# Someone said this is all caused by STRESS...but why is it that certain foods....



## beach (May 12, 2000)

Ok, if the only cause of IBS is STRESS than how come certain foods trigger it for me??? I'm not getting that......


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## Nat (Sep 29, 2001)

I think it's a combination of both (at least for me!). Nat


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## Nat (Sep 29, 2001)

I think it's a combination of both (at least for me!). Nat


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## HipJan (Apr 9, 1999)

I personally don't think that "stress" - or at least emotional stress or anxiety - is the only trigger of IBS. I think several factors may trigger it, especially if they are working in combination. I think for many people, anxiety may be the primary factor (and maybe it alone can be enough), but I also think that the bowels - and other parts of the body, for that matter - can begin to function improperly for a myriad of reasons. Look at some of our American/Western diets, for starters. Eating poorly on a long-term basis, I'm convinced, can eventually do us bad.


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## HipJan (Apr 9, 1999)

I personally don't think that "stress" - or at least emotional stress or anxiety - is the only trigger of IBS. I think several factors may trigger it, especially if they are working in combination. I think for many people, anxiety may be the primary factor (and maybe it alone can be enough), but I also think that the bowels - and other parts of the body, for that matter - can begin to function improperly for a myriad of reasons. Look at some of our American/Western diets, for starters. Eating poorly on a long-term basis, I'm convinced, can eventually do us bad.


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## Kathleen M. (Nov 16, 1999)

I don't know where you got that information but the generally held consensus is thatSTRESS DOES NOT CAUSE IBS.However there are MANY triggers for IBS symptoms.These vary between people.For some people stress IS the main and perhaps the only trigger for symptoms.For other people it is certain foods.For other people it is over-responsiveness to internal physiological cues (like if you a have problems after most meals or most every morning...that's a physiological trigger).Weather and other external environmental factors may trigger some people.Some people may respond more to certain triggers when they are in combination with other triggers so that may be why some triggers are hit and miss. Once again.IBS IS NOT *JUST* A PROBLEM WITH STRESS!!STRESS *IS* A MAJOR TRIGGER FOR *SOME* PEOPLE.Many people seem to assume that becuase X triggers my IBS that X explains EVERYBODY's IBS.This is VERY untrue, but a popular misconception. It's why you see alot of "If you would just do it my way your IBS would be cured" kinda things on various websites and on bulliten boards. K.


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## Kathleen M. (Nov 16, 1999)

I don't know where you got that information but the generally held consensus is thatSTRESS DOES NOT CAUSE IBS.However there are MANY triggers for IBS symptoms.These vary between people.For some people stress IS the main and perhaps the only trigger for symptoms.For other people it is certain foods.For other people it is over-responsiveness to internal physiological cues (like if you a have problems after most meals or most every morning...that's a physiological trigger).Weather and other external environmental factors may trigger some people.Some people may respond more to certain triggers when they are in combination with other triggers so that may be why some triggers are hit and miss. Once again.IBS IS NOT *JUST* A PROBLEM WITH STRESS!!STRESS *IS* A MAJOR TRIGGER FOR *SOME* PEOPLE.Many people seem to assume that becuase X triggers my IBS that X explains EVERYBODY's IBS.This is VERY untrue, but a popular misconception. It's why you see alot of "If you would just do it my way your IBS would be cured" kinda things on various websites and on bulliten boards. K.


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## anita-ariel (Oct 28, 2001)

hi,*for me*, stress or anxiety is what causes my IBS (once it goes away, symptoms fade). HOWEVER, certain foods do indeed make my symptoms worse (dairy products, greasy/carby fast food, beans, etc). For example for the past two weeks I wasn't able to eat out at restaurants because the ibs was really bad (it was finals season). basically all i could eat was tofu, soup, veggie burgers, fruit and sugar-free jell-o. it was okay at first, but after a while i was feeling ready to retch from the lack of variety.







So i definitely share your frustration with this thing, I KNOW how ANNOYING it is not being able to eat stuff you like, especially if you've *never* had problems w/ that food before. I know it doesn't make ANY sense, and what's worse is that because of that, other people just assume i have psycho eating habits, when i turn down offers to go out for sundaes or cake. You don't know how many friends always kept insisting that i was probably just "lactose intolerant" and i should try Lactaid.







ARGH Or people assummed i was on a low-fat diet and I was trying to starve myself. ARGGHH! They don't know that about a year and a half ago, i lived off of whole-milk yogurt, cottage cheese, mozzarella string cheese, steaks, macadamia nuts, and chicken salads w/ guacamole and extra sour cream. i poured heavy cream into my hot chocolate. on occasion i would eat 1/2 pints of ice cream, and no gas, pain, no D or C! But then when exam time comes, or when i have other stressful issues to deal with (new job, moving to the other coast, starting graduate school, etc) my digestive system GIVES UP on me and so i have to watch what i eat VERY CAREFULLY. Sometimes i get really bad gas/pain from eating ANYTHING, and so i have to fast for half a day or something.i think the worst part about this whole IBS thing is that it doesn't make ANY physical sense! (to me, at least). i don't get how on Monday i can eat one thing and get major gas, pain, D, etc, but on Friday i can eat the EXACTLY THE SAME THING and have no issues.







I tell you, my digestive system has a mind of its own







-Izzy


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## anita-ariel (Oct 28, 2001)

hi,*for me*, stress or anxiety is what causes my IBS (once it goes away, symptoms fade). HOWEVER, certain foods do indeed make my symptoms worse (dairy products, greasy/carby fast food, beans, etc). For example for the past two weeks I wasn't able to eat out at restaurants because the ibs was really bad (it was finals season). basically all i could eat was tofu, soup, veggie burgers, fruit and sugar-free jell-o. it was okay at first, but after a while i was feeling ready to retch from the lack of variety.







So i definitely share your frustration with this thing, I KNOW how ANNOYING it is not being able to eat stuff you like, especially if you've *never* had problems w/ that food before. I know it doesn't make ANY sense, and what's worse is that because of that, other people just assume i have psycho eating habits, when i turn down offers to go out for sundaes or cake. You don't know how many friends always kept insisting that i was probably just "lactose intolerant" and i should try Lactaid.







ARGH Or people assummed i was on a low-fat diet and I was trying to starve myself. ARGGHH! They don't know that about a year and a half ago, i lived off of whole-milk yogurt, cottage cheese, mozzarella string cheese, steaks, macadamia nuts, and chicken salads w/ guacamole and extra sour cream. i poured heavy cream into my hot chocolate. on occasion i would eat 1/2 pints of ice cream, and no gas, pain, no D or C! But then when exam time comes, or when i have other stressful issues to deal with (new job, moving to the other coast, starting graduate school, etc) my digestive system GIVES UP on me and so i have to watch what i eat VERY CAREFULLY. Sometimes i get really bad gas/pain from eating ANYTHING, and so i have to fast for half a day or something.i think the worst part about this whole IBS thing is that it doesn't make ANY physical sense! (to me, at least). i don't get how on Monday i can eat one thing and get major gas, pain, D, etc, but on Friday i can eat the EXACTLY THE SAME THING and have no issues.







I tell you, my digestive system has a mind of its own







-Izzy


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## bernard (Jan 4, 2000)

Hi beach*Forget about stress!!!! please!!!!* don't let *anyone* go over your tmind about IBS. Don't do that mistake i did. Don't say (like a said 10 years ago) "may be, it's the truth, it's stress even if i don't feel it...."My story: Thinking as above i did(1) Went to a psychotherapist -> No effect after spending money and time. Obviously he found some bad point in my life. But i don't know anyone with only good points.(2) Went to a psychanalyste -> He said i had no trouble in my head (just one appointment, he didn't wanted to see me again. He was having peoples with trouble lot more than the "supposed" problem i was having)(3) Took 6 months away without any work, wife, stress -> No effect.(4) Anti-anxiety tablets, anti-depressant tablets -> No effect after medication end. During medication, i was so dizziness that i don't remember what was my state (i wanted to sleep ALL the time ... i even sleep one time ON THE FLOOR because of the drug)etc....Stresses ONLY add to the disease. Making things worst.I have some other diseases, some of them have been cleared (for example my pain in my leg because of a sciatica) by itself. When the disease was present, every time i was in bad mood, stressed and more the diseases was WORST.When the disease went away, then when i was stresses, bad mood or whatever was my BAD thinking * I HAD ABSOLUTELY NO RETURN OF THAT STUPID PAIN IN MY LEG!!!!!*The real problem is that when IBS hit you, you pass the first week without really thinking about it since it's new and you don't think it will stay. Then after some time "what's going on?" thinking emerge since it STAY! Then the loop begin: Med, Exam, still the trouble, Med again, exam again, ...no response???? then this THINGS stresses you. Then this add to the trouble. Things are worst ....then you become depressed, then this thing *IS DRIVING YOU* (don't want to go out, don't want to stay far from a toilet,..) ...... etc etc etc.My other thinking about such a disease is that if that disease was caused by stress then the cave man living 10000 years ago would have been hit by the disease (think about living in a country with wild dangerous animal, no automatic heating in winter, need to found food,..etc) and would have been eliminated as a natural things. Suppose such a guy in front of the big giant mammouth and a sudden spasm in the colon. Can't help others. The whole community, during hunting, could be killed because of that!....------------------------


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## bernard (Jan 4, 2000)

Hi beach*Forget about stress!!!! please!!!!* don't let *anyone* go over your tmind about IBS. Don't do that mistake i did. Don't say (like a said 10 years ago) "may be, it's the truth, it's stress even if i don't feel it...."My story: Thinking as above i did(1) Went to a psychotherapist -> No effect after spending money and time. Obviously he found some bad point in my life. But i don't know anyone with only good points.(2) Went to a psychanalyste -> He said i had no trouble in my head (just one appointment, he didn't wanted to see me again. He was having peoples with trouble lot more than the "supposed" problem i was having)(3) Took 6 months away without any work, wife, stress -> No effect.(4) Anti-anxiety tablets, anti-depressant tablets -> No effect after medication end. During medication, i was so dizziness that i don't remember what was my state (i wanted to sleep ALL the time ... i even sleep one time ON THE FLOOR because of the drug)etc....Stresses ONLY add to the disease. Making things worst.I have some other diseases, some of them have been cleared (for example my pain in my leg because of a sciatica) by itself. When the disease was present, every time i was in bad mood, stressed and more the diseases was WORST.When the disease went away, then when i was stresses, bad mood or whatever was my BAD thinking * I HAD ABSOLUTELY NO RETURN OF THAT STUPID PAIN IN MY LEG!!!!!*The real problem is that when IBS hit you, you pass the first week without really thinking about it since it's new and you don't think it will stay. Then after some time "what's going on?" thinking emerge since it STAY! Then the loop begin: Med, Exam, still the trouble, Med again, exam again, ...no response???? then this THINGS stresses you. Then this add to the trouble. Things are worst ....then you become depressed, then this thing *IS DRIVING YOU* (don't want to go out, don't want to stay far from a toilet,..) ...... etc etc etc.My other thinking about such a disease is that if that disease was caused by stress then the cave man living 10000 years ago would have been hit by the disease (think about living in a country with wild dangerous animal, no automatic heating in winter, need to found food,..etc) and would have been eliminated as a natural things. Suppose such a guy in front of the big giant mammouth and a sudden spasm in the colon. Can't help others. The whole community, during hunting, could be killed because of that!....------------------------


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## eric (Jul 8, 1999)

Beach, this is the worlds recognized leader in IBS research.Read this. http://www.aboutibs.org/Publications/clinicalIssues.html Stress can come in many forms both physical and mental. It also has to do with tought and emotions in IBS.


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## eric (Jul 8, 1999)

Beach, this is the worlds recognized leader in IBS research.Read this. http://www.aboutibs.org/Publications/clinicalIssues.html Stress can come in many forms both physical and mental. It also has to do with tought and emotions in IBS.


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## eric (Jul 8, 1999)

It will help everyone who has IBS or gut problems to seriouly understand this. http://www.ahealthyme.com/topic/mindbodygut


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## eric (Jul 8, 1999)

It will help everyone who has IBS or gut problems to seriouly understand this. http://www.ahealthyme.com/topic/mindbodygut


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## linr (May 18, 2000)

I agree with Kmottus. The one thing that really stresses me out is when people assume because the Drs. have yet to find a physical thing (tumor,obstruction etc)that it must be stress and that I bring the whole thing on myself. If that were the case then I should be locked up. I have been dealing with this for 30 years and I tend to believe that it drives me nuts not the other way around.Sure stress can make a bad situation worse but in my case I really believe that there is a virus lurking or that it is a chemical thing going on in the gut when certain foods are introduced.I'm not saying stress can't make someone sick, I know someone who get's himself so worked up about things that you would think he was going to drop over right in front of you.We all deal with things differently. Just don't let anyone tell you that stress is the only reason someone has IBS.


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## linr (May 18, 2000)

I agree with Kmottus. The one thing that really stresses me out is when people assume because the Drs. have yet to find a physical thing (tumor,obstruction etc)that it must be stress and that I bring the whole thing on myself. If that were the case then I should be locked up. I have been dealing with this for 30 years and I tend to believe that it drives me nuts not the other way around.Sure stress can make a bad situation worse but in my case I really believe that there is a virus lurking or that it is a chemical thing going on in the gut when certain foods are introduced.I'm not saying stress can't make someone sick, I know someone who get's himself so worked up about things that you would think he was going to drop over right in front of you.We all deal with things differently. Just don't let anyone tell you that stress is the only reason someone has IBS.


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## eric (Jul 8, 1999)

Stress, does not cause IBS!!!!!!!! It does however influence it greatly. Not overt stress even and there is a difference between stress/ anxiety and how emotions themselves effect IBS, right down to words themselves as triggers.How much your gut responds to things is individual for sure conciously or subconciously. http://www.ibsgroup.org/other/usnews000403.htm " Are you a gut responder" http://www.aboutibs.org/Publications/gutResponder.html If your like me with thirty years of IBS pain and symptoms or if you have had this for a while then I would think personally its highly unlikely that it hasn't generated some major anxiety in your life. Part of this is actually a loop generating symptoms.IBS is actually activating/turning up a part of the brain dealing with emotions and pain."Neuroimaging has provided evidence of physiological differences between normal individuals and those suffering from IBS in the way a visceral stimulus (ie, rectal distention) is processed in the brain.[14,15] Initial data from positron emission tomography (PET) scans demonstrated increased activation of the anterior cingulate cortex (ACC) among normal individuals, comparedto IBS patients. The ACC is a cerebral cortical area that is rich in opiate receptors and is thought to be a major component of cognitive circuits relating to perception as well as descending spinal pathways involving pain. More recently, fMRI was used to demonstrate increased activity in the ACC, prefrontal (PF), and insular cortex areas, and in the thalamus of IBS patients compared to normal individuals."


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## moldie (Sep 25, 1999)

Right on linr! (and others regarding this stress issue). K. explained it beautifully!


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## eric (Jul 8, 1999)

Stress, does not cause IBS!!!!!!!! It does however influence it greatly. Not overt stress even and there is a difference between stress/ anxiety and how emotions themselves effect IBS, right down to words themselves as triggers.How much your gut responds to things is individual for sure conciously or subconciously. http://www.ibsgroup.org/other/usnews000403.htm " Are you a gut responder" http://www.aboutibs.org/Publications/gutResponder.html If your like me with thirty years of IBS pain and symptoms or if you have had this for a while then I would think personally its highly unlikely that it hasn't generated some major anxiety in your life. Part of this is actually a loop generating symptoms.IBS is actually activating/turning up a part of the brain dealing with emotions and pain."Neuroimaging has provided evidence of physiological differences between normal individuals and those suffering from IBS in the way a visceral stimulus (ie, rectal distention) is processed in the brain.[14,15] Initial data from positron emission tomography (PET) scans demonstrated increased activation of the anterior cingulate cortex (ACC) among normal individuals, comparedto IBS patients. The ACC is a cerebral cortical area that is rich in opiate receptors and is thought to be a major component of cognitive circuits relating to perception as well as descending spinal pathways involving pain. More recently, fMRI was used to demonstrate increased activity in the ACC, prefrontal (PF), and insular cortex areas, and in the thalamus of IBS patients compared to normal individuals."


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## moldie (Sep 25, 1999)

Right on linr! (and others regarding this stress issue). K. explained it beautifully!


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## eric (Jul 8, 1999)

I have actually heard people from the bb here say just reading the bb aggravated their symptoms.


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## eric (Jul 8, 1999)

I have actually heard people from the bb here say just reading the bb aggravated their symptoms.


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## moldie (Sep 25, 1999)

My body gets stressed out by meds too bernard! Good point. What may one's magic pill is another one's poison. I have never had a stooling problem during emotional/mental stress. I did have one when I was experiencing an over-growth infection, however. Also with food triggers.Now that we've seen the brain doing during stress and anticipation of stress, lets see what the colon activity is like during this time. We've seen it after food before when you showed us eric, and that made a lot of sense.


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## moldie (Sep 25, 1999)

My body gets stressed out by meds too bernard! Good point. What may one's magic pill is another one's poison. I have never had a stooling problem during emotional/mental stress. I did have one when I was experiencing an over-growth infection, however. Also with food triggers.Now that we've seen the brain doing during stress and anticipation of stress, lets see what the colon activity is like during this time. We've seen it after food before when you showed us eric, and that made a lot of sense.


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## eric (Jul 8, 1999)

This needs to go here to."Even more interesting was the observation that anticipation of rectal stimulation in IBS also activated the pre-frontal cortex. The last finding indicates a direct connection between emotional stimuli and colonic function.""In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship. "This is a very interesting observation!!!!!! http://www.mindbodydigestive.com/ibsmind.html


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## eric (Jul 8, 1999)

This needs to go here to."Even more interesting was the observation that anticipation of rectal stimulation in IBS also activated the pre-frontal cortex. The last finding indicates a direct connection between emotional stimuli and colonic function.""In one interesting experiment, balloon distension of the small intestine in IBS patients caused pain. However, if the patients were mentally distracted during the balloon distension, they did not feel pain. This illustrates a typical brain-gut relationship. "This is a very interesting observation!!!!!! http://www.mindbodydigestive.com/ibsmind.html


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## angry (Jul 25, 2001)

Remember when all ulcers were "caused" by stress?Now they have shown it is a virus in most cases.It's a cop out to blame stress.What about the majority of the population which handle the same kind of stress you and I do without IBS? Clearly they should have IBS too.Also there is a population of IBS people who are not experiencing unusual stress. How can that be?They clearly should not have it.


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## angry (Jul 25, 2001)

Remember when all ulcers were "caused" by stress?Now they have shown it is a virus in most cases.It's a cop out to blame stress.What about the majority of the population which handle the same kind of stress you and I do without IBS? Clearly they should have IBS too.Also there is a population of IBS people who are not experiencing unusual stress. How can that be?They clearly should not have it.


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## eric (Jul 8, 1999)

Moldie read the last link I posted.Angry did you read the last link?Stress does not cause IBS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!However, it greatly influences the gut brain connection!!!!!!!!!!!!!!!!!!!!!!!!!!!!!There is still also a componet to ulcers and stress.It isn't blaming stress its understanding it and how it effects IBS and a main substance is serotonin in the body and how its regulated between the ENS and the CNS.


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## eric (Jul 8, 1999)

Moldie read the last link I posted.Angry did you read the last link?Stress does not cause IBS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!However, it greatly influences the gut brain connection!!!!!!!!!!!!!!!!!!!!!!!!!!!!!There is still also a componet to ulcers and stress.It isn't blaming stress its understanding it and how it effects IBS and a main substance is serotonin in the body and how its regulated between the ENS and the CNS.


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## beach (May 12, 2000)

Wow, I didn't realize how strongly people felt about this. This is all good to know. Thanks!


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## beach (May 12, 2000)

Wow, I didn't realize how strongly people felt about this. This is all good to know. Thanks!


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## Redclaw (Sep 22, 2001)

Stress gets the blame for everything from ingrown toenails to heart disease and IBS.As Angry says, it's a cop-out for people who won't face the real causes of most disease.A friend tells me her poor husband is so stressed by his taxi driving job, he now has a bad heart.When I said BS, the real problem is smoking, drinking, bad eating habits, no exercise etc, she got all upset.Still wants to believe the problem is stress! What can anyone do???


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## Redclaw (Sep 22, 2001)

Stress gets the blame for everything from ingrown toenails to heart disease and IBS.As Angry says, it's a cop-out for people who won't face the real causes of most disease.A friend tells me her poor husband is so stressed by his taxi driving job, he now has a bad heart.When I said BS, the real problem is smoking, drinking, bad eating habits, no exercise etc, she got all upset.Still wants to believe the problem is stress! What can anyone do???


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## eric (Jul 8, 1999)

It seems that a lot of people don't understand the role of anxiety, stress and emotions in IBS!!! Or they want to choose to ignore it which is a big mistake!!!!!!It is a complicated issue, but I will keep working on it, it is one of the most important aspects to understanding IBS.


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## eric (Jul 8, 1999)

It seems that a lot of people don't understand the role of anxiety, stress and emotions in IBS!!! Or they want to choose to ignore it which is a big mistake!!!!!!It is a complicated issue, but I will keep working on it, it is one of the most important aspects to understanding IBS.


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## norbert46 (Feb 20, 2001)

Eric, a lot of people absolutely refuse to accept that there is any mental/brain process involved in their gut disorder which can be made better with any kind of therapy. Many folks don't realize that stress/anxiety has a tremendous effect on the body even when it isn't felt conciously. The communications between the brain and the gut are supposed to be handled by the autonomic system but many of us may have a flaw in that system. If a person has taken all the tests and nothing is found physically and then they try all the meds, herbs, accupuncture and other things without relief but refuse to believe that it is possible for hypnotherapy or CBT to help, then they have just condemned themselves to living with IBS their entire life. Other than Lotronex there has been no medicine to help and even Lotronex actually worked on the brain/gut connection by blocking the Serotonin nerve transmitting fluid on the gut end! Norb


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## norbert46 (Feb 20, 2001)

Eric, a lot of people absolutely refuse to accept that there is any mental/brain process involved in their gut disorder which can be made better with any kind of therapy. Many folks don't realize that stress/anxiety has a tremendous effect on the body even when it isn't felt conciously. The communications between the brain and the gut are supposed to be handled by the autonomic system but many of us may have a flaw in that system. If a person has taken all the tests and nothing is found physically and then they try all the meds, herbs, accupuncture and other things without relief but refuse to believe that it is possible for hypnotherapy or CBT to help, then they have just condemned themselves to living with IBS their entire life. Other than Lotronex there has been no medicine to help and even Lotronex actually worked on the brain/gut connection by blocking the Serotonin nerve transmitting fluid on the gut end! Norb


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## nmwinter (May 31, 2001)

I think the reason that itcan be such an emotional issue is that people equate stress causing problems with the term "it's all in your head." meaning if youmwoudl just think the right wayt, it would all go away. And we all know that's not true. But clearly stress can play a physiological part - I know when I am stressed, my stomach may churcn acid or my neck muscles may tense up causing headaches. So while stress isn't the root cause of IBS, it certainly can be a trigger for it for many of us. As can foods or other circumstances. nancy


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## nmwinter (May 31, 2001)

I think the reason that itcan be such an emotional issue is that people equate stress causing problems with the term "it's all in your head." meaning if youmwoudl just think the right wayt, it would all go away. And we all know that's not true. But clearly stress can play a physiological part - I know when I am stressed, my stomach may churcn acid or my neck muscles may tense up causing headaches. So while stress isn't the root cause of IBS, it certainly can be a trigger for it for many of us. As can foods or other circumstances. nancy


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## AZmom1 (Dec 6, 1999)

It's not stress. It' our *reaction* to stress that is the problem.


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## AZmom1 (Dec 6, 1999)

It's not stress. It' our *reaction* to stress that is the problem.


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## trbell (Nov 1, 2000)

there do seem to be many who believe the old idea that the mind and the body are separate?tom


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## trbell (Nov 1, 2000)

there do seem to be many who believe the old idea that the mind and the body are separate?tom


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## BQ (May 22, 2000)

I understand that my thoughts can cause a physical chemical reaction to occur in my body. That reaction that my body makes, exacerbates my IBS. If I change those thoughts, I can change my body's reaction.







BQ


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## BQ (May 22, 2000)

I understand that my thoughts can cause a physical chemical reaction to occur in my body. That reaction that my body makes, exacerbates my IBS. If I change those thoughts, I can change my body's reaction.







BQ


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## eric (Jul 8, 1999)

FYI "How stress effects the body." This is a woman's site, sorry Tom. http://www.amwa-doc.org/publications/WCHea...samwa-ch09.html Then how does stress effects IBSThis was posted back in 96 in the ladies home journal.How come you get butterflies in your stomach before job interviews? Because scientists now believe there is a brain in your gut. Jackie D Wood PHD chairman of the physiology department at Ohio state university college of medicine in Columbus calls this structure ï¿½the little brainï¿½ to distinguish it from the one in your head. But the truth is its not so small. The brain in the gut or enteric nervous system as scientist call it contains over one hundred million neurons as many as the spinal cord. And this complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. This little brain is connected to the big brain by the vagus nerves, a bundle of nerve fibers running from the GI tract to the head. And, to the fascination of researchers, virtually all the classes of neurotransmitters found in the brain are also present in the gut. The more we learn about the enteric nervous system the more similar it seems to the brain.ï¿½ says Michael Gershon, M.D. chairman of anatomy and cell biology at Columbia University College of Physicians and surgeons, In New York city. Not surprisingly one nervous system may mirror the response of the other. Stress can cause your brain to release chemicals that fool your gut into believing you are physically ill. Thatï¿½s why when youï¿½re anxious, you feel butterflies in your stomach or when stress is greater, you get diarrhea or cramping. Doctors have long wondered why people afflicted with gastrointestinal problems, especially problems with no known organic causes, like irritable bowel syndrome are prone to disturbed sleep.ï¿½ Now we have a better idea of what may be going on, Say Kevin Olden, M.D., a gastroenterologist and psychiatrist at the University of California, in San Francisco. ï¿½Your stomach can be upset without your even knowing it and a dysfunctional gut can have an impact on natural sleep patternsï¿½ Like the big brain; the little brain is rich in receptors sites for mood-regulating chemicals such as endorphins and Serotonin. It is also rich in receptor sites for drugs like opiates. So when we take a psychoactive drug the gut is a frequent target of side effects. Some antidepressants and opiate-based painkillers for example are notorious for causing constipation. Now, seeking to turn a disadvantage into strength, researchers hope to develop psychoactive agents into new therapies for gastrointestinal disturbances. ï¿½The theory is,ï¿½ explains Olden, if a drug does something to the brain, it does something to the gut and might be used to the patients favor.ï¿½ Could the enteric nervous system explain gut feelingsï¿½? Absolutely, say experts. As Wood observes, the primitive parts of the brain that respond to fear communicate closely with the gut. That mean we may get a visceral reaction to a threat before the higher cortex can fully puzzle out whatï¿½s going on. So, ï¿½pay attention to your gut,ï¿½ Wood advises. ï¿½It may know something before you do.ï¿½


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## eric (Jul 8, 1999)

FYI "How stress effects the body." This is a woman's site, sorry Tom. http://www.amwa-doc.org/publications/WCHea...samwa-ch09.html Then how does stress effects IBSThis was posted back in 96 in the ladies home journal.How come you get butterflies in your stomach before job interviews? Because scientists now believe there is a brain in your gut. Jackie D Wood PHD chairman of the physiology department at Ohio state university college of medicine in Columbus calls this structure ï¿½the little brainï¿½ to distinguish it from the one in your head. But the truth is its not so small. The brain in the gut or enteric nervous system as scientist call it contains over one hundred million neurons as many as the spinal cord. And this complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. This little brain is connected to the big brain by the vagus nerves, a bundle of nerve fibers running from the GI tract to the head. And, to the fascination of researchers, virtually all the classes of neurotransmitters found in the brain are also present in the gut. The more we learn about the enteric nervous system the more similar it seems to the brain.ï¿½ says Michael Gershon, M.D. chairman of anatomy and cell biology at Columbia University College of Physicians and surgeons, In New York city. Not surprisingly one nervous system may mirror the response of the other. Stress can cause your brain to release chemicals that fool your gut into believing you are physically ill. Thatï¿½s why when youï¿½re anxious, you feel butterflies in your stomach or when stress is greater, you get diarrhea or cramping. Doctors have long wondered why people afflicted with gastrointestinal problems, especially problems with no known organic causes, like irritable bowel syndrome are prone to disturbed sleep.ï¿½ Now we have a better idea of what may be going on, Say Kevin Olden, M.D., a gastroenterologist and psychiatrist at the University of California, in San Francisco. ï¿½Your stomach can be upset without your even knowing it and a dysfunctional gut can have an impact on natural sleep patternsï¿½ Like the big brain; the little brain is rich in receptors sites for mood-regulating chemicals such as endorphins and Serotonin. It is also rich in receptor sites for drugs like opiates. So when we take a psychoactive drug the gut is a frequent target of side effects. Some antidepressants and opiate-based painkillers for example are notorious for causing constipation. Now, seeking to turn a disadvantage into strength, researchers hope to develop psychoactive agents into new therapies for gastrointestinal disturbances. ï¿½The theory is,ï¿½ explains Olden, if a drug does something to the brain, it does something to the gut and might be used to the patients favor.ï¿½ Could the enteric nervous system explain gut feelingsï¿½? Absolutely, say experts. As Wood observes, the primitive parts of the brain that respond to fear communicate closely with the gut. That mean we may get a visceral reaction to a threat before the higher cortex can fully puzzle out whatï¿½s going on. So, ï¿½pay attention to your gut,ï¿½ Wood advises. ï¿½It may know something before you do.ï¿½


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## angry (Jul 25, 2001)

Eric,Of course I read the article. We agreed that stress isn't the cause. However, I disagree with the party line here that THE solution is mind bending in the form of CBT, hypo et all.Lotronex showed that a simple fast acting pill can solve the IBS(D) problem. It doesn't depend at all upon months of CBT, hypno, yoga or any other mind altering method. I suspect some of those in the therapy business dread the thought of such a pill putting them out of business and/or cutting into their research money.Look at what can happen during six months of unsuccessful treatment:1) One can loose their job2) One can go bankrupt3) One can't even pursue "therapies" because of the expense.Frankly, I don't care at all about the current theories. I simply want results and get on with my life. I don't have the luxury or desire to ponder my navel and inner thoughts. I don't think I am alone in this. Go ahead accuse me of being narrow minded. I don't care. I would, however, accuse you of the same. You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution.


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## angry (Jul 25, 2001)

Eric,Of course I read the article. We agreed that stress isn't the cause. However, I disagree with the party line here that THE solution is mind bending in the form of CBT, hypo et all.Lotronex showed that a simple fast acting pill can solve the IBS(D) problem. It doesn't depend at all upon months of CBT, hypno, yoga or any other mind altering method. I suspect some of those in the therapy business dread the thought of such a pill putting them out of business and/or cutting into their research money.Look at what can happen during six months of unsuccessful treatment:1) One can loose their job2) One can go bankrupt3) One can't even pursue "therapies" because of the expense.Frankly, I don't care at all about the current theories. I simply want results and get on with my life. I don't have the luxury or desire to ponder my navel and inner thoughts. I don't think I am alone in this. Go ahead accuse me of being narrow minded. I don't care. I would, however, accuse you of the same. You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution.


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## Mike NoLomotil (Jun 6, 2000)

Hi Beach:Still not done with Christmas shopping so here is a quickie and maybe I can come back tomorrow for some discussion...your question though _______________________________________"if the only cause of IBS is STRESS than how come certain foods trigger it for me??? " ________________________________________The reason is because anyone who says that Stress is the sole cause of IBS is shovelling good old fashioned Texas cow pies. Period.Stress will aggravate the symptoms, and the symptoms will cause and aggaravate stress and vice versa then vice versa.The explanation of the multiple mechanisms of how foods produce symptoms is posted all over my posts for the last year. This book will give you a leg up on the subject over most people:"FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, London) http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 Then there is a lot more to add since the book was published but it is the best compilation of info available which will explain why if someone says that to you you should let them talk to da hand because the head ain't listenin'....Gotta runMNL


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## Mike NoLomotil (Jun 6, 2000)

Hi Beach:Still not done with Christmas shopping so here is a quickie and maybe I can come back tomorrow for some discussion...your question though _______________________________________"if the only cause of IBS is STRESS than how come certain foods trigger it for me??? " ________________________________________The reason is because anyone who says that Stress is the sole cause of IBS is shovelling good old fashioned Texas cow pies. Period.Stress will aggravate the symptoms, and the symptoms will cause and aggaravate stress and vice versa then vice versa.The explanation of the multiple mechanisms of how foods produce symptoms is posted all over my posts for the last year. This book will give you a leg up on the subject over most people:"FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, London) http://www.amazon.com/exec/obidos/ASIN/089...6487508-3420903 Then there is a lot more to add since the book was published but it is the best compilation of info available which will explain why if someone says that to you you should let them talk to da hand because the head ain't listenin'....Gotta runMNL


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## Mike NoLomotil (Jun 6, 2000)

PSGo read the thread on MAST CELLS for some more info that is recent on the subject from the immunologic perspectiveMNL


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## Mike NoLomotil (Jun 6, 2000)

PSGo read the thread on MAST CELLS for some more info that is recent on the subject from the immunologic perspectiveMNL


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## bernard (Jan 4, 2000)

Eric, i totally agree with you about that "brain-gut" things. PET does show it. But ....


> quote:"In one interesting experiment, balloon distension of the smallintestine in IBS patients caused pain. However, if thepatients were mentally distracted during the balloondistension, they did not feel pain. This illustrates a typicalbrain-gut relationship. "


This i don't agree. This is normal brain function. When something more important than an other thing appears, then the brain tend to treat this new even before the old one. The same happens in my job for example. You'r working on something, then the boss is coming asking to treat a new even as RUSH. So the old work is forbidden for some time but DON'T DISAPPEARS. It is just an hidden thing.I already experimented that:When i had my sciatica, i was in great pain for long. Because i was a smoker (not heavy, i stopped so many time) AND this thing was driving me crazy, then i was smoking like a chimney. I was in a wood in bad mood smoking, then i dropped away my cigarette. Then guess what, i saw some smoke!!! coming out of leaves. I was so surprised and since i was in a wood, the immediate action was to kill that fire that was starting. Guess what, *my leg pain was no more felt*. But when all the stuff cleared, then i was feeling back again the pain in my leg.This only means that the second even needed to be treated as MORE IMPORTANT.I tend to think that the "brain-gut" behavior we can see in IBS people is a CONSEQUENCE of that IBS state like if the brain was saying "he! i have lighted a red light (pain) ... but you'r not taking action my guy ... so, i will no more try to reduce the gut pain by my own because it's non sense to continue, i have other thing to do" like if the computer (brain) is following a new program following an instruction as "if .... then .....else....".So i agree with you about we have to re-educate the brain to redirect it to the original program.----- I'm working in the computer field, so i tend to do analogy between brain and computer. I'm not a gut specialist, and all of this is just what i think it's going on.


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## bernard (Jan 4, 2000)

Eric, i totally agree with you about that "brain-gut" things. PET does show it. But ....


> quote:"In one interesting experiment, balloon distension of the smallintestine in IBS patients caused pain. However, if thepatients were mentally distracted during the balloondistension, they did not feel pain. This illustrates a typicalbrain-gut relationship. "


This i don't agree. This is normal brain function. When something more important than an other thing appears, then the brain tend to treat this new even before the old one. The same happens in my job for example. You'r working on something, then the boss is coming asking to treat a new even as RUSH. So the old work is forbidden for some time but DON'T DISAPPEARS. It is just an hidden thing.I already experimented that:When i had my sciatica, i was in great pain for long. Because i was a smoker (not heavy, i stopped so many time) AND this thing was driving me crazy, then i was smoking like a chimney. I was in a wood in bad mood smoking, then i dropped away my cigarette. Then guess what, i saw some smoke!!! coming out of leaves. I was so surprised and since i was in a wood, the immediate action was to kill that fire that was starting. Guess what, *my leg pain was no more felt*. But when all the stuff cleared, then i was feeling back again the pain in my leg.This only means that the second even needed to be treated as MORE IMPORTANT.I tend to think that the "brain-gut" behavior we can see in IBS people is a CONSEQUENCE of that IBS state like if the brain was saying "he! i have lighted a red light (pain) ... but you'r not taking action my guy ... so, i will no more try to reduce the gut pain by my own because it's non sense to continue, i have other thing to do" like if the computer (brain) is following a new program following an instruction as "if .... then .....else....".So i agree with you about we have to re-educate the brain to redirect it to the original program.----- I'm working in the computer field, so i tend to do analogy between brain and computer. I'm not a gut specialist, and all of this is just what i think it's going on.


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## moldie (Sep 25, 1999)

bernard, I'll second this quote: "In one interesting experiment, balloon distension of the smallintestine in IBS patients caused pain. However, if thepatients were mentally distracted during the balloondistension, they did not feel pain. This illustrates a typicalbrain-gut relationship. "(in fact I had it highlighted and copied to my clipboard before I even scrolled down to your post.And, I'll raise you this: My first experience with flexible sigmoid. Scared indeed. When he first put the tube in and started going with it, I said to myself "Wow! This is a piece of cake." Then he must have gotten to the sigmoid portion. I had all I could do to hold it together. When he was done, I was almost in shock from the pain. I said to him "You are going to have to shoot me before you do that again!"My second experience, this time a colonoscopy, and different doctor. I recalled the pain of the first, and was glad they were going to try medicating me first. I apparently layed quietly for a long time. I recall myself going "ooooeeeeeehhhhhhh!" Somewhere in the middle. Then remember hearing the nurse saying she would give me something for pain. A little while later, I recall someone saying they were going to give me oxygen by mask because my respriations were were depressed. I later read in my chart that the GI doc was unable to complete the procedure, although she never told me this (but then again, I don't remember much of anything about that procedure other than what I mentioned and vomiting just before I left because I don't tolerate Demerol too well). I was sick as a dog (what does that mean, anyway - does a dog get sicker than a human?), the rest of the day.Now what would you conclude from the above? While I would say that there is probably a portion of the population that may have irritable brain syndrome, there are some others that really do have irritable bowel syndrome. The trouble with this is that doctors want to label both sets of people with "IBS" and treat them the same. So, eric, you are probably right. There are some people who can be helped with CBT or hypnosis, but others that it may not help.


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## moldie (Sep 25, 1999)

bernard, I'll second this quote: "In one interesting experiment, balloon distension of the smallintestine in IBS patients caused pain. However, if thepatients were mentally distracted during the balloondistension, they did not feel pain. This illustrates a typicalbrain-gut relationship. "(in fact I had it highlighted and copied to my clipboard before I even scrolled down to your post.And, I'll raise you this: My first experience with flexible sigmoid. Scared indeed. When he first put the tube in and started going with it, I said to myself "Wow! This is a piece of cake." Then he must have gotten to the sigmoid portion. I had all I could do to hold it together. When he was done, I was almost in shock from the pain. I said to him "You are going to have to shoot me before you do that again!"My second experience, this time a colonoscopy, and different doctor. I recalled the pain of the first, and was glad they were going to try medicating me first. I apparently layed quietly for a long time. I recall myself going "ooooeeeeeehhhhhhh!" Somewhere in the middle. Then remember hearing the nurse saying she would give me something for pain. A little while later, I recall someone saying they were going to give me oxygen by mask because my respriations were were depressed. I later read in my chart that the GI doc was unable to complete the procedure, although she never told me this (but then again, I don't remember much of anything about that procedure other than what I mentioned and vomiting just before I left because I don't tolerate Demerol too well). I was sick as a dog (what does that mean, anyway - does a dog get sicker than a human?), the rest of the day.Now what would you conclude from the above? While I would say that there is probably a portion of the population that may have irritable brain syndrome, there are some others that really do have irritable bowel syndrome. The trouble with this is that doctors want to label both sets of people with "IBS" and treat them the same. So, eric, you are probably right. There are some people who can be helped with CBT or hypnosis, but others that it may not help.


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## eric (Jul 8, 1999)

Angry, you can agree or disagree, accept or not except, anything you like. That is your decision and yours only to make."Lotronex showed that a simple fast acting pill can solve the IBS(D) problem. It doesn't depend at all upon months of CBT, hypno, yoga or any other mind altering method."Actually Lotronex showed one pathway to the symptoms of IBS D and has shown to be effective in about 50% of the IBS d predomintate patients. However, it did not address all central symptoms. Yes people got better. There have been no long term studies done on this drug and its possible effects, it also had side effects although it seems relatively safe.Zelnorm for C, has shown to be effective in about 25 % of IBS C predominate patients. It does improve some more of the central features of IBS including pain. No long term use studies.That leaves a majority of C and D people out of luck.These drugs you have to take for life. There are other meds as well you can read about on the 5ht forums and get more info there.The same "line" telling you these drugs work are the same line telling you HT and CBT are effective for some of the same reasons the drugs work with no side effects and no worry for long term use. (It has been shown you actually continue to improve after treatment)!!!!!!!!!!!!1It the case of HT it is almost tailor made for IBS and all central symptoms with the highest percentage successs rate of all treatments and has been shown to be effective. It works on IBS and dyspesia and studies are going to be done in the future on other Functional gastro disorders.The combination of meds and these treatments have shown to be the most superior treatment."I suspect some of those in the therapy business dread the thought of such a pill putting them out of business and/or cutting into their research money."This is an anger comment at the frustration of the medical community. I believe most doctors would rather see their patients get better naturally. In the case off Mike tapes it could not be easier to do and inexpensive in the long run."Look at what can happen during six months of unsuccessful treatment: 1) One can loose their job 2) One can go bankrupt 3) One can't even pursue "therapies" because of the expense."Are you saying you tried one and it didn't work?"Frankly, I don't care at all about the current theories. I simply want results and get on with my life. I don't have the luxury or desire to ponder my navel and inner thoughts. I don't think I am alone in this. Go ahead accuse me of being narrow minded. I don't care. I would, however, accuse you of the same. You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution."I care about all the cuurent theories and facts.The treatments won't work unless your open minded and educated on IBS to know why they would work, so yes I would not see this helping "YOU" at this time, you would put up to much resistence.You can accuse me of being narrow minded all you want, I have helped thousands of people with IBS, in education, support and treatment to improve their quality of life and manage their IBS.I am active in two support groups outside of the bb here that I do for free. I recieve hundreds of emails a week."You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution."It's HT, and I am offering one of the best soulution out there at this time for all central symptoms of IBS. It is also not the only thing I recommend, but it maybe what your focus and expectation of me is.Bottom line: Its your choice to try it or not.I recommend CBT even though I have not done it because I understand how and why it would help IBS, and yes it probably is more time consuming, but after thirty years of "IBS Hell" I would have done anything including suicide.Since I was going no where with my refractory IBS and felt like a medicine cabinet, I had to learn and change!!!!!!!!!!!!!In the meantime you can hold your breath waiting for a "CURE".Moldie and Bernard I will get back to you.Moldie, all IBS patients have this brain gut dysregualtion going on.Dr Drossman " The Brain and the gut are both operative in IBS" People really need to understand this!


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## eric (Jul 8, 1999)

Angry, you can agree or disagree, accept or not except, anything you like. That is your decision and yours only to make."Lotronex showed that a simple fast acting pill can solve the IBS(D) problem. It doesn't depend at all upon months of CBT, hypno, yoga or any other mind altering method."Actually Lotronex showed one pathway to the symptoms of IBS D and has shown to be effective in about 50% of the IBS d predomintate patients. However, it did not address all central symptoms. Yes people got better. There have been no long term studies done on this drug and its possible effects, it also had side effects although it seems relatively safe.Zelnorm for C, has shown to be effective in about 25 % of IBS C predominate patients. It does improve some more of the central features of IBS including pain. No long term use studies.That leaves a majority of C and D people out of luck.These drugs you have to take for life. There are other meds as well you can read about on the 5ht forums and get more info there.The same "line" telling you these drugs work are the same line telling you HT and CBT are effective for some of the same reasons the drugs work with no side effects and no worry for long term use. (It has been shown you actually continue to improve after treatment)!!!!!!!!!!!!1It the case of HT it is almost tailor made for IBS and all central symptoms with the highest percentage successs rate of all treatments and has been shown to be effective. It works on IBS and dyspesia and studies are going to be done in the future on other Functional gastro disorders.The combination of meds and these treatments have shown to be the most superior treatment."I suspect some of those in the therapy business dread the thought of such a pill putting them out of business and/or cutting into their research money."This is an anger comment at the frustration of the medical community. I believe most doctors would rather see their patients get better naturally. In the case off Mike tapes it could not be easier to do and inexpensive in the long run."Look at what can happen during six months of unsuccessful treatment: 1) One can loose their job 2) One can go bankrupt 3) One can't even pursue "therapies" because of the expense."Are you saying you tried one and it didn't work?"Frankly, I don't care at all about the current theories. I simply want results and get on with my life. I don't have the luxury or desire to ponder my navel and inner thoughts. I don't think I am alone in this. Go ahead accuse me of being narrow minded. I don't care. I would, however, accuse you of the same. You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution."I care about all the cuurent theories and facts.The treatments won't work unless your open minded and educated on IBS to know why they would work, so yes I would not see this helping "YOU" at this time, you would put up to much resistence.You can accuse me of being narrow minded all you want, I have helped thousands of people with IBS, in education, support and treatment to improve their quality of life and manage their IBS.I am active in two support groups outside of the bb here that I do for free. I recieve hundreds of emails a week."You also need to think outside of your "CBT" box and get in touch with what the masses really need in terms of a solution."It's HT, and I am offering one of the best soulution out there at this time for all central symptoms of IBS. It is also not the only thing I recommend, but it maybe what your focus and expectation of me is.Bottom line: Its your choice to try it or not.I recommend CBT even though I have not done it because I understand how and why it would help IBS, and yes it probably is more time consuming, but after thirty years of "IBS Hell" I would have done anything including suicide.Since I was going no where with my refractory IBS and felt like a medicine cabinet, I had to learn and change!!!!!!!!!!!!!In the meantime you can hold your breath waiting for a "CURE".Moldie and Bernard I will get back to you.Moldie, all IBS patients have this brain gut dysregualtion going on.Dr Drossman " The Brain and the gut are both operative in IBS" People really need to understand this!


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## norbert46 (Feb 20, 2001)

It always amazes me how the people who dismiss any brain/mind connection with IBS will use their uneducated opinion to argue with facts presented by professional testing processes? In very basic terms your gut only moves or spasms if the brain directs the nerves there to respond in that manner. A lot of research shows a problem with the Serotonin chemical that transfers nerve impulses. Lotronex can block the serotonin at the gut location and slow or stop the spasms. Some psychmeds can help some people(never did me)by blocking the serotonin in the brain area but that also has a possible side effect on many other things such as libido,blurred vision,tremors etc(I have experienced these myself). Next is hypnotherapy which is just a deep relaxation not mindbending. You are listening to a calming story that makes you really relax and ultimately if successful will lower the serotonin and other stress chemicals such as norepinepherine(adrenelin)in the brain. There are no bad side effects in fact one good side effect is very peaceful sleeping if done with hypnotapes at bedtime. After 35yrs of IBS/D and almost being a recluse even with all the tests,psychmeds etc the Lotronex stopped the "D" and made me feel great but some small amounts of gas and adjustment for constipation were necessary.The Lotronex cost me $150/month because my insurance wouldn't pay for males, then they took Lotronex off the market. Within a week my "D" came back and I came to this BB to sign a petition to get it back. I saw the explanations for the hypnotape program and figured what the heck I've spent thousands of dollars and suffered bad side effects,also many hours of MD visits and hospital testing, what do I have to lose? Well for the first time in all those years I have no problem and can do as I wish and something in the hypno program changed/fixed my problem. Many others are saying the same on the CognitiveBB. But what I don't understand is that if you just got a lessening of the problem, why wouldn't you try it? It is no more mental than taking the psychmeds to alter the same brain chemicals? You can't know if it'll work unless you try it and the process couldn't be simpler than the tape program! That is my little attempt at making your future and holidays better. Good luck, Norb


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## norbert46 (Feb 20, 2001)

It always amazes me how the people who dismiss any brain/mind connection with IBS will use their uneducated opinion to argue with facts presented by professional testing processes? In very basic terms your gut only moves or spasms if the brain directs the nerves there to respond in that manner. A lot of research shows a problem with the Serotonin chemical that transfers nerve impulses. Lotronex can block the serotonin at the gut location and slow or stop the spasms. Some psychmeds can help some people(never did me)by blocking the serotonin in the brain area but that also has a possible side effect on many other things such as libido,blurred vision,tremors etc(I have experienced these myself). Next is hypnotherapy which is just a deep relaxation not mindbending. You are listening to a calming story that makes you really relax and ultimately if successful will lower the serotonin and other stress chemicals such as norepinepherine(adrenelin)in the brain. There are no bad side effects in fact one good side effect is very peaceful sleeping if done with hypnotapes at bedtime. After 35yrs of IBS/D and almost being a recluse even with all the tests,psychmeds etc the Lotronex stopped the "D" and made me feel great but some small amounts of gas and adjustment for constipation were necessary.The Lotronex cost me $150/month because my insurance wouldn't pay for males, then they took Lotronex off the market. Within a week my "D" came back and I came to this BB to sign a petition to get it back. I saw the explanations for the hypnotape program and figured what the heck I've spent thousands of dollars and suffered bad side effects,also many hours of MD visits and hospital testing, what do I have to lose? Well for the first time in all those years I have no problem and can do as I wish and something in the hypno program changed/fixed my problem. Many others are saying the same on the CognitiveBB. But what I don't understand is that if you just got a lessening of the problem, why wouldn't you try it? It is no more mental than taking the psychmeds to alter the same brain chemicals? You can't know if it'll work unless you try it and the process couldn't be simpler than the tape program! That is my little attempt at making your future and holidays better. Good luck, Norb


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## eric (Jul 8, 1999)

I will come back to this and stress, but I had to add accurate hypnotherapy information.In helping to understand hypnosis and the "MIND Bending comments". This is not IBS specific, but good information. HOW AND WHY HYPNOSIS WORKS Thomas Yarnell, Ph.D. Licensed Clinical Psychologist Hypnosis Specialist Modern hypnosis has been used for hundreds of years to build self-confidence, change habits, lose weight with weight loss programs, stop smoking, improve memory, end behavior problems in children and eliminate anxiety, fear and phobias. The question is, WHAT IS HYPNOSIS? Hypnosis is a state of mind characterized by relaxed brain waves and a state of hyper-suggestibility. Hypnosis and hypnotic suggestions have played a major role in healing for thousands of years. According to the World Health Organization, 90% of the general population can be hypnotized. Hypnosis is a perfectly normal state that just about everyone has experienced. What we call "highway hypnosis" is a natural hypnotic state. You drive somewhere and don't remember driving or even remember seeing the usual landmarks. You are on automatic pilot. The natural hypnotic state also exists when you become so involved in a book, TV show or some other activity that everything else is blocked out. Someone can talk to you and you don't even see or hear them. Whenever you concentrate that strongly, you automatically slip into the natural hypnotic state. The hypnotic state, by itself, is only useful for the relaxation it produces. The real importance of hypnosis to the healing and emotional change process is that while you are in the hypnotic state, your mind is open and receptive to suggestions. Positive and healing suggestions are able to sink deeply into your mind much more quickly and strongly than when you are in a normal, awake state of mind. I say positive suggestions because all research has demonstrated that while in the hypnotic state, you cannot be made to do anything against your moral values. All of our habitual and behavior controlling thoughts reside in what is called our subconscious mind. It's called that because it is deeper than our conscious mind. It's below our level of consciousness. We are unaware of the thoughts and feelings that reside there. Did you ever forget you had a dental appointment or some other appointment that you really didn't want to keep? Your subconscious mind is where that thought or memory that you had to go to the dentist at 2 PM went when you forgot you had the appointment. Once it was too late to go, your conscious mind relaxed and the memory came back. Imagine that there is a trap door between your conscious mind and your subconscious mind. Normally, the trap door is closed until your brain waves slow down to a relaxed, alpha brain wave level. This happens when you are asleep. The door opens for short periods of time and ideas, images and thoughts come out of your subconscious mind. We call what comes out in your sleep, "dreams". When you are in a state of hypnosis, the door also opens so helpful suggestions can be directed into your subconscious mind or forgotten memories can be retrieved.  The hypnotic induction that hypnotists use is simply a way to focus your attention and concentration so you will go into that natural, normal hypnotic state. Once in the state of hypnosis, the trap door opens and suggestions to help you can be given. The list of ways hypnosis has been used to help children, adolescents and adults is practically endless but does include: weight loss, stopping smoking, building self-confidence and self-esteem, improving academic performance at every age level, improving test taking ability from children through high school, college, medical and law school as well as the National Teacher Certification Exam, pain management, eliminating anxiety, fear and phobias, stress management, insomnia and other sleep problems and helping to heal physical problems. 2. To really work well, suggestions must be reinforced by repetition. Most of the habits, feelings and emotions we want to change are deeply implanted in our subconscious mind and will not just "go away" with one set of suggestions. Most of the time, the hypnotic suggestions need to be repeated on a regular basis until you notice a change. This is one reason that most specialists in hypnosis give clients cassette tapes of their sessions so they can listen to them every day. It's also the reason why hypnosis tapes you buy can work so well. You get to listen to them every day or often enough that the suggestions become permanently a part of you. There is no way to predict how long it will take to see change. It will depend partly on your motivation and commitment. The Three Keys to the successful use of hypnosis for self improvement and personal growth are self motivation, repetition and believable suggestions. 1. The motivation to change must come from within you. If you are trying to change because someone else wants you to "lose weight" or "stop smoking", the chances are greately reduced that the hypnosis will work. For example, I've worked with many people for weight loss or to quit smoking who came to me because their physician or spouse wanted them to change. These people do not respond as well to the hypnosis as those who really want to change. Those who came because they wanted to quit smoking or lose weight responded quickly and easily. Before you start to use hypnosis for your self improvement, you should get it clear in your own mind why you want to change. This clear intention to change will help the hypnotic suggestions to take hold and manifest themselves in your everyday life. 3. The third key to the successful use of hypnosis for personal change is believable suggestions. If you are to accept a suggestion, your mind must first accept it as a real possibility. Telling a chocoholic that chocolate will be disgusting to them and will make them sick is too big a stretch for the imagination. If a suggestion like this even took hold, it would only last a short time because it would be so unbelievable to a real chocolate lover. In cases like this, one of the successful weight loss suggestions I use is that the next time the individual eats chocolate, it will not taste quite as good as the time before. This is far more acceptable and believable to most people. Then, with enough repetition over a period of time, chocolate loses much of it's positive taste and control over that person. One final note is that HYPNOSIS IS NOT DANGEROUS. There are almost no risks  when used by trained professionals. You cannot be made to do anything that is against your moral values. An amateur or stage hypnotist might give you suggestions that might embarrass you, might not work or that might make you feel uncomfortable or self-conscious at the time. To avoid this, stick with professionally trained hypnosis specialists. The one risk I know about involves falling asleep. If you are tired or if you become too relaxed, you may move from the state of hypnosis to the normal sleep state. This is fine if you were going to go to sleep right after the trance but if you have other plans after listening to a hypnosis tape, you may want to set an alarm clock just in case you fall asleep. I've even had students fall asleep because they became too relaxed. In relation to this, never listen to a hypnosis tape while driving. It is very dangerous for you and everyone else on the road. Don't even listen to it if you are a passanger as the relaxation suggestions could make the driver fall asleep. Over the years, self improvement and personal growth using hypnosis has helped millions of people change their lives permanently because it is a safe and powerful tool for changing your thoughts, feelings and habits. Copyright C 2001 by Thomas D. Yarnell, Ph.D., Clinical Psychologist. All rights reserved. This material may be copied for educational purposes as long as full credit is given to Dr. Yarnell In helping to understand why it helps for IBS.Hypnotherapy Hypnotherapy has been by approved by the American Medical Association as a valid medical treatment since 1958, though the concept of using a state of hypnosis to alleviate both physical and mental ills has recurred throughout the history of medicine from ancient times. By reaching the subconscious level of the mind, hypnotherapy can be used to alter the way a person consciously perceives health problems, and also promote new manners of response to them. Hypnosis is often thought to be therapy that only affects the mind, but as mind and body are inseparably joined, hypnosis can also help physical ailments. During a state of hypnosis, consciousness is not lost, it becomes more selective, and typically a patient becomes aware of internal processes rather than the outside worldï¿½s distractions. Most people report the actual experience of being hypnotized as pleasant, comfortable, and extremely relaxing. Hypnotherapy is beneficial not only for the relaxation it induces, but for the state of suggestibility that characterizes it. In this state, the mind is open to receiving ideas and suggestions that promote positive thoughts and healing changes.[6] During normal waking hours, the window between the conscious and subconscious minds is closed, but any state of relaxation that results in alpha brain waves will open it. Typically, this happens during sleep, and dreams result. Hypnotherapy induces this same state of relaxation while the patient is awake, and allows helpful suggestions (such as those aimed at controlling health problems) to be directed into the subconscious mind. Only ten percent or so of the population is not susceptible to hypnosis ï¿½ the rest of us can turn to this therapy for relief of symptoms from disorders as wide ranging as: asthma, allergies, strokes, multiple sclerosis, Parkinson's disease, cerebral palsy, high blood pressure, nausea and vomiting, irregular heartbeat, muscle spasms, paralysis, and, with well-documented success rates, irritable bowel syndrome. Hypnotherapy has in fact proven highly effective in alleviating all of the various IBS symptoms. [7] Over 15 years of solid scientific research has demonstrated hypnotherapy as an effective, safe and inexpensive choice for IBS symptom alleviation.[8] It has been so overwhelmingly successful in this regard that Adriane Fugh-Berman, MD, chair of the National Women's Health Network in Washington, DC, has said that hypnosis should be the treatment of choice for IBS cases which have not responded to conventional therapy. Since the ï¿½conventional therapyï¿½ offered to most IBS patients ranges from nothing at all to a lifetime prescription for semi-effective anti-spasmodic drugs, I take this statement as the closest thing to a whole-hearted endorsement an alternative therapy can hope to get from a mainstream medical spokesperson. For IBS, one of hypnotherapy's greatest benefits is its well-established ability to reduce the effects of stress. Your state of mind can have a direct impact on your physical well-being, even when youï¿½re in the best of health. If youï¿½re struggling with IBS, the tension, anxiety, and depression that comes from living with an incurable illness can actually undermine your immune system and further compromise your health. Hypnotherapy can reduce this stress and its resultant negative impact by placing you in a deeply relaxed state, promoting positive thoughts and coping strategies, and clearing your mind of negative attitudes. IBS in fact is almost uniquely suited to treatment by hypnotherapy, for several reasons. First, as just noted, stress-related attacks can be significantly reduced. Second, one of the most impressive aspects from hypnotherapy, and of tremendous benefit to IBS sufferers, is its well-documented ability to relieve virtually all types and degrees of pain.[9] Finally, because IBS is not a disease at all but a syndrome, if you can relieve and prevent the symptoms, you have effectively cured yourself of the disorder. The underlying dysfunction may still be present but if you suffer no noticeable effects from it, you will be living an IBS-free life. This outcome is a definite possibility from hypnotherapy treatments. As with other alternative therapies, though there is solid evidence that hypnotherapy can provide lasting health benefits for many patients, there is uncertainty about precisely how and why the treatments work. Most scientists believe that hypnotherapy acts upon the unconscious, and affects the bodyï¿½s regulation of involuntary reactions that are normally beyond a personï¿½s control. Hypnotherapy puts these autonomic responses under the patientï¿½s power. Happily, treatment is suitable for people of all ages and physical conditions, as there are no risks or side effects.


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## eric (Jul 8, 1999)

I will come back to this and stress, but I had to add accurate hypnotherapy information.In helping to understand hypnosis and the "MIND Bending comments". This is not IBS specific, but good information. HOW AND WHY HYPNOSIS WORKS Thomas Yarnell, Ph.D. Licensed Clinical Psychologist Hypnosis Specialist Modern hypnosis has been used for hundreds of years to build self-confidence, change habits, lose weight with weight loss programs, stop smoking, improve memory, end behavior problems in children and eliminate anxiety, fear and phobias. The question is, WHAT IS HYPNOSIS? Hypnosis is a state of mind characterized by relaxed brain waves and a state of hyper-suggestibility. Hypnosis and hypnotic suggestions have played a major role in healing for thousands of years. According to the World Health Organization, 90% of the general population can be hypnotized. Hypnosis is a perfectly normal state that just about everyone has experienced. What we call "highway hypnosis" is a natural hypnotic state. You drive somewhere and don't remember driving or even remember seeing the usual landmarks. You are on automatic pilot. The natural hypnotic state also exists when you become so involved in a book, TV show or some other activity that everything else is blocked out. Someone can talk to you and you don't even see or hear them. Whenever you concentrate that strongly, you automatically slip into the natural hypnotic state. The hypnotic state, by itself, is only useful for the relaxation it produces. The real importance of hypnosis to the healing and emotional change process is that while you are in the hypnotic state, your mind is open and receptive to suggestions. Positive and healing suggestions are able to sink deeply into your mind much more quickly and strongly than when you are in a normal, awake state of mind. I say positive suggestions because all research has demonstrated that while in the hypnotic state, you cannot be made to do anything against your moral values. All of our habitual and behavior controlling thoughts reside in what is called our subconscious mind. It's called that because it is deeper than our conscious mind. It's below our level of consciousness. We are unaware of the thoughts and feelings that reside there. Did you ever forget you had a dental appointment or some other appointment that you really didn't want to keep? Your subconscious mind is where that thought or memory that you had to go to the dentist at 2 PM went when you forgot you had the appointment. Once it was too late to go, your conscious mind relaxed and the memory came back. Imagine that there is a trap door between your conscious mind and your subconscious mind. Normally, the trap door is closed until your brain waves slow down to a relaxed, alpha brain wave level. This happens when you are asleep. The door opens for short periods of time and ideas, images and thoughts come out of your subconscious mind. We call what comes out in your sleep, "dreams". When you are in a state of hypnosis, the door also opens so helpful suggestions can be directed into your subconscious mind or forgotten memories can be retrieved. The hypnotic induction that hypnotists use is simply a way to focus your attention and concentration so you will go into that natural, normal hypnotic state. Once in the state of hypnosis, the trap door opens and suggestions to help you can be given. The list of ways hypnosis has been used to help children, adolescents and adults is practically endless but does include: weight loss, stopping smoking, building self-confidence and self-esteem, improving academic performance at every age level, improving test taking ability from children through high school, college, medical and law school as well as the National Teacher Certification Exam, pain management, eliminating anxiety, fear and phobias, stress management, insomnia and other sleep problems and helping to heal physical problems. 2. To really work well, suggestions must be reinforced by repetition. Most of the habits, feelings and emotions we want to change are deeply implanted in our subconscious mind and will not just "go away" with one set of suggestions. Most of the time, the hypnotic suggestions need to be repeated on a regular basis until you notice a change. This is one reason that most specialists in hypnosis give clients cassette tapes of their sessions so they can listen to them every day. It's also the reason why hypnosis tapes you buy can work so well. You get to listen to them every day or often enough that the suggestions become permanently a part of you. There is no way to predict how long it will take to see change. It will depend partly on your motivation and commitment. The Three Keys to the successful use of hypnosis for self improvement and personal growth are self motivation, repetition and believable suggestions. 1. The motivation to change must come from within you. If you are trying to change because someone else wants you to "lose weight" or "stop smoking", the chances are greately reduced that the hypnosis will work. For example, I've worked with many people for weight loss or to quit smoking who came to me because their physician or spouse wanted them to change. These people do not respond as well to the hypnosis as those who really want to change. Those who came because they wanted to quit smoking or lose weight responded quickly and easily. Before you start to use hypnosis for your self improvement, you should get it clear in your own mind why you want to change. This clear intention to change will help the hypnotic suggestions to take hold and manifest themselves in your everyday life. 3. The third key to the successful use of hypnosis for personal change is believable suggestions. If you are to accept a suggestion, your mind must first accept it as a real possibility. Telling a chocoholic that chocolate will be disgusting to them and will make them sick is too big a stretch for the imagination. If a suggestion like this even took hold, it would only last a short time because it would be so unbelievable to a real chocolate lover. In cases like this, one of the successful weight loss suggestions I use is that the next time the individual eats chocolate, it will not taste quite as good as the time before. This is far more acceptable and believable to most people. Then, with enough repetition over a period of time, chocolate loses much of it's positive taste and control over that person. One final note is that HYPNOSIS IS NOT DANGEROUS. There are almost no risks when used by trained professionals. You cannot be made to do anything that is against your moral values. An amateur or stage hypnotist might give you suggestions that might embarrass you, might not work or that might make you feel uncomfortable or self-conscious at the time. To avoid this, stick with professionally trained hypnosis specialists. The one risk I know about involves falling asleep. If you are tired or if you become too relaxed, you may move from the state of hypnosis to the normal sleep state. This is fine if you were going to go to sleep right after the trance but if you have other plans after listening to a hypnosis tape, you may want to set an alarm clock just in case you fall asleep. I've even had students fall asleep because they became too relaxed. In relation to this, never listen to a hypnosis tape while driving. It is very dangerous for you and everyone else on the road. Don't even listen to it if you are a passanger as the relaxation suggestions could make the driver fall asleep. Over the years, self improvement and personal growth using hypnosis has helped millions of people change their lives permanently because it is a safe and powerful tool for changing your thoughts, feelings and habits. Copyright C 2001 by Thomas D. Yarnell, Ph.D., Clinical Psychologist. All rights reserved. This material may be copied for educational purposes as long as full credit is given to Dr. Yarnell In helping to understand why it helps for IBS.Hypnotherapy Hypnotherapy has been by approved by the American Medical Association as a valid medical treatment since 1958, though the concept of using a state of hypnosis to alleviate both physical and mental ills has recurred throughout the history of medicine from ancient times. By reaching the subconscious level of the mind, hypnotherapy can be used to alter the way a person consciously perceives health problems, and also promote new manners of response to them. Hypnosis is often thought to be therapy that only affects the mind, but as mind and body are inseparably joined, hypnosis can also help physical ailments. During a state of hypnosis, consciousness is not lost, it becomes more selective, and typically a patient becomes aware of internal processes rather than the outside worldï¿½s distractions. Most people report the actual experience of being hypnotized as pleasant, comfortable, and extremely relaxing. Hypnotherapy is beneficial not only for the relaxation it induces, but for the state of suggestibility that characterizes it. In this state, the mind is open to receiving ideas and suggestions that promote positive thoughts and healing changes.[6] During normal waking hours, the window between the conscious and subconscious minds is closed, but any state of relaxation that results in alpha brain waves will open it. Typically, this happens during sleep, and dreams result. Hypnotherapy induces this same state of relaxation while the patient is awake, and allows helpful suggestions (such as those aimed at controlling health problems) to be directed into the subconscious mind. Only ten percent or so of the population is not susceptible to hypnosis ï¿½ the rest of us can turn to this therapy for relief of symptoms from disorders as wide ranging as: asthma, allergies, strokes, multiple sclerosis, Parkinson's disease, cerebral palsy, high blood pressure, nausea and vomiting, irregular heartbeat, muscle spasms, paralysis, and, with well-documented success rates, irritable bowel syndrome. Hypnotherapy has in fact proven highly effective in alleviating all of the various IBS symptoms. [7] Over 15 years of solid scientific research has demonstrated hypnotherapy as an effective, safe and inexpensive choice for IBS symptom alleviation.[8] It has been so overwhelmingly successful in this regard that Adriane Fugh-Berman, MD, chair of the National Women's Health Network in Washington, DC, has said that hypnosis should be the treatment of choice for IBS cases which have not responded to conventional therapy. Since the ï¿½conventional therapyï¿½ offered to most IBS patients ranges from nothing at all to a lifetime prescription for semi-effective anti-spasmodic drugs, I take this statement as the closest thing to a whole-hearted endorsement an alternative therapy can hope to get from a mainstream medical spokesperson. For IBS, one of hypnotherapy's greatest benefits is its well-established ability to reduce the effects of stress. Your state of mind can have a direct impact on your physical well-being, even when youï¿½re in the best of health. If youï¿½re struggling with IBS, the tension, anxiety, and depression that comes from living with an incurable illness can actually undermine your immune system and further compromise your health. Hypnotherapy can reduce this stress and its resultant negative impact by placing you in a deeply relaxed state, promoting positive thoughts and coping strategies, and clearing your mind of negative attitudes. IBS in fact is almost uniquely suited to treatment by hypnotherapy, for several reasons. First, as just noted, stress-related attacks can be significantly reduced. Second, one of the most impressive aspects from hypnotherapy, and of tremendous benefit to IBS sufferers, is its well-documented ability to relieve virtually all types and degrees of pain.[9] Finally, because IBS is not a disease at all but a syndrome, if you can relieve and prevent the symptoms, you have effectively cured yourself of the disorder. The underlying dysfunction may still be present but if you suffer no noticeable effects from it, you will be living an IBS-free life. This outcome is a definite possibility from hypnotherapy treatments. As with other alternative therapies, though there is solid evidence that hypnotherapy can provide lasting health benefits for many patients, there is uncertainty about precisely how and why the treatments work. Most scientists believe that hypnotherapy acts upon the unconscious, and affects the bodyï¿½s regulation of involuntary reactions that are normally beyond a personï¿½s control. Hypnotherapy puts these autonomic responses under the patientï¿½s power. Happily, treatment is suitable for people of all ages and physical conditions, as there are no risks or side effects.


----------



## linr (May 18, 2000)

I don't think that those who are opposed to the 'stress causes IBS or agravates the colon theory' are really uneducated or closeminded. I know in my case what bothers me about the whole stress theory are the Drs. that wave you out of the room with a diagnosis of IBS that is caused by stress and that you should just calm down etc. I KNOW that stress can make an IBS attack worse and I use meditation to keep anxiety under control. I am also taking Tai Chi and yoga to get a grip on stress. BUT no one will convince me that ALL of my stomach and intestinal problems relate to stress. I can be anywhere at anytime,even asleep and have an IBS attack.I can be out having a grand time and have an attack. I can have an absolutely horrible day and then come home eat whatever I want and feel fine for weeks. Who knows? That is the real question.I think IBS is a very complex thing and I am willing to try anything to releive it, so I am not knocking hypnotherapy or anything else. Just saying there is more to it than stress alone.I also think every case is unique. I know quite a few people who have IBS and we all have varying symptoms and very different personalities.I also know a few people who were originally diagnosed with IBS and were later told they had crohns or celiacs.Funny, how after the new diagnosis the Drs. no longer talked about the stress factor and concentrated on medication. It's so confusing !


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## linr (May 18, 2000)

I don't think that those who are opposed to the 'stress causes IBS or agravates the colon theory' are really uneducated or closeminded. I know in my case what bothers me about the whole stress theory are the Drs. that wave you out of the room with a diagnosis of IBS that is caused by stress and that you should just calm down etc. I KNOW that stress can make an IBS attack worse and I use meditation to keep anxiety under control. I am also taking Tai Chi and yoga to get a grip on stress. BUT no one will convince me that ALL of my stomach and intestinal problems relate to stress. I can be anywhere at anytime,even asleep and have an IBS attack.I can be out having a grand time and have an attack. I can have an absolutely horrible day and then come home eat whatever I want and feel fine for weeks. Who knows? That is the real question.I think IBS is a very complex thing and I am willing to try anything to releive it, so I am not knocking hypnotherapy or anything else. Just saying there is more to it than stress alone.I also think every case is unique. I know quite a few people who have IBS and we all have varying symptoms and very different personalities.I also know a few people who were originally diagnosed with IBS and were later told they had crohns or celiacs.Funny, how after the new diagnosis the Drs. no longer talked about the stress factor and concentrated on medication. It's so confusing !


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## eric (Jul 8, 1999)

Norbert, thanks for your comments. Its important for others to see this is safe and that you get better long term.Its also important for the senior members to speak up on the stress/anxiety/emotional issues.


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## eric (Jul 8, 1999)

Norbert, thanks for your comments. Its important for others to see this is safe and that you get better long term.Its also important for the senior members to speak up on the stress/anxiety/emotional issues.


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## bernard (Jan 4, 2000)

> quote:Moldie and Bernard I will get back to you.


Huuuu?????







Anyway, i'm just IBS mild ("annoying"). I should have done some HT with time by myself??? (i read some book about this and tried by myself following the instructions). It's a long time i didn't go to the hospital (anyway i don't trust those doc, they just found anything wrong even if you are in pain) or had very painful attacks. I went to the restaurant and no trouble today. So everything is good. Anyway, even if i'm cured of that IBS i have some other stuff that botter me more these days.I'm going to Puerta Vallarta to morrow for one week. Should be ok.Have a merry Christmas and happy new year.---


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## bernard (Jan 4, 2000)

> quote:Moldie and Bernard I will get back to you.


Huuuu?????







Anyway, i'm just IBS mild ("annoying"). I should have done some HT with time by myself??? (i read some book about this and tried by myself following the instructions). It's a long time i didn't go to the hospital (anyway i don't trust those doc, they just found anything wrong even if you are in pain) or had very painful attacks. I went to the restaurant and no trouble today. So everything is good. Anyway, even if i'm cured of that IBS i have some other stuff that botter me more these days.I'm going to Puerta Vallarta to morrow for one week. Should be ok.Have a merry Christmas and happy new year.---


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## angry (Jul 25, 2001)

You hypo/cbt guys really miss the point.First axiom. One has to be toilet trained to work.Second axiom. A treatment that is available only to the elite is useless to the masses.You criticize the drugs because they ONLY help 50 and 25% of the suffers. However, I've brought this up before it's been ignored. My guestimate is that due to the limited number of trained CBT/hypno specialists in this area that you might be able to successfully treat maybe 1% of the suffers max. I'd say the drug solution far and away could help more people. Your argue that you have to take drugs for life. So what? People take insulin, heart medications, antidepressants and other drugs for life. By the way, the number of studies of long term effects on these in general is limited and for antidepressants practically non-existant.If one doesn't want to take them for life then use them like "chemotherapy" while one keeps his job and goes after the other options-- which may or may not produce any net benefit. The cost issue was brought up. $160/month seems like a bargain compared to 6 months to a year of CBT paid out of pocket. What is the cost of loosing your job? If the problem can't be solved in short enough time you loose your job and your medical coverage. You can't then pursue the solutions your touting. I take that back, perhaps the independently wealthy elite can. How many do you guess are independently wealthy.I see that typical disclaimer most people use when they can't accept that their pet treatment doesn't live up to their claims. It goes like this "if hypno/cbt doesn't work for you, you must be resisting it, be closed minded, or doing something wrong." That is a cop out designed to blame the sufferer rather than the treatment. A decent treatment should work even if somebody isn't gung ho about it. Coverting the choir hardly proves anything.Better living through chemistry isn't something to be feared. It is perhaps the only way to mass produce a solution.


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## angry (Jul 25, 2001)

You hypo/cbt guys really miss the point.First axiom. One has to be toilet trained to work.Second axiom. A treatment that is available only to the elite is useless to the masses.You criticize the drugs because they ONLY help 50 and 25% of the suffers. However, I've brought this up before it's been ignored. My guestimate is that due to the limited number of trained CBT/hypno specialists in this area that you might be able to successfully treat maybe 1% of the suffers max. I'd say the drug solution far and away could help more people. Your argue that you have to take drugs for life. So what? People take insulin, heart medications, antidepressants and other drugs for life. By the way, the number of studies of long term effects on these in general is limited and for antidepressants practically non-existant.If one doesn't want to take them for life then use them like "chemotherapy" while one keeps his job and goes after the other options-- which may or may not produce any net benefit. The cost issue was brought up. $160/month seems like a bargain compared to 6 months to a year of CBT paid out of pocket. What is the cost of loosing your job? If the problem can't be solved in short enough time you loose your job and your medical coverage. You can't then pursue the solutions your touting. I take that back, perhaps the independently wealthy elite can. How many do you guess are independently wealthy.I see that typical disclaimer most people use when they can't accept that their pet treatment doesn't live up to their claims. It goes like this "if hypno/cbt doesn't work for you, you must be resisting it, be closed minded, or doing something wrong." That is a cop out designed to blame the sufferer rather than the treatment. A decent treatment should work even if somebody isn't gung ho about it. Coverting the choir hardly proves anything.Better living through chemistry isn't something to be feared. It is perhaps the only way to mass produce a solution.


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## norbert46 (Feb 20, 2001)

Linr, I can relate to your confusion. The MD's are helpless to treat you unless some test shows a physical problem so they do "wave you off" as you say. They will not give you high powered steroid meds to treat Crohn's and permanently destroy some of your other organs in the "hope" that they might work even though the tests show no Crohn's so that leaves you with a Psychiatrist giving the trial and error with psychmeds which is what I would advise to be the "last" resort from my experiences. There are MDs that have IBS and don't you think they experimented that way since they could get the meds? I'll bet they've tried steroids, antibiotics and a lot of other meds that didn't work for them. I don't have your answers because as you've said it may not have been the same as mine and maybe the hypnotapes wouldn't totally stop your IBS. But my question would be- if you worked the hypnotape program through completion and your IBS stopped as mine has would you then admit that some brain/gut imbalance has been corrected? Again, there is only one way to find out and it is inexpensive and easy to use! If you are having any problems with the tape program Mike and Eric will even address you on a personal basis through e-mail or on the Cognitive hypno BB, you sure couldn't expect more help than that. Angry, to directly address your reasoning I will say that I agree with you on some of your points. If Mike's Hypnotape100 program had been expensive I would not have tried them as I'm not rich either, just a retired machinist! Second I know that the Lotronex worked to some high degree and if the hypno didn't work and I still had problems with IBS/D I would still pay the Rx and take the Lotronex(if it came back on the market)for the rest of my life even not knowing the long term effects. But Lotronex is not available and the tapes are and many of us were helped so what would you expect me to advise? Nothing else worked! Good luck, Norb


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## norbert46 (Feb 20, 2001)

Linr, I can relate to your confusion. The MD's are helpless to treat you unless some test shows a physical problem so they do "wave you off" as you say. They will not give you high powered steroid meds to treat Crohn's and permanently destroy some of your other organs in the "hope" that they might work even though the tests show no Crohn's so that leaves you with a Psychiatrist giving the trial and error with psychmeds which is what I would advise to be the "last" resort from my experiences. There are MDs that have IBS and don't you think they experimented that way since they could get the meds? I'll bet they've tried steroids, antibiotics and a lot of other meds that didn't work for them. I don't have your answers because as you've said it may not have been the same as mine and maybe the hypnotapes wouldn't totally stop your IBS. But my question would be- if you worked the hypnotape program through completion and your IBS stopped as mine has would you then admit that some brain/gut imbalance has been corrected? Again, there is only one way to find out and it is inexpensive and easy to use! If you are having any problems with the tape program Mike and Eric will even address you on a personal basis through e-mail or on the Cognitive hypno BB, you sure couldn't expect more help than that. Angry, to directly address your reasoning I will say that I agree with you on some of your points. If Mike's Hypnotape100 program had been expensive I would not have tried them as I'm not rich either, just a retired machinist! Second I know that the Lotronex worked to some high degree and if the hypno didn't work and I still had problems with IBS/D I would still pay the Rx and take the Lotronex(if it came back on the market)for the rest of my life even not knowing the long term effects. But Lotronex is not available and the tapes are and many of us were helped so what would you expect me to advise? Nothing else worked! Good luck, Norb


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## eric (Jul 8, 1999)

Angry, you really are angry and that is a stress emotion that will generated your symptoms through the CNS-ENS connection. You will have a better quailty of life if you calm the brain-gut axis. Every one can choose their own methods. But I highly recommend you research them and know what they do and how there doing it.For the record Angry you seem to think I am opposed to drugs for treatment and that is simply not true, however for people's general health I would rather not see people on them long term or at all if it isn't necessary.First rule of IBS: education and a good doctor patient relationship.


----------



## eric (Jul 8, 1999)

Angry, you really are angry and that is a stress emotion that will generated your symptoms through the CNS-ENS connection. You will have a better quailty of life if you calm the brain-gut axis. Every one can choose their own methods. But I highly recommend you research them and know what they do and how there doing it.For the record Angry you seem to think I am opposed to drugs for treatment and that is simply not true, however for people's general health I would rather not see people on them long term or at all if it isn't necessary.First rule of IBS: education and a good doctor patient relationship.


----------



## eric (Jul 8, 1999)

Moldie and bernardDistraction for pain. http://google.yahoo.com/bin/query?p=distra...+pain&hc=0&hs=0 Bernard have a great Christmas and have fun. Send a ticket if you have an extra.


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## eric (Jul 8, 1999)

Moldie and bernardDistraction for pain. http://google.yahoo.com/bin/query?p=distra...+pain&hc=0&hs=0 Bernard have a great Christmas and have fun. Send a ticket if you have an extra.


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## eric (Jul 8, 1999)

Angry, when a pill comes out to fix the dysregulation of neurotranismitters between the gut brain and the brain and back, I am sure this bb, myself included will be the first to let you know they found a "Cure" for IBS.Hopefully, future research will get funding from both the private sector and the public sector.


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## eric (Jul 8, 1999)

Angry, when a pill comes out to fix the dysregulation of neurotranismitters between the gut brain and the brain and back, I am sure this bb, myself included will be the first to let you know they found a "Cure" for IBS.Hopefully, future research will get funding from both the private sector and the public sector.


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## eric (Jul 8, 1999)

Beach, lets go back to your question. The connection to the things everything here talked about stress, food, why the new IBS drugs work, why HT and CBT work and anti-depresants do what they do, all of this is connected to serotonin and IBS.The weather can effect the regulation of serotonin in IBS and generate symptoms.Your gut is a muscle controled by certain chemicals and electrical impulses. So a variety of stimuli to the system can trigger you IBS. Including foods and stress. But there are others.


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## eric (Jul 8, 1999)

Beach, lets go back to your question. The connection to the things everything here talked about stress, food, why the new IBS drugs work, why HT and CBT work and anti-depresants do what they do, all of this is connected to serotonin and IBS.The weather can effect the regulation of serotonin in IBS and generate symptoms.Your gut is a muscle controled by certain chemicals and electrical impulses. So a variety of stimuli to the system can trigger you IBS. Including foods and stress. But there are others.


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## Mike NoLomotil (Jun 6, 2000)

These stress-threads are fun. They are always so&#8230;.so..what is the word I am reaching for&#8230;stressful!







_____________________________________________"It's not stress. It' our reaction to stress that is the problem."_____________________________________________LMAO&#8230;.."It's not the fall that kills you it is the sudden stop!"' EXCELLENT paraphraseology. 10 MNL Points to you for turning-the-phrase!!!







___________________________________________"I would say that there is probably a portion of the population that may have irritable brain syndrome,.."__________________________________________I agree. I would also add that there is a part of the population treating IBS that suffers "Irrational Brain Syndrome"._____________________________________________"It seems that a lot of people don't understand the role of anxiety, stress and emotions in IBS!!! Or they want to choose to ignore it which is a big mistake!!!!!!"___________________________________________And apparently stressful.







I agree this is quite stupid. It is just as stupid as, in this day and age, caregivers following or promoting single-mode therapies to IBS patients when it has been established for 20 years that an integrated Disease Management Program (multi-modal therapy) produces the best outcomes. _________________________________"You will have a better quality of life if you calm the brain-gut axis. Every one can choose their own methods..."_________________________________This is true. Although you will have an even BETTER quality of life if you not only seek to "calm the brain-gut axis" with behavioral therapies but also are under the care of someone who knows how to implement a multi-modal integrated Disease Management approach to your care, which will also competently isolate and remove physical causal bases for the symptoms. Key word: "competently".The decision of what to do should never be set forth as if it is an "either-or proposition", or choice, to IBS victims no matter by whom. If the patients symptom-reduction program is not multi-modal and integrated she will not achieve the best possible outcomes. The outcomes will always be compromised to a greater or lesser degree. You cannot manage IBS by treating one system component or one sub-system any more than you can optimize the operation of a car by optimizing only the EEC system and connected sensors.This concept is the paramount concept to instill into the patients "brain-gut axis".







Happy Holidays, Stay Loose, and Be WellMNL


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## Mike NoLomotil (Jun 6, 2000)

These stress-threads are fun. They are always so&#8230;.so..what is the word I am reaching for&#8230;stressful!







_____________________________________________"It's not stress. It' our reaction to stress that is the problem."_____________________________________________LMAO&#8230;.."It's not the fall that kills you it is the sudden stop!"' EXCELLENT paraphraseology. 10 MNL Points to you for turning-the-phrase!!!







___________________________________________"I would say that there is probably a portion of the population that may have irritable brain syndrome,.."__________________________________________I agree. I would also add that there is a part of the population treating IBS that suffers "Irrational Brain Syndrome"._____________________________________________"It seems that a lot of people don't understand the role of anxiety, stress and emotions in IBS!!! Or they want to choose to ignore it which is a big mistake!!!!!!"___________________________________________And apparently stressful.







I agree this is quite stupid. It is just as stupid as, in this day and age, caregivers following or promoting single-mode therapies to IBS patients when it has been established for 20 years that an integrated Disease Management Program (multi-modal therapy) produces the best outcomes. _________________________________"You will have a better quality of life if you calm the brain-gut axis. Every one can choose their own methods..."_________________________________This is true. Although you will have an even BETTER quality of life if you not only seek to "calm the brain-gut axis" with behavioral therapies but also are under the care of someone who knows how to implement a multi-modal integrated Disease Management approach to your care, which will also competently isolate and remove physical causal bases for the symptoms. Key word: "competently".The decision of what to do should never be set forth as if it is an "either-or proposition", or choice, to IBS victims no matter by whom. If the patients symptom-reduction program is not multi-modal and integrated she will not achieve the best possible outcomes. The outcomes will always be compromised to a greater or lesser degree. You cannot manage IBS by treating one system component or one sub-system any more than you can optimize the operation of a car by optimizing only the EEC system and connected sensors.This concept is the paramount concept to instill into the patients "brain-gut axis".







Happy Holidays, Stay Loose, and Be WellMNL


----------



## eric (Jul 8, 1999)

FYI Revisiting IBS: Perspectives for the New Millennium http://www.gastroendonews.com/specreps/gen0106/0106.html "Introduction Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders seen in specialty and primary care practice, yet only recently has it attracted the attention of investigators and clinicians in GI and primary care. That was the message of Douglas A. Drossman, MD, professor of medicine and psychiatry, University of North Carolina (UNC) at Chapel Hill School of Medicine and co-director of the UNC Center for Functional GI and Motility Disorders. Dr. Drossman introduced 3 experts presenting the latest findings in IBS research at the 65th annual scientific meeting of the American College of Gastroenterology in New York City. These speakers discussed the following concepts: the use of brain imaging techniques to understand how patients with IBS may be more sensitive to gut stimuli; the theory that, in some cases, an acute outbreak of gastroenteritis may lead to long-term chronic IBS; and the latest treatment options clinicians can prescribe to treat IBS and the abdominal pain and discomfort that are associated with the syndrome. The following Special Report will discuss these topics. Brain Imaging: CNS Abnormalities in IBS Patients Traditionally, researchers studying the pathophysiology of IBSï¿½a condition characterized by a combination of abdominal pain and discomfort and altered bowel habitsï¿½have relied on measurement of gut function and the subjective responses of patients to given stimuli, according to Emeran A. Mayer, MD, professor of medicine and physiology at the UCLA School of Medicine and director of the UCLA/CURE Neuroenteric Disease Program, Los Angeles. However, researchers have turned to functional brain imaging techniques, including evoked potential recordings, positron emission tomography, andï¿½most recentlyï¿½functional magnetic resonance imaging, to assess activation of brain regions during visceral stimulation, in terms of increased brain activity or regional blood flow. These innovative methods have begun to demonstrate alterations in brain function in IBS patients that may help explain enhanced perception of gut stimuli. Dr. Mayer discussed the visceral hypersensitivity noted in IBS patients, including affective processing of visceral sensations, and therefore decreased discomfort thresholds/tolerance; altered arousal or hypervigilance, leading to generalized hyperresponsiveness to sensory stimuli; increased threat appraisal of and attention to visceral sensations; and stress-induced visceral hyperalgesia. The circuitry of brainï¿½gut reactions that control patients' responses to stressors is found within the "emotional motor system," said Dr. Mayer. The output of this circuitry in response to stressors or emotional experiences can be measured "in terms of autonomic, pain-modulatory, and neuroendocrine responses. Furthermore, it is modulated by a variety of factors such as belief systems, thoughts, and emotions; all play significant roles in modulating response. What is important, though, is that the output can pretty much explain the characteristic IBS symptoms." Autonomic regulation affects not only the muscle cells in the gut, but other cell types, including mast cells, enterochromaffin cells, and the intrinsic neurons of the enteric nervous system. "Therefore," Dr. Mayer explained, "the autonomic nervous system, by stimulating the release of substances from these cells, can change the sensitivity of the gut to a variety of gut stimuli or internal stressors." A recent breakthrough is the discovery that "in response to stressors, this system makes the gut more sensitive," a process referred to as stress-induced visceral hyperalgesia. "Many of you may have experienced that when you go to give a presentation, you may suddenly experience the urge to go to the toilet," Dr. Mayer explained. "It's not that you have a full bladder; it's that the anxiety over the imminent presentation causes the sensory pathways from the bladder to the brain [to be] more sensitive. What's attractive about this concept is that psychosocial stressors arising in the external environment and/or physical stressors arising from within the body, such as gut inflammation, can result in activation of the emotional motor system." Thus, hyperresponsiveness of these stress circuits in the brain might result in altered responses to the internal stresses associated with inflammation and external stressors. Dr. Mayer listed the evidence for different types of visceral hypersensitivity, including lowered discomfort threshold and decreased tolerance to balloon distention of the colon. According to Dr. Mayer, IBS patients show, along with a hyperresponsiveness to stimuli, "a tendency of increased threat appraisal of certain visceral sensations, something of an old-fashioned concept that's coming back in vogue. It's quite well known that patients with a variety of functional disorders feel more threatened by sensory experiences coming from different parts of the body." If one refers to evidence from studies that "measure the impact of intense, repetitive sigmoid colon distention [a 'visceral stressor'] on the perception of the discomfort threshold for rectal distention," Dr. Mayer said, one can see that "following this intervention, only in IBS patients was there a characteristic lowering of the rectal discomfort threshold into the range of hyperalgesia, whereas there was no threshold reduction in healthy control subjects or in those with mildly reactive ulcerative colitis." There are additional examples from other laboratories using psychosocial stressors as well. "The studies that I summarized briefly all have relied on subjective symptoms of perceptional stimuli in response to stimulation of the periphery," said Dr. Mayer. "But ultimately, this is not a very accurate way of assessing what's going on within the 'black box' of the brain. The optimum way would be to measure directly at the brain level, something that is no longer dependent on the subjective reporting of the patient." In the brain, there are "serial and parallel processing of different aspects of visceral sensory information," said Dr. Mayer. Input from the gut enters through multiple channels, and partially overlapping central circuits process the perceptual experience of gut sensations, with both autonomic pain modulatory responses. When sensory signals reach the brain, the input is measured and encoded, and includes the primary appraisal of threat and feelings of unpleasantness the individual experiences in response to the particular stimulus. In addition, parallel processing via modulatory pathways involving stress-activated systems can either up- or downregulate any of the modulatory systems. Previous experience and memory also strongly influence the perception of visceral stimulation, which again can modulate information processing. There are two different regions in the brain that encode the objective intensity of the stimuli, Dr. Mayer continued. Subjective perceptions are modulated by the attentional state of the individual, and by memories of past similar events, which influence the subjective interpretation of the unpleasantness of the experience. Dr. Mayer first explained the intensity-coding process. "The simplest aspect of this information," he said, "comes up through the spinal cord and is encoded in an area of the brain called the insula, which is the visceral sensory cortex." The insula is the part of the brain that most objectively encodes information from the periphery. "Currently, there's no evidence in this region of a difference between IBS patients and control patients, although the evidence is scarce and further studies are needed," noted Dr. Mayer. The second aspect of pain modulation within the brainï¿½"which may be more important in IBS," according to Dr. Mayerï¿½is the affective appraisal of the sensory information that reaches the insula, which happens at the level of the anterior cingulate cortex. In a study by Montreal researchers (Science 1997;277:968-971), the unpleasantness ratings of the stimulus were modulated by hypnotizing subjects. The subjective experience of unpleasantness was either increased or decreased in response to a given somatic stimulus. "The anterior cingulate cortex was the one region of the brain that showed a close correlation toward multiple changes of the subjective unpleasant rating," Dr. Mayer said. In other studies, this region showed decreased blood flow when subjects were treated with opioids. Given the altered affective stimulus processing for IBS patients, what is the relevance for clinical practitioners? Among the most common complaints of IBS patients, as reported by physicians, are heartburn, bloating of the lower GI tract, sensation of fullness, incomplete rectal evacuation, and abdominal pain, explained Dr. Mayer. "The amplification of the unpleasantness of these experiencesï¿½which in the healthy individual is not even consciously perceived once they reach the brainï¿½is one way to explain this range of symptoms," he said. "A more complex and higher-level interpretation of the sensory experience is a modulation based on memory and past experiences." Here, a different area of the brain comes into play; sensory association areas in the parietal cortex, which have connections to the main memory centers within the brain and also to the prefrontal cortex. "By putting together results from a large number of somatic pain studies, this conclusion was reached: This network of recalling past memories of similar events and interpreting these past memories in the cortex plays a major role in the threat appraisal that IBS patients perform on the sensory experience." According to Dr. Mayer, this altered threat appraisal in IBS patients leads them to make statements such as: "I am afraid not to be close enough to a bathroom"; "I am afraid that anything I eat may trigger my abdominal pain"; "I am afraid I will be uncomfortable all day if I don't have a bowel movement in the morning"; and "When my belly hurts, I am afraid I may have cancer." "All of these statements are based on beliefs and memory of past events that are recalled any time the patient gets into a similar situation or feels anxious," noted Dr. Mayer. "This recall is modulated by the prefrontal cortex when the sensory experience [is processed]." Another relevant modulatory factor is related to the stress response, specifically to activation of the locus caeruleus, a tiny nucleus within the brain stem that potentially threatening experiences activate. "One unique feature of that nucleus is that it projects to virtually all the regions of the brain that also receive visceral input," said Dr. Mayer. "These projections secrete norepinephrine, and a low or moderate amount of norepinephrine release would activate these regions, increasing arousal. But if norepinephrine release is excessive, it may have the opposite effect and inhibit these target areas." The enhanced arousal process regulated by the locus caeruleus is common not only in IBS, but in clinical conditions frequently overlapping with IBS, such as anxiety, panic disorder, and post-traumatic stress syndrome. Thus, "there may be a common link between these disorders, even though the symptoms are very different," he said. Arousal is reduced, as shown in animal models, by sedatives, anxiolytics, and low-dose tricyclics, Dr. Mayer continued. He suggested that this may be the reason why low-dose tricyclics, among other medications, are helpful in treating some IBS symptoms. A subgroup of patients with IBS may respond positively to relaxation therapy and exercise. The evolving knowledge of altered central nervous system (CNS) responses in IBS patients could provide a basis for more rational therapies, concluded Dr. Mayer. Altered processing of visceral sensations in brain regions such as the anterior cingulate cortex is currently the most convincing abnormality in IBS patients, he said. "By changing the visceral input to that region of the brain, it certainly would decrease the unpleasantness of the experience," he explained, "and there may be a model whereby peripherally acting compounds such as serotonin [5-HT] receptorï¿½modulating drugs may decrease some of the pain." As for the problem of altered arousal, or hypervigilance, Dr. Mayer said that possible treatments could include novel anxiolytics. He added that further research is needed to see what, if any, effect the 5-HT3 receptor antagonists or substance P antagonists would have. When considering the increased threat appraisal of visceral sensations and for inappropriate beliefs about the disorder in IBS patients, Dr. Mayer suggested the possibility of treatment, "not so much with medications, but with cognitive behavioral therapies that will change the response to situations or patient recall of inappropriate memories of similar situations." Stress-induced visceral hyperalgesia may respond well to stress management and relaxation techniques in a subset of IBS patients, but new interventions aimed at reducing altered CNS responses are clearly needed."


----------



## eric (Jul 8, 1999)

FYI Revisiting IBS: Perspectives for the New Millennium http://www.gastroendonews.com/specreps/gen0106/0106.html "Introduction Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders seen in specialty and primary care practice, yet only recently has it attracted the attention of investigators and clinicians in GI and primary care. That was the message of Douglas A. Drossman, MD, professor of medicine and psychiatry, University of North Carolina (UNC) at Chapel Hill School of Medicine and co-director of the UNC Center for Functional GI and Motility Disorders. Dr. Drossman introduced 3 experts presenting the latest findings in IBS research at the 65th annual scientific meeting of the American College of Gastroenterology in New York City. These speakers discussed the following concepts: the use of brain imaging techniques to understand how patients with IBS may be more sensitive to gut stimuli; the theory that, in some cases, an acute outbreak of gastroenteritis may lead to long-term chronic IBS; and the latest treatment options clinicians can prescribe to treat IBS and the abdominal pain and discomfort that are associated with the syndrome. The following Special Report will discuss these topics. Brain Imaging: CNS Abnormalities in IBS Patients Traditionally, researchers studying the pathophysiology of IBSï¿½a condition characterized by a combination of abdominal pain and discomfort and altered bowel habitsï¿½have relied on measurement of gut function and the subjective responses of patients to given stimuli, according to Emeran A. Mayer, MD, professor of medicine and physiology at the UCLA School of Medicine and director of the UCLA/CURE Neuroenteric Disease Program, Los Angeles. However, researchers have turned to functional brain imaging techniques, including evoked potential recordings, positron emission tomography, andï¿½most recentlyï¿½functional magnetic resonance imaging, to assess activation of brain regions during visceral stimulation, in terms of increased brain activity or regional blood flow. These innovative methods have begun to demonstrate alterations in brain function in IBS patients that may help explain enhanced perception of gut stimuli. Dr. Mayer discussed the visceral hypersensitivity noted in IBS patients, including affective processing of visceral sensations, and therefore decreased discomfort thresholds/tolerance; altered arousal or hypervigilance, leading to generalized hyperresponsiveness to sensory stimuli; increased threat appraisal of and attention to visceral sensations; and stress-induced visceral hyperalgesia. The circuitry of brainï¿½gut reactions that control patients' responses to stressors is found within the "emotional motor system," said Dr. Mayer. The output of this circuitry in response to stressors or emotional experiences can be measured "in terms of autonomic, pain-modulatory, and neuroendocrine responses. Furthermore, it is modulated by a variety of factors such as belief systems, thoughts, and emotions; all play significant roles in modulating response. What is important, though, is that the output can pretty much explain the characteristic IBS symptoms." Autonomic regulation affects not only the muscle cells in the gut, but other cell types, including mast cells, enterochromaffin cells, and the intrinsic neurons of the enteric nervous system. "Therefore," Dr. Mayer explained, "the autonomic nervous system, by stimulating the release of substances from these cells, can change the sensitivity of the gut to a variety of gut stimuli or internal stressors." A recent breakthrough is the discovery that "in response to stressors, this system makes the gut more sensitive," a process referred to as stress-induced visceral hyperalgesia. "Many of you may have experienced that when you go to give a presentation, you may suddenly experience the urge to go to the toilet," Dr. Mayer explained. "It's not that you have a full bladder; it's that the anxiety over the imminent presentation causes the sensory pathways from the bladder to the brain [to be] more sensitive. What's attractive about this concept is that psychosocial stressors arising in the external environment and/or physical stressors arising from within the body, such as gut inflammation, can result in activation of the emotional motor system." Thus, hyperresponsiveness of these stress circuits in the brain might result in altered responses to the internal stresses associated with inflammation and external stressors. Dr. Mayer listed the evidence for different types of visceral hypersensitivity, including lowered discomfort threshold and decreased tolerance to balloon distention of the colon. According to Dr. Mayer, IBS patients show, along with a hyperresponsiveness to stimuli, "a tendency of increased threat appraisal of certain visceral sensations, something of an old-fashioned concept that's coming back in vogue. It's quite well known that patients with a variety of functional disorders feel more threatened by sensory experiences coming from different parts of the body." If one refers to evidence from studies that "measure the impact of intense, repetitive sigmoid colon distention [a 'visceral stressor'] on the perception of the discomfort threshold for rectal distention," Dr. Mayer said, one can see that "following this intervention, only in IBS patients was there a characteristic lowering of the rectal discomfort threshold into the range of hyperalgesia, whereas there was no threshold reduction in healthy control subjects or in those with mildly reactive ulcerative colitis." There are additional examples from other laboratories using psychosocial stressors as well. "The studies that I summarized briefly all have relied on subjective symptoms of perceptional stimuli in response to stimulation of the periphery," said Dr. Mayer. "But ultimately, this is not a very accurate way of assessing what's going on within the 'black box' of the brain. The optimum way would be to measure directly at the brain level, something that is no longer dependent on the subjective reporting of the patient." In the brain, there are "serial and parallel processing of different aspects of visceral sensory information," said Dr. Mayer. Input from the gut enters through multiple channels, and partially overlapping central circuits process the perceptual experience of gut sensations, with both autonomic pain modulatory responses. When sensory signals reach the brain, the input is measured and encoded, and includes the primary appraisal of threat and feelings of unpleasantness the individual experiences in response to the particular stimulus. In addition, parallel processing via modulatory pathways involving stress-activated systems can either up- or downregulate any of the modulatory systems. Previous experience and memory also strongly influence the perception of visceral stimulation, which again can modulate information processing. There are two different regions in the brain that encode the objective intensity of the stimuli, Dr. Mayer continued. Subjective perceptions are modulated by the attentional state of the individual, and by memories of past similar events, which influence the subjective interpretation of the unpleasantness of the experience. Dr. Mayer first explained the intensity-coding process. "The simplest aspect of this information," he said, "comes up through the spinal cord and is encoded in an area of the brain called the insula, which is the visceral sensory cortex." The insula is the part of the brain that most objectively encodes information from the periphery. "Currently, there's no evidence in this region of a difference between IBS patients and control patients, although the evidence is scarce and further studies are needed," noted Dr. Mayer. The second aspect of pain modulation within the brainï¿½"which may be more important in IBS," according to Dr. Mayerï¿½is the affective appraisal of the sensory information that reaches the insula, which happens at the level of the anterior cingulate cortex. In a study by Montreal researchers (Science 1997;277:968-971), the unpleasantness ratings of the stimulus were modulated by hypnotizing subjects. The subjective experience of unpleasantness was either increased or decreased in response to a given somatic stimulus. "The anterior cingulate cortex was the one region of the brain that showed a close correlation toward multiple changes of the subjective unpleasant rating," Dr. Mayer said. In other studies, this region showed decreased blood flow when subjects were treated with opioids. Given the altered affective stimulus processing for IBS patients, what is the relevance for clinical practitioners? Among the most common complaints of IBS patients, as reported by physicians, are heartburn, bloating of the lower GI tract, sensation of fullness, incomplete rectal evacuation, and abdominal pain, explained Dr. Mayer. "The amplification of the unpleasantness of these experiencesï¿½which in the healthy individual is not even consciously perceived once they reach the brainï¿½is one way to explain this range of symptoms," he said. "A more complex and higher-level interpretation of the sensory experience is a modulation based on memory and past experiences." Here, a different area of the brain comes into play; sensory association areas in the parietal cortex, which have connections to the main memory centers within the brain and also to the prefrontal cortex. "By putting together results from a large number of somatic pain studies, this conclusion was reached: This network of recalling past memories of similar events and interpreting these past memories in the cortex plays a major role in the threat appraisal that IBS patients perform on the sensory experience." According to Dr. Mayer, this altered threat appraisal in IBS patients leads them to make statements such as: "I am afraid not to be close enough to a bathroom"; "I am afraid that anything I eat may trigger my abdominal pain"; "I am afraid I will be uncomfortable all day if I don't have a bowel movement in the morning"; and "When my belly hurts, I am afraid I may have cancer." "All of these statements are based on beliefs and memory of past events that are recalled any time the patient gets into a similar situation or feels anxious," noted Dr. Mayer. "This recall is modulated by the prefrontal cortex when the sensory experience [is processed]." Another relevant modulatory factor is related to the stress response, specifically to activation of the locus caeruleus, a tiny nucleus within the brain stem that potentially threatening experiences activate. "One unique feature of that nucleus is that it projects to virtually all the regions of the brain that also receive visceral input," said Dr. Mayer. "These projections secrete norepinephrine, and a low or moderate amount of norepinephrine release would activate these regions, increasing arousal. But if norepinephrine release is excessive, it may have the opposite effect and inhibit these target areas." The enhanced arousal process regulated by the locus caeruleus is common not only in IBS, but in clinical conditions frequently overlapping with IBS, such as anxiety, panic disorder, and post-traumatic stress syndrome. Thus, "there may be a common link between these disorders, even though the symptoms are very different," he said. Arousal is reduced, as shown in animal models, by sedatives, anxiolytics, and low-dose tricyclics, Dr. Mayer continued. He suggested that this may be the reason why low-dose tricyclics, among other medications, are helpful in treating some IBS symptoms. A subgroup of patients with IBS may respond positively to relaxation therapy and exercise. The evolving knowledge of altered central nervous system (CNS) responses in IBS patients could provide a basis for more rational therapies, concluded Dr. Mayer. Altered processing of visceral sensations in brain regions such as the anterior cingulate cortex is currently the most convincing abnormality in IBS patients, he said. "By changing the visceral input to that region of the brain, it certainly would decrease the unpleasantness of the experience," he explained, "and there may be a model whereby peripherally acting compounds such as serotonin [5-HT] receptorï¿½modulating drugs may decrease some of the pain." As for the problem of altered arousal, or hypervigilance, Dr. Mayer said that possible treatments could include novel anxiolytics. He added that further research is needed to see what, if any, effect the 5-HT3 receptor antagonists or substance P antagonists would have. When considering the increased threat appraisal of visceral sensations and for inappropriate beliefs about the disorder in IBS patients, Dr. Mayer suggested the possibility of treatment, "not so much with medications, but with cognitive behavioral therapies that will change the response to situations or patient recall of inappropriate memories of similar situations." Stress-induced visceral hyperalgesia may respond well to stress management and relaxation techniques in a subset of IBS patients, but new interventions aimed at reducing altered CNS responses are clearly needed."


----------



## eric (Jul 8, 1999)

An example of how you can control your body using biofeedback.History of Biofeedback In the early part of the century, in Germany, J.H. Schultz developed a technique called Autogenic Training. In this method, verbal instructions are used to guide a person to a different, more relaxed and controlled, physiological state. The method flourished, and the results were reported upon by Wolfgang Luthe in 1969 in the United States. The technique is still used to this day, but it is so thoroughly marbled in to what biofeedback clinicians do that it may no longer be distinguished as Autogenic Training. Edmund Jacobson developed the technique of Progressive Relaxation training in the 1930ï¿½s in the United States. This was a series of muscle activities to teach people awareness of tension and relaxation. The effect was to reduce muscle tension and certain causes and effects of stress and other symptoms. In the 1960ï¿½s and 1970ï¿½s there began to be an awareness in the Western world of the Eastern yogic traditions and the ability of some yogis and other masters to alter their physiology volitionally. Most dramatically, a yogi could survive in a sealed box by voluntarily reducing his metabolic rate to the point where he would not exhaust the supply of oxygen over a period of hoursï¿½a hazard that would have killed any other man. After a designated period of time, he would raise his metabolic rate again and ask to be released from the enclosure. The altered states that were being achieved by meditative means attracted the attention of a few key researchers. The gurus taught that in this state of relaxation and control they could change a number of variables that were thought to be autonomously regulated: blood pressure, heart rate, finger or hand temperature. These functions are managed by the autonomic nervous system, so named precisely because it was thought that such functions could not be altered voluntarily. The autonomic nervous system has two divisionsï¿½the sympathetic and the parasympathetic. The sympathetic nervous system gets you up, gets you ready and gets you going, and regulates the flight/fight response. It gets you on the freeway, keeps you thinking about going to the doctorï¿½s office, or what kind of presentation you are going to make. The parasympathetic nervous system calms and relaxes you (when you lie down, take your break, go to sleep etc.), and manages body functions like digestion. The two work in tandem with each other in a reciprocal relationship. It was Canon and Selye, researchers in the body response to stress, who increased general awareness of the role of stress in physical diseases and mental disorders. Many of these manifested in disregulations of autonomic response. Hatha yoga, and other yogic traditions, became established in the United States as techniques for physical relaxation and enhancement of conscious control over our physiology. Additionally, meditation techniques such as Transcendental Meditation and Zen Buddhism stimulated the elaboration of the Relaxation Response by George Benson in 1975, the notion of Behavioral Stillness by Mulholland, the Quieting Reflex by Chuck Stroebel in1982, and the attention training technique of Open Focus ï¿½ by Les Fehmi in 1980. The idea of influencing and controlling the body with the conscious mind was finally getting a toehold in the West. There are many other methods used to promote relaxation and manage pain and stress. A few of these include Silva Mind Control, Norman Shealyï¿½s Biogenics, Interactive Guided Imagery (SM) (developed by Bresler and Rossman) and hypnosis. A number of these techniques have been combined with biofeedback instrumentation to enhance learning physiological self-regulation (or mind-body control). History of Thermal or Temperature Biofeedback Temperature biofeedback is the easiest to conceptualize and also to instrument. Straightforwardly, it is the bodyï¿½s tendency to "conserve" resources when stressed, so circulation is withdrawn from both the periphery and the gut, and delivered instead to the large muscles, the heart, and the brain, which would be needed for fight/flight. When we are threatened by a disgruntled rhinoceros, digestion can wait, and we donï¿½t need warm hands and feet. This stress response mechanism is meant to be used sparingly, only when needed. When stress is chronic, e.g. when the disagreeable supervisor is always oin your back, it takes a toll on the body. Temperature biofeedback can then teach the body how to return to a better resting state and "unlearn" its acquired bad habits. Typical thermal biofeedback devices present a resistance to current flow that varies strongly with temperature. This resistance is measured and can be converted into degrees of temperature, and displayed in terms of a graph or an image for feedback to the person, and for display to the therapist. The person simply has to know when he is getting better or changing for the worse, and learning takes place. The measurements are non-invasive, requiring only the taping of a sensor on the skin (typically on the fingertip), and the probes involved do not deliver any current to the body. History of Galvanic Skin Response Biofeedback Galvanic Skin Response biofeedback has its basis in early medical research. In the latter half of the nineteenth century, investigators became aware that skin resistance varied all over the body. Although this was originally dismissed as artifact, eventually it was established that galvanic skin response varied systematically with the state of physiological arousal and even with mental processing. These changes were identified with sweat gland activity. Later the famous psychologist Carl Jung established GSR as an objective way to track physiological arousal, and laid the basis for the further development of the field. In the general case, the stress response is accompanied by increased sweat gland activity. Hence, cold and clammy hands. Biofeedback training may be undertaken to train the body toward relaxation, as well as back to a more normal response pattern (warm and dry hands). Galvanic Skin Response (GSR) biofeedback is also known by other terms, including Electrodermal Response (EDR) or Skin Conductance Response (SCR) or Skin Conductance Level (SCL). GSR is measured by passing a miniscule current between two sensors mounted on the skin. The dominant current path will be via the layer of moisture on the skin, allowing its resistance (or, equivalently, conductance) to be measured and displayed. Two measures are of interest: 1) the steady-state skin conductance, and 2) the response to a sudden challenge, such as a handclap. Both are useful indicators. The combination of temperature and GSR is a favorite way among biofeedback therapists to measure the effects of stress management. Initially, it is a matter of finding out where a person "carries his stress," and then addressing that variable. Additionally, these measures are often used to give clues to states of arousal and distress in psychotherapy. In cases of migraine headaches or Raynaudï¿½s disease or other peripheral vascular diseases the patient is encouraged to learn temperature training (often using Autogenic Training as well). History of Electromyographic Biofeedback Electromyographic (EMG) Biofeedback has its origin in the work of Galvani, who discovered electrical responses in nerve and muscle action in the early 1800ï¿½s. EMG biofeedback utilizes the electrical activity generated by muscles as an indicator of muscle tension, and rewards a decrease in muscle tension toward more normal values. The EMG signal is picked up by electrodes placed on the muscle group of interest, and is expressed in microvolts. Research in this field began in 1969. By 1974, EMG biofeedback was used for muscle spasm in such conditions as spastic torticollis. In 1977, Wolf and Basmajian set up a measurement scale for grading stroke patients as they made progress in neuromuscular re-education. Basmajian showed that humans could learn to exercise control over the firing of single motor units. (In a charming but undignified detail that did not make it into the published literature, the control was so complete that a subject could get his wired-up motor unit beating out the rhythm of Yankee Doodle Dandy.) By repeatedly exercising the muscle with EMG feedback, function could be gradually restored in many instances where it has been completely lost. In recent years the practical application of this technique of retraining individual muscle groups for spinal cord injury and other cases of paralysis has been pioneered by Bernard Brucker. Unfortunately, this spectacular breakthrough in the treatment of various kinds of paralysis and paresis is not yet widely known, and remains available only to the fortunate few. Jeff Cram, Stu Donaldson and others have refined the more standard EMG feedback techniques in recent years to include very specific muscle exercises and movement. The potential benefit of these techniques unfortunately also remains under-exploited. Currently, EMG biofeedback is standardly used for muscle tension and muscle spasms, in pain management where muscle tension is involved, and in certain physical therapy applications such as neuromuscular re-education. This work is relevant to stroke victims, accident victims, and to those suffering from spasticity. EMG biofeedback is also a standard component of any program of general relaxation training. History of Muscle Strength Training A close relative of the EMG technique is muscle strength training. Whereas in EMG training we monitor electrical activity in neurons that control individual muscle groups, in muscle strength training we measure the output of muscle activity directly. This has its most prominent application to incontinence. The use of biofeedback as a treatment for urinary incontinence started with Kegel in 1948. First, Kegel used a structured exercise program for lax pelvic floor muscles. After exercising, the improved pelvic floor muscle tone enhanced the support to the pelvic structures (bladder neck and urethra) and therefore reduced incontinence. Subsequently, Kegel introduced the pressure perineometer to give direct feedback on the effectiveness of the muscle-strengthening exercise. The unit is placed in the vagina and the pressure of the muscle contraction is displayed on a pressure gauge or a computer screen. This work may have been the very first use of biofeedback instrumentation of any kind. The exercises have been taught to women post-pregnancy for many years to strengthen perineal structures stretched in childbirth. It turns out to be important that these exercisesï¿½when used for incontinence trainingï¿½be taught with the periometer. Otherwise, other muscles can enter into the exercises and failure of the treatment, or even adverse consequences, can ensue. Since the time of Kegel there have been many studies and many methods used. The periometer still appears to be the instrument of choice for urinary incontinence. There can be more than 80% success with long-term follow-up showing retention of benefit. Muscle strength training is also the method of choice for fecal (stool) incontinence. In 1973, Kohlenberg successfully used a water balloon attached to a tube and a clear cylinder to encourage the strengthening of the external anal sphincter muscle, which began the current treatment for fecal incontinence. In 1974, Engel used a three-balloon device to reinforce three of the responses that encourage continence. Another version of the periometer is also used with success for stool incontinence. Since then, the techniques have improved and the success rate for biofeedback training for those who are good candidates is at least 70% for continence or 75% for decrease in frequency of incontinent episodes History of Breath Training Many symptoms that are experienced as caused by stress may in fact be due to breathing incorrectly. These symptoms include panic, functional chest pain, asthma, irritable bowel syndrome, migraine headaches and hypertension and many others. The influence of breathing on regulation of state is just coming to be understood. One of the things that distinguishes us as human beings is the exquisite control of breath that makes speech possible. For us, therefore, control of the breath is not quite as "automatic" as other autonomic functions. There is more of a voluntary component, and that may enlarge the opportunities for things to go wrong on the one hand, and the possibilities of re-regulation by explicit training on the other. In 1975, Hirai suggested that the regularity of the lung action which moves the diaphragm caused the abdominal contents to stimulate the vagus nerve. This stimulates the parasympathetic nervous system, bringing about relaxation. More recently, the important role of blood carbon dioxide level in autonomic nervous system regulation was recognized (Naifeh, Kamiya, and Sweet). The stress response has the characteristic of driving one toward hyperventilation. Chronic hyperventilation, accompanied by excessively low carbon dioxide levels, can then create its own set of problems. Various techniques for teaching breathing skills have been developed, utilizing both biofeedback measures and/or behavioral techniques. Eric Peper has pioneered in this field, developing programs for patients as well as training professionals. Since we can be aware of our own breathing without instrumentation, much of this can be rehearsed on an individual basis. However, these techniques can be aided as well by instrumentation that ranges from the simplest augmentation device that allows one to hear oneï¿½s own breath all the way to capnometers that measure carbon dioxide content in the exhaled breath. In the middle lie other instruments such as inspirometers that measure air inhalation/exhalation volume, or pneumographs (strain gauges) that measure expansion of the chest or abdominal area with breathing. Such instruments can encourage a shift from thoracic breathing to the more healthful diaphragmatic or abdominal breathing. Yet other instruments guide a trainee in maintaining a suitably low breathing rate during the training session by giving him or her a signal to track. Most recently, measurements have extended to what is called Respiratory Sinus Arrhythmia (RSA), a subtle pattern of variation in heart rate that tracks the breathing process. History of General Relaxation Training The verbal techniques of promoting relaxation and control remain a very important part of the biofeedback discipline, whether or not instrumentation is employed to aid the process. Relaxation with guided imagery, that is, suggestion of a beautiful place, a healing story, or a reframing of an old problem have become very popular. Many practitioners have become experts in this area. Emmett Miller, for example, has developed numerous videotapes for support in addressing various problems such as smoking, chronic headaches, or immune system insufficiency. In the 1970ï¿½s, Carl Simonton showed that imagery could augment the treatment of cancer patients. David Bresler and Martin Rossman developed "Interactive Guided Imagery" (SM), in which a guide encourages the client to develop his own imagery and dialogue with his/her own inner wisdom (called "Inner Advisor" or "Inner Healer") and thus encourages self-management for oneï¿½s own health. An important way in which our body can communicate to us is through visual imagery. Conversely, by invoking imagery, we can direct the response of the body. Religious and spiritual imagery can be very significant here as well, since much stress that is experienced may in fact emerge out of a fundamental spiritual yearning. Another tool, Conditioned Relaxation, was developed by David Bresler ("Free Yourself From Pain") in the 1970ï¿½s to encourage busy people to realize that with very little effort they could accomplish stress management. It is based on Pavlovï¿½s theory of Classical Conditioning in which he trained dogs to salivate to a bell by pairing the bell with meat powder, and after some time he found that the dogs would salivate upon hearing the bell alone. The relaxation exercise is preceded by (paired with) a signal, in this case, a breath (hence his term "signal breath"). The exercise proceeds with certain key phrases built into it (called anchors). The body learns to relax. After some dedicated practice the body is able to relax just with the signal or the breath. Les Fehmi developed the "Open Focus"ï¿½ self-guided program of learning attentional skills. The techniques have been refined over many years of clinical research. The work emanates out of the realization that our state of arousal and activation are closely coupled to our state of attention. If we "pay attention to how we pay attention" we can also re-normalize arousal. The larger objective, then, remains the "control of state," but in this case the task can be accomplished without instrumentation on a personal training basis. Training ourselves to enlarge our attentional focus calms the body. A repeated exercise of this opening up of our attentional focus can be a useful corrective for the tendency in the industrialized world to become narrowly focused, fragmented in mental processing, and distractible as a result of the daily challenges we face. It is found that we perform best when we work out of the most relaxed state consistent with the challenges we face. Relaxed in this sense does not mean belly-up at the beach, but rather a state of de-stressed control. And when a particular task can be rehearsed, it is best overlearned, so that it can be accomplished without conscious micro-management. Giving our bodies regularly the experience of learned "open focus" allows us to maximize resilience in the face of challenge. Summary The above has covered briefly some of the dominant themes that have emerged in the field of biofeedback. The over-arching message of all of these developments is that the body-mind is profoundly responsive to interventions that simply support the way the body is supposed to work in the first place. Biofeedback is a gentle but persistent nudge to get the "system" back toward a better, more functional place. Self-regulation is the way the system works. Training in self-regulation simply takes advantage of that. In our enthusiasm for the latest findings of allopathic medicine, we lose sight of the fact that ultimately nearly all healing is self-healing. We now turn to the emerging field of EEG biofeedback, which is extending the reach of self-regulation techniques to yet other conditions.


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## eric (Jul 8, 1999)

An example of how you can control your body using biofeedback.History of Biofeedback In the early part of the century, in Germany, J.H. Schultz developed a technique called Autogenic Training. In this method, verbal instructions are used to guide a person to a different, more relaxed and controlled, physiological state. The method flourished, and the results were reported upon by Wolfgang Luthe in 1969 in the United States. The technique is still used to this day, but it is so thoroughly marbled in to what biofeedback clinicians do that it may no longer be distinguished as Autogenic Training. Edmund Jacobson developed the technique of Progressive Relaxation training in the 1930ï¿½s in the United States. This was a series of muscle activities to teach people awareness of tension and relaxation. The effect was to reduce muscle tension and certain causes and effects of stress and other symptoms. In the 1960ï¿½s and 1970ï¿½s there began to be an awareness in the Western world of the Eastern yogic traditions and the ability of some yogis and other masters to alter their physiology volitionally. Most dramatically, a yogi could survive in a sealed box by voluntarily reducing his metabolic rate to the point where he would not exhaust the supply of oxygen over a period of hoursï¿½a hazard that would have killed any other man. After a designated period of time, he would raise his metabolic rate again and ask to be released from the enclosure. The altered states that were being achieved by meditative means attracted the attention of a few key researchers. The gurus taught that in this state of relaxation and control they could change a number of variables that were thought to be autonomously regulated: blood pressure, heart rate, finger or hand temperature. These functions are managed by the autonomic nervous system, so named precisely because it was thought that such functions could not be altered voluntarily. The autonomic nervous system has two divisionsï¿½the sympathetic and the parasympathetic. The sympathetic nervous system gets you up, gets you ready and gets you going, and regulates the flight/fight response. It gets you  on the freeway, keeps you thinking about going to the doctorï¿½s office, or what kind of presentation you are going to make. The parasympathetic nervous system calms and relaxes you (when you lie down, take your break, go to sleep etc.), and manages body functions like digestion. The two work in tandem with each other in a reciprocal relationship. It was Canon and Selye, researchers in the body response to stress, who increased general awareness of the role of stress in physical diseases and mental disorders. Many of these manifested in disregulations of autonomic response. Hatha yoga, and other yogic traditions, became established in the United States as techniques for physical relaxation and enhancement of conscious control over our physiology. Additionally, meditation techniques such as Transcendental Meditation and Zen Buddhism stimulated the elaboration of the Relaxation Response by George Benson in 1975, the notion of Behavioral Stillness by Mulholland, the Quieting Reflex by Chuck Stroebel in1982, and the attention training technique of Open Focus ï¿½ by Les Fehmi in 1980. The idea of influencing and controlling the body with the conscious mind was finally getting a toehold in the West. There are many other methods used to promote relaxation and manage pain and stress. A few of these include Silva Mind Control, Norman Shealyï¿½s Biogenics, Interactive Guided Imagery (SM) (developed by Bresler and Rossman) and hypnosis. A number of these techniques have been combined with biofeedback instrumentation to enhance learning physiological self-regulation (or mind-body control). History of Thermal or Temperature Biofeedback Temperature biofeedback is the easiest to conceptualize and also to instrument. Straightforwardly, it is the bodyï¿½s tendency to "conserve" resources when stressed, so circulation is withdrawn from both the periphery and the gut, and delivered instead to the large muscles, the heart, and the brain, which would be needed for fight/flight. When we are threatened by a disgruntled rhinoceros, digestion can wait, and we donï¿½t need warm hands and feet. This stress response mechanism is meant to be used sparingly, only when needed. When stress is chronic, e.g. when the disagreeable supervisor is always oin your back, it takes a toll on the body. Temperature biofeedback can then teach the body how to return to a better resting state and "unlearn" its acquired bad habits. Typical thermal biofeedback devices present a resistance to current flow that varies strongly with temperature. This resistance is measured and can be converted into degrees of temperature, and displayed in terms of a graph or an image for feedback to the person, and for display to the therapist. The person simply has to know when he is getting better or changing for the worse, and learning takes place. The measurements are non-invasive, requiring only the taping of a sensor on the skin (typically on the fingertip), and the probes involved do not deliver any current to the body. History of Galvanic Skin Response Biofeedback Galvanic Skin Response biofeedback has its basis in early medical research. In the latter half of the nineteenth century, investigators became aware that skin resistance varied all over the body. Although this was originally dismissed as artifact, eventually it was established that galvanic skin response varied systematically with the state of physiological arousal and even with mental processing. These changes were identified with sweat gland activity. Later the famous psychologist Carl Jung established GSR as an objective way to track physiological arousal, and laid the basis for the further development of the field. In the general case, the stress response is accompanied by increased sweat gland activity. Hence, cold and clammy hands. Biofeedback training may be undertaken to train the body toward relaxation, as well as back to a more normal response pattern (warm and dry hands). Galvanic Skin Response (GSR) biofeedback is also known by other terms, including Electrodermal Response (EDR) or Skin Conductance Response (SCR) or Skin Conductance Level (SCL). GSR is measured by passing a miniscule current between two sensors mounted on the skin. The dominant current path will be via the layer of moisture on the skin, allowing its resistance (or, equivalently, conductance) to be measured and displayed. Two measures are of interest: 1) the steady-state skin conductance, and 2) the response to a sudden challenge, such as a handclap. Both are useful indicators. The combination of temperature and GSR is a favorite way among biofeedback therapists to measure the effects of stress management. Initially, it is a matter of finding out where a person "carries his stress," and then addressing that variable. Additionally, these measures are often used to give clues to states of arousal and distress in psychotherapy. In cases of migraine headaches or Raynaudï¿½s disease or other peripheral vascular diseases the patient is encouraged to learn temperature training (often using Autogenic Training as well). History of Electromyographic Biofeedback Electromyographic (EMG) Biofeedback has its origin in the work of Galvani, who discovered electrical responses in nerve and muscle action in the early 1800ï¿½s. EMG biofeedback utilizes the electrical activity generated by muscles as an indicator of muscle tension, and rewards a decrease in muscle tension toward more normal values. The EMG signal is picked up by electrodes placed on the muscle group of interest, and is expressed in microvolts. Research in this field began in 1969. By 1974, EMG biofeedback was used for muscle spasm in such conditions as spastic torticollis. In 1977, Wolf and Basmajian set up a measurement scale for grading stroke patients as they made progress in neuromuscular re-education. Basmajian showed that humans could learn to exercise control over the firing of single motor units. (In a charming but undignified detail that did not make it into the published literature, the control was so complete that a subject could get his wired-up motor unit beating out the rhythm of Yankee Doodle Dandy.) By repeatedly exercising the muscle with EMG feedback, function could be gradually restored in many instances where it has been completely lost. In recent years the practical application of this technique of retraining individual muscle groups for spinal cord injury and other cases of paralysis has been pioneered by Bernard Brucker. Unfortunately, this spectacular breakthrough in the treatment of various kinds of paralysis and paresis is not yet widely known, and remains available only to the fortunate few. Jeff Cram, Stu Donaldson and others have refined the more standard EMG feedback techniques in recent years to include very specific muscle exercises and movement. The potential benefit of these techniques unfortunately also remains under-exploited. Currently, EMG biofeedback is standardly used for muscle tension and muscle spasms, in pain management where muscle tension is involved, and in certain physical therapy applications such as neuromuscular re-education. This work is relevant to stroke victims, accident victims, and to those suffering from spasticity. EMG biofeedback is also a standard component of any program of general relaxation training. History of Muscle Strength Training A close relative of the EMG technique is muscle strength training. Whereas in EMG training we monitor electrical activity in neurons that control individual muscle groups, in muscle strength training we measure the output of muscle activity directly. This has its most prominent application to incontinence. The use of biofeedback as a treatment for urinary incontinence started with Kegel in 1948. First, Kegel used a structured exercise program for lax pelvic floor muscles. After exercising, the improved pelvic floor muscle tone enhanced the support to the pelvic structures (bladder neck and urethra) and therefore reduced incontinence. Subsequently, Kegel introduced the pressure perineometer to give direct feedback on the effectiveness of the muscle-strengthening exercise. The unit is placed in the vagina and the pressure of the muscle contraction is displayed on a pressure gauge or a computer screen. This work may have been the very first use of biofeedback instrumentation of any kind. The exercises have been taught to women post-pregnancy for many years to strengthen perineal structures stretched in childbirth. It turns out to be important that these exercisesï¿½when used for incontinence trainingï¿½be taught with the periometer. Otherwise, other muscles can enter into the exercises and failure of the treatment, or even adverse consequences, can ensue. Since the time of Kegel there have been many studies and many methods used. The periometer still appears to be the instrument of choice for urinary incontinence. There can be more than 80% success with long-term follow-up showing retention of benefit. Muscle strength training is also the method of choice for fecal (stool) incontinence. In 1973, Kohlenberg successfully used a water balloon attached to a tube and a clear cylinder to encourage the strengthening of the external anal sphincter muscle, which began the current treatment for fecal incontinence. In 1974, Engel used a three-balloon device to reinforce three of the responses that encourage continence. Another version of the periometer is also used with success for stool incontinence. Since then, the techniques have improved and the success rate for biofeedback training for those who are good candidates is at least 70% for continence or 75% for decrease in frequency of incontinent episodes History of Breath Training Many symptoms that are experienced as caused by stress may in fact be due to breathing incorrectly. These symptoms include panic, functional chest pain, asthma, irritable bowel syndrome, migraine headaches and hypertension and many others. The influence of breathing on regulation of state is just coming to be understood. One of the things that distinguishes us as human beings is the exquisite control of breath that makes speech possible. For us, therefore, control of the breath is not quite as "automatic" as other autonomic functions. There is more of a voluntary component, and that may enlarge the opportunities for things to go wrong on the one hand, and the possibilities of re-regulation by explicit training on the other. In 1975, Hirai suggested that the regularity of the lung action which moves the diaphragm caused the abdominal contents to stimulate the vagus nerve. This stimulates the parasympathetic nervous system, bringing about relaxation. More recently, the important role of blood carbon dioxide level in autonomic nervous system regulation was recognized (Naifeh, Kamiya, and Sweet). The stress response has the characteristic of driving one toward hyperventilation. Chronic hyperventilation, accompanied by excessively low carbon dioxide levels, can then create its own set of problems. Various techniques for teaching breathing skills have been developed, utilizing both biofeedback measures and/or behavioral techniques. Eric Peper has pioneered in this field, developing programs for patients as well as training professionals. Since we can be aware of our own breathing without instrumentation, much of this can be rehearsed on an individual basis. However, these techniques can be aided as well by instrumentation that ranges from the simplest augmentation device that allows one to hear oneï¿½s own breath all the way to capnometers that measure carbon dioxide content in the exhaled breath. In the middle lie other instruments such as inspirometers that measure air inhalation/exhalation volume, or pneumographs (strain gauges) that measure expansion of the chest or abdominal area with breathing. Such instruments can encourage a shift from thoracic breathing to the more healthful diaphragmatic or abdominal breathing. Yet other instruments guide a trainee in maintaining a suitably low breathing rate during the training session by giving him or her a signal to track. Most recently, measurements have extended to what is called Respiratory Sinus Arrhythmia (RSA), a subtle pattern of variation in heart rate that tracks the breathing process. History of General Relaxation Training The verbal techniques of promoting relaxation and control remain a very important part of the biofeedback discipline, whether or not instrumentation is employed to aid the process. Relaxation with guided imagery, that is, suggestion of a beautiful place, a healing story, or a reframing of an old problem have become very popular. Many practitioners have become experts in this area. Emmett Miller, for example, has developed numerous videotapes for support in addressing various problems such as smoking, chronic headaches, or immune system insufficiency. In the 1970ï¿½s, Carl Simonton showed that imagery could augment the treatment of cancer patients. David Bresler and Martin Rossman developed "Interactive Guided Imagery" (SM), in which a guide encourages the client to develop his own imagery and dialogue with his/her own inner wisdom (called "Inner Advisor" or "Inner Healer") and thus encourages self-management for oneï¿½s own health. An important way in which our body can communicate to us is through visual imagery. Conversely, by invoking imagery, we can direct the response of the body. Religious and spiritual imagery can be very significant here as well, since much stress that is experienced may in fact emerge out of a fundamental spiritual yearning. Another tool, Conditioned Relaxation, was developed by David Bresler ("Free Yourself From Pain") in the 1970ï¿½s to encourage busy people to realize that with very little effort they could accomplish stress management. It is based on Pavlovï¿½s theory of Classical Conditioning in which he trained dogs to salivate to a bell by pairing the bell with meat powder, and after some time he found that the dogs would salivate upon hearing the bell alone. The relaxation exercise is preceded by (paired with) a signal, in this case, a breath (hence his term "signal breath"). The exercise proceeds with certain key phrases built into it (called anchors). The body learns to relax. After some dedicated practice the body is able to relax just with the signal or the breath. Les Fehmi developed the "Open Focus"ï¿½ self-guided program of learning attentional skills. The techniques have been refined over many years of clinical research. The work emanates out of the realization that our state of arousal and activation are closely coupled to our state of attention. If we "pay attention to how we pay attention" we can also re-normalize arousal. The larger objective, then, remains the "control of state," but in this case the task can be accomplished without instrumentation on a personal training basis. Training ourselves to enlarge our attentional focus calms the body. A repeated exercise of this opening up of our attentional focus can be a useful corrective for the tendency in the industrialized world to become narrowly focused, fragmented in mental processing, and distractible as a result of the daily challenges we face. It is found that we perform best when we work out of the most relaxed state consistent with the challenges we face. Relaxed in this sense does not mean belly-up at the beach, but rather a state of de-stressed control. And when a particular task can be rehearsed, it is best overlearned, so that it can be accomplished without conscious micro-management. Giving our bodies regularly the experience of learned "open focus" allows us to maximize resilience in the face of challenge. Summary The above has covered briefly some of the dominant themes that have emerged in the field of biofeedback. The over-arching message of all of these developments is that the body-mind is profoundly responsive to interventions that simply support the way the body is supposed to work in the first place. Biofeedback is a gentle but persistent nudge to get the "system" back toward a better, more functional place. Self-regulation is the way the system works. Training in self-regulation simply takes advantage of that. In our enthusiasm for the latest findings of allopathic medicine, we lose sight of the fact that ultimately nearly all healing is self-healing. We now turn to the emerging field of EEG biofeedback, which is extending the reach of self-regulation techniques to yet other conditions.


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## norbert46 (Feb 20, 2001)

Mike NoLomotil you are a total roar. How about another "analogy" Said the Blonde to her girlfriend- " It's not the way he does it that gets to me, it's the cute way he gets on and off?"







Eric, when I get through studying and absorbing all the research my brains should push up some hair to cover my balding noggin? The facts are evident but for someone to benefit, they have to at least have an open mind and be willing? Norb


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## norbert46 (Feb 20, 2001)

Mike NoLomotil you are a total roar. How about another "analogy" Said the Blonde to her girlfriend- " It's not the way he does it that gets to me, it's the cute way he gets on and off?"







Eric, when I get through studying and absorbing all the research my brains should push up some hair to cover my balding noggin? The facts are evident but for someone to benefit, they have to at least have an open mind and be willing? Norb


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## AZmom1 (Dec 6, 1999)

Excuse me, but I guess I better explain my simple remark, "It's not stress, it's the reaction to the stress that is the problem."Stress is a part of everyone's daily life. Everyone has stress, but people deal with it differently. As an example of reacting in a stressful situation, I'll use flying. My brother travels three-four days a week, every week. He does it without thinking, doesn't bother him in the least. He deals with packing, luggage, timetables, bad food, delays, time zone changes, and that "fasten your seat belt sign" that we IBSers panic at. I wouldn't, couldn't do what he does. I find flying extremely stressful. Even the *thought*of a trip could make me panic and bring on an IBS attack. For weeks and months I could have a physical reaction (IBS symptoms) to the thought of a stressful event.CBT trains us to use conscious thoughts to underreact to situations and use positive thoughts to keep from overreacting. Hypnosis does the same thing, but using techniques that work with the subconscious part of the mind. It takes a special way of talking to the subconscious and that is why it is important to go to a qualified hypnotherapist. The problem with doing self-hypnosis without the guidance of a hypnotherapist is that the conscious mind is too active, so one tends not to get into a hypnotic state.The interesting part is that our thoughts create a physical reaction. I truly believe that had I not overreacted to my first IBS attack, I may never have developed IBS. It may have limited itself to a one time event. After the first attack I worried about another coming. I worried more and more, and the attacks came, and became regular. I expected them, and my expectations were fulfilled. Our subconscious mind tries to protect us. We constantly think about an IBS attack, and it thinks that is what we want, so that's what we get. It goes on and on. The more we think about it, the "what if's" begin, and often the worst comes true. A pattern is set up. We have an attack in the grocery line, then we have one everytime we get in line because we've been dwelling on it since the last one. "I *knew* I'd have an IBS attack..." Your thoughts cause the physical reaction. My sister just had her gall bladder removed. I asked her if she was having any symptoms, and she responded, "just some diarrhea." She will not get IBS as many do after her gall bladder removal, because she is not allowing her symptoms to affect her. She is underreacting with "it's no big deal."Eric has done a good job of explaining the mechanics. He and I together had IBS for 60 years, and both of us were helped by hypnotherapy. It can even change thought patterns that have been established over a lifetime. So where does Lotronex fit in? Obviously there is the placebo effect, which is *very* strong in IBS patients. It works on the neurotransmitters that have led to our IBS reaction. It does chemically (with an expensive pill) what I have been able to do chemically (with my subconscious mind.) WHAT??? Impossible you say? Operations were done successfully hundreds of years ago with hypnosis as anesthesia. Blood flow can be stopped with hypnosis. Pain can be obliterated. Healing is speeded up with hypnosis. It is clear that using suggestion, the subconscious mind can affect physical changes.AZ


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## AZmom1 (Dec 6, 1999)

Excuse me, but I guess I better explain my simple remark, "It's not stress, it's the reaction to the stress that is the problem."Stress is a part of everyone's daily life. Everyone has stress, but people deal with it differently. As an example of reacting in a stressful situation, I'll use flying. My brother travels three-four days a week, every week. He does it without thinking, doesn't bother him in the least. He deals with packing, luggage, timetables, bad food, delays, time zone changes, and that "fasten your seat belt sign" that we IBSers panic at. I wouldn't, couldn't do what he does. I find flying extremely stressful. Even the *thought*of a trip could make me panic and bring on an IBS attack. For weeks and months I could have a physical reaction (IBS symptoms) to the thought of a stressful event.CBT trains us to use conscious thoughts to underreact to situations and use positive thoughts to keep from overreacting. Hypnosis does the same thing, but using techniques that work with the subconscious part of the mind. It takes a special way of talking to the subconscious and that is why it is important to go to a qualified hypnotherapist. The problem with doing self-hypnosis without the guidance of a hypnotherapist is that the conscious mind is too active, so one tends not to get into a hypnotic state.The interesting part is that our thoughts create a physical reaction. I truly believe that had I not overreacted to my first IBS attack, I may never have developed IBS. It may have limited itself to a one time event. After the first attack I worried about another coming. I worried more and more, and the attacks came, and became regular. I expected them, and my expectations were fulfilled. Our subconscious mind tries to protect us. We constantly think about an IBS attack, and it thinks that is what we want, so that's what we get. It goes on and on. The more we think about it, the "what if's" begin, and often the worst comes true. A pattern is set up. We have an attack in the grocery line, then we have one everytime we get in line because we've been dwelling on it since the last one. "I *knew* I'd have an IBS attack..." Your thoughts cause the physical reaction. My sister just had her gall bladder removed. I asked her if she was having any symptoms, and she responded, "just some diarrhea." She will not get IBS as many do after her gall bladder removal, because she is not allowing her symptoms to affect her. She is underreacting with "it's no big deal."Eric has done a good job of explaining the mechanics. He and I together had IBS for 60 years, and both of us were helped by hypnotherapy. It can even change thought patterns that have been established over a lifetime. So where does Lotronex fit in? Obviously there is the placebo effect, which is *very* strong in IBS patients. It works on the neurotransmitters that have led to our IBS reaction. It does chemically (with an expensive pill) what I have been able to do chemically (with my subconscious mind.) WHAT??? Impossible you say? Operations were done successfully hundreds of years ago with hypnosis as anesthesia. Blood flow can be stopped with hypnosis. Pain can be obliterated. Healing is speeded up with hypnosis. It is clear that using suggestion, the subconscious mind can affect physical changes.AZ


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## Lesley Taylor (Dec 22, 2001)

Thought I'd throw in my 2 cents worth. Stress exacerbates most physical conditions but to imply stress "causes" IBS is nonsense. If that were the case 99% of people would have it. I've read about several causes of IBS: "lack of dietary fibre, ABNORMAL responses of the gastrointestinal tract to stress, and specific food intolerances or sensitivities." Some people may have all three. I feel too that is also a motility problem - food travels either too fast or too slow through the digestive tract. But people who imply that "we bring it upon ourselves by worrying about it" are insensitive to say the least. If I worried about having a heart attack or an asthma attack, I wouldn't bring one on!! I don't have those problems. IBS is a real disorder.


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## Lesley Taylor (Dec 22, 2001)

Thought I'd throw in my 2 cents worth. Stress exacerbates most physical conditions but to imply stress "causes" IBS is nonsense. If that were the case 99% of people would have it. I've read about several causes of IBS: "lack of dietary fibre, ABNORMAL responses of the gastrointestinal tract to stress, and specific food intolerances or sensitivities." Some people may have all three. I feel too that is also a motility problem - food travels either too fast or too slow through the digestive tract. But people who imply that "we bring it upon ourselves by worrying about it" are insensitive to say the least. If I worried about having a heart attack or an asthma attack, I wouldn't bring one on!! I don't have those problems. IBS is a real disorder.


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## BQ (May 22, 2000)

Lesley, I don't think ANYone here implied, hinted or came a hair's width close to saying..."Stress causes IBS". Read the posts again, if you would, I'm sure you will see that most people are saying it does not *cause* it.NO one here has said, implied, hinted or came a hair's width close to saying "It is all in our heads and not a real disorder."It IS NOT our 'fault' that we have this. There is no blame to be given or taken.I have found that accepting that I have it in the first place was very helpful. The next thing that helped me the most was actually reading all the info that Eric and other's have posted and all the links he & others had pointed me to. No, before you ask.... I really stink at science type stuff. And yes, I had difficulty deciphering what in the Sam Hill half of the links and postings said & meant...SOOOOO I asked lots & LOTS of questions and the folks here very patiently answered & kept answering, at times, until I understood.Educating myself about IBS was THE, yes *THE* best thing I did for myself. And now my symptoms are at least 80% reduced.So unfortunately, this achievement included lots of science, LOL that I would have preferred to leave under whatever rock it usually resides... but alas..... It Ain't that easy.So here's the crow bar I used to lift the rock and start with the science. I'll loan ya mine.







Start chipping away







Hope this leads to you feeling loads better real soon.







BQ


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## BQ (May 22, 2000)

Lesley, I don't think ANYone here implied, hinted or came a hair's width close to saying..."Stress causes IBS". Read the posts again, if you would, I'm sure you will see that most people are saying it does not *cause* it.NO one here has said, implied, hinted or came a hair's width close to saying "It is all in our heads and not a real disorder."It IS NOT our 'fault' that we have this. There is no blame to be given or taken.I have found that accepting that I have it in the first place was very helpful. The next thing that helped me the most was actually reading all the info that Eric and other's have posted and all the links he & others had pointed me to. No, before you ask.... I really stink at science type stuff. And yes, I had difficulty deciphering what in the Sam Hill half of the links and postings said & meant...SOOOOO I asked lots & LOTS of questions and the folks here very patiently answered & kept answering, at times, until I understood.Educating myself about IBS was THE, yes *THE* best thing I did for myself. And now my symptoms are at least 80% reduced.So unfortunately, this achievement included lots of science, LOL that I would have preferred to leave under whatever rock it usually resides... but alas..... It Ain't that easy.So here's the crow bar I used to lift the rock and start with the science. I'll loan ya mine.







Start chipping away







Hope this leads to you feeling loads better real soon.







BQ


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## Mike NoLomotil (Jun 6, 2000)

It is nice of Eric to consume bandwidth posting (again) stuff that is already known and which is illustrative of what is worng in the fioeld of IBS research, thus maiking my point for me.It would be lovely to have the time to (AGAIN) go step by step through the tutorial on what everybody already knows about the gut and brain function in patients with IBS pointing out how the CEU program is constructed to present conclusions on how affective behavior can alter not only processing of afferent sensory input from pain, pressure or stretch receptors, and how the efferent "response" can be altered as a consequence. Further the disussion of how psychosocial consequences of IBS and their effects on gut motility can be attenuated through behavioral therapies including HT is re-expressive of the same info we already know.This is a very fine tutorial from the perspective of that group of researchers and clinicians (who also espouse the "symptom based empirical diagnosis" approach to IBS, which seems to have paid no attention to any immunologists or alllergists findings about the OTHER key system in the intergated loop of psychneuroimmunoendocrine function: the aberrant immune response of the small bowel. This has been quantitifed, that it is the result of an alteration in the oral-tolerance mechanism, and that it is not provoked by aberrant CNS efferent stimuli (though it can be attenuated or amplified by such, and the reaction threshold lowered, or the tolerance threshold as you wish to view it). However this is clearly not (at least in the d-types and cyclics who are always studied from this perspective) in fact the primary source of the loss of tolerance. The CNS plays a secondary role in those patients who have been studied.The PRIMARY mechansims of immune response are NOT efferent stimuli from the CNS but mechanisms (there are at this time up to 8 specific immunologic and non-immunologic mechanims which directly activate various immunocyte reactions, but Ig[x] and complement so far seem to be the markers in the small gut of IBS victims) better understood by reading this book:The Immune System by Peter Parham http://www.amazon.com/exec/obidos/ASIN/081...4326764-6290107 or ANY new immunology book, and THEN studying the work of the investigators whose findings do not bear the following tag: _____________________________"This Special Report is supported through an unrestricted educational grant from Novartis Pharmaceuticals and Bristol-Myers Squibb. " ___________________________All the work which purports that brain imgaing methods are diagnostic of the causal basis of so called IBS bears this disclosure somewhere. It is not diagnostic of the causal basis of "IBS", though it may be reflective of a mechnisms linked to the causal basis. That is a more accurate claim.Whichever method is used, it is quantification of one of the events, in this case neural and vascular activity, in the areas of the nervous system imaged. In these tutorials this work is always presented in a vacuum from the in vivo work in the small bowel which is confirmatory of a local proinflammatory response to ingestants which ALSO has QUANTIFIED a primary source of enteric hyperalgesia observed in IBS: the release of specific mediators within the lamina propria, where the nerve endings in question reside, which produce the afferent sensory input TO the CNS, and which also control the local neural stimuli of smooth muscle.It also ignores the fact that proinflammatory mediators which upregulate bowel smooth muscle are among those involved.This lecture and its posting are exemplary of what the hole is in IBS research: the right hnd either does not know what the left hand is doing, or the right hand knows what the left hand is doing but what it is doing conflicts with the views and objectives of the right hand therefore its activities are ignored or waived-off "compelling and warrants further research" which of course will not be funded by any of the deep pockets working on the other side of the road. It conflicts with their heavily committed line of "investigation".Any observation of altered neural respone in any area of the brain, any observation of altered bloodflow in the brain, or anywhere else for that matter, is not properly assessed unless ones assays the possible chemical stimuli which can cause that alteration in activity, and not suppose to conlcude it should be attributed solely to the affective behavioral alterations which result from the psychsosoical consequences of IBS. Logic and deductive resasoning do not substitute for quantification of phsyical mediators. Some Sweddes, laboring away in realtive obscurity so to speak, have proven that already.In fact we must note that the very word "attenuation" used when describing the effects of hypontherapy signifies the practitioner recognizes the difference between attenuating a reaction or response or neural activity from avoiding it or preventing it from occurring in the first place.The first time I read this CEU program (which was not here in this thread) my response was the same as it always is to programs which are prepared with funding provided by pharmaceutical firms: they are presented in that narrow perspective which is consistent with the stated aims of all drug funded research work: find and prescribe better drugs. And since behaviroal therapies alone rarely produce full remission, they are ofetn combined in their protocols presently with antidepressant therapy. And the work narrowyl focused on 5HT[x] is so focused on this sole medaitor to the exlsuion of others because it is the most convenient and likely target for pharmacotherapeutic intervention (new drug development).Heck this coment even confirms how laypeople just buy-into this concept as being somehow related to CURES for IBS: _____________________________"...when a pill comes out to fix the dysregulation of neurotranismitters between the gut brain and the brain and back, I am sure this bb, myself included will be the first to let you know they found a "Cure" for IBS." _____________________________IF this is the definition of "cure", then those immunolgosists and allergists working on immunomodulators are alot closer to a "cure" than the drug companies! Thats great to hear!







These substances block the the activation of different types of the immunocytes involved, such as stabilizing mast cells, granulocytic cells, and some even improve the cell wall intergity of non-granulocytic imunocytes. So if there were a protocol released tomorrwo which, by combining 2 or three specific immunomodulators, restored otal tolerance and blocked the reactions which produce the symptoms of IBS-d ancd cyclic IBS, ahve we Cured it? No. This is symptomatic reduction by intervention.To presuppose, and then teach, that somehow the neural dysfunction is self generating, and that the mast cells, lymphocyte, granulocyte, platelet and EC cell activity in the small bowel is sourced to an aberration in the CNS borne of alterations in cognitive function simply ignores the presence of known mechansism of triggering immune response that have been recovered from the small intestine. Or does one think that Ig[x] links with and sensitizes gut mast cells and basophils under direction of the brain, and does not react to its corresponding antigen when presented in the small bowel by ingesting it unless an aberrant efferent signal is received from the CNS? [Don't answer that







its rhetorical]The system is wholly integrated and cannot be viewed otherwise or incomplete or even false conclusions will be passed on. This phenomeneon (esp d-type and cyclic IBS) cannot be sole-sourced to stress-induced or altered affective behaviorally induced dysfunction when it so has been quantified that the denervated immunocytes react on their own....in vitro means out of the body. They are provoked in the body by exposure to "antigen" and out of the body when expsoed to "anygen". How did the patients brain reach across the miles to blow apart the lymphocytes or granulocytes "in vitro" which are blowing apart "in vivo"?I think thuis is unlikely, therefor again this is what is wrong with IBS research and IBS teaching: it is funded by groups with different agendas and the work does not get combined since each group (birds of a feather flock together) is "incestuous" in the professional sense.Happy Holidays...Eat well, think well, be well.(Note again my constant affirmation, appearing after everything I post, that to achieve the most effective therapy one must address both issues of diet and behavioral response before posting anything silly like I say food is everything or I am attacking some doctor etc etc thus putting words in my mouth...er, posts.)MNL


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## Mike NoLomotil (Jun 6, 2000)

It is nice of Eric to consume bandwidth posting (again) stuff that is already known and which is illustrative of what is worng in the fioeld of IBS research, thus maiking my point for me.It would be lovely to have the time to (AGAIN) go step by step through the tutorial on what everybody already knows about the gut and brain function in patients with IBS pointing out how the CEU program is constructed to present conclusions on how affective behavior can alter not only processing of afferent sensory input from pain, pressure or stretch receptors, and how the efferent "response" can be altered as a consequence. Further the disussion of how psychosocial consequences of IBS and their effects on gut motility can be attenuated through behavioral therapies including HT is re-expressive of the same info we already know.This is a very fine tutorial from the perspective of that group of researchers and clinicians (who also espouse the "symptom based empirical diagnosis" approach to IBS, which seems to have paid no attention to any immunologists or alllergists findings about the OTHER key system in the intergated loop of psychneuroimmunoendocrine function: the aberrant immune response of the small bowel. This has been quantitifed, that it is the result of an alteration in the oral-tolerance mechanism, and that it is not provoked by aberrant CNS efferent stimuli (though it can be attenuated or amplified by such, and the reaction threshold lowered, or the tolerance threshold as you wish to view it). However this is clearly not (at least in the d-types and cyclics who are always studied from this perspective) in fact the primary source of the loss of tolerance. The CNS plays a secondary role in those patients who have been studied.The PRIMARY mechansims of immune response are NOT efferent stimuli from the CNS but mechanisms (there are at this time up to 8 specific immunologic and non-immunologic mechanims which directly activate various immunocyte reactions, but Ig[x] and complement so far seem to be the markers in the small gut of IBS victims) better understood by reading this book:The Immune System by Peter Parham http://www.amazon.com/exec/obidos/ASIN/081...4326764-6290107 or ANY new immunology book, and THEN studying the work of the investigators whose findings do not bear the following tag: _____________________________"This Special Report is supported through an unrestricted educational grant from Novartis Pharmaceuticals and Bristol-Myers Squibb. " ___________________________All the work which purports that brain imgaing methods are diagnostic of the causal basis of so called IBS bears this disclosure somewhere. It is not diagnostic of the causal basis of "IBS", though it may be reflective of a mechnisms linked to the causal basis. That is a more accurate claim.Whichever method is used, it is quantification of one of the events, in this case neural and vascular activity, in the areas of the nervous system imaged. In these tutorials this work is always presented in a vacuum from the in vivo work in the small bowel which is confirmatory of a local proinflammatory response to ingestants which ALSO has QUANTIFIED a primary source of enteric hyperalgesia observed in IBS: the release of specific mediators within the lamina propria, where the nerve endings in question reside, which produce the afferent sensory input TO the CNS, and which also control the local neural stimuli of smooth muscle.It also ignores the fact that proinflammatory mediators which upregulate bowel smooth muscle are among those involved.This lecture and its posting are exemplary of what the hole is in IBS research: the right hnd either does not know what the left hand is doing, or the right hand knows what the left hand is doing but what it is doing conflicts with the views and objectives of the right hand therefore its activities are ignored or waived-off "compelling and warrants further research" which of course will not be funded by any of the deep pockets working on the other side of the road. It conflicts with their heavily committed line of "investigation".Any observation of altered neural respone in any area of the brain, any observation of altered bloodflow in the brain, or anywhere else for that matter, is not properly assessed unless ones assays the possible chemical stimuli which can cause that alteration in activity, and not suppose to conlcude it should be attributed solely to the affective behavioral alterations which result from the psychsosoical consequences of IBS. Logic and deductive resasoning do not substitute for quantification of phsyical mediators. Some Sweddes, laboring away in realtive obscurity so to speak, have proven that already.In fact we must note that the very word "attenuation" used when describing the effects of hypontherapy signifies the practitioner recognizes the difference between attenuating a reaction or response or neural activity from avoiding it or preventing it from occurring in the first place.The first time I read this CEU program (which was not here in this thread) my response was the same as it always is to programs which are prepared with funding provided by pharmaceutical firms: they are presented in that narrow perspective which is consistent with the stated aims of all drug funded research work: find and prescribe better drugs. And since behaviroal therapies alone rarely produce full remission, they are ofetn combined in their protocols presently with antidepressant therapy. And the work narrowyl focused on 5HT[x] is so focused on this sole medaitor to the exlsuion of others because it is the most convenient and likely target for pharmacotherapeutic intervention (new drug development).Heck this coment even confirms how laypeople just buy-into this concept as being somehow related to CURES for IBS: _____________________________"...when a pill comes out to fix the dysregulation of neurotranismitters between the gut brain and the brain and back, I am sure this bb, myself included will be the first to let you know they found a "Cure" for IBS." _____________________________IF this is the definition of "cure", then those immunolgosists and allergists working on immunomodulators are alot closer to a "cure" than the drug companies! Thats great to hear!







These substances block the the activation of different types of the immunocytes involved, such as stabilizing mast cells, granulocytic cells, and some even improve the cell wall intergity of non-granulocytic imunocytes. So if there were a protocol released tomorrwo which, by combining 2 or three specific immunomodulators, restored otal tolerance and blocked the reactions which produce the symptoms of IBS-d ancd cyclic IBS, ahve we Cured it? No. This is symptomatic reduction by intervention.To presuppose, and then teach, that somehow the neural dysfunction is self generating, and that the mast cells, lymphocyte, granulocyte, platelet and EC cell activity in the small bowel is sourced to an aberration in the CNS borne of alterations in cognitive function simply ignores the presence of known mechansism of triggering immune response that have been recovered from the small intestine. Or does one think that Ig[x] links with and sensitizes gut mast cells and basophils under direction of the brain, and does not react to its corresponding antigen when presented in the small bowel by ingesting it unless an aberrant efferent signal is received from the CNS? [Don't answer that







its rhetorical]The system is wholly integrated and cannot be viewed otherwise or incomplete or even false conclusions will be passed on. This phenomeneon (esp d-type and cyclic IBS) cannot be sole-sourced to stress-induced or altered affective behaviorally induced dysfunction when it so has been quantified that the denervated immunocytes react on their own....in vitro means out of the body. They are provoked in the body by exposure to "antigen" and out of the body when expsoed to "anygen". How did the patients brain reach across the miles to blow apart the lymphocytes or granulocytes "in vitro" which are blowing apart "in vivo"?I think thuis is unlikely, therefor again this is what is wrong with IBS research and IBS teaching: it is funded by groups with different agendas and the work does not get combined since each group (birds of a feather flock together) is "incestuous" in the professional sense.Happy Holidays...Eat well, think well, be well.(Note again my constant affirmation, appearing after everything I post, that to achieve the most effective therapy one must address both issues of diet and behavioral response before posting anything silly like I say food is everything or I am attacking some doctor etc etc thus putting words in my mouth...er, posts.)MNL


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## eric (Jul 8, 1999)

Mike, obviosuly a lot of people don't know about the mind gut connection. These are the top researchers from around the world studying (all) mechanism for IBS, not just food intolerence.This "DR's in IBS don't know about immunology research is bull****.""The circuitry of brainï¿½gut reactions that control patients' responses to stressors is found within the "emotional motor system," said Dr. Mayer. The output of this circuitry in response to stressors or emotional experiences can be measured "in terms of autonomic, pain-modulatory, and neuroendocrine responses. Furthermore, it is modulated by a variety of factors such as belief systems, thoughts, and emotions; all play significant roles in modulating response. What is important, though, is that the output can pretty much explain the characteristic IBS symptoms." Autonomic regulation affects not only the muscle cells in the gut, but other cell types, including (MAST CellS), enterochromaffin cells, and the intrinsic neurons of the enteric nervous system. "Therefore," Dr. Mayer explained, "the autonomic nervous system, by stimulating the release of substances from these cells, can change the sensitivity of the gut to a variety of gut stimuli or internal stressors." A recent breakthrough is the discovery that "in response to stressors, this system makes the gut more sensitive," a process referred to as stress-induced visceral hyperalgesia. "Many of you may have experienced that when you go to give a presentation, you may suddenly experience the urge to go to the toilet," Dr. Mayer explained. "It's not that you have a full bladder; it's that the anxiety over the imminent presentation causes the sensory pathways from the bladder to the brain [to be] more sensitive. What's attractive about this concept is that psychosocial stressors arising in the external environment and/or physical stressors arising from within the body, such as gut inflammation, can result in activation of the emotional motor system." Thus, hyperresponsiveness of these stress circuits in the brain might result in altered responses to the internal stresses associated with inflammation and external stressors." "Given the altered affective stimulus processing for IBS patients, what is the relevance for clinical practitioners? Among the most common  complaints of IBS patients, as reported by physicians, are heartburn, bloating of the lower GI tract, sensation of fullness, incomplete rectal evacuation, and abdominal pain, explained Dr. Mayer. "The amplification of the unpleasantness of these experiencesï¿½which in the healthy individual is not even consciously perceived once they reach the brainï¿½is one way to explain this range of symptoms," he said. "A more complex and higher-level interpretation of the sensory experience is a modulation based on memory and past experiences." Here, a different area of the brain comes into play; sensory association areas in the parietal cortex, which have connections to the main memory centers within the brain and also to the prefrontal cortex. "By putting together results from a large number of somatic pain studies, this conclusion was reached: This network of recalling past memories of similar events and interpreting these past memories in the cortex plays a major role in the threat appraisal that IBS patients perform on the sensory experience." According to Dr. Mayer, this altered threat appraisal in IBS patients leads them to make statements such as: "I am afraid not to be close enough to a bathroom"; "I am afraid that anything I eat may trigger my abdominal pain"; "I am afraid I will be uncomfortable all day if I don't have a bowel movement in the morning"; and "When my belly hurts, I am afraid I may have cancer." "All of these statements are based on beliefs and memory of past events that are recalled any time the patient gets into a similar situation or feels anxious," noted Dr. Mayer. "This recall is modulated by the prefrontal cortex when the sensory experience [is processed]."


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## eric (Jul 8, 1999)

Mike, obviosuly a lot of people don't know about the mind gut connection. These are the top researchers from around the world studying (all) mechanism for IBS, not just food intolerence.This "DR's in IBS don't know about immunology research is bull****.""The circuitry of brainï¿½gut reactions that control patients' responses to stressors is found within the "emotional motor system," said Dr. Mayer. The output of this circuitry in response to stressors or emotional experiences can be measured "in terms of autonomic, pain-modulatory, and neuroendocrine responses. Furthermore, it is modulated by a variety of factors such as belief systems, thoughts, and emotions; all play significant roles in modulating response. What is important, though, is that the output can pretty much explain the characteristic IBS symptoms." Autonomic regulation affects not only the muscle cells in the gut, but other cell types, including (MAST CellS), enterochromaffin cells, and the intrinsic neurons of the enteric nervous system. "Therefore," Dr. Mayer explained, "the autonomic nervous system, by stimulating the release of substances from these cells, can change the sensitivity of the gut to a variety of gut stimuli or internal stressors." A recent breakthrough is the discovery that "in response to stressors, this system makes the gut more sensitive," a process referred to as stress-induced visceral hyperalgesia. "Many of you may have experienced that when you go to give a presentation, you may suddenly experience the urge to go to the toilet," Dr. Mayer explained. "It's not that you have a full bladder; it's that the anxiety over the imminent presentation causes the sensory pathways from the bladder to the brain [to be] more sensitive. What's attractive about this concept is that psychosocial stressors arising in the external environment and/or physical stressors arising from within the body, such as gut inflammation, can result in activation of the emotional motor system." Thus, hyperresponsiveness of these stress circuits in the brain might result in altered responses to the internal stresses associated with inflammation and external stressors." "Given the altered affective stimulus processing for IBS patients, what is the relevance for clinical practitioners? Among the most common complaints of IBS patients, as reported by physicians, are heartburn, bloating of the lower GI tract, sensation of fullness, incomplete rectal evacuation, and abdominal pain, explained Dr. Mayer. "The amplification of the unpleasantness of these experiencesï¿½which in the healthy individual is not even consciously perceived once they reach the brainï¿½is one way to explain this range of symptoms," he said. "A more complex and higher-level interpretation of the sensory experience is a modulation based on memory and past experiences." Here, a different area of the brain comes into play; sensory association areas in the parietal cortex, which have connections to the main memory centers within the brain and also to the prefrontal cortex. "By putting together results from a large number of somatic pain studies, this conclusion was reached: This network of recalling past memories of similar events and interpreting these past memories in the cortex plays a major role in the threat appraisal that IBS patients perform on the sensory experience." According to Dr. Mayer, this altered threat appraisal in IBS patients leads them to make statements such as: "I am afraid not to be close enough to a bathroom"; "I am afraid that anything I eat may trigger my abdominal pain"; "I am afraid I will be uncomfortable all day if I don't have a bowel movement in the morning"; and "When my belly hurts, I am afraid I may have cancer." "All of these statements are based on beliefs and memory of past events that are recalled any time the patient gets into a similar situation or feels anxious," noted Dr. Mayer. "This recall is modulated by the prefrontal cortex when the sensory experience [is processed]."


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## eric (Jul 8, 1999)

FYIChin J Physiol 1999 Dec 31;42(4):201-10 Related Articles, Books, LinkOut Erratum in: Chin J Physiol 2000 Mar 31;43(1):48 Neurotransmission at the interface of sympathetic and enteric divisions of the autonomic nervous system. Wood JD. Department of Physiology, The Ohio State University College of Medicine and Public Health, Columbus 43210, USA. wood.13###osu.edu The sympathetic and enteric divisions of the autonomic nervous system are interactive in the determination of the functional state of the digestive tract. Activation of the sympathetic input suppresses digestive function primarily through release of norepinephrine at its synaptic interface with the enteric nervous system. The enteric nervous system functions like an independent minibrain in the initiation of the various programmed patterns of digestive tract behavior and moment-to-moment control as the neural microcircuits carry-out the behavioral patterns. Most of the postganglionic projections from sympathetic prevertebral ganglia terminate as synapses in myenteric and submucous ganglia of the enteric nervous system. Two primary actions of the sympathetic input are responsible for suppression of motility and secretion. First is presynaptic inhibitory action of norepinephrine to suppress release of neurotransmitters at fast and slow excitatory synapses in the enteric neural microcircuits and this effectively shuts-down the circuit. Second is inhibitory synaptic input to submucosal secretomotor neurons to the intestinal crypts. The alpha, adrenergic receptor subtype mediates both actions. Axons of secretomotor neurons to the crypts bifurcate to innervate and dilate the submucosal vasculature. Dilitation of the vasculature increases blood flow in support of increased secretion. Sympathetic inhibitory input to the secretomotor neurons therefore suppresses both secretion and blood flow. Activation of the sympathetic nervous system cannot explain the symptoms of secretory diarrhea and abdominal discomfort associated with psychologic and other forms of stress. Current evidence suggests that brain to mast cell connections account for stress-induced gastrointestinal symptoms. Degranulation of enteric mast cells by neural inputs releases inflammatory mediators that enhance excitability of intestinal secretomotor neurons while suppressing the release of norepinephrine from postganglionic sympathetic axons. This is postulated to underlie the secretory diarrhea and abdominal discomfort associated with stress. Publication Types: Review Review, Tutorial PMID: 10707895 [PubMed - indexed for MEDLINE]


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## eric (Jul 8, 1999)

FYIChin J Physiol 1999 Dec 31;42(4):201-10 Related Articles, Books, LinkOut Erratum in: Chin J Physiol 2000 Mar 31;43(1):48 Neurotransmission at the interface of sympathetic and enteric divisions of the autonomic nervous system. Wood JD. Department of Physiology, The Ohio State University College of Medicine and Public Health, Columbus 43210, USA. wood.13###osu.edu The sympathetic and enteric divisions of the autonomic nervous system are interactive in the determination of the functional state of the digestive tract. Activation of the sympathetic input suppresses digestive function primarily through release of norepinephrine at its synaptic interface with the enteric nervous system. The enteric nervous system functions like an independent minibrain in the initiation of the various programmed patterns of digestive tract behavior and moment-to-moment control as the neural microcircuits carry-out the behavioral patterns. Most of the postganglionic projections from sympathetic prevertebral ganglia terminate as synapses in myenteric and submucous ganglia of the enteric nervous system. Two primary actions of the sympathetic input are responsible for suppression of motility and secretion. First is presynaptic inhibitory action of norepinephrine to suppress release of neurotransmitters at fast and slow excitatory synapses in the enteric neural microcircuits and this effectively shuts-down the circuit. Second is inhibitory synaptic input to submucosal secretomotor neurons to the intestinal crypts. The alpha, adrenergic receptor subtype mediates both actions. Axons of secretomotor neurons to the crypts bifurcate to innervate and dilate the submucosal vasculature. Dilitation of the vasculature increases blood flow in support of increased secretion. Sympathetic inhibitory input to the secretomotor neurons therefore suppresses both secretion and blood flow. Activation of the sympathetic nervous system cannot explain the symptoms of secretory diarrhea and abdominal discomfort associated with psychologic and other forms of stress. Current evidence suggests that brain to mast cell connections account for stress-induced gastrointestinal symptoms. Degranulation of enteric mast cells by neural inputs releases inflammatory mediators that enhance excitability of intestinal secretomotor neurons while suppressing the release of norepinephrine from postganglionic sympathetic axons. This is postulated to underlie the secretory diarrhea and abdominal discomfort associated with stress. Publication Types: Review Review, Tutorial PMID: 10707895 [PubMed - indexed for MEDLINE]


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## Lesley Taylor (Dec 22, 2001)

Hi BDMaybe I'm stupid but I was basically responding to the original posting by beach who said "if stress is the only cause of IBS, why do certain foods...etc." I was not saying that stress does cause it, but I myself have had a doctor tell me to "just relax" when I told him my symptoms....I realize that most informed people refute this notion.


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## Lesley Taylor (Dec 22, 2001)

Hi BDMaybe I'm stupid but I was basically responding to the original posting by beach who said "if stress is the only cause of IBS, why do certain foods...etc." I was not saying that stress does cause it, but I myself have had a doctor tell me to "just relax" when I told him my symptoms....I realize that most informed people refute this notion.


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## BQ (May 22, 2000)

Lesley We have ALL, I think been, told that by one Dr. or another at some time during our search for symptom management. That is something the medical community should be ashamed about. I wasn't saying anything other than what the others have said. I shouldn't have addressed you personally, and for that I apologize. I didn't know where you were at with this idea. Please forgive me. I do know it IS helpful to learn as much as is possible about it, cause if we all wait for those Doc's to stop patting us on the head and actually help us.... well... we are gonna wait a loooooong time. So I hope I haven't forever offended you and that you may soon find some help managing your symptoms.







BQ


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## BQ (May 22, 2000)

Lesley We have ALL, I think been, told that by one Dr. or another at some time during our search for symptom management. That is something the medical community should be ashamed about. I wasn't saying anything other than what the others have said. I shouldn't have addressed you personally, and for that I apologize. I didn't know where you were at with this idea. Please forgive me. I do know it IS helpful to learn as much as is possible about it, cause if we all wait for those Doc's to stop patting us on the head and actually help us.... well... we are gonna wait a loooooong time. So I hope I haven't forever offended you and that you may soon find some help managing your symptoms.







BQ


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## BQ (May 22, 2000)

Hey Boys???? Isn't it possible that the immune response is effected by the CNS?? Isn't that possible???? BQ


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## BQ (May 22, 2000)

Hey Boys???? Isn't it possible that the immune response is effected by the CNS?? Isn't that possible???? BQ


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## TryingToDeal (Dec 21, 2001)

Ive had wonderful stress free days that i came down ill with ibs on it's not caused by stress but stress can induce it they found that most people with ibs have a mutated gene and that this mutated gene caused anxiety a lot of times as well this mutation causes both but neither of them caused one another so hopefully now that they found somewhat of a reason they can help us i found this out on onhealth.com


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## TryingToDeal (Dec 21, 2001)

Ive had wonderful stress free days that i came down ill with ibs on it's not caused by stress but stress can induce it they found that most people with ibs have a mutated gene and that this mutated gene caused anxiety a lot of times as well this mutation causes both but neither of them caused one another so hopefully now that they found somewhat of a reason they can help us i found this out on onhealth.com


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## flux (Dec 13, 1998)

> quote:This i don't agree. This is normal brain function.


I think you misread what it says. They are saying it *is* normal brain function.


> quote:n very basic terms your gut only moves or spasms if the brain directs the nerves there to respond in that manner.


Actually, the gut largely runs by itself without input from the brain. The brain is needed only for 1) swallowing 2) gastric compliance and emptying and 3) defecation. However, the brain can meddle at other times if the intestinal nerves permit it (presumably, they often do) and is constantly listening to what the gut is doing, although what it hears may not always be the truth.


> quote:Isn't it possible that the immune response is effected by the CNS?? Isn't that possible????


This is a leading idea at this time!Food is probably not involved much in *causing* symptoms. There are natural effects of food on the gut behavior and these are just amplified along the brain-gut axis, making it appear that food itself is the cause. In addition, it is often difficult to make associations between food and symptoms, so sometimes people draw incorrect conclusions (e.g, lactose intolerance).


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## flux (Dec 13, 1998)

> quote:This i don't agree. This is normal brain function.


I think you misread what it says. They are saying it *is* normal brain function.


> quote:n very basic terms your gut only moves or spasms if the brain directs the nerves there to respond in that manner.


Actually, the gut largely runs by itself without input from the brain. The brain is needed only for 1) swallowing 2) gastric compliance and emptying and 3) defecation. However, the brain can meddle at other times if the intestinal nerves permit it (presumably, they often do) and is constantly listening to what the gut is doing, although what it hears may not always be the truth.


> quote:Isn't it possible that the immune response is effected by the CNS?? Isn't that possible????


This is a leading idea at this time!Food is probably not involved much in *causing* symptoms. There are natural effects of food on the gut behavior and these are just amplified along the brain-gut axis, making it appear that food itself is the cause. In addition, it is often difficult to make associations between food and symptoms, so sometimes people draw incorrect conclusions (e.g, lactose intolerance).


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## Lesley Taylor (Dec 22, 2001)

S'ok, BQ, I'm not offended, I'm just new here! As far as the discussion goes, my own take on all this is that our digestive systems are like everyone elses, our peristalsis just tends to work in a wonky fashion - not smooth and steady like normal people. Why this occurs, no one is sure of. Obviously the brain is at the root of it. There is also something called the 'gastro-colic' reflex that is evident in babies and young children - eat = poop. One is suppose to outgrow this or manage this, but many ppl with IBS don't. That's why we react so strongly after a large meal. I'm IBS D/C but my symptoms are quite mild - after reading about some ppl's problems here I realize I have nothing to complain about at all! I feel humbled...Merry Christmas everyone - hope ppl can enjoy without suffering! Cheers!


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## Lesley Taylor (Dec 22, 2001)

S'ok, BQ, I'm not offended, I'm just new here! As far as the discussion goes, my own take on all this is that our digestive systems are like everyone elses, our peristalsis just tends to work in a wonky fashion - not smooth and steady like normal people. Why this occurs, no one is sure of. Obviously the brain is at the root of it. There is also something called the 'gastro-colic' reflex that is evident in babies and young children - eat = poop. One is suppose to outgrow this or manage this, but many ppl with IBS don't. That's why we react so strongly after a large meal. I'm IBS D/C but my symptoms are quite mild - after reading about some ppl's problems here I realize I have nothing to complain about at all! I feel humbled...Merry Christmas everyone - hope ppl can enjoy without suffering! Cheers!


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## Blair (Dec 15, 1998)

"The reason is because anyone who says that Stress is the sole cause of IBS is shovelling good old fashioned Texas cow pies. Period"Thats funny, just like this BB.Nobody knows what causes IBS, period.


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## Blair (Dec 15, 1998)

"The reason is because anyone who says that Stress is the sole cause of IBS is shovelling good old fashioned Texas cow pies. Period"Thats funny, just like this BB.Nobody knows what causes IBS, period.


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## TryingToDeal (Dec 21, 2001)

one question why doesn't ERIC put a link to all of what he says each thing takes forever to scroll through goodness sakes have some decency!


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## TryingToDeal (Dec 21, 2001)

one question why doesn't ERIC put a link to all of what he says each thing takes forever to scroll through goodness sakes have some decency!


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## Mike NoLomotil (Jun 6, 2000)

Comment: ___________________________________"Mike, obviosuly a lot of people don't know about the mind gut connection. These are the top researchers from around the world studying (all) mechanism for IBS, not just food intolerence" ____________________________________This is the silliest thing I have read in a week. Thanks for the laugh. I will let them know that they have been incapable of understnding their neuroimmune physiology, and their awareness of the work being done by the doctors you post is merely a figment of their imagination. In particualr Dr's Brostoff and Bengtsson will be grateful to hear that they are unaware of the role of the CNS in affecting gut function so that they can quickly bine up on an obviously alien subject.Actually what the problem is here is quite the opposite. You do not comrpehend the message I write nor how I write it due to selective thinking so there is no need for me to post any further response since you have a scotoma to the subject. As the Vedas state "A proud mind cannot learn anything".As far as your constant pontificating about how only the doctors on the drug industry funded Rome Committee and other other such related organizations are the the "top docs" in the world, once again you persist in presenting an insoluble argument where non exists for purely rhetorical purposes.If the investigators fail to investigate a critical element or set of elements in the equation I don't care who they are. If you are leaving it out you are leaving it out if you are Joe Shmoe, MD or Christian Barnard, MD. I worked for pay for the so called tiop-docs in pulmonary medicine at one time, who had the best-funded pulmonary medicien research center in the freakin USA. Big deal. And if they left a key element out of the equation prior to setting forth their conclusions I would and did point that out as well, and that it compromises the conclsuions. Sometimes this happens as oversight, sometimes it is out of necessity as it conflicts with the objectives of the investgation and the objectives of the Founder of the Feast. That is fact too.Until the work of the top European docs studying very specifically the immunoligic function opf the bowel directly, and quantifying the specific markers which must be quantified to assess immune function, the whole of the work on so called IBS work is incomplete as it has not been integrated. Gee I am sorry its a fact but its a fact.And to suggest that you know more about the so called brain-gut connection then these senior physicians, researchers, Department Chairman at major medical universities is the height of ludicrousness. Oh, am I supposed to forward your "tutorials" on the automonomic nervous system to them so as to teach them the folly of their ways? ________________________Hi Bar BQ...you asked "Hey Boys???? Isn't it possible that the immune response is effected by the CNS?? Isn't that possible???? BQ ". ________________________Absolutely, and in fact nobody says otherwsie that I know of. I thought I pointed out somewhere (without rereading the whole tedious thread)what (in GENERAL) the integrated role of specific CNS components are that are linked to and part of the integrated gastroneuroimmunoendoexocrine system are. This is why its helpful to read a few good physiology books as a lot of what gets taught or said or posted is done in a vaccum of conceptualization. There are at least 8 specific immunologic "mechanisms" for immunocyte activation. This is linked to gut function, circulatory function, CNS function, endocrine function and excrine function which are all involved in regulating gut function.It is more than a 2-way street it is an all-way street as specific alterations, even non-anatomical (ie dysbiosis), in specific gut functionn will then alter immune response which will effect CNS and endocrine response. There are also specific alterations in CNS function which will affect endocrine function and/or immunocyte function or both. And since everything is wired by afferent-efferent relfex loops they are inseparable. But folks keep trying to separate them for more than just teaching purposes, and this is when you start to promulgate incomplete therum. Everyone in their first year of premed knows how this system basically works.What is difficult in wading through the morass of info vis a vis so called IBS is that many investigative approaches are too single minded, largely due to the objectives of the team, the background of the team, the funding objectives of the financier etc. And indeed in the absence of other markers which contradict the theory that the aberrant immune function seen in the bowel of IBS patients is CNS-primary, the CNS primary theory to explain the loss-of-oral-tolerance mechanism could be plausible as anything else. IF the markers were absent.BUT since the specific markers of known immunologic mechanisms are recovered from the bowel when an investigator actually looks for them, it shoots a hole in the theory. If you have a patient who is challenge-positive for an immunocyte response to a specific food and who clinically would be diagnosed with IBS-d or cyclic, who is non-atopic, who is SPT negative and RAST negative for specific circulating Ig[x] (lets say E) to the test positive foods,(and the challenge was 100% blinded via a multi-lument indwelling jejunal isolation catheter so the patient does not even know if you are doing anything at any time much less what you are doing hence the whole placebo or suggestion-response theory goes out the window) then you isolate and challenge his small bowel and recover not only the mediators which quantify the food PROVOKED an abnormal response (read closely Fluxie...provoked) BUT the damn washings keep coming back with IgE besides, well,one can ignore the smoke if you want but the bullet is gonna get ya.Indeed mast cells are not the only immunocytes whose stability can be altered by other than Ig[x] or complement or cytoxoc responses, or whatever. There are circulating immunocytes which the CNS can modulate...how can you wire a circulating immunocyte? hey you put, say, alpha adrenergic receptors on it so circulating adrenergic neurotransmitters can reach the receptor site and effect the cell.OOOPS! But then again, we must rememeber to stop there because the physicians doing the immunologic investigations don't know anything about that silly nervous system, and strike a puzzled pose when someone says "Brain-Gut Axis" like "HUH? Duh?". They only know "food intolerance" so it is impossible for me to have picked up any information from them. Whoops.







Happy HolidaysMNL


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## Mike NoLomotil (Jun 6, 2000)

Comment: ___________________________________"Mike, obviosuly a lot of people don't know about the mind gut connection. These are the top researchers from around the world studying (all) mechanism for IBS, not just food intolerence" ____________________________________This is the silliest thing I have read in a week. Thanks for the laugh. I will let them know that they have been incapable of understnding their neuroimmune physiology, and their awareness of the work being done by the doctors you post is merely a figment of their imagination. In particualr Dr's Brostoff and Bengtsson will be grateful to hear that they are unaware of the role of the CNS in affecting gut function so that they can quickly bine up on an obviously alien subject.Actually what the problem is here is quite the opposite. You do not comrpehend the message I write nor how I write it due to selective thinking so there is no need for me to post any further response since you have a scotoma to the subject. As the Vedas state "A proud mind cannot learn anything".As far as your constant pontificating about how only the doctors on the drug industry funded Rome Committee and other other such related organizations are the the "top docs" in the world, once again you persist in presenting an insoluble argument where non exists for purely rhetorical purposes.If the investigators fail to investigate a critical element or set of elements in the equation I don't care who they are. If you are leaving it out you are leaving it out if you are Joe Shmoe, MD or Christian Barnard, MD. I worked for pay for the so called tiop-docs in pulmonary medicine at one time, who had the best-funded pulmonary medicien research center in the freakin USA. Big deal. And if they left a key element out of the equation prior to setting forth their conclusions I would and did point that out as well, and that it compromises the conclsuions. Sometimes this happens as oversight, sometimes it is out of necessity as it conflicts with the objectives of the investgation and the objectives of the Founder of the Feast. That is fact too.Until the work of the top European docs studying very specifically the immunoligic function opf the bowel directly, and quantifying the specific markers which must be quantified to assess immune function, the whole of the work on so called IBS work is incomplete as it has not been integrated. Gee I am sorry its a fact but its a fact.And to suggest that you know more about the so called brain-gut connection then these senior physicians, researchers, Department Chairman at major medical universities is the height of ludicrousness. Oh, am I supposed to forward your "tutorials" on the automonomic nervous system to them so as to teach them the folly of their ways? ________________________Hi Bar BQ...you asked "Hey Boys???? Isn't it possible that the immune response is effected by the CNS?? Isn't that possible???? BQ ". ________________________Absolutely, and in fact nobody says otherwsie that I know of. I thought I pointed out somewhere (without rereading the whole tedious thread)what (in GENERAL) the integrated role of specific CNS components are that are linked to and part of the integrated gastroneuroimmunoendoexocrine system are. This is why its helpful to read a few good physiology books as a lot of what gets taught or said or posted is done in a vaccum of conceptualization. There are at least 8 specific immunologic "mechanisms" for immunocyte activation. This is linked to gut function, circulatory function, CNS function, endocrine function and excrine function which are all involved in regulating gut function.It is more than a 2-way street it is an all-way street as specific alterations, even non-anatomical (ie dysbiosis), in specific gut functionn will then alter immune response which will effect CNS and endocrine response. There are also specific alterations in CNS function which will affect endocrine function and/or immunocyte function or both. And since everything is wired by afferent-efferent relfex loops they are inseparable. But folks keep trying to separate them for more than just teaching purposes, and this is when you start to promulgate incomplete therum. Everyone in their first year of premed knows how this system basically works.What is difficult in wading through the morass of info vis a vis so called IBS is that many investigative approaches are too single minded, largely due to the objectives of the team, the background of the team, the funding objectives of the financier etc. And indeed in the absence of other markers which contradict the theory that the aberrant immune function seen in the bowel of IBS patients is CNS-primary, the CNS primary theory to explain the loss-of-oral-tolerance mechanism could be plausible as anything else. IF the markers were absent.BUT since the specific markers of known immunologic mechanisms are recovered from the bowel when an investigator actually looks for them, it shoots a hole in the theory. If you have a patient who is challenge-positive for an immunocyte response to a specific food and who clinically would be diagnosed with IBS-d or cyclic, who is non-atopic, who is SPT negative and RAST negative for specific circulating Ig[x] (lets say E) to the test positive foods,(and the challenge was 100% blinded via a multi-lument indwelling jejunal isolation catheter so the patient does not even know if you are doing anything at any time much less what you are doing hence the whole placebo or suggestion-response theory goes out the window) then you isolate and challenge his small bowel and recover not only the mediators which quantify the food PROVOKED an abnormal response (read closely Fluxie...provoked) BUT the damn washings keep coming back with IgE besides, well,one can ignore the smoke if you want but the bullet is gonna get ya.Indeed mast cells are not the only immunocytes whose stability can be altered by other than Ig[x] or complement or cytoxoc responses, or whatever. There are circulating immunocytes which the CNS can modulate...how can you wire a circulating immunocyte? hey you put, say, alpha adrenergic receptors on it so circulating adrenergic neurotransmitters can reach the receptor site and effect the cell.OOOPS! But then again, we must rememeber to stop there because the physicians doing the immunologic investigations don't know anything about that silly nervous system, and strike a puzzled pose when someone says "Brain-Gut Axis" like "HUH? Duh?". They only know "food intolerance" so it is impossible for me to have picked up any information from them. Whoops.







Happy HolidaysMNL


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## Mike NoLomotil (Jun 6, 2000)

O I missed this in my seasonal jolliness: __________________________________"This is a leading idea at this time! __________________________________It not an idea its a fact that it effects...the idea that it is the primary effector may have been set forth but it is set forth by those who did not check for conflicting markers nor take into account that others have isolated them. Or they must simply igonore the findings. At least in the patient subset of D-types and cyclics who can be confirmed to be provocable by specific dietary components, that theory will not fit as immunologic mechansims can be isolated. _______________________________"Food is probably not involved much in causing symptoms. There are natural effects of food on the gut behavior and these are just amplified along the brain-gut axis, making it appear that food itself is the cause. In addition, it is often difficult to make associations between food and symptoms, so sometimes people draw incorrect conclusions (e.g, lactose intolerance). _________________________________This is false. It is actually part true and part false.In the 70% of the population of IBS that has d-or-cyclic symptom sets various foods or chemicals provoke a small bowel centered immune response indeed sometimes by known allergy (circulating Ig[x} detetcibel with RAST or ELISA} or by pseudoallergy provoked via lectin or specific peptides, or even histamine contamination or direct-cheotoxicity which can break down the cell wall and release mediators. These are some of the mechansism but not all. This is where the work done in Europe moves forward and has and contionues to isolate novel mechanisms heretofore unseen.The most intersting is the fact that IgE can be recovered after challenge by jejunal isolation with foods that have no chemo or psaudallaergy properties, the patient is non-atopic, SPT negative, RAST negative therefor totally nt allergic by conventional definition. So not only does his small bowel get bathed in proingflammtotry mediators in a mast cell and circulating immunocyte reaction PROVOKED Inappropriately by various food to which she is not allergenic nor is pseudoallergy or chemotoxicity possible BUT specific IgE has been recovered to that food which is NOT circulating but gut localized.Now WHY this aberration in immunologuic function appears remains to be seen, and indeed at some point there may emerge solid markers of aberrant efferent stimuli casuing immunocytes to be inaopprpriately armed...but the CNS does not effect immunoglobulin formation thus sensitization. This at least has been isolated as one apparent mechanism. OR it could very well be normal that there is specific IgE int the gut and the reacticity to it is altered by an aberrant efferent input. Who knows? They JUST ISOLATED IT....and it is being compiled for publication as it is another oiece of the puzzle just located. Where nothing is certain everything is POSSIBLE. BUT it is certain that specific fopodstuffs provoke reactions and that they can be isolated, avoided, and symptoms relieved and it is not restricted to pseudoallergu or chemotoxicity. And it can be duplicasted accuratley in vitro "wholly disconnected" from CNS influence (unless prearmed by a neurotransimetter? need some analytical instrument rental time down at UM in the serology dept. to take a lok next year since no on else is going to).And it appears now some wierd local IgE mechansism is at least in part implicated. Everything else is speculative.Sorry, this eevent is not a primary neurologic mechanism. Sadly, delayed, dose dependent sensitivity to various foods or additives which is avoidable by elimination diet or reversible with certain immunomodulators is a cardinal feature at least of D-type and cyclic IBS so far as has been successfully treated for years.. Read the books written by those who know the field and teach it in medical schhols and treat patients succesfully with the knowledge before posting misleading statments to patients. This is unethical.Oh, then here we see even more selective reading and thinking. Of course it is often difficult if not impossible for people to draw correct correlations between diet and symptom provocation because the nature of the reactions experienced, simplifed, are dose-dependent and delayed onset. Practitioners and dieticisn unfamiliar with this, or unaccepting of the fact that this characterized non-alllergenic food intolerance teach the patient to look for reactions with methods which are used for, thus implemented, as if they are looking for food ALLERGIES. So that is all they will find...the "minority" problem of comorbid allergy, pseudoallergy or chemotoxic reactions...those which are not delayed onset nor dose dependent. The pereptuation of this practice results in a substanmtial amount of needless pharmacotherapy and behavioral therpy to attenuate the effects of reactions which could be isolated an avoided using the proper tools. This has been shown repeatedly for more than a decade.BUT as long as the wrong tools persist in clinical use the wrong conclusion is formed and the patient suffers as a result. To those reading please note that the disavowing a reality does not consitute its non-existence. Perpetuation of the disinformation, Myth, that their diet has little to do with their symptoms, or that it is a few easily isolatable foods such as lectin containing foods, specific petides, histaminic foods, etc. is a disservice to people who can be helped. But it does keep the drug sales going.--------------------Have a Merry One.MNL


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## Mike NoLomotil (Jun 6, 2000)

O I missed this in my seasonal jolliness: __________________________________"This is a leading idea at this time! __________________________________It not an idea its a fact that it effects...the idea that it is the primary effector may have been set forth but it is set forth by those who did not check for conflicting markers nor take into account that others have isolated them. Or they must simply igonore the findings. At least in the patient subset of D-types and cyclics who can be confirmed to be provocable by specific dietary components, that theory will not fit as immunologic mechansims can be isolated. _______________________________"Food is probably not involved much in causing symptoms. There are natural effects of food on the gut behavior and these are just amplified along the brain-gut axis, making it appear that food itself is the cause. In addition, it is often difficult to make associations between food and symptoms, so sometimes people draw incorrect conclusions (e.g, lactose intolerance). _________________________________This is false. It is actually part true and part false.In the 70% of the population of IBS that has d-or-cyclic symptom sets various foods or chemicals provoke a small bowel centered immune response indeed sometimes by known allergy (circulating Ig[x} detetcibel with RAST or ELISA} or by pseudoallergy provoked via lectin or specific peptides, or even histamine contamination or direct-cheotoxicity which can break down the cell wall and release mediators. These are some of the mechansism but not all. This is where the work done in Europe moves forward and has and contionues to isolate novel mechanisms heretofore unseen.The most intersting is the fact that IgE can be recovered after challenge by jejunal isolation with foods that have no chemo or psaudallaergy properties, the patient is non-atopic, SPT negative, RAST negative therefor totally nt allergic by conventional definition. So not only does his small bowel get bathed in proingflammtotry mediators in a mast cell and circulating immunocyte reaction PROVOKED Inappropriately by various food to which she is not allergenic nor is pseudoallergy or chemotoxicity possible BUT specific IgE has been recovered to that food which is NOT circulating but gut localized.Now WHY this aberration in immunologuic function appears remains to be seen, and indeed at some point there may emerge solid markers of aberrant efferent stimuli casuing immunocytes to be inaopprpriately armed...but the CNS does not effect immunoglobulin formation thus sensitization. This at least has been isolated as one apparent mechanism. OR it could very well be normal that there is specific IgE int the gut and the reacticity to it is altered by an aberrant efferent input. Who knows? They JUST ISOLATED IT....and it is being compiled for publication as it is another oiece of the puzzle just located. Where nothing is certain everything is POSSIBLE. BUT it is certain that specific fopodstuffs provoke reactions and that they can be isolated, avoided, and symptoms relieved and it is not restricted to pseudoallergu or chemotoxicity. And it can be duplicasted accuratley in vitro "wholly disconnected" from CNS influence (unless prearmed by a neurotransimetter? need some analytical instrument rental time down at UM in the serology dept. to take a lok next year since no on else is going to).And it appears now some wierd local IgE mechansism is at least in part implicated. Everything else is speculative.Sorry, this eevent is not a primary neurologic mechanism. Sadly, delayed, dose dependent sensitivity to various foods or additives which is avoidable by elimination diet or reversible with certain immunomodulators is a cardinal feature at least of D-type and cyclic IBS so far as has been successfully treated for years.. Read the books written by those who know the field and teach it in medical schhols and treat patients succesfully with the knowledge before posting misleading statments to patients. This is unethical.Oh, then here we see even more selective reading and thinking. Of course it is often difficult if not impossible for people to draw correct correlations between diet and symptom provocation because the nature of the reactions experienced, simplifed, are dose-dependent and delayed onset. Practitioners and dieticisn unfamiliar with this, or unaccepting of the fact that this characterized non-alllergenic food intolerance teach the patient to look for reactions with methods which are used for, thus implemented, as if they are looking for food ALLERGIES. So that is all they will find...the "minority" problem of comorbid allergy, pseudoallergy or chemotoxic reactions...those which are not delayed onset nor dose dependent. The pereptuation of this practice results in a substanmtial amount of needless pharmacotherapy and behavioral therpy to attenuate the effects of reactions which could be isolated an avoided using the proper tools. This has been shown repeatedly for more than a decade.BUT as long as the wrong tools persist in clinical use the wrong conclusion is formed and the patient suffers as a result. To those reading please note that the disavowing a reality does not consitute its non-existence. Perpetuation of the disinformation, Myth, that their diet has little to do with their symptoms, or that it is a few easily isolatable foods such as lectin containing foods, specific petides, histaminic foods, etc. is a disservice to people who can be helped. But it does keep the drug sales going.--------------------Have a Merry One.MNL


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## Schultzie (Dec 20, 2001)

I agree with the fact that STRESS DOES NOT CAUSE IBS, but if you have IBS, stress will add to the problem..Just as certain foods will affect one person and not the other..I personally, do notice a difference that when I'm under a great deal of stress, my IBS gets worse.."Merry Christmas to All"


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## Schultzie (Dec 20, 2001)

I agree with the fact that STRESS DOES NOT CAUSE IBS, but if you have IBS, stress will add to the problem..Just as certain foods will affect one person and not the other..I personally, do notice a difference that when I'm under a great deal of stress, my IBS gets worse.."Merry Christmas to All"


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## flux (Dec 13, 1998)

> quote:......BUT as long as the wrong tools persist in clinical use the wrong conclusion is formed and the patient suffers as a result. To those reading please note that the disavowing a reality does not consitute its non-existence. Perpetuation of the disinformation, Myth, that their diet has little to do with their symptoms, or that it is a few easily isolatable foods such as lectin containing foods, specific petides, histaminic foods, etc. is a disservice to people who can be helped.


The above tone you just heard was just a test of the Emergency Broadcast System..Had this been a real emergency..you would have been given real and accurate information from real and well-respected IBS experts from around the globe. This concludes this test of the Emergency Broadcast system..


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## flux (Dec 13, 1998)

> quote:......BUT as long as the wrong tools persist in clinical use the wrong conclusion is formed and the patient suffers as a result. To those reading please note that the disavowing a reality does not consitute its non-existence. Perpetuation of the disinformation, Myth, that their diet has little to do with their symptoms, or that it is a few easily isolatable foods such as lectin containing foods, specific petides, histaminic foods, etc. is a disservice to people who can be helped.


The above tone you just heard was just a test of the Emergency Broadcast System..Had this been a real emergency..you would have been given real and accurate information from real and well-respected IBS experts from around the globe. This concludes this test of the Emergency Broadcast system..


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## BQ (May 22, 2000)

Hmmmm It was just a guess....







Hey Boys.... If the 'contest' is based on # of letters or syllables???? I think MNoLO has got ya beat.Mike, It was only a vague guess, cause ya see I had a little trouble getting my _CNS_ to process words like this:"gastroneuroimmunoendoexocrine" (Yes folks, scroll up... it IS there. Yes, I counted, more letters than the whole freakin alphabet -29- and, by my count, 12 syllables.)







BQ


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## Jared (Sep 1, 2001)

Just to throw a whole lot of gasoline on the fire--researchers at UCLA have done studies which seem to indicate that stress may indeed "cause" IBS. Before everyone jumps all over me, let me explain.The current thinking is that certain people are genetically pre-disposed to IBS. That means from the moment we [IBS sufferers] are born we _might_ get IBS. The initial trigger seems to be a traumatic life event. In some people it is childhood abuse. In others it is a serious intestinal infection. In still others it is a messy drawn-out divorce. The doctors I talked with at UCLA, Dr. Lin Chang and Dr. Emeran Mayer, were quick to point out that it isn't stress itself which is the initial trigger, but exposure to a prolonged and traumatic stressful event. Could be a car crash, could be the death of a parent, could be abdominal surgery etc. This seems to activate the "gene" for IBS which in turn subtly changes our physiology and neurology. If correct it would explain why so many people seem to "contract" IBS in so many different ways. As far as research goes, UCLA has been doing tests on rats, which apparently have a nervous response system and digestive system that is comparable to humans. One particular study that Dr. Mayer shared with me is interesting to note.The researchers took two groups of neonatal rats, a control group and the experimental group. The experimental pups were separated from their mother after birth for a few hours each day. Rat mothers who don't wean their pups forget they have kids and stop caring for them, so this simulates "parental neglect." When the experimental group reached adulthood, they exhibited signs of having what looked like IBS! They had higher fecal output rates when placed in stressful situations than control groups. Furthermore, a colon balloon distension test was done, like the one done on human IBS patients. The experimental group registered the equivalent of pain (since a rat can't say "ouch" they had to use other measures such as muscle contractions) at lower air pressures--just like people with IBS!The results are fairly startling. Dr. Mayer told me they are currently examining the genes in the experimental and control rats in the hope that they can identify some difference in them that might lead researchers to finding a genetic cause for IBS.-- Jared


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## BQ (May 22, 2000)

Hmmmm It was just a guess....







Hey Boys.... If the 'contest' is based on # of letters or syllables???? I think MNoLO has got ya beat.Mike, It was only a vague guess, cause ya see I had a little trouble getting my _CNS_ to process words like this:"gastroneuroimmunoendoexocrine" (Yes folks, scroll up... it IS there. Yes, I counted, more letters than the whole freakin alphabet -29- and, by my count, 12 syllables.)







BQ


----------



## Jared (Sep 1, 2001)

Just to throw a whole lot of gasoline on the fire--researchers at UCLA have done studies which seem to indicate that stress may indeed "cause" IBS. Before everyone jumps all over me, let me explain.The current thinking is that certain people are genetically pre-disposed to IBS. That means from the moment we [IBS sufferers] are born we _might_ get IBS. The initial trigger seems to be a traumatic life event. In some people it is childhood abuse. In others it is a serious intestinal infection. In still others it is a messy drawn-out divorce. The doctors I talked with at UCLA, Dr. Lin Chang and Dr. Emeran Mayer, were quick to point out that it isn't stress itself which is the initial trigger, but exposure to a prolonged and traumatic stressful event. Could be a car crash, could be the death of a parent, could be abdominal surgery etc. This seems to activate the "gene" for IBS which in turn subtly changes our physiology and neurology. If correct it would explain why so many people seem to "contract" IBS in so many different ways. As far as research goes, UCLA has been doing tests on rats, which apparently have a nervous response system and digestive system that is comparable to humans. One particular study that Dr. Mayer shared with me is interesting to note.The researchers took two groups of neonatal rats, a control group and the experimental group. The experimental pups were separated from their mother after birth for a few hours each day. Rat mothers who don't wean their pups forget they have kids and stop caring for them, so this simulates "parental neglect." When the experimental group reached adulthood, they exhibited signs of having what looked like IBS! They had higher fecal output rates when placed in stressful situations than control groups. Furthermore, a colon balloon distension test was done, like the one done on human IBS patients. The experimental group registered the equivalent of pain (since a rat can't say "ouch" they had to use other measures such as muscle contractions) at lower air pressures--just like people with IBS!The results are fairly startling. Dr. Mayer told me they are currently examining the genes in the experimental and control rats in the hope that they can identify some difference in them that might lead researchers to finding a genetic cause for IBS.-- Jared


----------



## Mike NoLomotil (Jun 6, 2000)

Jared,That's a good illustration of what I would call my "perpetual point" about so called IBS.If one goes to page 569 of the (17th edition) of the Merck Manual (if you have a diferent edition go to the chapter on Chronic Obstructive Pulmonary disease). Many years ago there were people with apparent lung diseases who clearly had some common base or bases for their symptoms, and they were seprated into groups based upon their primary symptoms, and they all had some symptoms which overlapped to varying degrees. Long before the pathology (underlying diseases) of COPD were understood, however, medicine was able to observe and diagnose COPD vitcims based on clinical presentation, symptoms, and history then provide therapies to reduce the sympotms (which were somewhat different for each symptom set, yet had varying degrees of commonality).As scientific prowess and technology progressed, medicine gained new means of studying the cardiopulmonary system more closely, both in vivo and in vitro. As they did, the underlying diseases slowly were understood and then it was eventually clear why the patients could be grouped by symptoms and why some were unique and some overlapped. Medicine eventually also learned how to avoid the diseases which were avoidable, and which symptom sets were not avoidable because of genetic prediposition (atopy) or genetic predisposition to deficiencies in certain protective pulmonary enzymes.So the syndrome of "COPD" has its "Pink Puffers" and "Blue Bloaters" and "Wheezers". At this stage of understanding of the synmdrome of IBS the symptom subsets are "Diarrheic Type", "Cyclic Type", "Constipation Type".As a consequence of steady advances in technology and understanding on several fronts, the underlying causal basis for the "multiple types" slowly are beginning to emerge from the foggy years of "spastic colon", and are passing through the always-inevitable symptom-based diagnsosis and treatment phase, and will in the next few years seee ach of the causal bases for the multiple overlapping disease conditions which we now call IBS revealed. The Symptom BAsed Diagnosis Phase is not the end-game, nor should it be viewed as such. It is a common and oft-repeated transitional PHASE of clinical medicine.The picture of IBS will, in the end, look alot like the overlapping-rings in the COPD picture which shows how gas-exchange airway pathology (emphysema) can overlap with conducting airway damage (chronic bronchitis) which can both overlap with reversible airway obstruction (various asthmatic conditions).Where all the controversy comes from is when investigators or practitionsers or lay people claim to have gained the sole undersatnding or "The Cause" Of "IBS" when in fact there is no single casue, nor will there be nor is "IBS" a distinct disease unto itself but a "syndrome" going through the phase of symptom-driven managment. In the end,as distinct pathologies are isolated and then carved-off with "oh know we know that is Disease X", the population attributed to "IBS" shrinks...and there may be in the end game some distinct pathology that medicine universally declares to be a distinct disease and let it keep the name IBS...or the overlapping conditions may be isolated but the term IBS persists as a categorization of disease sub-types, just like COPD does persist to this day for "obstructive pulmonary diseases". Only time will tell.It is clear there are subpopulations, for example, of some patients who are predisposed (just like atopic disease), there are those who develop symptoms as a result of some form of trauma or another to one or more parts of the system (the intestine itself, its nerves, or the CNS) and those who develop symptoms secondary to a primary dysfunction of one of the subsystems which can act independently of the CNS (immune system, enocrine system, etc.)secondary to an as yet well understood mechanism. There can be overlap.If one argues otherwise, one is being unwise. One is ignoring some part or parts of the evidence which makes this all quite clear, and only selecting that part of the evidence which supports that part of the causal basis which either interersts one, or where ones other interests lie. So each "investigator" can indeed claim some portion of the high-ground attributable to the causal basis for the conditions, since there are multiple places to be claimed.Hence, BARBQ,







my constant use of the invented-but-merely-illustrative word "gastroneuroimmunoendoexocrine system" to describe the organ system dysfunctonal in IBS. I am not in a contest at all. I am trying to make a point which will help sick people gain a better understanding, thus better ability to approach, their condition. Its a word-picture intended to show the degree of complexity and integral interraction between each of these systems in regulating bowel function and the systemic symptoms which can also accompany bowel dysfunction seen in IBS. So, yes, it is indeed a virtually inscrutable and unpronouncable term, just as the problem of IBS cannot be reduced to a single common denominator. To say it can is inconsisent with the realities of the syndrome.This is also why, no matter how you slice it up, multi-modal disease managment programs which consist of proper dietary therapy, behavioral therapies and supportive pharmacotherapy all specifically tailored to the patients specific needs will produce the best outcomes compared to any single-mode therapy and why I do not espouse single-mode therapy. It is also why when people do espouse single-mode therapy I tend to engage on that point since no single mode therapy will produce the optimal outcomes for all patients. I don't care who invented it. _____________________________________"The above tone you just heard was just a test of....etc" ______________________________________Hey that IS funny and if we were in the Comedy Club your set is the best, no doubt.







Also since you posted this, yet have made it very clear in your prior writings that you have Never even Read any of the primary books on the subject written by acknowledged experts in the area of immunologic investigatory approaches and therapies, yet you assume a position of authority on the subject and perist in dissuading sick people from considering that medical information you have never read yourself, you also win the







award, hands down!I recommend that taking some of that creative energy and dedicating it to studying the subject at leat a littel bit by at least reading this book, even if you read not a smidgen more of any of those doctors work you will be better prepared to advise people since you will have actaully read something on the subject:"FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, London)http://www.amazon.com/exec/obidos/ASIN/089...r=2-1/102-64875 08-3420903[/URL]Or, just keep them one liners coming! It's easier.







Eat well. Think well. Be well. Read more.MNL


----------



## Mike NoLomotil (Jun 6, 2000)

Jared,That's a good illustration of what I would call my "perpetual point" about so called IBS.If one goes to page 569 of the (17th edition) of the Merck Manual (if you have a diferent edition go to the chapter on Chronic Obstructive Pulmonary disease). Many years ago there were people with apparent lung diseases who clearly had some common base or bases for their symptoms, and they were seprated into groups based upon their primary symptoms, and they all had some symptoms which overlapped to varying degrees. Long before the pathology (underlying diseases) of COPD were understood, however, medicine was able to observe and diagnose COPD vitcims based on clinical presentation, symptoms, and history then provide therapies to reduce the sympotms (which were somewhat different for each symptom set, yet had varying degrees of commonality).As scientific prowess and technology progressed, medicine gained new means of studying the cardiopulmonary system more closely, both in vivo and in vitro. As they did, the underlying diseases slowly were understood and then it was eventually clear why the patients could be grouped by symptoms and why some were unique and some overlapped. Medicine eventually also learned how to avoid the diseases which were avoidable, and which symptom sets were not avoidable because of genetic prediposition (atopy) or genetic predisposition to deficiencies in certain protective pulmonary enzymes.So the syndrome of "COPD" has its "Pink Puffers" and "Blue Bloaters" and "Wheezers". At this stage of understanding of the synmdrome of IBS the symptom subsets are "Diarrheic Type", "Cyclic Type", "Constipation Type".As a consequence of steady advances in technology and understanding on several fronts, the underlying causal basis for the "multiple types" slowly are beginning to emerge from the foggy years of "spastic colon", and are passing through the always-inevitable symptom-based diagnsosis and treatment phase, and will in the next few years seee ach of the causal bases for the multiple overlapping disease conditions which we now call IBS revealed. The Symptom BAsed Diagnosis Phase is not the end-game, nor should it be viewed as such. It is a common and oft-repeated transitional PHASE of clinical medicine.The picture of IBS will, in the end, look alot like the overlapping-rings in the COPD picture which shows how gas-exchange airway pathology (emphysema) can overlap with conducting airway damage (chronic bronchitis) which can both overlap with reversible airway obstruction (various asthmatic conditions).Where all the controversy comes from is when investigators or practitionsers or lay people claim to have gained the sole undersatnding or "The Cause" Of "IBS" when in fact there is no single casue, nor will there be nor is "IBS" a distinct disease unto itself but a "syndrome" going through the phase of symptom-driven managment. In the end,as distinct pathologies are isolated and then carved-off with "oh know we know that is Disease X", the population attributed to "IBS" shrinks...and there may be in the end game some distinct pathology that medicine universally declares to be a distinct disease and let it keep the name IBS...or the overlapping conditions may be isolated but the term IBS persists as a categorization of disease sub-types, just like COPD does persist to this day for "obstructive pulmonary diseases". Only time will tell.It is clear there are subpopulations, for example, of some patients who are predisposed (just like atopic disease), there are those who develop symptoms as a result of some form of trauma or another to one or more parts of the system (the intestine itself, its nerves, or the CNS) and those who develop symptoms secondary to a primary dysfunction of one of the subsystems which can act independently of the CNS (immune system, enocrine system, etc.)secondary to an as yet well understood mechanism. There can be overlap.If one argues otherwise, one is being unwise. One is ignoring some part or parts of the evidence which makes this all quite clear, and only selecting that part of the evidence which supports that part of the causal basis which either interersts one, or where ones other interests lie. So each "investigator" can indeed claim some portion of the high-ground attributable to the causal basis for the conditions, since there are multiple places to be claimed.Hence, BARBQ,







my constant use of the invented-but-merely-illustrative word "gastroneuroimmunoendoexocrine system" to describe the organ system dysfunctonal in IBS. I am not in a contest at all. I am trying to make a point which will help sick people gain a better understanding, thus better ability to approach, their condition. Its a word-picture intended to show the degree of complexity and integral interraction between each of these systems in regulating bowel function and the systemic symptoms which can also accompany bowel dysfunction seen in IBS. So, yes, it is indeed a virtually inscrutable and unpronouncable term, just as the problem of IBS cannot be reduced to a single common denominator. To say it can is inconsisent with the realities of the syndrome.This is also why, no matter how you slice it up, multi-modal disease managment programs which consist of proper dietary therapy, behavioral therapies and supportive pharmacotherapy all specifically tailored to the patients specific needs will produce the best outcomes compared to any single-mode therapy and why I do not espouse single-mode therapy. It is also why when people do espouse single-mode therapy I tend to engage on that point since no single mode therapy will produce the optimal outcomes for all patients. I don't care who invented it. _____________________________________"The above tone you just heard was just a test of....etc" ______________________________________Hey that IS funny and if we were in the Comedy Club your set is the best, no doubt.







Also since you posted this, yet have made it very clear in your prior writings that you have Never even Read any of the primary books on the subject written by acknowledged experts in the area of immunologic investigatory approaches and therapies, yet you assume a position of authority on the subject and perist in dissuading sick people from considering that medical information you have never read yourself, you also win the







award, hands down!I recommend that taking some of that creative energy and dedicating it to studying the subject at leat a littel bit by at least reading this book, even if you read not a smidgen more of any of those doctors work you will be better prepared to advise people since you will have actaully read something on the subject:"FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff (M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, London)http://www.amazon.com/exec/obidos/ASIN/089...r=2-1/102-64875 08-3420903[/URL]Or, just keep them one liners coming! It's easier.







Eat well. Think well. Be well. Read more.MNL


----------



## eric (Jul 8, 1999)

Jared, ya did notice the post I posted by Dr Mayer yes.







He is a major researcher in IBS.There is still no direct proof stress causes IBS, but yes they may show that stress has to be a part of it to start it. We also need to seperate the different stressor and anxiety and emotions themselves.That no immunlogists or people who understand immunology is bull, some of the worlds best like Dr Gershon and Dr Mayer and Dr Jackie Wood.Lets just look at Woods credentials for a moment.Jackie D Wood, PhD Professor, Departments of Physiology and Cell Biology, andInternal Medicine Ph.D.: University of Illinois Postdoctoral Training: University of Illinois, Dr. C. Ladd Prosser (614) 292-4888 FAX (614) 292-4888 email: wood.13###osu.edu RESEARCH AREA Neurophysiology of the enteric nervous system and entericneuro-immuno-physiology. CURRENT RESEARCH The general aim of the research is to advance understanding of physiological control ofmammalian gastrointestinal functions in health and disease states. Intestinal behavior emergesfrom coordinated activity of the musculature, mucosal epithelium and blood vasculature.Organized behavior of these effector systems is determined by the enteric nervous system inconcert with input from the cephalic brain. The enteric nervous system is recognized as anindependent integrative system that behaves like a minibrain with synaptic microcircuitspositioned close to the effector systems it controls. The enteric nervous system consists ofsensory neurons, interneurons and motor neurons to the effector systems. Interneuronalmicrocircuits process sensory information, contain a library of programs that determine gutbehavior during different digestive states and control the outflow of information in motorneurons. These functions involve the same and additional arrays of synaptic events andneurotransmitters (eg., neuropeptides, biogenic amines and acetylcholine) as the brain and spinalcord. My research investigates electrical and synaptic behavior of enteric neurons in the variousspecialized regions of the gastrointestinal tract. Apart from the brain-in-the-gut, the digestive tract is recognized as the organ system with thegreatest concentration of immune cells in the body. In its position at one of the dirtiest ofinterfaces between the body and outside world, the intestinal mucosal immune systemcontinuously encounters dietary antigens, bacteria, viruses and toxins. Physical and chemicalbarriers at the epithelial interface are insufficient to exclude fully the large antigen load therebyallowing chronic challenges to the mucosal immune system. Studies with antigen sensitized animal models in my laboratory discovered directcommunication between the mucosal immune system and the minibrain in the intestine. Thecommunication is meaningful and results in adaptive behavior of the bowel in response tocircumstances within the lumen that are threatening to the functional integrity of the wholeanimal. Communication is chemical in nature (paracrine) and incorporates specialized sensingfunctions of the immune cells for specific antigens together with the capacity of the entericnervous system for intelligent interpretation of the signals. Immuno-neural integration progressessequentially beginning with immune detection followed by signal transfer to entericmicrocircuits followed by neural interpretation and then selection of a specific neural programof coordinated mucosal secretion and motor propulsion that effectively clears the antigenic threatfrom the intestinal lumen. Experimental approaches to immuno-neural interaction brings togetherthe disciplines of mucosal immunology and enteric neurophysiology. Included in the research on neuroimmunology is an animal model for idiopathic ulcerative colitisand colon cancer. The animal model for inflammatory bowel disease is a newworld monkeycalled the cotton-top tamarin in which work is underway to determine the etiology of colitiswhich has been determined to result from environmental stress. Results of work on the cotton-toptamarin in its natural habitat in Columbia, South America shows no inflammatory bowel diseaseor colon cancer in the wild living monkeys. The project investigates neural pathways from brainto colon involved in stress initiated colitis in the tamarin model. EQUIPMENT AND TECHNIQUES Research approaches include electrophysiological recording with microelectrodes or patchclamp technology of electrical and synaptic behavior of neurons of the enteric nervous system orenteric glial cells in culture. Included also is intracellular dye marking for morphologicalassessment of enteric neurons, immunocytochemical localization of neurotransmitters in theenteric nervous system and assay of adenylate cyclase activity in signal transductionmechanisms in enteric neurons in freshly isolated ganglia and in enteric neuronal cell cultures. REPRESENTATIVE PUBLICATIONS. Wood JD, and Peck OC (1999) Colitis and colon cancer in the cotton-top tamarin. InfectiousPathogens in Gastrointestinal and Hepatic Disorders, ed. Guglietta A, and Lirussi F. Barcelonarous Scientific Press, pp.135-146. Wood JD (1999) Neurotransmission at the interface of sympathetic and enteric divisions of theautonomic nervous system. Chinese Journal of Physiology, 42: 201-210 Xia Y, Hu HZ, Liu S, Pothoulakis C, and Wood JD (2000) Clostridium difficile toxin-A excitesenteric neurons and suppresses sympathetic neurotransmission in the guinea-pig. Gut, (in press). Wood JD, Peck OC, Tefend KS, Stonerook MJ, Caniano DA, Mutabagani KH, Lohtï¿½k S, andSharma HM (2000) Evidence that colitis is initiated by environmental stress and sustained byfecal factors in the cotton-top tamarin (Saguinus oedipus). Digestive Diseases and Sciences, 45:385-393. Wood J.D. (2000). Neuropathy in the brain-in-the-gut. European J. Gastroenterology andHepatology 12: 1-4. LECTURE ON IRRITABLE BOWEL SYNDROME To view the lecture: ï¿½Neurophysiology of brain-gut interactions during stressï¿½ by Dr. J.D. Woodgo to www.conference-cast.com/ibs. First, click on ï¿½proceed without registeringï¿½, then on ï¿½Lecturesï¿½ A RealPlayer plug-in is required to view the lecture. A free RealPlayer 7 Basic plug-in isavailable at www.real.com. lets go back to the basics though.Does stress cause IBS or similar disorders in the digestive tract?Does stress exacerbate symptoms in people who already have these disorders?What kind of stress are the worst and will the problems go away if stress is decreased? http://www.med.ucla.edu/ndp/Newsletters/Fall99Stress.htm


----------



## eric (Jul 8, 1999)

Jared, ya did notice the post I posted by Dr Mayer yes.







He is a major researcher in IBS.There is still no direct proof stress causes IBS, but yes they may show that stress has to be a part of it to start it. We also need to seperate the different stressor and anxiety and emotions themselves.That no immunlogists or people who understand immunology is bull, some of the worlds best like Dr Gershon and Dr Mayer and Dr Jackie Wood.Lets just look at Woods credentials for a moment.Jackie D Wood, PhD Professor, Departments of Physiology and Cell Biology, andInternal Medicine Ph.D.: University of Illinois Postdoctoral Training: University of Illinois, Dr. C. Ladd Prosser (614) 292-4888 FAX (614) 292-4888 email: wood.13###osu.edu RESEARCH AREA Neurophysiology of the enteric nervous system and entericneuro-immuno-physiology. CURRENT RESEARCH The general aim of the research is to advance understanding of physiological control ofmammalian gastrointestinal functions in health and disease states. Intestinal behavior emergesfrom coordinated activity of the musculature, mucosal epithelium and blood vasculature.Organized behavior of these effector systems is determined by the enteric nervous system inconcert with input from the cephalic brain. The enteric nervous system is recognized as anindependent integrative system that behaves like a minibrain with synaptic microcircuitspositioned close to the effector systems it controls. The enteric nervous system consists ofsensory neurons, interneurons and motor neurons to the effector systems. Interneuronalmicrocircuits process sensory information, contain a library of programs that determine gutbehavior during different digestive states and control the outflow of information in motorneurons. These functions involve the same and additional arrays of synaptic events andneurotransmitters (eg., neuropeptides, biogenic amines and acetylcholine) as the brain and spinalcord. My research investigates electrical and synaptic behavior of enteric neurons in the variousspecialized regions of the gastrointestinal tract. Apart from the brain-in-the-gut, the digestive tract is recognized as the organ system with thegreatest concentration of immune cells in the body. In its position at one of the dirtiest ofinterfaces between the body and outside world, the intestinal mucosal immune systemcontinuously encounters dietary antigens, bacteria, viruses and toxins. Physical and chemicalbarriers at the epithelial interface are insufficient to exclude fully the large antigen load therebyallowing chronic challenges to the mucosal immune system. Studies with antigen sensitized animal models in my laboratory discovered directcommunication between the mucosal immune system and the minibrain in the intestine. Thecommunication is meaningful and results in adaptive behavior of the bowel in response tocircumstances within the lumen that are threatening to the functional integrity of the wholeanimal. Communication is chemical in nature (paracrine) and incorporates specialized sensingfunctions of the immune cells for specific antigens together with the capacity of the entericnervous system for intelligent interpretation of the signals. Immuno-neural integration progressessequentially beginning with immune detection followed by signal transfer to entericmicrocircuits followed by neural interpretation and then selection of a specific neural programof coordinated mucosal secretion and motor propulsion that effectively clears the antigenic threatfrom the intestinal lumen. Experimental approaches to immuno-neural interaction brings togetherthe disciplines of mucosal immunology and enteric neurophysiology. Included in the research on neuroimmunology is an animal model for idiopathic ulcerative colitisand colon cancer. The animal model for inflammatory bowel disease is a newworld monkeycalled the cotton-top tamarin in which work is underway to determine the etiology of colitiswhich has been determined to result from environmental stress. Results of work on the cotton-toptamarin in its natural habitat in Columbia, South America shows no inflammatory bowel diseaseor colon cancer in the wild living monkeys. The project investigates neural pathways from brainto colon involved in stress initiated colitis in the tamarin model. EQUIPMENT AND TECHNIQUES Research approaches include electrophysiological recording with microelectrodes or patchclamp technology of electrical and synaptic behavior of neurons of the enteric nervous system orenteric glial cells in culture. Included also is intracellular dye marking for morphologicalassessment of enteric neurons, immunocytochemical localization of neurotransmitters in theenteric nervous system and assay of adenylate cyclase activity in signal transductionmechanisms in enteric neurons in freshly isolated ganglia and in enteric neuronal cell cultures. REPRESENTATIVE PUBLICATIONS. Wood JD, and Peck OC (1999) Colitis and colon cancer in the cotton-top tamarin. InfectiousPathogens in Gastrointestinal and Hepatic Disorders, ed. Guglietta A, and Lirussi F. Barcelonarous Scientific Press, pp.135-146. Wood JD (1999) Neurotransmission at the interface of sympathetic and enteric divisions of theautonomic nervous system. Chinese Journal of Physiology, 42: 201-210 Xia Y, Hu HZ, Liu S, Pothoulakis C, and Wood JD (2000) Clostridium difficile toxin-A excitesenteric neurons and suppresses sympathetic neurotransmission in the guinea-pig. Gut, (in press). Wood JD, Peck OC, Tefend KS, Stonerook MJ, Caniano DA, Mutabagani KH, Lohtï¿½k S, andSharma HM (2000) Evidence that colitis is initiated by environmental stress and sustained byfecal factors in the cotton-top tamarin (Saguinus oedipus). Digestive Diseases and Sciences, 45:385-393. Wood J.D. (2000). Neuropathy in the brain-in-the-gut. European J. Gastroenterology andHepatology 12: 1-4. LECTURE ON IRRITABLE BOWEL SYNDROME To view the lecture: ï¿½Neurophysiology of brain-gut interactions during stressï¿½ by Dr. J.D. Woodgo to www.conference-cast.com/ibs. First, click on ï¿½proceed without registeringï¿½, then on ï¿½Lecturesï¿½ A RealPlayer plug-in is required to view the lecture. A free RealPlayer 7 Basic plug-in isavailable at www.real.com. lets go back to the basics though.Does stress cause IBS or similar disorders in the digestive tract?Does stress exacerbate symptoms in people who already have these disorders?What kind of stress are the worst and will the problems go away if stress is decreased? http://www.med.ucla.edu/ndp/Newsletters/Fall99Stress.htm


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## AZmom1 (Dec 6, 1999)

Back to basics.According to Ernest Rossi PhD:


> quote: When our emotional state is optimal, we are hardly ever aware of the enteric system's automatic activity. When we are emotionally upset, however, the entire gastrointestinal tract can express our discomfort. The sensitivity of the gastrointestinal tract to mental stress is one of the most widely recognized manifestations of psychosomatic problems.


I think we can all agree stress causes upset stomachs. Does it cause IBS? What makes us have IBS and others only temporary upset stomachs? Maybe we channel our stress towards our gut, rather that deal directly with the stress? Could this be why hypnotherapy and CBT works so well for IBS? Perhaps learning to reframe and rechannel the stress signals into appropriate patterns allows the body to heal itself.AZ


----------



## AZmom1 (Dec 6, 1999)

Back to basics.According to Ernest Rossi PhD:


> quote: When our emotional state is optimal, we are hardly ever aware of the enteric system's automatic activity. When we are emotionally upset, however, the entire gastrointestinal tract can express our discomfort. The sensitivity of the gastrointestinal tract to mental stress is one of the most widely recognized manifestations of psychosomatic problems.


I think we can all agree stress causes upset stomachs. Does it cause IBS? What makes us have IBS and others only temporary upset stomachs? Maybe we channel our stress towards our gut, rather that deal directly with the stress? Could this be why hypnotherapy and CBT works so well for IBS? Perhaps learning to reframe and rechannel the stress signals into appropriate patterns allows the body to heal itself.AZ


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## Mike NoLomotil (Jun 6, 2000)

Try as I might, once again I cannot find where this was said: _________________________________"['That no immunlogists or people who understand immunology']is bull, some of the worlds best like Dr Gershon and Dr Mayer and Dr Jackie Wood..." ___________________________________Never said anything about "no immunologists or people who undrstood immunology"...I DID say this: ____________________________________"Until the work of the top European docs studying very specifically the immunologic function of the bowel directly, and quantifying the specific markers which must be quantified to assess immune function, the whole of the work on so called IBS work is incomplete as it has not been integrated" ____________________________________So this does not say that that there are "no immunologists..." etc. To suggest that I said that indeed is "bull" in itself. There are immunologists and allergists doing direct, in vivo jejunal isolation studies (intralumenal and laparoscopic) which have isolated specific proinflammtory markers and cellular responses provocable by specific dietary challenges, and which are ablated when the provocation is removed.These are not animal model studies these are humans with IBS symtpoms who are food-provocation positive non-atopic, RAST negative etc. Very specific and very typical of the person who shows up in the PCPs office a thousand times a day with IBS-d or cyclic symptoms who comes up test-negative to all standard investigations used in the differential diagnosis ending up on therapuies which often have little positive benefit in the long run other than increased pharmaceutical dependency.There was no mention of credentials, nor should one deign to try to create "credential matching contest" with the likes of Brostoff, Bengtsson, Tornbloom, Stefanini, Kniker... whomever... It is not relevant and there is no way to "win" per se since their credentials in this area of investigation are impressive as well. It's the results that matter. So I won't go posting resumes and bibliographies again etc as it is not really the issue.So what I said, again, as always, is that this is an important piece of the puzzle that needs to be integrated with all the other findings when setting forth postulates about "IBS".That seems pretty simple and logical, and it really does not matter if it is a GI doc, PCP, allergist, psychiatrist, or dentist who did not think about that work or disregards it...exclusion is exclusion. It has always been so odd to me over the last decade how many people, physicians and non-physicians, get so annoyed by the fact that there are ways and means to reduce or eliminate the symptoms of IBS-d and cyclic IBS with specific dietary manipulation by isolating cellular immune and tissue immune and non-immune reactions to dietary components.Folks even go so far as to try to dissuade people from believeing their own remission of symptoms on that basis, even to go so far as to indignently state it is "impossible" to the now-asymptomatic and drug-free patient standing before them.I'll even bet that someone would try to suggest "illusion" even to one very interesting patient one doctor has on the protocol now who has had the diagnosis of IBS and apparently comorbid Cyclic Vomiting Syndrome whose symptoms have been reduced by at least 70% after only about 2 weeks is also hallucinating that she has stopped her 36 hour bouts of non-stop vomiting and uncontrollable diarrhea....in spite of the fact her tested sensitivities correlate to her diet and symptom onset.Yes its foolishness....has little if anything to do with each other. Thank goodness nobody told her body, or the other peoples' bodies.







Eat well. Think Well. be Well.MNL


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## Mike NoLomotil (Jun 6, 2000)

Try as I might, once again I cannot find where this was said: _________________________________"['That no immunlogists or people who understand immunology']is bull, some of the worlds best like Dr Gershon and Dr Mayer and Dr Jackie Wood..." ___________________________________Never said anything about "no immunologists or people who undrstood immunology"...I DID say this: ____________________________________"Until the work of the top European docs studying very specifically the immunologic function of the bowel directly, and quantifying the specific markers which must be quantified to assess immune function, the whole of the work on so called IBS work is incomplete as it has not been integrated" ____________________________________So this does not say that that there are "no immunologists..." etc. To suggest that I said that indeed is "bull" in itself. There are immunologists and allergists doing direct, in vivo jejunal isolation studies (intralumenal and laparoscopic) which have isolated specific proinflammtory markers and cellular responses provocable by specific dietary challenges, and which are ablated when the provocation is removed.These are not animal model studies these are humans with IBS symtpoms who are food-provocation positive non-atopic, RAST negative etc. Very specific and very typical of the person who shows up in the PCPs office a thousand times a day with IBS-d or cyclic symptoms who comes up test-negative to all standard investigations used in the differential diagnosis ending up on therapuies which often have little positive benefit in the long run other than increased pharmaceutical dependency.There was no mention of credentials, nor should one deign to try to create "credential matching contest" with the likes of Brostoff, Bengtsson, Tornbloom, Stefanini, Kniker... whomever... It is not relevant and there is no way to "win" per se since their credentials in this area of investigation are impressive as well. It's the results that matter. So I won't go posting resumes and bibliographies again etc as it is not really the issue.So what I said, again, as always, is that this is an important piece of the puzzle that needs to be integrated with all the other findings when setting forth postulates about "IBS".That seems pretty simple and logical, and it really does not matter if it is a GI doc, PCP, allergist, psychiatrist, or dentist who did not think about that work or disregards it...exclusion is exclusion. It has always been so odd to me over the last decade how many people, physicians and non-physicians, get so annoyed by the fact that there are ways and means to reduce or eliminate the symptoms of IBS-d and cyclic IBS with specific dietary manipulation by isolating cellular immune and tissue immune and non-immune reactions to dietary components.Folks even go so far as to try to dissuade people from believeing their own remission of symptoms on that basis, even to go so far as to indignently state it is "impossible" to the now-asymptomatic and drug-free patient standing before them.I'll even bet that someone would try to suggest "illusion" even to one very interesting patient one doctor has on the protocol now who has had the diagnosis of IBS and apparently comorbid Cyclic Vomiting Syndrome whose symptoms have been reduced by at least 70% after only about 2 weeks is also hallucinating that she has stopped her 36 hour bouts of non-stop vomiting and uncontrollable diarrhea....in spite of the fact her tested sensitivities correlate to her diet and symptom onset.Yes its foolishness....has little if anything to do with each other. Thank goodness nobody told her body, or the other peoples' bodies.







Eat well. Think Well. be Well.MNL


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## ohnometo (Sep 20, 2001)

I need to respond to this post....I am one of the people who has been to ALL types of Dr's and to the hospital's, 1,0000's of times...Have had all kinds of test and even at one of the leading Hospitals in the United States.....Have been to different therapist and yes I am one of those who got dependent on "Pills" many years ago...I have had allergy test (skin prick) and everything come back ok on that...I have had this problem for 40 years !!! I have had every test, every light, every scope, at all ends a number of times...All is well...So I come to this board back in the Fall reading alot of post and got very interested in this food intolerance...I always had an idea that something was going on besides stressssss..Yes, I have stress and anxiety in my life but who wouldn't and I do believe that stress can play a part in my IBS-D there is no doubt about it...SoI decided to try LeapAllergy just to see if maybe I had a food intolerance to something...and it come back some of my trigger foods the number #1 being apple I have had all my life....I drank that all of my life, eat it, baked with it, ect...I have been sick since my first hospital admission in 1961 with my stomach, D, nausea, vomiting, flushing of the face, joints hurting, and I can go on and on...After I got my results back from Leap and saw apple was very high along with some other trigger foods that I have been giving up my symptoms seem to be getting better..I know it will take alittle time for everything to get out of my system but in the last 2 weeks, my D has gotten better, all of my belching is getting better, I havent throwed-up one time..I have felt sick a day or so but that was it. I have only had trouble once with D and that was just alittle bit today....I just want to say please dont put down people that food intolerance "might" play a part in their IBS-D because it might be the only hope that maybe they can get things under control alittle better...I have really been through HELL like alot of other here on the board...So as I work on getting the foods out of my system and work on my stress level there is a chance that I wont have to suffer as much as I have....Thanks Mike for everything you have done for me and others you have really put hope back in my life !!!! Eric, thanks to you for all you have posted about the level that stress plays with IBS....I wouldn't have a chance here in life dealing with IBS and Cyclic Vomiting Syndrome.....So the wording below says it all for me and I for one dont want to go through the addiction to pharmaceutical dependencyagain..I have been there and it isnt a nice place to be...Trust Me***********These are not animal model studies these are humans with IBS symtpoms who are food-provocation positive non-atopic, RAST negative etc. Very specific and very typical of the person who shows up in the PCPs office a thousand times a day with IBS-d or cyclic symptoms who comes up test-negative to all standard investigations used in the differential diagnosis ending up on therapuies which often have little positive benefit in the long run other than increased pharmaceutical dependency.


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## ohnometo (Sep 20, 2001)

I need to respond to this post....I am one of the people who has been to ALL types of Dr's and to the hospital's, 1,0000's of times...Have had all kinds of test and even at one of the leading Hospitals in the United States.....Have been to different therapist and yes I am one of those who got dependent on "Pills" many years ago...I have had allergy test (skin prick) and everything come back ok on that...I have had this problem for 40 years !!! I have had every test, every light, every scope, at all ends a number of times...All is well...So I come to this board back in the Fall reading alot of post and got very interested in this food intolerance...I always had an idea that something was going on besides stressssss..Yes, I have stress and anxiety in my life but who wouldn't and I do believe that stress can play a part in my IBS-D there is no doubt about it...SoI decided to try LeapAllergy just to see if maybe I had a food intolerance to something...and it come back some of my trigger foods the number #1 being apple I have had all my life....I drank that all of my life, eat it, baked with it, ect...I have been sick since my first hospital admission in 1961 with my stomach, D, nausea, vomiting, flushing of the face, joints hurting, and I can go on and on...After I got my results back from Leap and saw apple was very high along with some other trigger foods that I have been giving up my symptoms seem to be getting better..I know it will take alittle time for everything to get out of my system but in the last 2 weeks, my D has gotten better, all of my belching is getting better, I havent throwed-up one time..I have felt sick a day or so but that was it. I have only had trouble once with D and that was just alittle bit today....I just want to say please dont put down people that food intolerance "might" play a part in their IBS-D because it might be the only hope that maybe they can get things under control alittle better...I have really been through HELL like alot of other here on the board...So as I work on getting the foods out of my system and work on my stress level there is a chance that I wont have to suffer as much as I have....Thanks Mike for everything you have done for me and others you have really put hope back in my life !!!! Eric, thanks to you for all you have posted about the level that stress plays with IBS....I wouldn't have a chance here in life dealing with IBS and Cyclic Vomiting Syndrome.....So the wording below says it all for me and I for one dont want to go through the addiction to pharmaceutical dependencyagain..I have been there and it isnt a nice place to be...Trust Me***********These are not animal model studies these are humans with IBS symtpoms who are food-provocation positive non-atopic, RAST negative etc. Very specific and very typical of the person who shows up in the PCPs office a thousand times a day with IBS-d or cyclic symptoms who comes up test-negative to all standard investigations used in the differential diagnosis ending up on therapuies which often have little positive benefit in the long run other than increased pharmaceutical dependency.


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## moldie (Sep 25, 1999)

quote:_________________________________________________The above tone you just heard was just a test of the Emergency Broadcast System..Had this been a real emergency..you would have been given real and accurate information from real and well-respected IBS experts from around the globe. This concludes this test of the Emergency Broadcast system.___________________________________________________Of course you will never hear anything soon because most of the so-called "IBS experts" are gastroenterologists who have no clue but to lump all IBS patients as "head cases" like they have done for years. Most Physicians in this category, (and flux) have such big egos that they would hate to see that all they claimed (like ulcers due to stress) was inaccurate. They failed miserably in this area, as they have failed miserably in IBS. A waste-basket label for anybody's bowel who is irritated. They know that they would lose a lot of patients if the truth got out, and the allergists, infection specialists, and immunologists, who are aware of the connection as to what can cause an irritable bowel, would then be able to take the credit where the credit is due. Besides this, all those medications that they tauted were the answer to everyone's IBS problem would be uncovered as only a band-aid approach to placate the masses of IBS patients all these years, until they really found out what was causing it. But there is no real need to find out, because IBS patients are not going to die anytime soon from this syndrome, only be doomed to suffer misery for the rest of their lives, so we can wait, because there is just not enough funding to go around. At least ulcer patients actually were in danger of losing their lives by bleeding to death. Perhaps there have been some patients who have been close to death from intestinal infections that had been overlooked and then ultimately caught when they were finally admitted to the hospital and undergone testing for this possibility. Doctors need to start listening to each other and their patients instead of trying to separate themselves because their egos get in the way.Sure you can help control your symptoms and alleviate some of the spasms by antispasmodics and even relaxation, but you can help prevent the spasms from beginning by avoiding the irritatants to begin with, and if their is an actual infection, then treating it. If you do have a mental/emotional problems that seem to set off your GI distress, then seek an therapist. But, if your GI distress seems not to follow "stress" triggors, but seems to be associated with consuming certain foods/medication, then seek out a qualified food/chemical allergists who can help you pinpoint them. __


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## moldie (Sep 25, 1999)

quote:_________________________________________________The above tone you just heard was just a test of the Emergency Broadcast System..Had this been a real emergency..you would have been given real and accurate information from real and well-respected IBS experts from around the globe. This concludes this test of the Emergency Broadcast system.___________________________________________________Of course you will never hear anything soon because most of the so-called "IBS experts" are gastroenterologists who have no clue but to lump all IBS patients as "head cases" like they have done for years. Most Physicians in this category, (and flux) have such big egos that they would hate to see that all they claimed (like ulcers due to stress) was inaccurate. They failed miserably in this area, as they have failed miserably in IBS. A waste-basket label for anybody's bowel who is irritated. They know that they would lose a lot of patients if the truth got out, and the allergists, infection specialists, and immunologists, who are aware of the connection as to what can cause an irritable bowel, would then be able to take the credit where the credit is due. Besides this, all those medications that they tauted were the answer to everyone's IBS problem would be uncovered as only a band-aid approach to placate the masses of IBS patients all these years, until they really found out what was causing it. But there is no real need to find out, because IBS patients are not going to die anytime soon from this syndrome, only be doomed to suffer misery for the rest of their lives, so we can wait, because there is just not enough funding to go around. At least ulcer patients actually were in danger of losing their lives by bleeding to death. Perhaps there have been some patients who have been close to death from intestinal infections that had been overlooked and then ultimately caught when they were finally admitted to the hospital and undergone testing for this possibility. Doctors need to start listening to each other and their patients instead of trying to separate themselves because their egos get in the way.Sure you can help control your symptoms and alleviate some of the spasms by antispasmodics and even relaxation, but you can help prevent the spasms from beginning by avoiding the irritatants to begin with, and if their is an actual infection, then treating it. If you do have a mental/emotional problems that seem to set off your GI distress, then seek an therapist. But, if your GI distress seems not to follow "stress" triggors, but seems to be associated with consuming certain foods/medication, then seek out a qualified food/chemical allergists who can help you pinpoint them. __


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## Guest (Dec 28, 2001)

IBS is absolutely caused by stress. It is also caused by diet. . If you go to a doc, and he or she prescribes an anti depressant, this will not help, only hurt the problem. Why? Well you need to directly deal with the problem instead of masking it. If you break your leg and the doc gives you a ton of painkillers, the pain may go away but you will need to fix the broken leg so it can heel. These "drugs" mask the pain. Prosac, Paxil, mask depression, anxiety, etc. You need to fix what happened that caused the depression in the first place. . You are always going to have stress in your life it is how you deal with it that is going to help you. You need to start skilled relaxation, i.e meditation 2 times a day for 20 minutes each. You also need to start a diet that does not included any refined foods, and you need to exercise a minimum of 4 times a week.


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## Guest (Dec 28, 2001)

IBS is absolutely caused by stress. It is also caused by diet. . If you go to a doc, and he or she prescribes an anti depressant, this will not help, only hurt the problem. Why? Well you need to directly deal with the problem instead of masking it. If you break your leg and the doc gives you a ton of painkillers, the pain may go away but you will need to fix the broken leg so it can heel. These "drugs" mask the pain. Prosac, Paxil, mask depression, anxiety, etc. You need to fix what happened that caused the depression in the first place. . You are always going to have stress in your life it is how you deal with it that is going to help you. You need to start skilled relaxation, i.e meditation 2 times a day for 20 minutes each. You also need to start a diet that does not included any refined foods, and you need to exercise a minimum of 4 times a week.


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## GailSusan (Dec 23, 2000)

I'm just a layperson suffering from IBS-C, but what Mike NoLo had to say about the parallels between IBS and medical science's early understanding of pulmonary dysfunctions seems to ring true from my own personal experience with this illness. I do have a sensitive nervous system that overreacts to stress and always has. However, I don't think I would have developed IBS had it not been for contracting a parasitic infection in Mexico and then food poisoning three years later. With each of these "gut wretching" illnesses I experienced chronic IBS problems that got worse. I also experienced food triggers that exacerbated my IBS symptoms, such as onions or cantalope. I went through hypnotherapy and CBT with trained psychologists, which helped to some degree. Three years ago I was in a clinical drug trial for Zelnorm and ALL my IBS symptoms went away. I was amazed as I thought at least some of the symptoms had to be due to stress or food allergies. Then the clinical drug trial ended and I was thrown back into my IBS symptoms again. I used Mike's tapes and they did help although I didn't get through them all. I'm now on the Zelnorm again, but it's not working as well as it did three years ago. I don't know whether that is because I haven't figured out the right dosing or because I have an extraordinary amount of stress in my life right now. I find that I can eat virtually anything, although if I overdo the onions they can still bother me a bit and I haven't dared to try the cantalope. So I guess my own theory about my particular IBS in my body is that it is primarily physiological and responds best to one specific medication that targets serontonin type-4 receptors in the gut. However, I do know from experience that when I cannot get that drug, the hypnotherapy tapes and avoiding certain trigger foods was critical for me. I have very severe IBS symptoms, and also had to ensure adequate hydration, fiber, exercise, and respond to nature's calls without delay. I'm not an expert so I can't contribute to the ongoing discussion in this thread, but thought I'd add my own experience here as an IBSer who tries to take in what all you experts are saying and apply it to my own situation. Carry on!


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## GailSusan (Dec 23, 2000)

I'm just a layperson suffering from IBS-C, but what Mike NoLo had to say about the parallels between IBS and medical science's early understanding of pulmonary dysfunctions seems to ring true from my own personal experience with this illness. I do have a sensitive nervous system that overreacts to stress and always has. However, I don't think I would have developed IBS had it not been for contracting a parasitic infection in Mexico and then food poisoning three years later. With each of these "gut wretching" illnesses I experienced chronic IBS problems that got worse. I also experienced food triggers that exacerbated my IBS symptoms, such as onions or cantalope. I went through hypnotherapy and CBT with trained psychologists, which helped to some degree. Three years ago I was in a clinical drug trial for Zelnorm and ALL my IBS symptoms went away. I was amazed as I thought at least some of the symptoms had to be due to stress or food allergies. Then the clinical drug trial ended and I was thrown back into my IBS symptoms again. I used Mike's tapes and they did help although I didn't get through them all. I'm now on the Zelnorm again, but it's not working as well as it did three years ago. I don't know whether that is because I haven't figured out the right dosing or because I have an extraordinary amount of stress in my life right now. I find that I can eat virtually anything, although if I overdo the onions they can still bother me a bit and I haven't dared to try the cantalope. So I guess my own theory about my particular IBS in my body is that it is primarily physiological and responds best to one specific medication that targets serontonin type-4 receptors in the gut. However, I do know from experience that when I cannot get that drug, the hypnotherapy tapes and avoiding certain trigger foods was critical for me. I have very severe IBS symptoms, and also had to ensure adequate hydration, fiber, exercise, and respond to nature's calls without delay. I'm not an expert so I can't contribute to the ongoing discussion in this thread, but thought I'd add my own experience here as an IBSer who tries to take in what all you experts are saying and apply it to my own situation. Carry on!


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## BQ (May 22, 2000)

"Multi-modal disease management". Agreed. Although perhaps, since it seems we _are_ hair splitting, "disease" should be "symptoms"?


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## BQ (May 22, 2000)

"Multi-modal disease management". Agreed. Although perhaps, since it seems we _are_ hair splitting, "disease" should be "symptoms"?


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## Mike NoLomotil (Jun 6, 2000)

BowelQueen:







Agreed. The Disease Management Association of America would probably use the word "disease" and you and I would probably, if the hair were to be split, both agree on "symptom management". From a viewpoint of precise speech that would be correct and the former incorrect.







Oh PS...to the Molding One:"IBS patients are not going to die anytime soon from this syndrome, only be doomed to suffer misery for the rest of their lives, ...."Yes indeed, thus perpetuating the revenue stream. As I recall vaguely from an HMO study, the avg IBS patient expenditures for healthcare costs seem to be about $4,500 in the base year of diagnosis and $3,000-$3,500 per year every year after that in perpetuity. If you can reduce or eliminate the symptoms substantially in a bunch of the 70% who are d-types or cyclics by simply isolating the foods or additives which provoke the symptoms and then modify diet accurately, the beneficiaries of those expenditures stand to lose a major chunk of change. So we are like a perpetually renewable fiscal resource!Happy New Year!!! Gotta go go go (No not THAT way..go AWAY!)MNL


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## Mike NoLomotil (Jun 6, 2000)

BowelQueen:







Agreed. The Disease Management Association of America would probably use the word "disease" and you and I would probably, if the hair were to be split, both agree on "symptom management". From a viewpoint of precise speech that would be correct and the former incorrect.







Oh PS...to the Molding One:"IBS patients are not going to die anytime soon from this syndrome, only be doomed to suffer misery for the rest of their lives, ...."Yes indeed, thus perpetuating the revenue stream. As I recall vaguely from an HMO study, the avg IBS patient expenditures for healthcare costs seem to be about $4,500 in the base year of diagnosis and $3,000-$3,500 per year every year after that in perpetuity. If you can reduce or eliminate the symptoms substantially in a bunch of the 70% who are d-types or cyclics by simply isolating the foods or additives which provoke the symptoms and then modify diet accurately, the beneficiaries of those expenditures stand to lose a major chunk of change. So we are like a perpetually renewable fiscal resource!Happy New Year!!! Gotta go go go (No not THAT way..go AWAY!)MNL


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## eric (Jul 8, 1999)

For Gail and others on Post infectious IBS. http://www.med.unc.edu/medicine/fgidc/post_infestious.htm


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## eric (Jul 8, 1999)

For Gail and others on Post infectious IBS. http://www.med.unc.edu/medicine/fgidc/post_infestious.htm


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## GailSusan (Dec 23, 2000)

Thanks, Eric. That article says most people recover fully within 3 years, but my IBS has been with me for at least ten years now and has gotten worse over time. I agree with the article that the psychological component makes a big difference. I know that is a factor with me, but there is definitely something physiological going on that the medicine helps.


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## GailSusan (Dec 23, 2000)

Thanks, Eric. That article says most people recover fully within 3 years, but my IBS has been with me for at least ten years now and has gotten worse over time. I agree with the article that the psychological component makes a big difference. I know that is a factor with me, but there is definitely something physiological going on that the medicine helps.


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## eric (Jul 8, 1999)

Gail, the medicine zelnorm is helping serotonin signals one of the things the HT was doing for you also.Most people recover from the intial inflammation and the unfortunate ones such as ourselves develop IBS. This leaves the communication out of whack between the gut and the brain.


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## eric (Jul 8, 1999)

Gail, the medicine zelnorm is helping serotonin signals one of the things the HT was doing for you also.Most people recover from the intial inflammation and the unfortunate ones such as ourselves develop IBS. This leaves the communication out of whack between the gut and the brain.


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## Mike NoLomotil (Jun 6, 2000)

There are a number of etiologies for persistent post-infectious 'IBS" symptoms. "Out of whack brain communication" is one theory or postulate which may apply to a specific subpopulation. There are others. One phenomenon that is not a theory and which can and does alter the immunologic function of the gut persistently, thus can cause peristent d or cyclic symptoms, is the disruption of the gut flora which can and does occur. This can and does cause persistent low level "inflammatory" reactivity as dysbiosis will alter each aspect of the chain of physiologic events essential to normal "oral tolerance".The present difficulty is in a) finding a truly effective means of determining if dysbiosis is indeed the casual basis for the eprsistent aberrant inlfammatory response....that is, how to isolate the subpopulations accurately and then







what will the optimial protocol be, since each persosn flora is vast and unoque to a degree...so the ultimate "broad spectrum probiotic" may need to be develoepd to offset the effects of the "broad spectrum antibiotic".While immunomodualtion can apparently reduce or eliminate the aberrant immunocyte responses seen this is still symptomatic tratment if dysbisosi are the causal basis.Right now the most effective "reversal therapy" seems to be to kill the patients entire gut flora then re-instill the flora of a family member, since their flora will most likely be close to or the same as the patient.This, however, is not only extreme but impractical for widespread use. But it does indeed take care of the problem with a creative solution.MNL


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## Mike NoLomotil (Jun 6, 2000)

There are a number of etiologies for persistent post-infectious 'IBS" symptoms. "Out of whack brain communication" is one theory or postulate which may apply to a specific subpopulation. There are others. One phenomenon that is not a theory and which can and does alter the immunologic function of the gut persistently, thus can cause peristent d or cyclic symptoms, is the disruption of the gut flora which can and does occur. This can and does cause persistent low level "inflammatory" reactivity as dysbiosis will alter each aspect of the chain of physiologic events essential to normal "oral tolerance".The present difficulty is in a) finding a truly effective means of determining if dysbiosis is indeed the casual basis for the eprsistent aberrant inlfammatory response....that is, how to isolate the subpopulations accurately and then







what will the optimial protocol be, since each persosn flora is vast and unoque to a degree...so the ultimate "broad spectrum probiotic" may need to be develoepd to offset the effects of the "broad spectrum antibiotic".While immunomodualtion can apparently reduce or eliminate the aberrant immunocyte responses seen this is still symptomatic tratment if dysbisosi are the causal basis.Right now the most effective "reversal therapy" seems to be to kill the patients entire gut flora then re-instill the flora of a family member, since their flora will most likely be close to or the same as the patient.This, however, is not only extreme but impractical for widespread use. But it does indeed take care of the problem with a creative solution.MNL


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## Nicol (Aug 13, 2000)

Let me throw a wrench in all of this. I have absolutely no connection to stress and IBS. All of my triggers are food. I am more sensitive to certain foods during my menstrual cycle but stress has never been a factor. Now does anyone have an explaination for that? I always thought it was because I have IBD as well.


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## Nicol (Aug 13, 2000)

Let me throw a wrench in all of this. I have absolutely no connection to stress and IBS. All of my triggers are food. I am more sensitive to certain foods during my menstrual cycle but stress has never been a factor. Now does anyone have an explaination for that? I always thought it was because I have IBD as well.


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## norbert46 (Feb 20, 2001)

All this doggone argueing about food vs stess has made me so anxious that I ate a whole bag full of M&M's with peanuts and now I have the sh*ts!! Now what do you want "the box or the curtain, the curtain or the box?".














I once went to a psychologist that could prove to anyone with his tests that stress/anxiety did affect everyone. The question is does it affect your particular system in ways you don't realize. Does it make your gut spasm? The reason most MD's believe that IBS/D is caused by stress is because most of them believe they have experienced it themselves! My family MD told me years ago that the testing procedure for becoming a doctor involved many things including an oral test whereby you sit in a room with a group of critical MD's firing questions at you and expecting an immediate accurate answer. He said that when most interns left that testroom they rushed straight to the restroom and exploded on the toilet! I have tried many meds, quit many foods and other than a brief experience with Lotronex nothing has helped until I ordered Mike's Hypnotape program. So far for the first time in 35yrs I have been under control since July/2001 ! This may not be the "cure" for everyone but I would expect most people to obtain their money's worth of relief and relaxation. If you still need more relief I would look into the food intolerance/alergy factors before even thinking about using the psychmeds, my experiences/side effects were bad! Good luck, Norb


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## norbert46 (Feb 20, 2001)

All this doggone argueing about food vs stess has made me so anxious that I ate a whole bag full of M&M's with peanuts and now I have the sh*ts!! Now what do you want "the box or the curtain, the curtain or the box?".














I once went to a psychologist that could prove to anyone with his tests that stress/anxiety did affect everyone. The question is does it affect your particular system in ways you don't realize. Does it make your gut spasm? The reason most MD's believe that IBS/D is caused by stress is because most of them believe they have experienced it themselves! My family MD told me years ago that the testing procedure for becoming a doctor involved many things including an oral test whereby you sit in a room with a group of critical MD's firing questions at you and expecting an immediate accurate answer. He said that when most interns left that testroom they rushed straight to the restroom and exploded on the toilet! I have tried many meds, quit many foods and other than a brief experience with Lotronex nothing has helped until I ordered Mike's Hypnotape program. So far for the first time in 35yrs I have been under control since July/2001 ! This may not be the "cure" for everyone but I would expect most people to obtain their money's worth of relief and relaxation. If you still need more relief I would look into the food intolerance/alergy factors before even thinking about using the psychmeds, my experiences/side effects were bad! Good luck, Norb


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## eric (Jul 8, 1999)

Nicol, what you posted is almost or is a biological Miracle.Are you saying that you have no anxiety over your IBS or IBD? http://www.ccfa.org/medcentral/library/diet/braingut.htm


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## eric (Jul 8, 1999)

Nicol, what you posted is almost or is a biological Miracle.Are you saying that you have no anxiety over your IBS or IBD? http://www.ccfa.org/medcentral/library/diet/braingut.htm


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## GailSusan (Dec 23, 2000)

MNL, I never had D or cyclic symptoms, only C. I don't really know what the etiology is of my IBS, but as you say there is a school of thought that there are permanent effects from these parasitic and bacterial infections in the gut. I also don't know what has more impact on my IBS -- stress, medication or trigger foods, but it seems to me that when my IBS is active the one thing I have the most control over is trigger foods. I have found the hypnotherapy to be the most effective in controlling the effects of stress long-term and Klonopin for controlling short-term, urgent symptoms. Unlike, Nicole, I do see a direct connection between my IBS and my reaction to stress. However, ultimately, in my case, medication has had the most impact (the Zelnorm) in controlling my IBS symptoms. My experience with my body supports the multimodal theory of IBS.


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## GailSusan (Dec 23, 2000)

MNL, I never had D or cyclic symptoms, only C. I don't really know what the etiology is of my IBS, but as you say there is a school of thought that there are permanent effects from these parasitic and bacterial infections in the gut. I also don't know what has more impact on my IBS -- stress, medication or trigger foods, but it seems to me that when my IBS is active the one thing I have the most control over is trigger foods. I have found the hypnotherapy to be the most effective in controlling the effects of stress long-term and Klonopin for controlling short-term, urgent symptoms. Unlike, Nicole, I do see a direct connection between my IBS and my reaction to stress. However, ultimately, in my case, medication has had the most impact (the Zelnorm) in controlling my IBS symptoms. My experience with my body supports the multimodal theory of IBS.


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## eric (Jul 8, 1999)

agreed Gail, and all of the things you mentioned helped serotonin.Gail your really close to really understanding this more so you know.







If you want to continue really to learn more on IBS study serotonin/5ht receptors and what serotonin does. You'll be very happy you did.


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## eric (Jul 8, 1999)

agreed Gail, and all of the things you mentioned helped serotonin.Gail your really close to really understanding this more so you know.







If you want to continue really to learn more on IBS study serotonin/5ht receptors and what serotonin does. You'll be very happy you did.


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## adrian wium albertyn (May 8, 2000)

IBS by itself causes stress.


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## adrian wium albertyn (May 8, 2000)

IBS by itself causes stress.


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## Nicol (Aug 13, 2000)

I am IBS C and not D. I have a pretty stress free life, I am a really easy going person. I am not saying stress does not affect me, I am saying it does not affect my IBS. As for anxiety over my IBS/IBD, I did have a little this holiday wondering if I could eat Christmas dinner but it all turned out fine and I had no problems. Now if anxiety/stress affected me then I would have had problems no matter what I ate.


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## Nicol (Aug 13, 2000)

I am IBS C and not D. I have a pretty stress free life, I am a really easy going person. I am not saying stress does not affect me, I am saying it does not affect my IBS. As for anxiety over my IBS/IBD, I did have a little this holiday wondering if I could eat Christmas dinner but it all turned out fine and I had no problems. Now if anxiety/stress affected me then I would have had problems no matter what I ate.


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## norbert46 (Feb 20, 2001)

Nicol, now we can discuss stress/anxiety vs. IBS. If you had a terrible Christmas dinner and your IBS bothered you would you say that it was stress/anxiety? Can you think of doing anything that you "know" will set off your IBS? There is no "magic" pill that is going eliminate the IBS, there may be some on the market in the next few years that will help with the symptoms. You can investigate food intolerance by using the elimination diet methods. Medical testing will assure that you don't have a disease or organic problem. Now let me tell you that I don't think anyone of us has IBS "all in the head"! It is not something we do to ourselves that we can just conciously stop. But our bodies are "chemical factories" that can be unbalanced and cause problems. Many studies have shown that our attitudes/thinking and brain/mind do control the balance of these chemicals. Example: you see a child about to get in the street with cars zooming by. Your mind tells your body to dump the adreneline/norepinepherine directly into your bloodstream to give you instant energy and supernormal strength to go get that child and prevent a death or severe injury. Your brain/mind is constantly evaluating everything you sense(see,smell,hear,feel etc) in light of keeping your body ready to react. The hypnotape program just helps to undo any incorrect thoughts that cause a physical reaction that is unnecessary. You will feel the relaxation and if listening at bedtime you will get the best sleep of your life after a while on the program! It is not mind bending or any other BS that unknowledgeable folks may spout! It has no bad side effects and even a person without IBS would greatly benefit from the deep relaxation, my wife can testify to that! Good luck Norb


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## norbert46 (Feb 20, 2001)

Nicol, now we can discuss stress/anxiety vs. IBS. If you had a terrible Christmas dinner and your IBS bothered you would you say that it was stress/anxiety? Can you think of doing anything that you "know" will set off your IBS? There is no "magic" pill that is going eliminate the IBS, there may be some on the market in the next few years that will help with the symptoms. You can investigate food intolerance by using the elimination diet methods. Medical testing will assure that you don't have a disease or organic problem. Now let me tell you that I don't think anyone of us has IBS "all in the head"! It is not something we do to ourselves that we can just conciously stop. But our bodies are "chemical factories" that can be unbalanced and cause problems. Many studies have shown that our attitudes/thinking and brain/mind do control the balance of these chemicals. Example: you see a child about to get in the street with cars zooming by. Your mind tells your body to dump the adreneline/norepinepherine directly into your bloodstream to give you instant energy and supernormal strength to go get that child and prevent a death or severe injury. Your brain/mind is constantly evaluating everything you sense(see,smell,hear,feel etc) in light of keeping your body ready to react. The hypnotape program just helps to undo any incorrect thoughts that cause a physical reaction that is unnecessary. You will feel the relaxation and if listening at bedtime you will get the best sleep of your life after a while on the program! It is not mind bending or any other BS that unknowledgeable folks may spout! It has no bad side effects and even a person without IBS would greatly benefit from the deep relaxation, my wife can testify to that! Good luck Norb


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## Mike NoLomotil (Jun 6, 2000)

Comment: ___________________________________"Nicol, what you posted is almost or is a biological Miracle." ___________________________________No it's not at all. It is a very common type of symptom-set which you have misunderstood.She is trying to convey to you the exact experience that she and uncountable other persons, including myself, experienced with our "IBS": the episodes are not precipitated by stress nor anxiety they are and were precipiated by intolerance to specific dietary components.There is nothing "miraculous" or stupid about this at all requiring a response belittling the person for stating this experience. It is a factual reality. This is no different treatment than the doctor who ignores the patients explanations and dismisses the patient with the usual "That's impossible....".Typically, these patients primary stress is a CONSEQUENCE of the episodes not the PRECPIPITATOR of the episodes. This is what she is conveying. The anxiety and stress, which are a natural consequence in ANY human being losing bowel control, are not pathologic. The response may or may not AMPLIFY an episode which has otherwise already been precipiatetd by another stimulus (in this case a dietary component).From the time it began when I was 8 years old until I went into remission in my early 40's, nothing related to stress ever precipitated an IBS episode yet I was a GI cripple from food intolerance.I used to have to stand and deliver lectures in front of 400-600 people at medical conferences, and in front of college classes teaching, in front of groups of Doctors at major medical universtites to teach them certain aspects of pulmonary care technology and never had an episode of D precipitated by any anticipatory stress vis a vis the event.BUT if I was having a bad "d" epsiode (later learning it was from eating some wheat and tomatoe and basil the day before) and could not get out of the bathroom knowing that there were 200 people waiting on me to speak 30 minutes from now, yes, that would cause anyone stress. But not pathologic and I required, even after 40 years of IBS, no behavioral therapy to achieve remission, nor to unlearn any behavioral patterns imprinted as a consequence of the psychosocial aspects of my disease.So all that being said does not mean that I nor the many many others who do not suffer stress-precipitated episodes are "medical miracles" at all, it means our symptoms are precipitated by diet and we can manage them with dietary manipulation absent the need for any psychotherapy or hypnotherapy.MNL


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## Mike NoLomotil (Jun 6, 2000)

Comment: ___________________________________"Nicol, what you posted is almost or is a biological Miracle." ___________________________________No it's not at all. It is a very common type of symptom-set which you have misunderstood.She is trying to convey to you the exact experience that she and uncountable other persons, including myself, experienced with our "IBS": the episodes are not precipitated by stress nor anxiety they are and were precipiated by intolerance to specific dietary components.There is nothing "miraculous" or stupid about this at all requiring a response belittling the person for stating this experience. It is a factual reality. This is no different treatment than the doctor who ignores the patients explanations and dismisses the patient with the usual "That's impossible....".Typically, these patients primary stress is a CONSEQUENCE of the episodes not the PRECPIPITATOR of the episodes. This is what she is conveying. The anxiety and stress, which are a natural consequence in ANY human being losing bowel control, are not pathologic. The response may or may not AMPLIFY an episode which has otherwise already been precipiatetd by another stimulus (in this case a dietary component).From the time it began when I was 8 years old until I went into remission in my early 40's, nothing related to stress ever precipitated an IBS episode yet I was a GI cripple from food intolerance.I used to have to stand and deliver lectures in front of 400-600 people at medical conferences, and in front of college classes teaching, in front of groups of Doctors at major medical universtites to teach them certain aspects of pulmonary care technology and never had an episode of D precipitated by any anticipatory stress vis a vis the event.BUT if I was having a bad "d" epsiode (later learning it was from eating some wheat and tomatoe and basil the day before) and could not get out of the bathroom knowing that there were 200 people waiting on me to speak 30 minutes from now, yes, that would cause anyone stress. But not pathologic and I required, even after 40 years of IBS, no behavioral therapy to achieve remission, nor to unlearn any behavioral patterns imprinted as a consequence of the psychosocial aspects of my disease.So all that being said does not mean that I nor the many many others who do not suffer stress-precipitated episodes are "medical miracles" at all, it means our symptoms are precipitated by diet and we can manage them with dietary manipulation absent the need for any psychotherapy or hypnotherapy.MNL


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## Mike NoLomotil (Jun 6, 2000)

Gail....Your experience vis a vis, supporting the multi-modal IBS approach, is indeed what many people who are independent thinkers come to when they step back and look at the diversity of symptom sets, history, and clinical presentation of various subpopulations of so called IBS. It is inescapable logic.Your symptom set is also, annoyingly, one of the more inscrutable as the presentation contains symptoms which are best described as "diametrically opposed". The 70% of people with d predominant or cyclic symptoms are and will be the easiest tio isolate causal basis for and will be the ones who find prophylactici relief first....the minority of c-types are going to have a tougher row to hoe to sort out the etiology. But you know, the world is round...we'll get there







MNL


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## Mike NoLomotil (Jun 6, 2000)

Gail....Your experience vis a vis, supporting the multi-modal IBS approach, is indeed what many people who are independent thinkers come to when they step back and look at the diversity of symptom sets, history, and clinical presentation of various subpopulations of so called IBS. It is inescapable logic.Your symptom set is also, annoyingly, one of the more inscrutable as the presentation contains symptoms which are best described as "diametrically opposed". The 70% of people with d predominant or cyclic symptoms are and will be the easiest tio isolate causal basis for and will be the ones who find prophylactici relief first....the minority of c-types are going to have a tougher row to hoe to sort out the etiology. But you know, the world is round...we'll get there







MNL


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## Nicol (Aug 13, 2000)

Norbert, you missed my other posts. I was simply stating that stress does not trigger my IBS. I have food triggers like Mike. I also suffer from Crohn's Disease which is predominately triggered by food as well as my menstrual cycle, which I mentioned in my other post. I do thank you for your reply to my post, it was greatly appreciated. My whole point was that I am one of the few who suffers from IBS with no gut/brain triggers.


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## Nicol (Aug 13, 2000)

Norbert, you missed my other posts. I was simply stating that stress does not trigger my IBS. I have food triggers like Mike. I also suffer from Crohn's Disease which is predominately triggered by food as well as my menstrual cycle, which I mentioned in my other post. I do thank you for your reply to my post, it was greatly appreciated. My whole point was that I am one of the few who suffers from IBS with no gut/brain triggers.


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