New IBS blood test-Not IBD

kazbern said...
The biopsies taken during colonoscopies do not reach the tissue where the nerves live. That's why.

I think I kind of understood that but don't colonoscopies visually look at things? Can they see the nerves at all visually or are they hidden underneath things and can't be looked at? If the nerves and underneath areas can't be visually looked at (thus maybe one reason for biopsies) then isn't it possible that while doing biopsies the biopsy itself may accidentally do damage to the nerves, since they can't see where the nerves are? And, if they can't see where the nerves are, are they just guessing that they are inflamed for an IBS diagnosis (just due to the fact that the patient continues to have symptoms)? The article in this thread seems to suggest that they have proof that in IBS the nerves are inflamed or damaged. If they can see where the nerves are to arrive at this conclusion then they ought to be able to visually tell if they are damaged or inflamed or not, which would be a more accurate diagnostic test instead of just guessing and pulling an IBS diagnosis out of thin air (which is what they seem to have been doing prior to discovering this blood test). This seems like a dilemma to me.

What about my thoughts that a biopsy could possibly accidentally damage the nerve itself during a colonoscopy? I also wonder if say a person has pancolitis, are we saying that with pancolitis the whole colon is inflamed but the nerves are sometimes not but if the nerves are also inflamed then the patient has both IBD and IBS? Or say the entire colon is inflamed, including the nerves, but if the treatments work to clear the inflammation in the colon, except for the nerves, are you then diagnosed with IBS? If so, this goes to my theory that they are not two totally unrelated random diseases because the same initial inflammation caused both the IBD and the IBS.

How do you feel that maybe the article suggests that almost every IBD'r who has been later diagnosed with IBS has had food poisoning during their condition and this is what is responsible for the IBS and not the initial inflammation process as you theorize?

I realize that an IBS diagnosis has so far always been a diagnosis of exclusion but that doesn't change the fact that they have kind of pulled that diagnosis out of thin air with no real evidence, other than exclusion. I don't know if you ever caught some of my earlier posts in other threads with links which showed that there are many diagnosed with IBS (not necessarily IBD'rs) that were actually a misdiagnosis, usually due to Microscopic Colits. I am actually really glad they have developed this new IBS blood test so that, if used, IBS won't be a diagnosis of exclusion anymore but something that can actually be tested for with a high degree of certainty and that doctors won't be able to use IBS as a scapegoat diagnosis anymore (assuming they do this test).

omg! Give it a rest!! This thread needs to die.

This explains the nerve damage difference between Crohn's and UC:

Structural abnormalities of the nervous system in Crohn's disease and ulcerative colitis
onlinelibrary.wiley.com/doi/10.1046/j.1365-2982.1998.00102.x/full

I have some more bookmarked somewhere. But there is nerve damage (enlargement) in some UC. Varies with patient. Again just search it out.

I see this is patented by Mark Pimentel? He is the Dr who championed small intestine bacterial overgrowth as a cause for IBS I think? Using hydrogen and methane breath tests to find it?..and he's done studies on rifaximin to clear it?

I'm glad that he perseveres with this and moved medicine away from the view that IBS people needed psychological therapy to cure them.

I have had post infective IBS I believe, it was quite different from my IBD. My UC flares follow the classic pattern of tensmus and some blood and mucous with it advancing up the colon if not caught with meds. The IBS was of a different character.

Well we will see what happens after this mess.
Sons family had it Monday I got it last night,pretty sure norovirus.
OMG,had it 10 years ago, but now 10 years older.
Gallons of liquid D, quarts of undigested VOMIT. I am at about the 18 hour mark, so I am now able to
type, only thing I can handle is tea. Been in bed the whole time, not counting the hours on the pot,
and trying to clean my sink out with a plunger at 3am.
Wife opened a jar of mustard, had to run from the smell otherwise would vomit.
All I have got to say is wow, now back to bed.
OM

NiceCupOfTea said...

London Lurker said...
I'm glad that he perseveres with this and moved medicine away from the view that IBS people needed psychological therapy to cure them.

But what if some IBS is caused by psychological issues such as stress and anxiety? Does that somehow render that particular form of IBS as 'inferior' or less worthy than IBS which has a more obviously physical basis?

Bear with me for the next bit, but it's no wonder that a stigma against mental illness still exists when people are absolutely desperate to find physical causes instead of psychological ones.

This makes me smile NCOT because I work in mental health and I'm not out to put myself out of work and it's funny I should be accused of creating stigma when I am trying to do the opposite of not sending people off to the psych for medically unexplained symptoms in the hope they are psychosomatic and thus cheapen the great things that talking therapy can do.

Fact is, many, many patients with IBS were sent off to see a counsellor or psych etc. and it did not help them much at all and it led to quite a lot of self blame with people thinking they were doing this to themselves and nothing was going to cure it either. Meanwhile, people who could afford it started to go off and get private stool testing and breath testing and a good proportion found a physical cure.

I have definitely had periods post flare where I have had digestive difficulties due to anxiety remaining from all of the stress of urgency when in flare and at those times some CBT and hypnotherapy helped me tremendously. I have witnessed many people's digestive difficulties ease with feeling better in themselves or with the practice of mindfulness. I have also experienced antibiotics clearing my post-infective IBS and have met others who have been helped by this.

There are different forms of IBS and different ways to treat it I'm sure. I'm all for offering talking therapy to those suffering from it but not for wasting the time of those who are not going to gain benefit from it or become despondent that it is not working.

Oh..and let's not forget the other scandal of women who actually had ovarian cancer being told they had IBS and sent for counselling. Thankfully though GPs are all clearly told now that the development of IBS in women over the age of 50 is rare and symptoms should be investigated, it's not long at all since women were sent along to the counsellor for their "post-menopasaul anxiety with IBS" that turned out very sadly to be ovarian cancer.

Hope you recover quickly Mike, take it easy...

Good link from Canada Mark...

Biopsies are taken with tiny forceps. They only grab a small piece of the bowel lining, and don't go near nerves.
The lining of the bowel has no 'feeling'. You could eat a bit of glass and not be aware of it passing, or swallow a pill cam! The bowel senses, and responds to, distension (stretching). When fibre is consumed, it swells the bowel contents, triggering faster peristalsis - which can cause pain.

The damage done to the complex nervous feedback system, from injury and/or inflammatory processes, is a newer area of study in the gut. It really is a complex relationship, but most often there is some kind of physical/chemical disturbance that starts the disharmony.

*missed NCOT's post...yeah, definitely a two way street.. Stress and anxiety can feed back into the gut processes.

Post Edited (ambling) : 5/15/2015 6:39:00 PM (GMT-6)

London Lurker said...
It seems we are still pack animals and a sense of not being "in the pack" causes stress and can trigger epigenetic change.

Won't bore you with details, but that's exactly what I'm feeling like at the moment. Well, technically I've felt it all my life, but it's only very recently that I've broken away from my dysfunctional pack (my family) and so the loneliness has intensified. I also suffered childhood bullying. It's not really surprising that I'm not very healthy.

London Lurker said...
For me it's one of the very difficult things with UC because the need for a loo and the fatigue have made me much more of a loner and it seems that this may add to ill health.

It's certainly understandable. I had the being too ill and fatigued to go out much for years. I'm in a surgery-induced remission, but still suffer from fatigue. Had a bit of that today; the drive went well, but it used up most of my mental and physical resources. (Switching lanes on the North Circular roundabout feels like you're taking your life into your hands: it's mad scary.) Was so tired for the first couple of hours, but thank god after that I perked up a bit, otherwise the whole day would have been a struggle to get through.

@OM - Hope you're feeling better today. I had a bout of norovirus a while ago. It was absolutely brutal; never felt that bad with norovirus before, I think it was the lack of a colon and dehydration which did me in.

NiceCupOfTea said...

London Lurker said...
It seems we are still pack animals and a sense of not being "in the pack" causes stress and can trigger epigenetic change.

Won't bore you with details, but that's exactly what I'm feeling like at the moment. Well, technically I've felt it all my life, but it's only very recently that I've broken away from my dysfunctional pack (my family) and so the loneliness has intensified. I also suffered childhood bullying. It's not really surprising that I'm not very healthy.
.

Respect you for trying to make the change NCOT. I hope you can find a new "pack". I need to get looking for mine. Being my most ill these past couple of years has been sobering to find how quickly people drop off

Glad you are doing better OM and hopefully not flared from this.

then it's time to find new people who will. Much, much easier said than done...

It shouldn't be that hard. After 5 years of posting (and sometimes getting banned), it seems that you have a good head on your shoulders. The whole class of newbies who arrived here in 2010 seem interesting, myself included, of course.

You live on the other side of the ocean and I am old enough to be your father. And for sure every day we would be at each others' throats fighting about vaccines and diet. But other than those minor details we might have been able to get along. In a world of 7 billion people there has to be someone out there who you could get along with.

Coffeemate said...
I must be a recluse, I don't get lonely. I prefer being alone.

Depends massively on circumstance as well as personality.

If I was surrounded by people for too long, I'd crave being on my own. It's a different story when you're on your own 24/7 with no obvious end in sight though. If you can enjoy that degree of solititude, I doff my hat to you.