# IBS does cause inflammation....



## Jen37 (Nov 10, 2011)

Hi all. When I last saw my GI doctor, he told me that IBS can cause some level of inflammation and irritation to the intestines. I always assumed that IBS does not cause actual inflammation. I would have to think it does cause some irritation otherwise we would not have so much pain. He said back in the day IBS was referred to as mucus colitis. Is this right that IBS can cause inflammation on a low level???


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## Kathleen M. (Nov 16, 1999)

IBS does not cause what we classically think of as inflammation.The appearance of the colon in a colonoscopy will be normal. No redness, no ulceration like you see in inflammatory bowel disease that tends to cause bloody diarrhea (which is not what you see in IBS)The appearance in the biopsies will be normal and not what you see in microscopic colitis where there is a big increase in certain immune cells that tend to cause copious watery diarrhea predominately at night (which is not the usual IBS pattern)Now there are some changes in the immune system that can be considered a very low level of inflammation, but so low you would not detect it with any test normally used to measure inflammation (so no change in blood markers of inflammation even the most sensitive ones as well as no visible inflammation and no typical microscopic inflammation seen) and you do not need any inflammation to have extreme pain. Most of the pain in IBS seems to be more from nerves in the gut sending inappropriate signals or the "door" that keeps the sensations in the gut nerves being opened and sending the signals up to the brain.Trust me, nerve pain can cause extreme pain when there is no inflammation of any kind. I severed a nerve in my finger. The fingertip was completely numb for a long time. By the time the nerve grew back any inflammation from the cut and the healing was long gone. When the nerve finally regrew the endings it was as if someone was smashing my finger with a sledgehammer every time the tip brushed by anything for about 2 days before the nerve learned when it was OK to scream at full volume and when to use it's "inside voice". That pain had nothing to do with inflammation. It is not true that the one and only cause of pain in the body is inflammation. Ask anyone with diabetic neuropathy. No inflammation in what is hurting, but the pain can be really really bad (or people with amputated limbs that still feel pain in the body part that isn't there so can't be inflamed, that is all nerve pain).I think why Irritable bowel got the "irritable" and the "itis" was removed from the name is because if there is any symptom from inflammation it is extremely low level, and I don't know if we are sure the small changes in immune system are the sole cause of all the major, obvious and obnoxious symptoms that can be as bad or worse than the symptoms shared with Inflammatory Bowel Disease when you can see all the inflammation and it triggers all the blood markers for inflammation, or the immune system differences are seen as a result of something else being broken (like the nervous system controlling the gut).All that being said, there may be treatments that eventually come from the small changes we have found in the immune system, but they aren't going to stop any of the investigation into the nervous system problems (where most of the IBS specific drug design has come from) because they found some other things going on.


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## Jen37 (Nov 10, 2011)

I actually have had elevated C-reactive proteins levels as well as sed-rate levels for years now, on and off. All my doctors did not seem concerned about it though( I am guessing when you have somethig like crohns or UC these numbers would be very highly elevated. I was told I likely have some kind of undifferenciated connective tissue disease or something. These levels have been elevated on and off for the last 8 years, way before I had any lower intestinal issues though. I guess it makes sense about the nerve pain thing. I have a lot of health issues that are inflammatory by nature like the Interstitial Cystitis, so I do worry sometimes that I may have some inflammation in my intestines.( though my GI doc says he is sure I have IBS). I also get skin inflammation from allergies as well. I guess that is why my Gastro was saying it may be possible to have some low level inflammation in the intestines with IBS which would make some sense. I mean when you have dyspepsia, there is some visual imflammation that can be seen. I am not sure if this would apply with the intestines or not, just a thought.


Kathleen M. said:


> IBS does not cause what we classically think of as inflammation.The appearance of the colon in a colonoscopy will be normal. No redness, no ulceration like you see in inflammatory bowel disease that tends to cause bloody diarrhea (which is not what you see in IBS)The appearance in the biopsies will be normal and not what you see in microscopic colitis where there is a big increase in certain immune cells that tend to cause copious watery diarrhea predominately at night (which is not the usual IBS pattern)Now there are some changes in the immune system that can be considered a very low level of inflammation, but so low you would not detect it with any test normally used to measure inflammation (so no change in blood markers of inflammation even the most sensitive ones as well as no visible inflammation and no typical microscopic inflammation seen) and you do not need any inflammation to have extreme pain. Most of the pain in IBS seems to be more from nerves in the gut sending inappropriate signals or the "door" that keeps the sensations in the gut nerves being opened and sending the signals up to the brain.Trust me, nerve pain can cause extreme pain when there is no inflammation of any kind. I severed a nerve in my finger. The fingertip was completely numb for a long time. By the time the nerve grew back any inflammation from the cut and the healing was long gone. When the nerve finally regrew the endings it was as if someone was smashing my finger with a sledgehammer every time the tip brushed by anything for about 2 days before the nerve learned when it was OK to scream at full volume and when to use it's "inside voice". That pain had nothing to do with inflammation. It is not true that the one and only cause of pain in the body is inflammation. Ask anyone with diabetic neuropathy. No inflammation in what is hurting, but the pain can be really really bad (or people with amputated limbs that still feel pain in the body part that isn't there so can't be inflamed, that is all nerve pain).I think why Irritable bowel got the "irritable" and the "itis" was removed from the name is because if there is any symptom from inflammation it is extremely low level, and I don't know if we are sure the small changes in immune system are the sole cause of all the major, obvious and obnoxious symptoms that can be as bad or worse than the symptoms shared with Inflammatory Bowel Disease when you can see all the inflammation and it triggers all the blood markers for inflammation, or the immune system differences are seen as a result of something else being broken (like the nervous system controlling the gut).All that being said, there may be treatments that eventually come from the small changes we have found in the immune system, but they aren't going to stop any of the investigation into the nervous system problems (where most of the IBS specific drug design has come from) because they found some other things going on.


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## Kathleen M. (Nov 16, 1999)

Generally with an autoimmune disease you have pretty high levels. Unfortunately you can't tell what the inflammation is from as every infection as well as lot of other things can pop them up a little bit.And some people do run high or low on any given measurement (the normal range only covers 95% of healthy controls and often there is a space between normal and clinically relevant).If you have other health conditions that could effect them hard to blame just the intestines and only the intestines. And sometimes sed rate will go up just from oral contraceptives or other medications.Often with upper GI things in the stomach if the acid can get to the stomach lining for any reason you will see redness, so it can be pretty non-specific. That acid is neutralized as it goes into the small intestine.If you have a lot of problems with that low level kind of inflammation with allergies and other things you might consider an anti-inflammatory diet as some foods tend to reduce inflammation and others tend to crank it up see: http://www.drweil.com/drw/u/ART02012/anti-inflammatory-dietNow it can be hard meshing that with what foods may set off your IBS, but may be something to think about.


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## Jen37 (Nov 10, 2011)

Thanks Kathleen, I appreciate the info, very informative. Also thanks for the link for the foods that reduce inflammation. I am going to check it out.


Kathleen M. said:


> Generally with an autoimmune disease you have pretty high levels. Unfortunately you can't tell what the inflammation is from as every infection as well as lot of other things can pop them up a little bit.And some people do run high or low on any given measurement (the normal range only covers 95% of healthy controls and often there is a space between normal and clinically relevant).If you have other health conditions that could effect them hard to blame just the intestines and only the intestines. And sometimes sed rate will go up just from oral contraceptives or other medications.Often with upper GI things in the stomach if the acid can get to the stomach lining for any reason you will see redness, so it can be pretty non-specific. That acid is neutralized as it goes into the small intestine.If you have a lot of problems with that low level kind of inflammation with allergies and other things you might consider an anti-inflammatory diet as some foods tend to reduce inflammation and others tend to crank it up see: http://www.drweil.com/drw/u/ART02012/anti-inflammatory-dietNow it can be hard meshing that with what foods may set off your IBS, but may be something to think about.


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## Puppy3D (Jul 28, 2004)

anti intlammation food is not enough. you need supplemnets.check out this:http://www.ibsgroup.org/forums/topic/111532-here-is-my-cure-for-ibs/page__p__765789__hl__quercetin__fromsearch__1#entry765789http://www.sciencedaily.com/releases/2010/08/100819141950.htmhttp://www.ncbi.nlm.nih.gov/pubmed/19438846latest research from germany points out that not only immunecells are over active in ibs, also bacterial flora produces inflammation and fecal proteases. that irritates gut nerves burns gut lining. so maybe probiotic may help too. http://crohnsandibsbreakthrough.com/blog/?s=proteases


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## Kathleen M. (Nov 16, 1999)

I just worry a lot of people will take a few pills thinking that will do as much or more than their lifestyle choices. If you eat a highly inflammatory diet I don't know how much good the supplements will do. Why spend a lot of money on them if you are just going to undo everything with your food choices?Foods have a lot more in them than any given supplement or combo of supplements as well and it is hard to replicate dietary effects in capsule form.Not that supplements are a bad idea, but my sense is you can easily undo all the work supplements do with poor diet, and for most of history our bodies have worked with complex and varied sources of things rather than high doses of one or two things (and often things extracted from a food or herb do not have the same benefit as the food as a whole if you get enough testing done to really compare the two).


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## overitnow (Nov 25, 2001)

Kathleen M. said:


> I just worry a lot of people will take a few pills thinking that will do as much or more than their lifestyle choices. If you eat a highly inflammatory diet I don't know how much good the supplements will do. Why spend a lot of money on them if you are just going to undo everything with your food choices?Foods have a lot more in them than any given supplement or combo of supplements as well and it is hard to replicate dietary effects in capsule form.Not that supplements are a bad idea, but my sense is you can easily undo all the work supplements do with poor diet, and for most of history our bodies have worked with complex and varied sources of things rather than high doses of one or two things (and often things extracted from a food or herb do not have the same benefit as the food as a whole if you get enough testing done to really compare the two).


Absorbancy does play a major role in this, as well. I took a highly absorbed grape based supplement for years which treated my D well. This past year I have moved to Mexico and have found some effect of the fresh fruit, vegetables, and chicken and fish to have finally allowed me to eliminate even the supplement. During the earlier part of my recovery, the supplement was able to control the D, even as it allowed me to reincorporate "bad" foods. Likely I could have stopped the supplement earlier, but I did not want to have to eat a limited diet forever. It has certainly worked for me for the past 12-13 years.Mark


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## Jen37 (Nov 10, 2011)

I have been on probiotcs for years now. I eat pretty healthy already. I mean all my meats ( which I only eat baked or roasted chicken, turkey, or fish) they are all antibitoic free and are all natural, no preservatives. I also am gluten free, have been for over 6 years now. I try and buy all organic vegetables and fruits as well. I unfortuantely have had to be on a low dose antibitoic for the last few years to prevent the nasty urinary infections I was getting. ( I also have IC which complicates things and makes a person highly suspeptible to infections of the urinary tract). This sucks, as I hate being on any kind of antibiotics. They are bad for the body. But getting infections all the time is bad too. I tried everyting natural to stop the urinary infections back four years ago and NOTHING worked. That is why they put me on that low dose anti-B. I was taking probitocs way before that though, as this is what my one holistic doctor recommended I do. I will say that all my IBS issues started after I got a tummy flu a year and half ago that my hubby brought home( he is a teacher). That is when all my gut issues started. It seemed to go down hill from there....I agree that being on an anti-inflammatory diet does make sense. I mean it is mind boggling to see all the #### they put in foods these days. I just heard that they are finding higher levels of arsenic in rice. Pretty scary stuff. That is why I try and stay organic as possible.


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