The U.N.C. Center for Functional GI
and Motility Disorders proudly presents, " Chat with the Experts from Home." The
second Tuesday of each month 8-10 EST.
http://www.med.unc.edu/medicine/fgidc/
On this page you'll find links to help
explain and understand Irritable Bowel Syndrome and the symptoms associated with
this chronic condition, by some of the most respected doctors in the field. You will also
find information on digestion and the digestive process.
IBS Health Bulletin Board
Welcome to IBS health online Bulletin Board for
support and information on irritable Bowel Syndrome.
Foundation for Digestive Health and
Nutrition is offering a patient educational video on irritable bowel syndrome
(IBS) Irritable Bowel Syndrome: "Transforming
Your Life Through IBS Management."
IBS Streaming Video
There is also printable information to
take to the doctor with you. I have found that this helps considerably, if I am
armed with specific questions to take with me. This saves valuable time for both
you and your doctor. It also helps in getting your specific questions answered.
With IBS it pays to do your homework.
Also on this page you will find a glossary page and a testing page on some of
the tests and procedures for digestive conditions.
The Rome Criteria
Process: Diagnosis and Legitimization of Irritable Bowel Syndrome
Irritable
Bowel Syndrome: How far do you go in the Workup?
Printable information:
Ten questions to ask your doctor.
Molly's Brochure
IBS Information:
U.N.C Center for Functional GI and Motility Disorders
MayoClinic
What Is Irritable Bowel Syndrome?
IFFGD
International Foundation for Functional Gastrointestinal Disorders
The Mind-Body Digestive Center
80 Central Park West New York, N.Y. 10023
UCLA/CURE
Neuroenteric Disease Program
IBS Clinical Issues *
Adapted from a radio interview conducted by Bob Enteen, host of Living
Without Limits, with Douglas Drossman, MD, UNC Center for Functional GI and
Motility Disorders at Chapel Hill North Carolina
UNC Center for Functional GI & Motility Disorders "Digest" {Free}
Irritable Bowel Syndrome: with
Permission from Jackson Gastroenterology.
Irritable Bowel Syndrome
What is an Irritable Bowel?
Medically, irritable bowel syndrome (IBS) is known by a variety of other terms:
spastic colon, spastic colitis, mucous colitis and nervous or functional bowel.
Usually, it is a disorder of the large intestine (colon), although other parts
of the intestinal tract -- even up to the stomach -- can be affected.
The colon, the last five feet of the intestine, serves two functions in the
body. First, it dehydrates and stores the stool so that, normally, a well-formed
soft stool occurs. Second, it quietly propels the stool from the right side over
to the rectum, storing it there until it can be evacuated. This movement occurs
by rhythmic contractions of the colon.
When IBS occurs, the colon does not contract normally. instead, it seems to
contract in a disorganized, at times violent, manner. The contractions may be
terribly exaggerated and sustained, lasting for prolonged periods of time. One
area of the colon may contract with no regard to another. At other times, there
may be little bowel activity at all. These abnormal contractions result in
changing bowel patterns with constipation being most common.
A second major feature of IBS is abdominal discomfort or pain. This may move
around the abdomen rather than remain localized in one area.
These disorganized, exaggerated and painful contractions lead to certain
problems. The pattern of bowel movements is often altered. Diarrhea may occur,
especially after meals, as the entire colon contracts and moves liquid stool
quickly into the rectum. Or, localized areas of the colon may remain contracted
for a prolonged time. When this occurs, which often happens in the section of
colon just above the rectum, the stool may be retained for a prolonged period
and be squeezed into small pellets. Excessive water is removed from the stool
and it becomes hard.
Also, air may accumulate behind these localized contractions, causing the bowel
to swell. So bloating and abdominal distress may occur.
Some patients see gobs of mucous in the stool and become concerned. Mucous is a
normal secretion of the bowel, although most of the time it cannot be seen. IBS
patients sometimes produce large amounts of mucous, but this is not a serious
problem.
The cause of most IBS symptoms -- diarrhea, constipation, bloating, and
abdominal pain -- are due to this abnormal physiology.
IBS is not a disease
Although the symptoms of IBS may be severe, the disorder itself is not a serious
one. There is no actual disease present in the colon. In fact, an operation
performed on the abdomen would reveal a perfectly normal appearing bowel.
Rather, it is a problem of abnormal function. The condition usually begins in
young people, usually below 40 and often in the teens. The symptoms may wax and
wane, being particularly severe at some times and absent at others. Over the
years, the symptoms tend to become less intense.
IBS is extremely common and is present in perhaps half the patients that see a
specialist in gastroenterology. It tends to run in families. The disorder does
not lead to cancer. Prolonged contractions of the colon, however, may lead to
diverticulosis, a disorder in which balloon-like pockets push out from the bowel
wall because of excessive, prolonged contractions.
Causes
While our knowledge is still incomplete about the function and malfunction of
the large bowel, some facts are well-known. Certain foods, such as coffee,
alcohol, spices, raw fruits, vegetables, and even milk, can cause the colon to
malfunction. In these instances avoidance of these substances is the simplest
treatment.
Infections, illnesses and even changes in the weather somehow can be associated
with a flare-up in symptoms. So can the premenstrual cycle in the female.
By far, the most common factor associated with the symptoms of IBS are the
interactions between the brain and the gut. The bowel has a rich supply of
nerves that are in communication with the brain. Virtually everyone has had, at
one time or another, some alteration in bowel function when under intense
stress, such as before an important athletic event, school examination, or a
family conflict.
People with IBS seem to have an overly sensitive bowel, and perhaps a super
abundance of nerve impulses flowing to the gut, so that the ordinary stresses
and strains of living somehow result in colon malfunction.
These exaggerated contractions can be demonstrated experimentally by placing
pressure- sensing devices in the colon. Even at rest, with no obvious stress,
the pressures tend to be higher than normal. With the routine interactions of
daily living, these pressures tend to rise dramatically. When an emotionally
charged situation is discussed, they can reach extreme levels not attained in
people without IBS. These symptoms are due to real physiologic changes in the
gut -- a gut that tends to be inherently overly sensitive, and one that
overreacts to the stresses and strains of ordinary living.
Diagnosis
The diagnosis of IBS often can be suspected just by a review of the patient's
medical history. In the end it is a diagnosis of exclusion; that is, other
conditions of the bowel need to be ruled out before a firm diagnosis of IBS can
be made.
A number of diseases of the gut, such as inflammation, cancer, and infection,
can mimic some or all of the IBS symptoms. Certain medical tests are helpful in
making this diagnosis, including blood, urine and stool exams, x-rays of the
intestinal tract and a lighted tube exam of the lower intestine. This exam is
called endoscopy, sigmoidoscopy or colonoscopy.
Additional tests often are required depending on the specific circumstances in
each case. If the proper medical history is obtained and if other diseases are
ruled out, a firm diagnosis of IBS then can usually be made.
Treatment
The treatment of IBS is directed to both the gut and the psyche. The diet
requires review, with those foods that aggravate symptoms being avoided.
Current medical thinking about diet has changed a great deal in recent years.
There is good evidence to suggest that, where tolerated, a high roughage and
bran diet is helpful. This diet can result in larger, softer stools which seem
to reduce the pressures generated in the colon.
Large amounts of beneficial fiber can be obtained by taking over-the-counter
bulking agents such as psyllium mucilloid (Metamucil, Konsyl) or methylcellulose
(Citrucel).
As many people have already discovered, the simple act of eating may, at times,
activate the colon. This action is a normal reflex, although in IBS patients it
tends to be exaggerated. It is sometimes helpful to eat smaller, more frequent
meals to block this reflex.
There are certain medications that help the colon by relaxing the muscles in the
wall of the colon, thereby reducing the bowel pressure. These drugs are called
antispasmodics. Since stress and anxiety may play a role in these symptoms, it
can at times be helpful to use a mild sedative, often in combination with an
antispasmodic.
Physical exercise, too, is helpful. During exercise, the bowel typically quiets
down. If exercise is used regularly and if physical fitness or conditioning
develops, the bowel may tend to relax even during non-exercise periods. The
invigorating effects of conditioning, of course, extend far beyond the intestine
and can be recommended for general health maintenance.
As important as anything else in controlling IBS is learning stress reduction,
or at least how to control the body's response to stress. It certainly is
well-known that the brain can exert controlling effects over many organs in the
body, including the intestine.
Summary
Patients with IBS can be assured that nothing serious is wrong with the bowel.
Prevention and treatment may involve a simple change in certain daily habits,
reduction of stressful situations, eating better and exercising regularly.
Perhaps the most important aspect of treatment is reassurance. For most
patients, just knowing that there is nothing seriously wrong is the best
treatment of all, especially if they can learn to deal with their symptoms on
their own.
http://www.gicare.com/pated/ecdgs03.htm
Digestion:
It is important to understand how the digestive
tract works.
Your Digestive System and How it Works
I also believe it is important to have some
backgroud on how the
nervous System works as that controls everything and is very important in IBS.
The Autonomic Nervous System
The
Nervous System Grays Anatomy
There is additional reading and
audio/visual information of interest on IBS and related material in the
news
sections.
Glossary
Tests and Procedures
Excellent Help in explaining IBS to family
and friends.
IBS Companion
- CD or Cassette
An informative and instructive guide
about IBS for the non-sufferer.
From Michael Mahoney: author of the successful IBS Audio 100 Program.
All to often, we forget that IBS not
only affects the sufferer, it can have a detrimental effect on the lives of
those around the sufferer. Holidays and days out might often be cancelled or
restricted. It is not easy having IBS, it is not easy supporting an IBS sufferer
either. This short recording is easy to understand explaining the symptoms,
common fears, and the explorative tests that IBS sufferers have to go through to
be diagnosed as having IBS. For those around the sufferer, it will provide
insight into this most troublesome condition. For the IBS sufferer it can be a
good source of explaining IBS when you have tried or you are tired of explaining
it to others. With gentle soothing background music this recording adds to
seeing both sides of the IBS equation. Recorded by Michael Mahoney, known by
many sufferers for his gentle, patient approach and for his support in helping
IBS sufferers and partners too.
IBS Companion
