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  1. #1
    Dahlia is offline Intermediate Member
    Join Date
    Jun 2008

    For those scared by their IBS Symptoms

    As there have been quite a few posts recently from people who are having a horrid time with IBS and feeling very anxious about it, I thought it might be useful to post a few pertinent excerpts from a book I have.

    The book is called 'Overcoming Irritable Bowel Syndrome' by Jonathan M. Berkowitz M.D. You can buy the book from Amazon and it has a wealth of information, both in terms of explaining why your body feels as it does and ways to overcome it. I haven't gone into huge amounts of detail here, due to copyright, but perhaps it will lead you to reading the book.

    Obviously we have a fantastic fact page on IBS already on the site, so I am writing about specific concerns members have had recently.

    - At least 20% of the population have IBS and it is the second most frequent reason for missing work (in the US).

    - There are 4 types: Abdominal Pain-Predominant, diarrhoea-predominant, constipation-predominant, and constipation/diarrhoea pre-dominant.

    - Symptoms tend to undergo a period of remission and exacerbation, often in response to predicatable factors such as stress/anxiety or a known irritant (e.g. wheat).

    - 25-50% of people with IBS experience nausea and heartburn as symptoms. Indigestion and acid reflux are also common.

    - Many people with IBS also experience urinary problems.

    - People with IBS have been shown to have lower thresholds for bowel pain, which could relate to how the brain processes information about activity in the bowel.

    - Abdominal pain is nearly always present and can range from mild to severe. It may be partially or completely resolved by defecation, only to come back later in the day. Bloating may also accompany the pain.

    - Abdominal pain is sometimes caused by eating, and relieved by going to the loo.

    - Pain can be dull, crampy and widespread, but also sharp and knifelike. It is not uncommon to have pain in multiple sites of the abdomen. It may radiate to the lower back.

    - The lower abdomen is often affected in terms of pain, esp. the left side.

    - Some people experience pain in the upper left abdomen or quadrant, which they may also feel in their chest. This is caused by gas and known as 'Splenic flexure syndrome'. The splenic flexure is part of the colon near the spleen and gas accumuates there as it sits high in the abdomen.

    - One trick to relieve pain in the upper left quadrant is to lie flat on your back and rasie your buttocks so they are higher than your abdomen. This way the gas rises naturally and travels to the rectum.

    - The bowel is hugely responsive to emotional and psychological factors. IBS can be a learned condition to stress, with the intestines becoming sensitised. This is why CBT and hynotherapy can help ease IBS.

    - The rapid bowel transit in some people with IBS decreases the time the body has to absorb gas, leaving more gas in the bowel (and more smelly!).

    - Another source of gas comes from swallowing air. Known as aerophagia, this mechanism plays a more significant role in people with anxiety, who tend to swallow more air. Hyperventilation is another factor in increased gas.

    - People with IBS suffer bloating, or the perception of bloating, often as they are 'gassy'.

    - Many people also pass small amount of stool, with whitish or clear mucus.

    - Constipation is one of the most common medical complaints, amongst the general population. IBS patients tend to have constipation for days or weeks, followed by a bout of diarrhoea. Most cases are caused by inadequate fibre intake.

    - For more than 90% of people, there is no identifiable reason for their constipation, and most of these will respond to increased fibre and water and taking exercise.

    - Constipated stoods are 'ribbon-like', 'pencil-thin', hard, or marble like. There will be a feeling of incompletion.

    - The longer the constipation goes on for, the more abdominal pain you will experience.

    - Most people feel the urge to defecate after breakfast and other meals.

    - IBS patients with diarrhoea will often need to defecate urgently after eating, often lots of gas is passed too.

    - It is unclear whether fibre works well for IBS-diarrhoea. For a minority of people it slows down the gut, but for many it exacerbates the problem. There are howevere different types of fibre - soluble vs. insoluble.

    - The Brain-Gut model shows that many people with IBS have autonomic nervous system dysfunction similar to those found in people with anxiety and depression. These systems stimulate each other, creating a vicious cycle of IBS, anxiety, and depression.

    - Oestrogen and hormones can impact on IBS symptoms, as can periods.

    - The pathways that control the bowels are also related to psychological disturbances - leading to a learned response.

    - One study showed that 77% of people surveyed had a psychiatric disorder just before or coinciding with their first IBS episode. It has been observed that IBS patients tend to have more concerns about their health (e.g. think they have cancer). These concerns have a dramatic effect on IBS symptoms and the likelihood of a poor treatment outcome.

    - However, it is not fair to say that IBS is purely psychological. IBS can initially start up after an infection, such as food poisoning or a virus.

    - Food allergies and intolerances can be partly to blame, in around 16-33% of cases. The most common offenders are alcohol, milk, eggs, caffeine, wheat, sorbitol, fatty foods, corn, sulfites and gas producing veg such as broccoli, sprouts, cabbage, cauliflower, onions. Smoking is also a culprit.

    - The only way to ascertain intolerances is to eliminate foods, keep a diary of what you eat and the symptoms, and reintroduce foods slowly one by one to see what happens.

    - If you identify a culprit food, do not be surprised that you experience IBS symptoms if you continue to eat it.

    - It's worth bearing in mind that some foods are blamed, but are not necessarily the culprit. When patients are told they have unwittingly eaten a food they believe they are intolerant to, they consequently show symptoms of IBS - despite not having been given the food in reality.

    - Certain vitmains and minerals, such as folic acid, Vitamin A, calcium, zinc, vitamin c, probiotics can all potentially help.

    - Acupuncture, CBT, Biofeedback and hypnotherapy have been shown to be very good for IBS. Exercise is also very important.

    - Prescription meds can also help.
    Last edited by Dahlia; 20-05-11 at 00:10.

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