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Posted 5/14/2015 2:48 PM (GMT 0)
Many here have or believe they also have IBS, so here is and FYI.

Old Mike

http://medicalxpress.com/news/2015-05-definitive-bowel-syndrome.html

Posted 5/14/2015 2:53 PM (GMT 0)
Wow great news that they have a test to determine whether a person has IBS (instead of or in addition to IBD).
And will settle a long-standing "discussion" between garylou and pb4.
Also interesting that IBS can be caused by food poisoning, I never knew that.
Posted 5/14/2015 4:02 PM (GMT 0)
LOL!!!! and OMG!!! That is hilarious!!!!! For a minute I thought it was April Fools all over again!

Okay, this time I have to say it out loud.....

I TOLD YOU GARY!!!!!

LOL, whew thanks Old Mike, thanks so much for finding and posting this....it's a really good read actually.

And imagardener, thanks, I was getting really tired defending IBS to gary, last night nearly did me in lol.
Posted 5/14/2015 4:18 PM (GMT 0)
I noticed on the article page, other articles and it turns out they've been doing this study since 2013!! Thank goodness it only took them basically 2 years to complete this study and I'm thrilled with the results of them finally figuring it all out --testing, that is--- what awesome and exciting news this is!
Posted 5/14/2015 4:38 PM (GMT 0)
Don't count your chickens before they're hatched. I certainly am very enthusiastic about this development and I think this is wonderfully fantastic. But, if you read the article, it says that "The tests, created by Mark Pimentel, MD, director of the GI Motility Program and Laboratory, confirm when a patient has developed IBS BECAUSE OF FOOD POISONING, a major cause of the disorder".

This suggests that the number one major cause of IBS is food poisoning, and that the tests can confirm this to a greater than 90% certainty.

This may actually wind up proving my main point that I have been making all along, that for someone with no symptoms, then is diagnosed with IBD which goes into clinical remission, the patient continues to have symptoms, and then they are labeled as having IBS - is a crock or, more nicely put, a misdiagnosis. Are you now believing that all of these people who fit into this category had IBD and IBD only but at some point got food poisoning during their condition, which triggered IBS in addition to IBD? If so I've got some oceanfront property in Iowa I can let you have cheaply.

Be careful for what you wish for PB4. Have you thought about the possibility that you can now get this blood test yourself for IBS and that it might actually confirm what I have been saying all along if you test negative?

I think it is utterly fantastic that they now have proof that IBS not only exists but can actually be tested for. This is going to separate out the people who truly do have IBS from those where the doctors got lazy and used it as a scapegoat diagnosis. Thanks for posting Old Mike because I'm actually looking forward to being proven right. My next GI appointment I am going to see if this test can be ordered for me. Who knows, maybe it will prove I actually do have IBS but, to the best of my knowledge, I have never had food poisoning during the time I have had UC.
Posted 5/14/2015 5:02 PM (GMT 0)
Well at least old mike is good for something even though I cant cure UC,at least as of yet.
Hopefully this test will work out for anyone with IBS symptoms.
It seems like it can distinguish IBD from IBS, gee I wonder what happens if you have both.
I have not been following your discussions,but have seen reference to them.
OM
Posted 5/14/2015 5:04 PM (GMT 0)
Gary, you needed to read just one more sentence. The theory in this article is that salmonella causes nerve damage in the bowel and that this nerve damage results in the functional disorder.

The test finds antibodies to salmonella and I think one other bacterial culprit.

But what about nerve damage caused by IBD? This has been my theory for a long time, that my bowel's motility problems are a direct result of chronic inflammation damaging the nerves. I had a good 3 year remission but still had motility issues. The blood test discussed in this article won't tell a patient anything about their functional disorder unless it is a result of infection by the bacteria being screened by the blood test.
Posted 5/14/2015 5:05 PM (GMT 0)
I could care less Gary, the chances of me testing negative for IBS is highly unlikely. IBD is not based on food poisoning, it's genetics and my mom had UC so that's proof enough for me that my IBD is genetics via my mom. She never had IBS but my daughter and one of my half sisters as well as myself do.

It's sad that you're still trying to connect IBS to still just being a part of IBD, enjoy believing that (which you've made up yourself) all you want.

And BTW, here's another link that was also in the article that Old Mike posted....it's the study for the blood test for IBS from October 2013...

http://medicalxpress.com/news/2015-05-definitive-bowel-syndrome.html
Posted 5/14/2015 5:10 PM (GMT 0)
http://medicalxpress.com/news/2015-05-definitive-bowel-syndrome.html


The other link from Old Mike's link he posted, in regards to the study for this new blood test for IBS from October 2013....


And also another link about the study...

http://medicalxpress.com/news/2011-05-deepens-common-gastrointestinal-disorder.html#nRlv
Posted 5/14/2015 5:43 PM (GMT 0)
Kaz: That makes a lot of sense but I do have one question regarding your thoughts on the subject. Let's say that you are right 100%. When they do a colonoscopy and find that your IBD is in "clinical remission", wouldn't they also discover that you either had nerve damage or inflamed nerves, thereby being able to diagnose you with either IBS or a "functional disorder" through actual observation of something wrong? How could they miss that? After all, the colon itself is no longer inflamed due to the clinical remission but they should be able to see that the nerves are still inflamed or that they are damaged.

pb4: believe it or not I can usually follow your train of thought on your IBS posts(even though I don't usually agree with it) but your last post has me scratching my head. I'm not really seeing how it is a response to my previous post. I never said one word about IBD being connected to food poisoning and I now believe that IBS is not only a separate condition than IBD but that they are not related - the very same thing that you believe. What I am saying, which I have been saying all along, is that many IBD'rs diagnosed with IBS while still having symptoms after a "clinical remission" do not actually have IBS but are misdiagnosed. It was these articles which connected food poisoning with IBS and I don't believe everyone still having symptoms after a clinical remission have had food poisoning which kicked off their IBS. Maybe some have but I doubt very much that the majority have. I actually look forward to seeing results from IBD'rs who take this IBS test. I would love to either be proven wrong or right through these tests. It would put us all one step closer to the truth. Kaz may actually have the answer, in which case the IBD and IBS (in IBD'rs) would actually be connected or a cause and effect relationship.
Posted 5/14/2015 6:03 PM (GMT 0)
Gary, I am not a pathologist, but I do not believe they are looking for nerve damage when they do biopsies for IBD. They are looking for specific markers in the mucosa of the colon related to inflation.

library.med.utah.edu/WebPath/GIHTML/GI061.html

Further research shows that people like me (with slow transit constipation) can have nerve damage, but the affected nerves are on the myenteric plexus and external submucous plexus and so cannot be investigated via superficial biopsies taken during colonoscopy:

www.ncbi.nlm.nih.gov/pubmed/11786765.

I guess the question then is how can internal inflammation affect these nerves? Maybe the same way that "food poisoning" can?

VIEW IMAGE

Here's an old paper on this topic: www.ncbi.nlm.nih.gov/pubmed/3822939
Posted 5/14/2015 6:18 PM (GMT 0)

kazbern said...
The blood test discussed in this article won't tell a patient anything about their functional disorder unless it is a result of infection by the bacteria being screened by the blood test.

Nail on head.

It'll only help a subset of patients with IBS. The rest will be as much in the dark as ever. It's better than nothing, but it's not like discovering a blood test which diagnoses all IBS. The latter would be amazingly useful.

Edit: And it's not even 100% accurate.

The blood tests identified the two antibodies associated with IBS—anti-Cdtb and anti-vinculin—with greater than 90 percent certainty.

Over 90% may sound like a lot, but that still leaves a large margin for error. The Prometheus IBD test isn't much less accurate than that and still it helps virtually nobody.

Disappointing.
Posted 5/14/2015 6:22 PM (GMT 0)
And here's the best paper of all:

www.jneuroinflammation.com/content/7/1/37
Posted 5/14/2015 6:23 PM (GMT 0)
Yes well Gary, your reply had me scratching my head as well...when you wrote this....

"This may actually wind up proving my main point that I have been making all along, that for someone with no symptoms, then is diagnosed with IBD which goes into clinical remission, the patient continues to have symptoms, and then they are labeled as having IBS - is a crock or, more nicely put, a misdiagnosis. Are you now believing that all of these people who fit into this category had IBD and IBD only but at some point got food poisoning during their condition, which triggered IBS in addition to IBD? If so I've got some oceanfront property in Iowa I can let you have cheaply."

That's what I was referring to in my reply back to you when I said this....
"It's sad that you're still trying to connect IBS to still just being a part of IBD, enjoy believing that (which you've made up yourself) all you want."

Why is it so unfathomable for you to believe that could happen, what? I couldn't have possibly gotten food poisoning while I already had IBD to trigger my IBS for me? Isn't that what you're saying? And it makes no sense for you to say that...and no, it doesn't prove the point you've been trying to make which has always been, IBS isn't real, it's some form of IBD that causes clinical remission patients that still have issues with their bowels.

I was merely pointing out that IBD isn't caused by food poisoning like IBS is and thought you'd see that what I've been saying all along is that IBS isn't some form of IBD like you keep saying it is. And now there's even proof but you're still bantering on about how you think it's still related because you call BS on IBS especially for IBD patients that have both conditions.

Then you wrote this...."What I am saying, which I have been saying all along, is that many IBD'rs diagnosed with IBS while still having symptoms after a "clinical remission" do not actually have IBS but are misdiagnosed. It was these articles which connected food poisoning with IBS and I don't believe everyone still having symptoms after a clinical remission have had food poisoning which kicked off their IBS. Maybe some have but I doubt very much that the majority have."

So my final response to you is, believe what you want, but that doesn't make it true, you're still trying to poke a bunch of holes into IBS even with proof provided to you...and all you do is keep making the same suggestion so I'm really done this whole IBS and IBD being able to affect one person at the same time because you don't want to believe it...that's what I got from your responses and I'm tired of reminding you what you've written and trying to explain how your "theory" doesn't match up against researched proof. Think what you want, I'm done with this conversation I have nothing more to say, the proof has been provided by the links and you're still rambling on about how you don't think this or that so whatever.

Have a great day!
Posted 5/14/2015 6:25 PM (GMT 0)
Money quote from the journal of neuroinflammation (emphasis mine):

"Inflammation is well known to affect gut function. Experimental data suggest that inflammation, even if mild, could lead to persistent changes in GI nerve and smooth muscle function, resulting in colonic dysmotility, hypersensitivity, and dysfunction even when the preceding infection is restricted to the proximal small intestine. Furthermore, alterations in gut function are observed after resolution of an acute intestinal inflammation, suggesting that inflammation-induced changes persist following recovery and play a major role in the generation of symptoms associated with IBD [6,7].

"Data obtained from biopsies from patients with IBD and animal models of IBD have consistently suggested a role of inflammatory effects on enteric neurons in the generation of symptoms associated with IBD [8,9]. The enteric nervous system (ENS), the intrinsic innervation of the bowel, controls virtually all GI functions (e.g., motility, secretion, blood flow, mucosal growth and aspects of the local immune system). It is presently unknown whether the persistent alterations in gut function observed following inflammation are due to altered properties of enteric nerves."
Posted 5/14/2015 6:28 PM (GMT 0)
so I feel justified in rejecting any suggestion of FODMAP diets etc to address my motility problems. Of course, if I had chronic diarrhea like some people with IBS I'd probably be singing a different song.
Posted 5/14/2015 7:26 PM (GMT 0)
It's interesting that directly below the article for the First Ever IBS Blood Test is a link to another article from 2 years ago (2013) that states:

The "first ever blood test" to distinguish IBS from IBD

As for if this one will be better - I guess time will tell. Good post though. My niece will be interested in this - She has severe IBS. Thanks OM.

Ha

Also quickly: Enteric infection has been shown in many cases to cause loss of tolerance and altered response to food antigens. You can search that out on google if you want to get right into it. Gut infection can trigger food tolerance issues and trigger food allergy.

Post Edited (Canada Mark) : 5/14/2015 1:33:06 PM (GMT-6)

Posted 5/14/2015 7:36 PM (GMT 0)
Also was just thinking a second ago, with our barrier issues there's no reason some of us could not have endured a "missed bout" of mild food poisoning that was chalked up to IBD as our symptoms, blood, mucus, etc might mask mild salmonella or other type infection. Maybe. Not sure. Just a thought that occurred.
Posted 5/14/2015 7:59 PM (GMT 0)
I think Kazbern actually has the most reasonable hypothesis of the situation but that hypothesis actually implies that the inflammation from IBD causes damage to the colon nerves, which leads to the functional disorder, IBS. If this assumption is correct then there is a causal relationship because it is the IBD damage which causes the nerve damage which eventually leads to an IBS diagnosis (assuming it wasn't misdiagnosed). In other words, they are related in a cause and effect way. This only applies to those where IBS had been diagnosed after an IBD diagnosis. This would be a subset that was not affected by food poisoning. The article about this new test implies that the majority of IBS cases are actually due to food poisoning. I'm still wondering if Kazbern's theory is true why they just can't look at the nerves in the colon during a colonoscopy to arrive at a real diagnosis.

pb4: You always take what I say so personally as if it was aimed at you. Most of the time I am not even talking about your own personal condition. You very well could have had food poisoning, which led to you getting IBS on top of IBD. I never said that was impossible but I did say that I doubt that most IBD'rs diagnosed later with IBS after a clinical remission have had food poisoning and that that is the reason for their IBS (mis)diagnosis. I'm looking forward to IBD'rs getting this IBS test because I think it will show that many of them do not really have IBS (my opinion). I'm willing to take the test myself to find out the results, no matter what they are but you seem to be afraid of finding out because it has the potential to rock your world. My thinking on IBS continues to evolve and has evolved quite a bit today alone but to me the evidence doesn't rubber stamp the guesses they have had in the past, in fact it shows things are not as they were thought to be.
Posted 5/14/2015 8:18 PM (GMT 0)
This controversy will never be fully resolved until juststud and Guardian join in the discussion to clear everything up.
Posted 5/14/2015 8:34 PM (GMT 0)

garylouisville said...
I'm still wondering if Kazbern's theory is true why they just can't look at the nerves in the colon during a colonoscopy to arrive at a real diagnosis.

The biopsies taken during colonoscopies do not reach the tissue where the nerves live. That's why.
Posted 5/14/2015 10:29 PM (GMT 0)
There is nerve damage in IBD... a few studies on it studies on it. Especially Crohn's studies as the inflammation and damage is deeper. Just google it as well. So there are two aspects or ways - enteric infection and nerve damage via bacteria and damage from the inflammatory immune response in IBD.
Posted 5/14/2015 10:42 PM (GMT 0)
There would be very few people who have not experienced food poisoning at some point in their life, and yet most do not suffer IBS as a result....
Undoubtedly there is at least some irritation, possibly leading to organic malfunction, of the nervous system in IBD.
Hopefully, given sufficient time and nurturing, the system can return to normal....once inflammation subsides.
Posted 5/14/2015 11:06 PM (GMT 0)
Ambling just reminded me - My Gi has a study on the Walkerton event. E-coli 0517 or whatever it's called I think it was. Thousands were struck ill and a few sadly passed away. Water contamination from agricultural runoff. Was one of the largest events ever. It got into the city water supply and spread rapidly.

The town is just about an hour and a bit away from me and McMaster Hospital where my GI is out of. Anyway the study is on the incidence of Post-Infectious IBS, which is the technical name of it. PI-IBS.

If one is interested in the topic just search Walkerton Ontario, ecoli PI-IBS. The rate was quite high. Not sure if any of the follow-ups showed resolution in some or not. Might be interesting to find out.

Or here - even easier: www.ncbi.nlm.nih.gov/pubmed/19180133
Posted 5/14/2015 11:42 PM (GMT 0)
Gary, are you just saying that iBD causes nerve damage the same as food poisoning and that the IBS (mis)diagnosis is due to the nerve damage created by iBD not just pure IBS from something like food poisoning? That makes sense to me.
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