coma...death resuscitation...brain dead [know you know why]So it is true that people with IBS of course are prone to spasm, sometimes severe when segmentatin runs wild, so this will produce transient accumulations of chyme and gas in various areas....but a permanent stricture would be more characteristic of an adhesion or other anatomical defect, the Merck Manual can give you an education on all that...but the smooth muscle spasms do come and go.The palpation-auscultation-percussion approach to abdominal viscera assessment is a very old and standard and useful technique. Hey this is in part what originally gave rise to the term "spastic colon" for IBS since you can palpate it and then see it on certin GI x-rays with contrast material. (good ol' fashioned Barium enema and barium swallow with time-lapse shots anyone? yuck)Dr. Welby lives.







MNL


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## bonniei (Jan 25, 2001)

Re: the percussion approach- Dr Welby sounds like a someone who could truly say gas was music to his ears!


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## bonniei (Jan 25, 2001)

Re: the percussion approach- Dr Welby sounds like a someone who could truly say gas was music to his ears!


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## flux (Dec 13, 1998)

> quote:So it is true that people with IBS of course are prone to spasm, sometimes severe when segmentatin runs wild,


I'm not sure what mechanism accounts for gas moving inefficiently in those IBSers in whom this occurs, but actually don't believe there is *any* difference in segmentation in them versus a heahlty gut.


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## flux (Dec 13, 1998)

> quote:So it is true that people with IBS of course are prone to spasm, sometimes severe when segmentatin runs wild,


I'm not sure what mechanism accounts for gas moving inefficiently in those IBSers in whom this occurs, but actually don't believe there is *any* difference in segmentation in them versus a heahlty gut.


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## katz (Feb 5, 2002)

OH, i really do believe that there is a really big difference in ibs afflicated persons and the so called "normal" persons! ibs can cause terrible gas, painful,smelly gas that "normal" individuals don't have to deal with. as for me, i just try to let my own body take its course without any kind of meds and hope to GOD that no one knows me when it all breaks loose! as for trapped gas, i sit in a warm tub and relax for about an half an hour and that really helps!


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## katz (Feb 5, 2002)

OH, i really do believe that there is a really big difference in ibs afflicated persons and the so called "normal" persons! ibs can cause terrible gas, painful,smelly gas that "normal" individuals don't have to deal with. as for me, i just try to let my own body take its course without any kind of meds and hope to GOD that no one knows me when it all breaks loose! as for trapped gas, i sit in a warm tub and relax for about an half an hour and that really helps!


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## flux (Dec 13, 1998)

> quote: ibs can cause terrible gas, painful,smelly gas that "normal" individuals don't have to deal with


Nope, there is no good evidence that IBS alters gas production or the type of gas produced.


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## flux (Dec 13, 1998)

> quote: ibs can cause terrible gas, painful,smelly gas that "normal" individuals don't have to deal with


Nope, there is no good evidence that IBS alters gas production or the type of gas produced.


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## Marriah (Mar 19, 2002)

Hummm....I don't know flux...smelled my farts lately?


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## Marriah (Mar 19, 2002)

Hummm....I don't know flux...smelled my farts lately?


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## bonniei (Jan 25, 2001)

Normal people have smelly farts too. Babies can have smelly poop


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## bonniei (Jan 25, 2001)

Normal people have smelly farts too. Babies can have smelly poop


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## Homebound (Jan 27, 2000)

I don't think it would be a stretch of the imagination for IBSer's to have more gas problems then the average person. We have more problems with pain, D and C. Why not gas? True normal people have smelly gas too. Shoot my husband has some of the worst!







But I don't think I've ever seen him hunched over with trapped gas pains like I have done. And yes I knew it was trapped gas pains, because I would be in pain for a while, then I would eventually pass it. Making the pain go away. I don't know, maybe it is just as much of a problem in "normal" people. But when you've got serious D and C problems, it probably seems 100 times worse. But that's just my opinion!Jennifer


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## Homebound (Jan 27, 2000)

I don't think it would be a stretch of the imagination for IBSer's to have more gas problems then the average person. We have more problems with pain, D and C. Why not gas? True normal people have smelly gas too. Shoot my husband has some of the worst!







But I don't think I've ever seen him hunched over with trapped gas pains like I have done. And yes I knew it was trapped gas pains, because I would be in pain for a while, then I would eventually pass it. Making the pain go away. I don't know, maybe it is just as much of a problem in "normal" people. But when you've got serious D and C problems, it probably seems 100 times worse. But that's just my opinion!Jennifer


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## Mike NoLomotil (Jun 6, 2000)

NOTE:"but actually don't believe there is any difference in segmentation in them versus a heahlty gut."Whether we beleive it or not has no bearing on the fact that it occurs...especially in patients with either/or both cell mediated and humoral inflammatory responses which begin in the small bowel area. which includes at least a sizeable portion of the d-predominant and cyclic population presently being diagnosed with 'IBS".There is as we all know active and excessive contraction (spasm) of the smooth muscle (which can include banded and longitudinal muscle), said contraction is provoked by specific mast cell and circulating cell mediators (such as the lymphocytes flound in the lamina propria at any time) when released, just as surely as if they stayed all neatly packed up and nothing but normal ENS and CNS regulation were managing smooth mjuscle function.Indeed the two contractile actions can become discoordinated. In fact I warrant if you have ever exprienced it you can feel it and you know what you are feeling when you know your own anatomy and the manner by which chyme is propelled along the GI tract, even in general.This is not to say that it is intrinsically more than episodic. That, indeed , is unclear as to what degree the twitchy smooth muscle remains twitchy enough that physical activity by the patient or even mechanical stimulation could elcit spasmodic contraction...that I agree is speculative as to 'frequency"...but there is reason to expect that the gut wall will behave in similar manner to the airways in many ways and this is a trait of the asthmatic airway behavior which has been compared itself to the behavior of the gut tissue in IBS. Hell, a deep sharp inhalation can provoke severe spasm in some asthmatics as a direct consequence of the effects of the mediators involved in upregulatinf sensory, motor, and smooth muscle contractility.One knows if one studied the specific array of mediators released by mast cells, lymphocytes, platelets, macrophages and their other immunocytic pals (which has been isolated numerous times in the small bowel of patients with clinical IBS symptoms, just not there in that facility...elsewhere)...that this can occur both via the motor nerves and through direct action upon the smooth muscles (reduced threshold of contraction....less stimulus required to depolarize a muscle...then increase the stimulus at the same time eitheor locally, centrally, or both as has been found at various times by various people using variosu tests which are not done in real time with other tests which would explain the observed phenomena better) just like smooth muscle in the bronchial walls in asthmatics.A twitchy bowel can be palpated...how well depends on as you know a lot of variables starting with what is in it and where at the time of examination and the skill of the examining physician...just as ome are ffar better than others at auscultation and percussion. It's not even really controvertible, except in the context of how often is it not episodic, and to what degree and in what subpopulation is the gut wall net response so labule as to show what soem say their doctors can palpate. (?? I dunno)MNL


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## Mike NoLomotil (Jun 6, 2000)

NOTE:"but actually don't believe there is any difference in segmentation in them versus a heahlty gut."Whether we beleive it or not has no bearing on the fact that it occurs...especially in patients with either/or both cell mediated and humoral inflammatory responses which begin in the small bowel area. which includes at least a sizeable portion of the d-predominant and cyclic population presently being diagnosed with 'IBS".There is as we all know active and excessive contraction (spasm) of the smooth muscle (which can include banded and longitudinal muscle), said contraction is provoked by specific mast cell and circulating cell mediators (such as the lymphocytes flound in the lamina propria at any time) when released, just as surely as if they stayed all neatly packed up and nothing but normal ENS and CNS regulation were managing smooth mjuscle function.Indeed the two contractile actions can become discoordinated. In fact I warrant if you have ever exprienced it you can feel it and you know what you are feeling when you know your own anatomy and the manner by which chyme is propelled along the GI tract, even in general.This is not to say that it is intrinsically more than episodic. That, indeed , is unclear as to what degree the twitchy smooth muscle remains twitchy enough that physical activity by the patient or even mechanical stimulation could elcit spasmodic contraction...that I agree is speculative as to 'frequency"...but there is reason to expect that the gut wall will behave in similar manner to the airways in many ways and this is a trait of the asthmatic airway behavior which has been compared itself to the behavior of the gut tissue in IBS. Hell, a deep sharp inhalation can provoke severe spasm in some asthmatics as a direct consequence of the effects of the mediators involved in upregulatinf sensory, motor, and smooth muscle contractility.One knows if one studied the specific array of mediators released by mast cells, lymphocytes, platelets, macrophages and their other immunocytic pals (which has been isolated numerous times in the small bowel of patients with clinical IBS symptoms, just not there in that facility...elsewhere)...that this can occur both via the motor nerves and through direct action upon the smooth muscles (reduced threshold of contraction....less stimulus required to depolarize a muscle...then increase the stimulus at the same time eitheor locally, centrally, or both as has been found at various times by various people using variosu tests which are not done in real time with other tests which would explain the observed phenomena better) just like smooth muscle in the bronchial walls in asthmatics.A twitchy bowel can be palpated...how well depends on as you know a lot of variables starting with what is in it and where at the time of examination and the skill of the examining physician...just as ome are ffar better than others at auscultation and percussion. It's not even really controvertible, except in the context of how often is it not episodic, and to what degree and in what subpopulation is the gut wall net response so labule as to show what soem say their doctors can palpate. (?? I dunno)MNL


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## Mike NoLomotil (Jun 6, 2000)

Hmmm...point to ponder... ____________________________________"Hummm....I don't know flux...smelled my farts lately? " ____________________________________Sometimes personal experience carries a lot of weigt. Perhaps some form of exchange of samples is in order...some insufflated impermeable device for capturing effluvia could be devised, which would sustain shipping and handling by UPS ground...perhaps this would be in order.In this way, it is my fervent hope, speculation could be set aside in the face of catching a whiff of the actual evidence?Just a thought....that's between you guys.Oh...good point II: _________________________________"...Babies can have smelly poop ..." _________________________________When in the world did you meet StephanieNL when she was BabyNL?







MNL


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## Mike NoLomotil (Jun 6, 2000)

Hmmm...point to ponder... ____________________________________"Hummm....I don't know flux...smelled my farts lately? " ____________________________________Sometimes personal experience carries a lot of weigt. Perhaps some form of exchange of samples is in order...some insufflated impermeable device for capturing effluvia could be devised, which would sustain shipping and handling by UPS ground...perhaps this would be in order.In this way, it is my fervent hope, speculation could be set aside in the face of catching a whiff of the actual evidence?Just a thought....that's between you guys.Oh...good point II: _________________________________"...Babies can have smelly poop ..." _________________________________When in the world did you meet StephanieNL when she was BabyNL?
 






MNL


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## bonniei (Jan 25, 2001)

> quote:There is as we all know active and excessive contraction (spasm) of the smooth muscle


Didn't know that but OTOH I don't know much. And didn't know about the discoordinated contractions either. That explains I suppose all the spasms people on the board talk aboutWas that BabyNL I smelled two years ago in a mall In florida? Whew! LOL


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## bonniei (Jan 25, 2001)

> quote:There is as we all know active and excessive contraction (spasm) of the smooth muscle


Didn't know that but OTOH I don't know much. And didn't know about the discoordinated contractions either. That explains I suppose all the spasms people on the board talk aboutWas that BabyNL I smelled two years ago in a mall In florida? Whew! LOL


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## DogsAreFun (Apr 5, 2002)

To Flux: I don't want to argue, but here's my personal experience on trapped gas. Two weeks ago, I had an exploratory laproscopy to find out the cause of my pain. My surgeon actually told me that he saw an overabundance of gas, "more gas than he had ever seen." trapped in my intestines. Why are you persisting in telling people that they don't have an abnormal amount of gas, when as in my case, it's quite possible that they do. Gas hurts! Are you trying to say that it doesn't? Do you merely feel that our pain perception of "some gas" is way out of wack with reality? I don't get it. Look at the wind. You can't see it, but you know it's there because the leaves of the trees blow. But if a person feels a lot of pain, bloating, and spasming, you say, well I don't think the pain is there because I can see no cause for it. I am living proof that it's there. Please respond.


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## DogsAreFun (Apr 5, 2002)

To Flux: I don't want to argue, but here's my personal experience on trapped gas. Two weeks ago, I had an exploratory laproscopy to find out the cause of my pain. My surgeon actually told me that he saw an overabundance of gas, "more gas than he had ever seen." trapped in my intestines. Why are you persisting in telling people that they don't have an abnormal amount of gas, when as in my case, it's quite possible that they do. Gas hurts! Are you trying to say that it doesn't? Do you merely feel that our pain perception of "some gas" is way out of wack with reality? I don't get it. Look at the wind. You can't see it, but you know it's there because the leaves of the trees blow. But if a person feels a lot of pain, bloating, and spasming, you say, well I don't think the pain is there because I can see no cause for it. I am living proof that it's there. Please respond.


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## flux (Dec 13, 1998)

> quote:Whether we beleive it or not has no bearing on the fact that it occurs.


Nope, never has been recorded in a person who really has IBS. Actually, abnormal segmentation has been recorded in those with neuropathic pseudo-obstruction. So it sounds like a misdiagnsosis.


> quote:all know active and excessive contraction (spasm)


Is that what spasm is? Physiologically, to me, spasm is a tetanus. But what you describe is just what you describe. I wouldn't necessarily says this is present in IBS either.


> quote:n fact I warrant if you have ever exprienced it you can feel it and you know what you are feeling when you know your own anatomy and the manner by which chyme is propelled along the GI tract, even in general.


Feel your insides, you mean? That wouldn't be normal nor would it be IBS. (This sounds like neuropathic pseudo-obstruction.)


> quote:A twitchy bowel can be palpated...


This also is neither normal nor IBS. (Do you what this sounds like? Yep, neuropathic pseudo-obstructionWhat you are describing could not possibly occur in true IBS (i.e, Rome-criteria) because IBS is defined by symptoms. Once an objective observer records either subjectively (palpation) or objectively (manometry) something abnormal happening in the intestine, the diagnosis of IBS is out.


> quote:My surgeon actually told me that he saw an overabundance of gas, "more gas than he had ever seen." trapped in my intestines


How did the surgeon "see" the gas? Did he puncture the intestine and it let out like a balloon?


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## flux (Dec 13, 1998)

> quote:Whether we beleive it or not has no bearing on the fact that it occurs.


Nope, never has been recorded in a person who really has IBS. Actually, abnormal segmentation has been recorded in those with neuropathic pseudo-obstruction. So it sounds like a misdiagnsosis.


> quote:all know active and excessive contraction (spasm)


Is that what spasm is? Physiologically, to me, spasm is a tetanus. But what you describe is just what you describe. I wouldn't necessarily says this is present in IBS either.


> quote:n fact I warrant if you have ever exprienced it you can feel it and you know what you are feeling when you know your own anatomy and the manner by which chyme is propelled along the GI tract, even in general.


Feel your insides, you mean? That wouldn't be normal nor would it be IBS. (This sounds like neuropathic pseudo-obstruction.)


> quote:A twitchy bowel can be palpated...


This also is neither normal nor IBS. (Do you what this sounds like? Yep, neuropathic pseudo-obstructionWhat you are describing could not possibly occur in true IBS (i.e, Rome-criteria) because IBS is defined by symptoms. Once an objective observer records either subjectively (palpation) or objectively (manometry) something abnormal happening in the intestine, the diagnosis of IBS is out.


> quote:My surgeon actually told me that he saw an overabundance of gas, "more gas than he had ever seen." trapped in my intestines


How did the surgeon "see" the gas? Did he puncture the intestine and it let out like a balloon?


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## DogsAreFun (Apr 5, 2002)

How did the surgeon "see" the gas? Did he puncture the intestine and it let out like a balloon? I don't know. He told me the gas pockets were there. He saw them. He was shocked at how excessive it was.







But are you calling him a liar? He's a surgeon. I don't think he would make that up. What you are describing could not possibly occur in true IBS (i.e, Rome-criteria) because IBS is defined by symptoms. Once an objective observer records either subjectively (palpation) or objectively (manometry) something abnormal happening in the intestine, the diagnosis of IBS is out. Are you saying it's all in my head?







Or could Crohn's, which I also have, cause this excessive amount of gas?


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## DogsAreFun (Apr 5, 2002)

How did the surgeon "see" the gas? Did he puncture the intestine and it let out like a balloon? I don't know. He told me the gas pockets were there. He saw them. He was shocked at how excessive it was.







But are you calling him a liar? He's a surgeon. I don't think he would make that up. What you are describing could not possibly occur in true IBS (i.e, Rome-criteria) because IBS is defined by symptoms. Once an objective observer records either subjectively (palpation) or objectively (manometry) something abnormal happening in the intestine, the diagnosis of IBS is out. Are you saying it's all in my head?







Or could Crohn's, which I also have, cause this excessive amount of gas?


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## Stace (Sep 20, 2000)

Melody,While most of the people here are wonderful, there are a small few that are annoying. Since you are new, I will tell you that Flux doesn't seem to believe in trapped gas. He is not a doctor nor does he suffer from IBS, so I recommend that you just ignore him. I have found that to be the best way to deal with him.Trapped gas is real in IBS and is a result of the spasms, which trap the gas. I suffer with it and don't appreciate his trivialization of such a painful matter for many of us. My GI has corroborated the whole trapped gas issue for me. Flux is lucky he has never suffered with it himself, but if he had then he wouldn't subject us to such insensitivity.Don't take his bait. Just ignore him. Stacey


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## Stace (Sep 20, 2000)

Melody,While most of the people here are wonderful, there are a small few that are annoying. Since you are new, I will tell you that Flux doesn't seem to believe in trapped gas. He is not a doctor nor does he suffer from IBS, so I recommend that you just ignore him. I have found that to be the best way to deal with him.Trapped gas is real in IBS and is a result of the spasms, which trap the gas. I suffer with it and don't appreciate his trivialization of such a painful matter for many of us. My GI has corroborated the whole trapped gas issue for me. Flux is lucky he has never suffered with it himself, but if he had then he wouldn't subject us to such insensitivity.Don't take his bait. Just ignore him. Stacey


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## flux (Dec 13, 1998)

> quote:He told me the gas pockets were there. He saw them. He was shocked at how excessive it was


Don't know where he was coming from. If you indeed had a "shocking" amount of gas, I would have expected him to not to do the procedure, for wouldn't you have been bloated like an elephant? Perhaps there were many little "pockets" and the surgeon summarilly concluded that to mean you had a lot of gas. In any case, having gas buildup due to inefficient explusion can happen in IBS. But it doesn't mean there is excess production present. That an unusual situation unrelated to IBS.


> quote:Are you saying it's all in my head?


Am referring to the unusual "twitchy" bowel here. Spasms" are present occasionally in IBS persons just as they are in the healthy, so I wouldn't put them in the same category as this "twitchiness", the true nature of which is unclear.


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## flux (Dec 13, 1998)

> quote:He told me the gas pockets were there. He saw them. He was shocked at how excessive it was


Don't know where he was coming from. If you indeed had a "shocking" amount of gas, I would have expected him to not to do the procedure, for wouldn't you have been bloated like an elephant? Perhaps there were many little "pockets" and the surgeon summarilly concluded that to mean you had a lot of gas. In any case, having gas buildup due to inefficient explusion can happen in IBS. But it doesn't mean there is excess production present. That an unusual situation unrelated to IBS.


> quote:Are you saying it's all in my head?


Am referring to the unusual "twitchy" bowel here. Spasms" are present occasionally in IBS persons just as they are in the healthy, so I wouldn't put them in the same category as this "twitchiness", the true nature of which is unclear.


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## bonniei (Jan 25, 2001)

I think this is an interesting discussion. Getting down to the nitty gritty of what a spasm is. The problem has been with definitions.To flux, spasm has been a tetanus. To Mike and perhaps the restof the board it just means contractions. flux says spasms( i assume he means contractions here) are present sometimes in IBS patients as in healthy people. Obviously it doesn't cause the same feeling of trapped gas in healthy people. There is just one study which says IBSers suffer from excessive gas. I admit one study doesn't very good evidence make. But suppose that study is correct, combine excessive gas with contractions and maybe you get the trapped gas sensation in some IBS patients


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## bonniei (Jan 25, 2001)

I think this is an interesting discussion. Getting down to the nitty gritty of what a spasm is. The problem has been with definitions.To flux, spasm has been a tetanus. To Mike and perhaps the restof the board it just means contractions. flux says spasms( i assume he means contractions here) are present sometimes in IBS patients as in healthy people. Obviously it doesn't cause the same feeling of trapped gas in healthy people. There is just one study which says IBSers suffer from excessive gas. I admit one study doesn't very good evidence make. But suppose that study is correct, combine excessive gas with contractions and maybe you get the trapped gas sensation in some IBS patients


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## Mike NoLomotil (Jun 6, 2000)

Exiting comments...hello I-95....I would love to go on with what can be an interesting discussion, that people can learn from, but I have to hit the road.The underlying issue El Fluxo did touch on here:"This also is neither normal nor IBS. (Do you what this sounds like? Yep, neuropathic pseudo-obstruction" and your references to misdiagnosis."Not normal" is certain "not IBS" is not, that is presumptive....since the populaton of people presently being given an IBS diagnosis consists of multiple causal basis for symptom generation..and there is no universal agreement on what consitutes the syndromes causal basis. There is only that which one well paid group hs set forth...that a symptom-based diagnosis should simply be made and then move on, treating the patient with empiricism, as if that is the limit of current understanding ergo all else is wasted. Not everyone agrees with that proposition, thankfully. I have had the privilege if seeing hundred, nay thousands, who were diagnosed and managed that way who did not achieve any significant remissio subsequently do so, with less or no medication. I don't buy it can't buy what I witness with my own two eyes to run cintrary to that proposition.Sadly, "neuropathic pseudoobstruction" also broadly describes observed activity which is consistent with consequences of the aggreagte events of multipathway immune rsponse in the small bowel, said aberrations are readily obsrvable in IBS d-types and cyclics if one bothers to actaully look at them, which most investigators do not. This includes activating t cells in the lamina propria, and the cascade of events which can occur...which may also include but not be limited to macrophage activation and even platelet activation.Hence an array of local and systemic events with varying neuromuscular consequences can be provoked by a small bowel proinflammatory event, which in turn can be provoked by a multitude of mechanisms which does included cell mediated immune response...and even humoral immune response. This has al been observed at one time or another in patients selected for their IBS symptoms.Anyway its moot...since IBS is a syndrome, not proven to be a distinct disease unto itself...and the causal basis for the syndromes symptoms as they are isolated will result in less and less people in the IBS population and more and mre with a casual diagnosis. So indeed as in the days before we understood the underlying etriologic basis for COPD, and the overlapping multiple conditions, I guess yopu could say that "misdiagnosis" could be made. But syndrome by nature is alwasy in flux as understanding evolves.The problem is that most studies done on so called IBS, espcially in the USA, have not focused at all on small bowel events vis a vis t cell activation in these d-types in additon to mast cell mechanisms. And whay would they since the end-game is better drugs...so one must quantify the applicable points of action....as opposed to what may be the uderlying basis for the observed neural action. SO one never knows if one of the mediators which acts directly on, say, some particular locus of the brain has been liberated and permitted into the CSF and thus elicited the aberrant activity observed in so caled IBS...if yu do not look it does not exist...and you form the conslcusions which suit the objectives which you pursue. This happens constantly.So not enough has been elucidated about the neuromuscualar dynamics in the small bowel and the consequences to t cell and mast activation in the small bowel upon the large bowel.This has been better looked at via jejunal isolation...and then the meduator studies have not been combined with studies of neuromuscaular alterations, and nocicpetive alterations.So if we think and look only in the box, indeed we can from conclusions which on the surface appear true and profound. The problem is that those paying attention have seen the evidence of that populaton of people, massive population, diagnosed with IBS-d predominant, whose GI symptoms are provoked by various dietary elements unique to the individual, htis is linked to immunocyte activation wholly seprate and apart from stress mechanisms, and sometimes whjolly apart form Ig[x] mechanisms yet surprisingly IgE shows up within the small bowel specific to a provokign agent though the circulating immunglobulins are absent. A whole separte mechansism not seen before appearing in the selected populationm with IBS symptoms proven invoked by blind oral challenge in non-allergic subjects.So who knows...80% of IBS patients could have s causal basis, which is neuroimmune, which has been heretofore never observed before. If that proves out then theyw ere all misdiagnosed? No theyw ere diagnosed based upon what the clinicians were given to understand at that time.When one then studies the specific mediators released in the small bowel, and their known effects on the enteric nervous system, smooth muscle, and systemic nervous system, as well as the circulatory system...a perpelexing set of issues arises. Which is, of course, how we will slowly sort of the causal basis for the symptoms observed...as ell as the neuroligic events that can be quantified by PET scanning et al.Anyway, gotta run so ya'll may enjoy picking apart and mulling verbiage, thrust and parry ober that which is diaphenous at best.And gut gas? Another subject over which more bandwidth has been wasted than I can accouint for.







See you down the road somewhere.Eat well. Think well. be well.MNL


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## Mike NoLomotil (Jun 6, 2000)

Exiting comments...hello I-95....I would love to go on with what can be an interesting discussion, that people can learn from, but I have to hit the road.The underlying issue El Fluxo did touch on here:"This also is neither normal nor IBS. (Do you what this sounds like? Yep, neuropathic pseudo-obstruction" and your references to misdiagnosis."Not normal" is certain "not IBS" is not, that is presumptive....since the populaton of people presently being given an IBS diagnosis consists of multiple causal basis for symptom generation..and there is no universal agreement on what consitutes the syndromes causal basis. There is only that which one well paid group hs set forth...that a symptom-based diagnosis should simply be made and then move on, treating the patient with empiricism, as if that is the limit of current understanding ergo all else is wasted. Not everyone agrees with that proposition, thankfully. I have had the privilege if seeing hundred, nay thousands, who were diagnosed and managed that way who did not achieve any significant remissio subsequently do so, with less or no medication. I don't buy it can't buy what I witness with my own two eyes to run cintrary to that proposition.Sadly, "neuropathic pseudoobstruction" also broadly describes observed activity which is consistent with consequences of the aggreagte events of multipathway immune rsponse in the small bowel, said aberrations are readily obsrvable in IBS d-types and cyclics if one bothers to actaully look at them, which most investigators do not. This includes activating t cells in the lamina propria, and the cascade of events which can occur...which may also include but not be limited to macrophage activation and even platelet activation.Hence an array of local and systemic events with varying neuromuscular consequences can be provoked by a small bowel proinflammatory event, which in turn can be provoked by a multitude of mechanisms which does included cell mediated immune response...and even humoral immune response. This has al been observed at one time or another in patients selected for their IBS symptoms.Anyway its moot...since IBS is a syndrome, not proven to be a distinct disease unto itself...and the causal basis for the syndromes symptoms as they are isolated will result in less and less people in the IBS population and more and mre with a casual diagnosis. So indeed as in the days before we understood the underlying etriologic basis for COPD, and the overlapping multiple conditions, I guess yopu could say that "misdiagnosis" could be made. But syndrome by nature is alwasy in flux as understanding evolves.The problem is that most studies done on so called IBS, espcially in the USA, have not focused at all on small bowel events vis a vis t cell activation in these d-types in additon to mast cell mechanisms. And whay would they since the end-game is better drugs...so one must quantify the applicable points of action....as opposed to what may be the uderlying basis for the observed neural action. SO one never knows if one of the mediators which acts directly on, say, some particular locus of the brain has been liberated and permitted into the CSF and thus elicited the aberrant activity observed in so caled IBS...if yu do not look it does not exist...and you form the conslcusions which suit the objectives which you pursue. This happens constantly.So not enough has been elucidated about the neuromuscualar dynamics in the small bowel and the consequences to t cell and mast activation in the small bowel upon the large bowel.This has been better looked at via jejunal isolation...and then the meduator studies have not been combined with studies of neuromuscaular alterations, and nocicpetive alterations.So if we think and look only in the box, indeed we can from conclusions which on the surface appear true and profound. The problem is that those paying attention have seen the evidence of that populaton of people, massive population, diagnosed with IBS-d predominant, whose GI symptoms are provoked by various dietary elements unique to the individual, htis is linked to immunocyte activation wholly seprate and apart from stress mechanisms, and sometimes whjolly apart form Ig[x] mechanisms yet surprisingly IgE shows up within the small bowel specific to a provokign agent though the circulating immunglobulins are absent. A whole separte mechansism not seen before appearing in the selected populationm with IBS symptoms proven invoked by blind oral challenge in non-allergic subjects.So who knows...80% of IBS patients could have s causal basis, which is neuroimmune, which has been heretofore never observed before. If that proves out then theyw ere all misdiagnosed? No theyw ere diagnosed based upon what the clinicians were given to understand at that time.When one then studies the specific mediators released in the small bowel, and their known effects on the enteric nervous system, smooth muscle, and systemic nervous system, as well as the circulatory system...a perpelexing set of issues arises. Which is, of course, how we will slowly sort of the causal basis for the symptoms observed...as ell as the neuroligic events that can be quantified by PET scanning et al.Anyway, gotta run so ya'll may enjoy picking apart and mulling verbiage, thrust and parry ober that which is diaphenous at best.And gut gas? Another subject over which more bandwidth has been wasted than I can accouint for.







See you down the road somewhere.Eat well. Think well. be well.MNL


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## flux (Dec 13, 1998)

> quote:"Not normal" is certain "not IBS" is not, that is presumptive....since the populaton of people presently being given an IBS diagnosis consists of multiple causal basis for symptom generation.


This is correct, but probably not relevant for the population who have the "twitchy" bowel you describe is but a fraction of less than one percent those who meet Rome.


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## flux (Dec 13, 1998)

> quote:"Not normal" is certain "not IBS" is not, that is presumptive....since the populaton of people presently being given an IBS diagnosis consists of multiple causal basis for symptom generation.


This is correct, but probably not relevant for the population who have the "twitchy" bowel you describe is but a fraction of less than one percent those who meet Rome.


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## bonniei (Jan 25, 2001)

> quoteopulation who have the "twitchy" bowel you describe is but a fraction of less than one percent those who meet Rome.


Says who and on what basis?







Just using your phrasing on me but would ssure like to know the answer to that


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## bonniei (Jan 25, 2001)

> quoteopulation who have the "twitchy" bowel you describe is but a fraction of less than one percent those who meet Rome.


Says who and on what basis?







Just using your phrasing on me but would ssure like to know the answer to that


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## DogsAreFun (Apr 5, 2002)

Thanks Stace. He was really beginning to annoy me with this topic, since I just wasted the last two weeks of my life in the hospital and in severe pain which my surgeon diagnosed as being caused by excessive gas. Then Flux trivializes the whole thing with his "What makes you think it's gas causing your problem." There's nothing wrong with you. There can't be anything physically wrong or else you wouldn't have IBS. I mean, I almost don't want to come to this board. It's going to upset my symptoms. Who does Flux think he is? He's second guessing my surgeon. I'm a registered nurse, and I can tell you Flux that there is more to life than studying textbook cases. People are individuals. You can't trivialize them into a category based on something you have read in a study. OK, that's my last time I talk to that character.


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## DogsAreFun (Apr 5, 2002)

Thanks Stace. He was really beginning to annoy me with this topic, since I just wasted the last two weeks of my life in the hospital and in severe pain which my surgeon diagnosed as being caused by excessive gas. Then Flux trivializes the whole thing with his "What makes you think it's gas causing your problem." There's nothing wrong with you. There can't be anything physically wrong or else you wouldn't have IBS. I mean, I almost don't want to come to this board. It's going to upset my symptoms. Who does Flux think he is? He's second guessing my surgeon. I'm a registered nurse, and I can tell you Flux that there is more to life than studying textbook cases. People are individuals. You can't trivialize them into a category based on something you have read in a study. OK, that's my last time I talk to that character.


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## TroubledHeart (Apr 8, 2002)

You can see gas...because my great grandmother died from gas...Gas had built up in her so bad that they could see it in x-rays...(my grandmother told me this) and when they went in to relieve the gas and pressure how heart collapsed or whatever it does...because it was not used to working withoug pressure of gas on it...FYI...It makes you wonder if some of these things are hereditary...Lactose Intolerance seems to be in my family...for certain...maybe IBS is too...and they just didnt know it...lol...side point...she also died after being fed milkshakes while in the hospital...you would think the doctors would have known better!...


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## TroubledHeart (Apr 8, 2002)

You can see gas...because my great grandmother died from gas...Gas had built up in her so bad that they could see it in x-rays...(my grandmother told me this) and when they went in to relieve the gas and pressure how heart collapsed or whatever it does...because it was not used to working withoug pressure of gas on it...FYI...It makes you wonder if some of these things are hereditary...Lactose Intolerance seems to be in my family...for certain...maybe IBS is too...and they just didnt know it...lol...side point...she also died after being fed milkshakes while in the hospital...you would think the doctors would have known better!...


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## Stace (Sep 20, 2000)

Melody,I just wanted to say that I hope you continue to come to this Board. It really is awesome (aside from the rare few annoying people). Stacey


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## Stace (Sep 20, 2000)

Melody,I just wanted to say that I hope you continue to come to this Board. It really is awesome (aside from the rare few annoying people). Stacey


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## bonniei (Jan 25, 2001)

Hey Mike I hope you will check in once a day and rescue us if we have some deficit in knowledge about the immunologicaL aspect or in other ways if need be


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## bonniei (Jan 25, 2001)

Hey Mike I hope you will check in once a day and rescue us if we have some deficit in knowledge about the immunologicaL aspect or in other ways if need be


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## flux (Dec 13, 1998)

> quote:Says who and on what basis?


There is no formal counting, so I'm going on gut instinct.


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## flux (Dec 13, 1998)

> quote:Says who and on what basis?


There is no formal counting, so I'm going on gut instinct.


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## bonniei (Jan 25, 2001)

AAh the gut instinct. It is a good thing you don't have IBS or I would have to wonder how reliable that was, flux


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## bonniei (Jan 25, 2001)

AAh the gut instinct. It is a good thing you don't have IBS or I would have to wonder how reliable that was, flux


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## DogsAreFun (Apr 5, 2002)

Thanks Stace. I will continue coming because I need the support, but I will ignore "certain people" who seem to get a kick out of making miserable people, (like myself when I'm in pain,) even more miserable.


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## DogsAreFun (Apr 5, 2002)

Thanks Stace. I will continue coming because I need the support, but I will ignore "certain people" who seem to get a kick out of making miserable people, (like myself when I'm in pain,) even more miserable.


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