Tuesday, May 7, 2013

What Is Irritable Bowel Syndrome?

Irritable Bowel Syndrome, or IBS, is a stress-related gastrointestinal disorder that affects one out of 10 folks. Not every person who suffers from IBS reports the illness. Because IBS is under-reported and hard to diagnose, nobody knows for sure how many folks truly have the disease. IBS is seen more frequently by family doctors than almost any other illness.

IBS symptoms come on suddenly and are terribly painful. Some of the most common symptoms are:.

Pain in the center of the abdominal area. IBS pain can be intermittent or constant sharp cramping.
Diarrhea and a change in stool.
Heartburn once eating or drinking.
Nauseated feelings.
Feelings of fullness or abdominal bloating.
Urgent need to use the toilet.
Feeling like the bowels won't completely empty.
IBS symptoms usually are part of other chronic conditions like chronic fatigue syndrome or fibromyalgia, such as:
Tiredness, fatigue, and malaise.
Muscular pains.
Sleep disorder or insomnia.
Sexual dysfunction.
Chronic headache.
Back pain, particularly in the lower back.

Medical testing of IBS sufferers typically reveals no physical abnormalities. IBS is diagnosed by ruling out other problems. IBS is assumed to be the matter if no alternative cause for the symptoms is revealed on medical tests.

Help is available for IBS however no single cure works on every one. No single drug can wipe out the symptoms of IBS, although some can help. IBS may be caused or worsened by anxiety and stress. Identifying what triggers IBS attacks is a vital part of managing the illness.

Hypnosis, stress management, biofeedback, and meditation are a number of the techniques used to manage IBS symptoms.

Cognitive Behavioral Therapy (*CBT) is one of the foremost effective treatments of IBS. CBT reduces IBS symptoms by teaching patients to 'reframe' stressful situations. Identifying the triggers that cause IBS attacks is vital to successful treatment. Triggers are totally different for every patient.
- *CBT: Cognitive behavioral treatment additionally referred to as cognitive behavioral remedies, is a psychotherapeutic method that targets to resolve issues regarding dysfunctional feelings, behaviors and cognitions by way of a objective-oriented, systematic procedure. The title is utilized in various how one can designate conduct remedy, cognitive treatment, and to seek advice from treatment based upon a mixture of elementary behavioral and cognitive research.

Lifestyle changes and reconsidering priorities is part of recovery from IBS. IBS patients are typically asked to record their symptoms in a journal during the first stages of the illness. Patients who journal will typically pinpoint factors that bring on their IBS attacks. Reluctance to make lifestyle changes or determine anxiety triggers is usually part of the matter which means journaling can be difficult.
IBS can not be cured by one treatment. Teaching IBS patients to better manage stress is important IBS patients must begin to more effectively manage their stress. Patients typically find that living in a way that minimizes or eliminates stress is difficult.
IBS symptoms can sometimes be helped by medication but only a doctor can decide. Medication does not help in each case. Pain management techniques can be a good part of treatment too.
Active participation of the patient is a crucial part of successful IBS treatment. IBS patients must help to identify which lifestyle changes need to be created to relieve symptoms.
IBS is treated with a mix of dietary changes, relaxation techniques, stress management, and lifestyle changes. A treatment approach that draws on a selection of methods is usually best. Medication is not the main methodology of treating IBS.
IBS is typically a condition that accompanies other chronic anxiety and pain disorders. Heredity could be a partial cause for IBS and other chronic pain and anxiety disorders.
Irritable Bowel Syndrome (IBS) is a chronic gastro-intestinal (GI) condition with no known cause or cure. Symptoms include diarrhea, constipation, cramping, gas, pain or bloating. Symptoms run in cycles lasting for days, months or years. IBS can be disabling and force many sufferers to feel like prisoners in their own homes.
Traditional intervention includes high fiber diets, antispasmodic and antidiarrhea medications, sedatives and antidepressants which offer relief only 25% of the time. Because IBS is not life threatening, is not a precursor to acute illness and is undetectable with diagnostic equipment, sufferers are usually told they have to live with it. Thankfully this is not the case. Hypnosis has been researched for over 20 years and stands alone as the most effective option for long-term IBS relief. Its success rate is consistently 70-95% and relief usually lasts at least two years. (Olafur S. Palsson, Psy.D)
IBS is an enormous problem affecting 35 million Americans and 4 of 5 are women. It is more common than asthma, diabetes, acid reflux and depression combined. IBS is responsible for 10% of all primary physician visits and is also the 2nd leading cause for employee absenteeism and costs the US 8 billion dollars a year.
Diagnosing IBS is no simple task. First the physician needs to rule out infections, parasites, lactose intolerance, Crohn's disease, celiac and gallbladder disease, dumping syndrome, ulcerative colitis and inflammatory bowel disease before an IBS diagnosis can be made.
The onset of symptoms ranges between the ages of 20-29 in adults and 9-11 in children. Some clients can trace the symptoms back to a traumatic event, illness or injury. Some begin having symptoms early in life for no apparent reason at all. IBS is also known to be generational. Many IBS sufferers go through life with no concept of what normal GI function is like.

Symptoms can be exacerbated by stress, chocolate, caffeine, alcohol, foods high in animal or vegetable fat, food dyes, artificial sweeteners, food or medication sensitivities or hormone fluctuation, but none are the cause. Some research indicates that IBS sufferers may have an abundance of specialized cells in the intestinal tract making them more reactive and sensitive. (Melissa J. Roth C.Ht., Ph.D.)

The irregularity of the GI tract is what is responsible for all the problems. If it moves too quickly the body doesn't absorb what it needs resulting in diarrhea. If it moves too slowly the body absorbs too much resulting in constipation. This erratic pattern can also dramatically affect how nutrients are absorbed and how well the colon absorbs waste out of the blood stream.

Hypnosis has a long history cluttered with myths, misinformation and manipulation. Most people only know about stage hypnosis but there is also a serious minded clinical side that is quickly establishing a foothold as a viable compliment to mainstream medicine. Hypnosis is the simple process of accessing subconscious thought which is where all of our habits, patterns, values and beliefs reside. With hypnosis clients are empowered to embrace healthier patterns of nutrition, exercise and to release unhealthy patterns like smoking in favor of more positive ones.
The subconscious mind is also our body's control center which regulates our inner network of complicated mechanisms. It regulates our heart and respiratory rate and controls the thousands of metabolic functions which occur automatically everyday of our lives. With unique access to this immensely powerful place hypnosis can also positively redirect specific areas of GI function, dramatically reduce stress, improve compliance with medication and diet regimes and also help clients see themselves as healthy and whole again. It gives them the feeling of control.
Hypnosis is by no means a magic pill. Success requires clients to be open to the process and motivated to assume responsibility for their recovery. Hypnotherapy for IBS relief involves up to several months of treatment and listening to recorded sessions at home. There are, however, some who do not respond as well as others. This includes clients over 50 years of age, those not open to the process and those with psychiatric disorders. One study indicates males with diarrhea as their major symptom as another group who do not experience as much relief. (Olafur S. Palsson, Psy.D)
The steady accumulation of positive scientific research is the reason hypnosis has finally begun to gain acceptance by the mainstream medical community. For over 20 years researchers like Olafur S. Palsson, Peter Whorwell, William Gonsalkorale and L.A. Houghton have been studying the benefits of hypnosis for IBS symptom relief. The following are brief descriptions of some of their findings.
One study compared 25 severe IBS clients treated with hypnosis to 25 patients with similar symptoms treated with other methods. The hypnosis group showed that in addition to significant IBS symptom relief they had fewer MD visits, lost less work time and rated an improved quality of life. Hypnosis clients unable to work before treatment went back to work afterwards. The study shows the economic benefits and improved health-related quality of life. (Houghton LA)
Another study which is the largest to date followed 250 IBS clients who were treated with 12 hypnosis sessions over a 3-month period and they also listened to recorded sessions at home. The conclusions showed dramatic improvement in all IBS symptoms. The average reduction in symptoms was more than 50% as well as increased quality of life and relief from anxiety and depression. (Gonsalkorale WM)
Lastly, the longest study to date treated and followed 204 IBS clients for up to 6 years. 71% showed immediate improvement, and 81% of this group was still improved years later. Quality of life scores were also still significantly improved at follow-up. Patients had less MD visits and required less medication long-term after hypnotherapy. Results indicate that most hypnosis clients benefit for at least five years. (Gonsalkorale WM)
Hypnosis isn't magic but can seem magical. Think of it as a daydream by design. It is a wonderful escape into an inner peacefulness that not only feels good but can be extremely good for you. In addition to offering IBS relief clients also become more relaxed in general, more focused and centered, and much less affected by the day-to-day distractions of life.

Irritable Bowel Syndrome (IBS) and Microscopic Colitis Symptoms Overlap

Symptoms of IBS and microscopic colitis overlap. In a group of biopsy proven microscopic colitis patients, there is noted that up to half have symptoms that meet diagnostic criteria for Irritable Bowel Syndrome (IBS). Microscopic colitis is diagnosed only by biopsies of the colon even when it appears normal. Symptom-based criteria for diagnosing IBS are not specific enough to rule out microscopic colitis. Some people with IBS have Mastocytic Enterocolitis, a newly recognized form of microscopic colitis characterized by increased numbers of mast cells in the intestinal lining. These cells can only be seen when special stains are applied to intestinal biopsies, a maneuver, not usually done by most pathologists or requested by most doctors performing intestinal biopsies.

PATIENTS WITH IBS SHOULD UNDERGO COLONOSCOPY WITH BIOPSIES OF NORMAL APPEARING INTESTINAL LINING

Patients suspected to have irritable bowel syndrome should undergo biopsies of the colon. This is absolutely necessary to exclude the possibility that they could have one of several forms of microscopic colitis. The diagnosis of microscopic colitis is made when biopsies of the colon have an increase in infection fighting or immune cells or deposits of excess collagen connective tissue in the lining of the digestive tract. In the most common form of microscopic colitis seen without special stains, excess lymphocyte white blood cells, or so called "intraepithelial lymphocytosis", seen under the microscope. This microscopic finding is present when the colon looks normal on the surface. Many doctors don't biopsy the colon when it looks normal despite obtaining a history of diarrhea from the patient. Microscopic colitis is a known treatable cause of diarrhea, bloating, gas and abdominal pain that can only be diagnosed by colon biopsies. In many patients who do get biopsies, spe cial stains are not ordered when the standard stains fail to reveal an abnormality. However, under special stains, excess mast cells may be seen and a diagnosis of a treatable form of IBS known as mastocytic enterocolitis is missed.

BLOOD TESTS SHOULD ALSO BE DONE BEFORE ASSUMING A DIAGNOSIS OF IBS

Blood tests should be done to screen for Celiac disease, ulcerative colitis and Crohn's disease. Without these blood tests and intestinal biopsies, Celiac disease, Crohn's disease and various forms of colitis especially microscopic colitis are frequently missed.

MULTIPLE BIOPSIES SHOULD BE DONE TO AVOID MISSING PATCHY AREAS OF INVOLVEMENT

Microscopic irritation or inflammation of the intestine can be patchy. Therefore, anyone undergoing colonoscopy or upper endoscopy with symptoms, especially diarrhea, bloating, gas or abdominal pain, should have multiple intestinal biopsies. Inflammation that is the cause of these symptoms is often only seen microscopically and may be patchy. However, once a diagnosis is made treatment with medications and/or diet is often effective.

EARLY FINDINGS OF INTESTINAL INFLAMMATION OFTEN CONSISTS ONLY OF INCREASED CELLS, SOMETIMES ONLY SEEN WITH SPECIAL STAINS

The earliest intestinal biopsy findings of Celiac disease and microscopic colitis is increased number of lymphocytes per 100 epithelial (intestinal lining) cells. In the colon intraepithelial lymphocytosis is considered diagnostic for microscopic colitis if 20 or more lymphocytes per 100 epithelial cells are found. Interestingly the criteria for abnormal intraepithelial lymphocytosis in Celiac disease has more recently been reduced from 40 IELs per 100 utilized for nearly thirty years to 30 per 100. Even more recent studies have indicated that this should be reduced further to 20-25 per 100 because it is noted that early gluten injury occurs with lower levels of lymphocytes in the intestinal lining and is associated with a favorable response to gluten free diet. Microscopic colitis frequently responds favorably to a gluten-free diet.

DON'T HAVE YOUR DIAGNOSIS MISSED BY FAILURE TO GET AN INTESTINAL BIOPSY AND BLOOD TESTS BEFORE ACCEPTING IBS

Numerous patients have come to me with a diagnosis of IBS for years who I have confirmed to have Celiac disease, microscopic colitis or non-celiac gluten sensitivity. These patients typically respond dramatically to a gluten free diet even in the absence of a diagnosis of Celiac disease. Several of my patients have both Celiac disease and a form of microscopic colitis such as lymphocytic or collagenous colitis.

UNNECESSARY DELAYS IN DIAGNOSIS AND SUFFERING NOT NECESSARY IF YOU BECOME YOUR OWN ADVOCATE

People often experience years of unnecessary suffering due to delays in diagnosis of Celiac disease, microscopic colitis, Mastocytic Enterocolitis, Crohn's disease, and food intolerance. Many developed preventable secondary complications such as osteoporosis, infertility, iron deficiency or autoimmune diseases. Most live for years with pain, stomach pains, and diarrhea under the false conclusion that they have IBS. Frustation occurs when you are told there is little to nothing that can be done besides taking anti-diarrhea and anti-spasm medications combined with a high fiber diet and fiber supplements. Yet, most note they are no better or even worse with increased fiber. If you have complained to your doctor that such agents seem to cause more severe bloating, gas, diarrhea and abdominal pain you are often scoffed at or told you are not being compliant. Little did you or your doctor know that increasing fiber intake can make you worse if you are gluten intolerant.

GLUTEN FREE DIET MAY HELP SYMPTOMS OF IBS AND SHOULD BE TRIED AFTER GETTING TESTED FOR CELIAC DISEASE FIRST

Don't accept a diagnosis of IBS without adequate diagnostic testing or consideration of a trial of gluten free diet. Before accepting IBS learn more about the various forms of colitis, Celiac disease, non-celiac gluten sensitivity, Crohn's disease and altered gut flora and be your own advocate when you visit your doctor.
IBS and Mindfulness
Mind and body are interrelated and any interruption in the mind due to negative thoughts, fears and phobias lead to anxiety, stress and lot other psychological disorders. Anxiety, thus leads to cramps in the stomach, abdominal pain, bloating, discomfort and irregular bowel movements causing diarrhea and constipation, which are some of the major symptoms of Irritable Bowel Syndrome or IBS.
IBS does not lead to any serious medical illness; however, it is the most common Gastrointestinal Tract disorder that results in disability, poor quality of life and social withdrawal. IBS is more common in women than men.
There are a lot of ways through which mind can be controlled to reduce the symptoms of IBS. Following are the ways, through which IBS symptoms can be reduced to a great extent:
CBT (Cognitive Behavioral Therapy)
Hypnotherapists and Psychotherapists are using Cognitive Behavioral Therapy in reducing the symptoms of IBS by putting emphasize on thought patterns and belief systems. CBT uses the following techniques:

Cognitive Therapy: Here the client is taught about certain problematic thoughts that trigger anxiety which increases the symptoms of IBS. In cognitive therapy, person is asked to self affirm or self suggest new thoughts and belief systems by using the technique of "Self-Talk". Client is taught about the disorder, coping skills and any misconceptions regarding the same are cleared.

Behavioral Therapy: Behavioral therapy with the help of Self- Hypnosis and Hetero Hypnosis helps the client to think in a better way and creates ways to overcome anxiety and various future problems. Self Hypnosis is a technique used by the client himself, through which he creates a heightened state of concentration, with the aim of following affirmations or suggestions. This helps in managing unwanted thoughts and negative belief patterns which change the negative state of mind to the more appropriate or a positive one. Anxiety is due to bottled up emotions. However, these can be addressed with the help of therapist by accessing the subconscious mind. This is called hetero Hypnosis. When the causes of anxiety are released with the help of Hypnotherapy techniques including breathing exercises, self hypnosis, Progressive Relaxation and Guided Imagery, symptoms of Irritable Bowel Syndrome can be dissolved completely.

Mindfulness
Mindfulness is a meditative state that helps you achieve a relaxed state and helps you focus on the present moment. The idea of Mindfulness is to be in the present moment without any judgments, decisions and thoughts. Mindfulness is based on moment to moment experience, without letting any positive or negative thoughts come into the mind. It does not let the person connect the past experiences with the present and makes the person incapable of making decisions for future. The idea is to simply experience the present moment by practicing various techniques and meditations that lead to healthier life, ultimately helping in the reduction of one's worry and anxiety.
Mindfulness meditations make you aware of all the tensions and stress that are going inside your body along with thoughts at the present moment and allows your mind not to accept those thoughts. After a lot of practice, client is able to accept and understand the situation, rather than creating a panic, fear or anxiety. Once it is practiced consistently, the results can be brilliant. This way, symptoms of IBS arising due to anxiety can be reduced.

Although irritable bowel syndrome (IBS) does not cause permanent damage or inflammation to the large intestines, nor does it increase the risk of colon cancer, it does disrupt the lives of patients. This common condition affects the colon and exhibits pain, abdominal cramping, distension, abnormal bowel function, heartburn and nausea, creating unpredictability and distress in normal, daily life. Remedies for IBS restore normalcy in daily routines.
Dietary and lifestyle changes with effective stress management can dramatically improve the symptoms associated with this disorder and effectively serves as one of the remedies for IBS. A few patients have more severe symptoms that benefit from additional medical help.

Certain foods are known triggers for IBS. Carbonated beverages, some raw fruit, vegetables known to be gas-producing, even chocolate can cause uncomfortable distension. Avoiding high-gas foods like cabbage, broccoli and cauliflower can alleviate bloating. Constipation prone patients may need to eat fiber and take supplements with additional fluids for prevention of this symptom. Diarrhea-predominant patients should avoid caffeine. Lactose intolerance is a genetic inability to process the sugars in dairy products, not associated with IBS.

Twice as many females suffer with IBS as males, leading research to attribute a hormonal component to this disorder. It is common for symptoms to flare around the time of menses. Common gastric illnesses can kick up the occurrence of aggressive IBS symptoms. Stress can exacerbate symptoms.
OTC loperamide is effective in relieving diarrhea from IBS. In addition, anticholinergics relieve bowel spasms for diarrhea control by modifying the autonomic nervous activity responsible for this symptom in the list of remedies for IBS. Patients that have a proliferation of intestinal bacteria may benefit from antibiotic treatment. Research is exploring the use of antibiotics as they are capable of destroying the population of good bacteria commonly associated with resultant diarrhea.
Clinical depression often accompanies painful conditions. Tricyclic antidepressants or serotonin reuptake inhibitors are effective in treating depression in patients with pain due to constipation. Tricyclics and SSRI are prescription drugs that moderate the neuron activity effecting intestinal motility that your physician may recommend for these disorders as remedies for IBS.
Diarrhea-predominant patients without depression may get relief with a low, maintenance dose of tricyclic drugs,for IBS. As this class of drug produces constipation as a common side effect, it can provide relief in patients with diarrhea. When antidepressants are ineffective in controlling symptoms, it may be conducive to seek counseling to effectively learn methods for managing stress.
Nerve receptor antagonists are prescription medications used for control of diarrhea with IBS. This drug is prescribed for women only. These drugs are effective by decreasing peristaltic waves in the intestines, thereby reducing diarrhea. A gastroenterologist will prescribe this drug for women that have not responded to other treatments. Other variations of this class of drugs is approved for women over 18 years old with constipation as the major symptom, and is prescribed in twice a day dosage to absolve hardened stools by increasing fluid content in the small intestine. This prescription drug is used only in females not helped by other treatments. It is not prescribed for males.
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