Parasites

Jesse one thing you could try is gut directed hypnotherapy as a safe and very possible effective method if you want to go a more natural root. It works for the majority of people who try it and has long lasting symptom relief. IF you have questions about why let me know. Its works on the the way the brain and gut communicate.

Also read this article. Stool testing is pretty accurate along with blood testing for parasites. However, certain symptoms would not be found with parasites that are found in IBS and vise versa.

Johns Hopkins gastroenterology and hepatology

"Stool testing for Ova and Parasites are generally of low yield (0-2%) and the outcome of therapy on symptoms of IBS in patients with parasites is unknown. "

http://www.hopkins-gi.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_id=551CDCA7-A3C1-49E5-B6A0-C19DE1F94871&GDL_Disease_id=F5E21D6B-A88E-44F9-900F-7E295C50D38B

You might want to read the whole site.

http://www.hopkins-gi.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_id=024CC2E1-2AEB-4D50-9E02-C79825C9F9BF&GDL_Disease_id=F5E21D6B-A88E-44F9-900F-7E295C50D38B

Who did the stool testing for bacteria?

There is a specific symptoms for an IBS diagnoses minus red flags. But no actual test or biological marker.

The HT might help IBS way more then you might think and if you have IBS its all about symptom control. In fact the HT might be better at the problem of IBS on the physiological side then the majority of most IBS treatments if it works for you. It is one of the most successful treatments for IBS to date.

I will come back to that later.

IBS is not "leaky gut" and the medical profession does not recgonize leaky gut. They do recgonize gut permeablity, but that is somewhat different then the alternative term "leaky gut."

They have already found some mechanisms that generate the symptoms of IBS they already know about, although not the exact cause/causes.

First

http://aboutibs.org/site/about-ibs/symptoms/diagnosis

You might want to read this also, scroll down the page to it.

Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality

http://www.med.unc.edu/medicine/fgidc/Autumn_2009_Digest.pdf

Do you have rectal hypersensivity by any chance?

Do you have pain or discomfort?

Do you have the sensation of incomplete evacuation?

Altered bowel movements?

Relief after a bowel movement?

"the way I understand it IBS just means you have a set of symptoms"

Nope they are a specific cluster of symptoms, minus red flags. Not just GI symptoms.

The diagnoses is no longer a diagnoses of exclusion or a "throw away diagnoses" That is wrong.

"I know that the docs don't believe in "leaky gut" or any of that stuff,"

No and there is a reason for that, but there is intestinal permeablity. That is one way you absorb nutrients. The functioning of sigmoid colon is mainly IBS.

Your IBS has an underlying cause, they just don't know exactly what it is yet, but a ton of good research has been done in the last five years. They know quite a bit about the d and c and d/c and pain aspects. In fact many issues about IBS.

Depending on the test you might not have had SIBO?

also you can have sibo and IBS, you can also have sibo without IBS and you can have just IBS.

The tricyclic is to help pain and gut functioning and increased anxiety.

This and some of your other symptoms are hallmark IBS symptoms. "generally relieved after a BM" and incomplete evacuation. In IBS the colon doesn't function normally and those are some of the abnormal symptoms in the cluster.

I can't diagnose you though, but your symptoms are consistent with IBS.

I am not sure you know the actual theories already on IBS, especially over the last five years and that is important in understanding IBS, which is a majorally complex condition.

There are just someways the body works that are important in IBS for one.

The majority of the bodies serotonin a neurotransmitter is located in the gut in specific cells that release it to start disgestion. This seems to be out of whack in IBS, but that is not the only issues.

 Video Corner: Serotonin

Increasingly our understanding of IBS is that it is a heterogeneous disorder – that is, multiple factors contribute to the well defined symptoms of the disorder. One of these suspected underlying dysfunctions involves serotonin, which is a neurotransmitter or messenger to nerves. Most serotonin in the body is in cells that line the gut where it senses what is going on and through receptors signals nerves that stimulate a response. The serotonin must then be reabsorbed (a process called re-uptake) into cells. This process appears to be disrupted in people with IBS.

http://www.aboutibs.org/site/learning-center/video-corner/serotonin

This is from the chairman of the Rome committe to diagnose these disorders, who I wrote to and know personally. 

Since I have suffered for thirty nine years of IBS I wonder what role foods play in IBS. So I asked Dr Douglas Drossman at  the UNC Center for Functional GI and Motility disorders and here was his response. This is not a substitute for seeking medical advise from your doctor on any specific conditions you may have, but for educational purposes only.

 Dr. Drossman is a Co-director of the Center and Professor of Medicine and Psychiatry at UNC-CH. He established a program of research in functional gastrointestinal disorders at UNC more than 15 years ago and has published more than 250 books, articles, and abstracts relating to epidemiology, psychosocial and quality of life assessment, design of treatment trials, and outcomes research in gastrointestinal disorders.
 

Dr Drossman's comments on foods for IBS Health.

Shawn,
To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Furthermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse.

However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature.

The cause of IBS is yet to be determined.  However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments.  Hope that helps.
Doug

http://www.ibshealth.com/ibsfoods2.htm

Rectal hypersensivity is a sensitive rectum, a lot of IBSers have it but not all. It can also be part of the sensation of incomplete evacuation. There is nothing in there or a very small amount, but the rectum still sends the signals to evacuate.

Since you have only had this for 14 months what do you think it started from, did you have any gut problems or anything, before hand?

IBS is a distint clinical entity.

 

Hi there, I think we may be mis-communicating a bit; I have IBS. I got the diagnosis, the doc said that's what it was, so that's sorted out. My search is for what causes my IBS, because I didn't have IBS my whole life, so I'm hopeful that I won't have it for the rest of my life as well, you know? It all started one night when I went to a party, got way too drunk, did some weed cupcakes, then the next day I had D, the day after that I passed a white stool and from then on I've settled into more or less the symptoms I described in my last post.

There are so many things out there people say will get rid of your IBS (food allergy avoidance, GAPS diet etc.) many of which seem more plausible than others. I'm just not quite ready to concentrate on symptom relief rather than keep looking for causes to treat. I did have an IGA test where I reacted to gluten, but I didn't have any problems with wheat for the first 17 years of my life, so something must have changed to make me react to that, right? Intestinal permeability seems like a logical possibility.

Thanks a lot for your input,

-Jesse

Hmm, I guess I'm a little confused. I'm not quite sure why you keep saying IBS is separate from other things, say food sensitivities, allergies or intolerances (all different things, but what I mean is for my example we can just pick one). I mean, IBS can start at any time, and then you said food allergies can start at any time as well. So what if you have food allergies, and you and your doctor don't know, so your doctor diagnoses you of having IBS, but then you find out about your food problems, remove the foods from your diet and get better? Or the same case, except replace food allergies with SIBO; you get diagnosed with IBS, but upon discovery and treatment of your SIBO all symptoms go away?

I guess I'm getting lost in the cause of IBS. You say they don't know the cause, but then also you're very sure that IBS is a separate condition of it's own quite apart from any food allergies or excessive permeability factors or SIBO. So in cases like the above mentioned, couldn't you argue that SIBO is masquerading as IBS? So at this point you have a diagnosis of IBS, but you also know that you've made a full recovery when treated for SIBO. And here I think is where I'm getting confused; for if SIBO and IBS are truly separate conditions than the patient in the above case never really had IBS at all, but rather had undiscovered SIBO. But then if SIBO or other factors can be in this way "mistaken" for IBS, then how can you possibly ever tell that you have this unique condition called "IBS" and not some other problem masquerading in a similar manner? And cases like the above example are what I consider to be "causes" of IBS; that is to say the underlying condition being diagnosed in a somewhat blanket fashion.

Hopefully you can see my dilemma, if my reasoning is unclear or if I've made an error I'd be glad to clarify. I'm really hoping you can see where I'm getting confused and put me on the right track!

Thanks again for your replies,

-Jesse

In IBS the brain and the gut are both operational to cause the symptoms. They have known this now for many years.

FYI

"The 'brain-gut axis' helps to explain the influence that thoughts, emotions, and psychological or social stress have on the function of the gut."

http://www.merck.com/yourhealthnow/volume2-2/braingut.html

2007 IFFGD Symposium Summary Report, Very much worth reading/state of the art research

"Stress can also significantly modify the immune response to the gut flora. So these are factors that could be affecting the sensitization in IBS and the condition itself. Brain-gut – The brain plays a role as well. The brain and the gut are connected. Thinking and feeling can have affects, influencing release of proteins that interact with the nervous system (neuropeptides), which can affect motility, secretion, blood flow, and inflammation. Stress may influence inflammatory pathways causing a dysregulation that can lead to emotional conditions and more stress – a vicious cycle. It is not a question as to whether this cycle begins in the gut or in the brain. The problem is that both systems are effected concurrently thus producing a disturbance of the regulation between the brain and gut; a “vicious cycle” with no beginning or end. Understanding this will open the door to more specific treatments. We can see examples of brain-gut interactions by looking at post-infectious IBS (PI-IBS) or dyspepsia."

Mast cells

FYI

"You have two brains: one in your head and another in your gut. Dr. Jackie D. Wood is a renowned physiologist at The Ohio State University. He calls the second brain, "the-little-brain-in-the-gut." This enteric nervous system is part of the autonomic nervous system and contains over one hundred million neurons, which is as many as are in the spinal cord. 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 in the gut is connected to the big brain by the vagus nerves, bundles of nerve fibers running from the GI tract to the head. All neurotransmitters, such as serotonin that are found in the brain are also present in the gut.

Dr Wood has discovered that this little-brain-in-the-gut has programs that are designed for our protection and which are very much like computer programs. They respond to perceived threats in the same way that the limbic system or the emotional brain does. So the threat of a gastrointestinal infection can activate the program that increases gut contractions in order to get rid of the infection. The symptoms are abdominal cramping and diarrhea.

Dr. Wood has determined that a type of cell found in the body and the gut, called the mast cell, is a key to understanding the connection of the big brain in the head with the little-brain-in-the-gut. Mast cells are involved in defense of the body. In response to certain threats or triggers, such as pollen or infection, mast cells release chemicals, such as histamine, that help to fight off the invader. Histamine is one of the chemicals that causes the symptoms of an allergy or a cold. When an infection of the gut occurs, such as food poisoning or gastroenteritis, the mast cells of the gut release histamine. The little-brain-in-the-gut interprets the mast cell signal of histamine release as a threat and calls up a protective program designed to remove the threat – at the expense of symptoms: abdominal pain and diarrhea.

The brain to mast cell connection has a direct clinical relevance for irritable bowel syndrome and other functional gastrointestinal syndromes. It implies a mechanism for linking allostasis and the good stress response to irritable states (e.g., abdominal pain and diarrhea) of the gut. Mast cells can be activated to release histamine in response to perceived psychological stress, whether the stressor or trigger is consciously perceived or not. So the end result is the same as if an infection activated the program in the-little-brain-in-the-gut: abdominal pain and diarrhea."

http://www.parkviewpub.com/nuggets/n5.html

So stress, emotions and anxiety and even PERCEIVED STRESSORS both physical and mental can trigger IBS. Part of that reaction has to do with the fight or flight reponce. This happens so fast you are NOT CONCIOUsLY AWARE of it happening.

Fight or flight

http://www.thebodysoulconnection.com/Educa...nter/fight.html

This system is connected to the autonomic nervous system and the parasympatheitc and sympathetic nervous systems. That help run digestion.

The organs (the "viscera") of our body, such as the heart, stomach and intestines, are regulated by a part of the nervous system called the autonomic nervous system (ANS). The ANS is part of the peripheral nervous system and it controls many organs and muscles within the body. In most situations, we are unaware of the workings of the ANS because it functions in an involuntary, reflexive manner. For example, we do not notice when blood vessels change size or when our heart beats faster. However, some people can be trained to control some functions of the ANS such as heart rate or blood pressure.
The ANS is most important in two situations:

In emergencies that cause stress and require us to
"fight" or take "flight" (run away)
and

In nonemergencies that allow us to "rest" and "digest."

http://faculty.washington.edu/chudler/auto.html