Western Healing Irritable Bowel Syndrome

Irritable bowel syndrome

HELPING (IBS) WITH MASSAGE HYPNOSIS AND PSYTHOTHERPY

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Irritable bowel syndrome (IBS)

is a functional bowel disorder characterized by abdominal pain, discomfort or bloating relieved by defecation and alteration of bowel habits. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). IBS may begin after an infection (post-infectious, IBS-PI) or a stressful life event. Other functional or pain disorders and certain psychological conditions are more common in those with IBS.

Treatment for IBS can include dietary adjustments,MASSAGE and Psychological Interventions. Patient Education

Several conditions may present as IBS including celiac disease, mild infections, several inflammatory bowel diseases, functional chronic constipation and chronic functional abdominal pain. In IBS, routine clinical tests yield no abnormalities, though the bowels may be more sensitive to certain stimuli, such as balloon insufflation testing. The exact cause of IBS is unknown. The most common theory is that IBS is a disorder of the interaction between the brain and the gut, although there may also be abnormalities in the gut flora or the immune system. And it is here at Western Healing we help most because of the ability to be able to massage the gut as well as delve into the interlect to uncover other efects of IBS

Symptoms

The primary symptoms of IBS are abdominal pain or discomfort in association with frequent diarrhea, constipation, or a change in bowel habits. There may also be urgency for bowel movements, a feeling of incomplete evacuation (tenesmus), bloating or abdominal distention. People with IBS more commonly than others have gastroesophageal reflux, symptoms relating to the genitourinary system, psychological symptoms, fibromyalgia, headache and backache

IBS can be classified as either diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) or IBS with alternating stool pattern (IBS-A or pain-predominant). In some individuals, IBS may have an acute onset and develop after an infectious illness characterised by two or more of the following: fever, vomiting, diarrhea, or positive stool culture. This post-infective syndrome has consequently been termed "post-infectious IBS" (IBS-PI).

Diagnosis

There is no specific laboratory or imaging test which can be performed to diagnose irritable bowel syndrome.Diagnosis of IBS involves excluding conditions which produce IBS-like symptoms, and then following a procedure to categorize the patient's symptoms.

Because there are many causes of diarrhea and IBS-like symptoms, the American Gastroenterological Association has published a set of guidelines for tests to be performed to diagnose other conditions which may have symptoms similar to IBS. These include gastrointestinal infections, lactose intolerance and Coeliac disease. Research has suggested that these guidelines are not always followed.Once other causes have been excluded, the diagnosis of IBS is performed using a diagnostic algorithm. Well-known algorithms include the Manning Criteria, the Rome I Criteria, the Rome II Process, the Kruis Criteria, and studies have compared their reliability. The more recent Rome III Process was published in 2006. Physicians may choose to use one of these criteria, or may use other guidelines based on their own experience and the patient's history. The algorithm may include additional tests to guard against mis-diagnosis of other diseases as IBS. Such "red flag" symptoms may include weight loss, GI bleeding, anemia, or nocturnal symptoms. However, researchers have noted that red flag conditions may not always contribute to accuracy in diagnosis — for instance, as many as 31% of IBS patients have blood in their stool.

The diagnostic algorithm identifies a name which can be applied to the patient's condition based on the combination of the patient's symptoms of diarrhea, abdominal pain, and constipation. For example, the statement "50% of returning travelers had developed functional diarrhea while 25% had developed IBS" would mean that half the travelers had diarrhea while a quarter had diarrhea with abdominal pain. While some researchers believe this categorization system will help physicians understand IBS, others have questioned the value of the system and suggested that all IBS patients have the same underlying disease but with different symptoms.

Researchers have identified several medical conditions, or comorbidities, which appear with greater frequency in patients diagnosed with IBS.

Headache, Fibromyalgia, and Depression: A study of 97,593 individuals with IBS identified comorbidities as headache, fibromyalgia, and depression. Fibromyalgia has also been identified in other studies as a comorbidity of IBS.

Inflammatory bowel disease: Some researchers have suggested that IBS is a type of low-grade inflammatory bowel disease. Researchers have suggested that IBS and IBD are interrelated diseases, noting that patients with IBD experience IBS-like symptoms when their IBD is in remission. A 3-year study found that patients diagnosed with IBS were 16.3 times more likely to develop IBD during the study period. Serum markers associated with inflammation have also been found in patients with IBS (see Causes).

One study has reported a statistically significant link between migraine headaches, IBS, and endometriosis.

Other chronic disorders. Interstitial cystitis may be associated with other chronic pain syndromes, such as irritable bowel syndrome and fibromyalgia. The connection between these syndromes is unknown. Initially, IBS was considered a psychosomatic illness and the involvement of biological and pathogenic factors was not verified until the 1990s, a process common in the history of emerging infectious diseases. The risk of developing IBS increases six-fold after acute gastrointestinal infection. Post-infection, further risk factors are young age, prolonged fever, anxiety and depression.

Psychosomatic illness

One of the first references to the concept of an "irritable bowel" appeared in the Rocky Mountain Medical Journal in 1950. The term was used to categorize patients who developed symptoms of diarrhea, abdominal pain, constipation, but where no well-recognized infective cause could be found. Early theories suggested that the Irritable Bowel was caused by a psychosomatic, or mental disorder. One paper from the 1980s investigated "learned illness behavior" in patients with IBS and peptic ulcers. Another study suggested that both IBS and stomach ulcer patients would benefit from 15 months of psychotherapy. Later, it would be found that most stomach ulcers were caused by a bacterial infection with Helicobacter pylori

Additional publications suggesting the role of brain-gut "axis" appeared in the 1990s, such as a study entitled Brain-gut response to stress and cholinergic stimulation in IBS published in the Journal of Clinical Gastroenterology in 1993. A 1997 study published in Gut magazine suggested that IBS was associated with a "derailing of the brain-gut axis."

A study showed that intestinal biopsies from patients with constipation predominant IBS secreted higher levels of serotonin in-vitro. Serotonin plays a role in regulating gastrointestinal motility and water content, and can be altered by some diseases and infections.

Psychotherapy and hypnotherapy

There is a strong brain-gut component to IBS, and cognitive therapy may improve symptoms in a portion of patients ] In a randomized controlled trial of referred patients, cognitive behavioral therapy helped even though patients in this study did not have any psychiatric diagnoses.

Gut-directed or gut-specific hypnotherapy or self-hypnosis is one of the most promising areas of IBS treatment. An uncontrolled study shows that symptom reduction/elimination from IBS hypnotherapy can last at least five years.

"There was a greater improvement in the psychotherapy groups for patients with IBS after three months and for both IBS and PUD (peptic ulcer disease) patients after 15 months. The difference had become more pronounced after 15 months, with the patients given psychotherapy showing further improvement, and the patients who had received medical treatment only showing some deterioration.”

by J Svedlund, A psychosomatic approach to treatment in the irritable bowel syndrome and peptic ulcer disease with aspects of the design of clinical trials, 1985.

Most peptic ulcers are now treated with 1-2 weeks of antibiotic therapy, since it has been discovered that they are caused by a combination of a genetic trait in the patient and infection with the bacteria H. Pylori

Who gets Irritable Bowel Syndrome?

The problem is more common in women, and often occurs in early adulthood. It may last for years or even life. However, there tend to be good and bad periods as the symptoms fluctuate.

Can it lead onto more serious disease?

People with Irritable Bowel Syndrome have been found to have a lower chance than others of developing more serious or life-threatening bowel diseases. This is reassuring to many people, but does not mean serious diseases cannot occur separately. Therefore any new symptoms, especially developing in later life after years of Irritable Bowel Syndrome should be evaluated by a doctor.

Does stress play a part?

Stress may intensify bowel contractions and there is some evidence that people with Irritable Bowel Syndrome cope less well with stress than do other people. This is not surprising given that sufferers do not feel well. In fact, it may be surprising that people with Irritable Bowel Syndrome are not more stressed! Managing stress effectively, especially when it relates to one’s health, is an individual matter. Breaking any feedback cycle which could be playing a role is, however, important. Remembering that Irritable Bowel Syndrome is not associated with any more serious or life-threatening underlying bowel disease is a good place to start. Help may be found through relaxation perhaps just by taking regular physical exercise. Adequate sleep and avoidance of fatigue should be sought. learning to cope with life’s stresses may be needed by some people. Avoiding stressful situations, learning new ways of coping with them or using biofeedback to control one’s response may all have roles to play.

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