IBS

Study: Children with IBS found to be deficient in vitamin D

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Image: Study: Children with IBS found to be deficient in vitamin D

As many as one in six children suffer from irritable bowel syndrome (IBS) and its uncomfortable symptoms, including cramps, bloating, diarrhea and constipation. However, it appears that many children with IBS are also deficient in vitamin D.

A study published in PLOS ONE revealed that more than 90 percent of children with IBS lack vitamin D.

Being deficient in vitamin D likewise increases their risk for decreased bone mass, as having adequate vitamin D levels is important for the growth and development of bones of children.

In the study, the researchers analyzed the medical records of 55 children with IBS and compared their data to 116 healthy controls. The results revealed that one out of every two children with IBS is deficient in vitamin D compared to one out of every four healthy children and adolescents without IBS.

The study further looked into the association between vitamin D status and the presence of anxiety, depression, and migraine headaches that often come with IBS. Patients with IBS and migraine had significantly lower vitamin D levels compared to controls, which suggests that supplementing with Vitamin D might improve their headache symptoms.

With these findings, the researchers recommend pediatric IBS patients to monitor their vitamin D status and supplement with vitamin D if they are deficient in the vitamin.

More on vitamin D

Vitamin D helps the body absorb calcium, which is one of the building blocks of bone. Vitamin D also plays a role in the nervous, muscle, and immune systems. There are three ways to get vitamin D: through the skin, from food, and from supplements. Foods that are naturally rich in vitamin D include fatty fish like salmon and tuna, beef liver, raw cheese, mushrooms, and egg yolks. After being exposed to sunlight, the body naturally produces vitamin D. However, too much exposure to the sun can result in skin aging and skin cancer, which is why many people try to get their vitamin D from other sources.

Mother Nature’s micronutrient secret: Organic Broccoli Sprout Capsules now available, delivering 280mg of high-density nutrition, including the extraordinary “sulforaphane” and “glucosinolate” nutrients found only in cruciferous healing foods. Every lot laboratory tested. See availability here.

The amount of vitamin D a person needs every day depends on their age. The recommended amounts of vitamin D are the following:

  • Birth to 12 months: 400 international units (IU)
  • Children 1 to 13 years: 600 IU
  • Teens 14 to 18 years: 600 IU
  • Adults 19 to 70 years: 600 IU
  • Adults 71 years and older: 800 IU
  • Pregnant and breastfeeding women: 600 IU

Unfortunately, many are deficient in vitamin D. In the U.S. alone, approximately 42 percent of the population is vitamin D deficient. People can become deficient in vitamin D for various reasons. Some may not get enough vitamin D in their diet or have a malabsorption problem, in which they could not absorb enough vitamin D from food, while others may not get enough sunlight exposure. Some people may also have problems with their liver or kidneys that these organs cannot convert vitamin D to its active form in the body. Taking certain medicines can also interrupt the body’s ability to covert or absorb vitamin D. (Related: Vitamin D deficiency is widespread among U.S. population, expectant mothers are deficient and giving birth to deficient infants.)

As mentioned earlier, vitamin D is important for bone growth and development. Severe vitamin D deficiency can result in bone density loss, which can contribute to osteoporosis and fractures. Vitamin D deficiency can also result in many other diseases. In children, it can cause rickets, which is a rare condition that causes the bones to become soft and bend. In adults, it can result in osteomalacia, which causes weak bones, bone pain, and muscle weakness.

Read more news stories and studies on the importance of vitamin D by going to VitaminD.news.

Sources include:

UMassMed.edu

MedlinePlus.gov

CantonMercy.org

Gastroenterologists Share 7 Things to Do When You Have Painful Gas

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Pain is the cruel cherry on top.
Gas-Pains

Pretty much no one is happy to have gas (with the exception of the elementary school set, who of course finds it hilarious). Gas is a normal part of having a body, but it can also be straight-up painful sometimes.

Since you probably don’t feel comfortable calling out sick from work with gas or otherwise letting it disrupt your life, you likely want to get things sorted out ASAP. As it turns out, the key to fixing painful gas is knowing why it happens in the first place.

There are a few reasons gas can develop, and, well, it has to go somewhere.

Gas often happens as a normal part of your digestive process. Your stomach and small intestine don’t entirely break down certain carbohydrates you eat, so they end up getting to your large intestine intact, according to the National Institute of Diabetes and Digestive and Kidney Diseases. There, bacteria make gas as they process these undigested sugars, fibers, and starches. Certain foods, like dairy products and cruciferous vegetables such as Brussels sprouts, are more likely to cause gas than others, but everyone’s triggers are different.

You can also get gas if you swallow a lot of air. While it’s unlikely that you’re actually trying to suck down a bunch of oxygen, certain habits like regularly using a straw, drinking carbonated beverages, eating too quickly, and chewing gum can cause you to take in more air than normal. When this causes gas, it’s typically via burping, since the air comes back up before it can go all the way to your stomach.Beyond those causes, gas can happen if you have health conditions that affect your digestive system, like irritable bowel syndrome, ulcerative colitis, or Crohn’s disease, or bacterial overgrowth in the small intestine, according to the Mayo Clinic.

OK, but why does gas sometimes hurt so bad that you want to cry and check yourself into the ER?

Good question. Painful gas and other bothersome symptoms like bloating can happen if gas builds up in your system because you can’t expel it (like if you’re purposely holding it in), if you eat something that really doesn’t agree with you, or if you have an underlying condition that prevents gas from moving through your system normally. All of this can cause spasms and distension in your large intestine during the digestive process, which can be pretty painful, Jamile Wakim-Fleming, M.D., a gastroenterologist at the Cleveland Clinic, tells SELF.

Unfortunately, there isn’t one magic pill that will immediately get rid of any painful gas you may be experiencing. The drug simethicone, which is an anti-foaming agent present in medicines like Gas-X, is designed to reduce bloating and pain from gas and may help, but it’s not a guarantee, Kyle Staller, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital, tells SELF.

There are, however, a few tricks you can try to either make the gas go away or, at the very least, make you feel better.

1. Sip a glass of water slowly.

Drinking water does two things, says Dr. Wakim-Fleming: It can help move any gas-causing foods in your system through the digestive process, and it makes it harder for your intestines to contract in a way that gasses you up. See, your intestines contract to move food, and if they contract too strongly or for too long, that can lead to or exacerbate gas.

2. Try to stop swallowing so much air—seriously.

Downing some water can be counterproductive if you’re doing it in a way that will only lead to more gas. Until the pain abates, avoid habits that can lead to swallowing a ton of air, like taking big gulps of water at a time, using straws, drinking fizzy beverages, sucking your food down too quickly, talking a lot while eating, and chewing gum, Dr. Wakim-Fleming says.

3. Try getting up and walking around.

Exercise isn’t just great for your overall health—it can also help clear up painful gas and bloating. While a five-mile run probably isn’t first on your to-do list when you’re doubled over in pain, if you can manage a quick walk or other gentle movement, that can make a big difference.

“Exercise helps exercise your intestines, too,” Dr. Wakim-Fleming says. Experts don’t know exactly why exercise helps move gas along, but something about physical activity helps to boost your intestines’ muscle activity, Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, Calif., tells SELF. (This is part of why exercise is recommended for constipation.)

4. Consider if dairy is actually the culprit.

If you’re currently in the fetal position dealing with gas pain, think back to how much cheese, milk, and ice cream you had recently—even if you don’t think you’re lactose intolerant. You can spend years having zero issues when you drink a venti latte in the A.M., followed by a grilled cheese sandwich at lunch…until you suddenly do. As most people age, they start making less lactase, an enzyme that breaks down lactose, the sugar in dairy products, Dr. Staller says. This is one cause of lactase deficiency and lactose intolerance. As your digestive system’s bacteria tries to break down lactose without enough lactase to do the job, you may experience annoying symptoms like more painful gas than usual.

“Many people in their 20s and 30s have symptoms and don’t suspect that it’s the dairy products,” Dr. Staller says. If you think dairy is behind your painful gas, try cutting it out for a few weeks (or at the very least, the rest of the day) and see where that gets you.

5. Have some peppermint oil or peppermint tea.

It’s not just for your breath—peppermint can act as a spasmolytic, meaning it may help stop your intestines from spasming too much (which is what increases gas), says Dr. Staller. While this mechanism has mainly been studied in regard to irritable bowel syndrome, the muscle contractions in that disorder are the same ones that can make gas feel so terrible, he says.

Doctors aren’t totally sure whether it’s better to take peppermint in a capsule form or via something more standard like a mint or peppermint tea, so feel free to try whatever you have handy (but be sure to follow the instructions if you’re ingesting peppermint oil as a pill).

6. Snuggle under a blanket with a heating pad on your abdomen.

It’s not a hard sell when you feel like crap, but cozying up under a blanket with a heating pad on your abdomen can actually help fight gas. Like peppermint, warmth can have an antispasmodic effect on your body and help your intestines to relax instead of contract too hard or too much, lessening that achy sensation that all too often comes along with gas, Dr. Wakim-Fleming says. And don’t worry that lying down means your gas is having to struggle against gravity to exit—it makes no difference either way, Dr. Farhadi says. (Though, as we said, getting up and walking around for a bit can also be helpful to do before or after you settle in with a heating pad.)

7. And lastly, commit to keeping your fiber intake in check.

Fiber is a key part of a healthy diet and digestive system. It bulks up your stool, which helps you stay regular instead of getting constipated. But on the flip side, having too much fiber can make you gassy as the bacteria in your colon works to break this tough nutrient down, Dr. Farhadi says.

If you find that you’re always in pain after you eat a salad with both broccoli and Brussels sprouts, it’s really best to avoid those foods (or whatever the fiber-heavy food may be) until you feel better—and to try to space out when you eat them in the future.

These tips should, at the very least, help make your painful gas feel a bit better. But if you’re struggling with incredibly painful gas and nothing is helping, call your doctor. They should be able to help you find the root of the issue—and how to stop it.

Living and looking for lavatories – why researching relief is so relevant

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Toilets are a source of interaction, social structures, organisation, norms and values. So why aren’t sociologists discussing them more?

Toilets are a private side of life that is rarely discussed, or if we do disclose our habits we do so with hesitation, euphemisms or a nervous giggle. But toilets are a very public issue.
Toilets are a private side of life that is rarely discussed, or if we do disclose our habits we do so with hesitation, euphemisms or a nervous giggle. But toilets are a very public issue. 

It may be a turn of the stomach, a nervous flutter, a morning coffee or a sudden, unpredictable rush. You may look for a sign, if you are lucky enough to live in a society where they are readily available. There may or may not be a queue, often depending on the room of your gender. You may look for disabled access, whether you are in a wheelchair or have an invisible illness. You may select a space based on who is there, or your perception of its cleanliness. For some, it is an unwritten rule that one cannot go next to another person relieving themselves. What are you looking for?

A lavatory.

Also known as a toilet, bog, ladies, gents, pisspot, restroom, dunny, convenience, powder room, and the WC, to name a few alternatives.

Toilets are mundane, an everyday space, a common fixture in the home and the workplace, a thing that we all use, in diverse ways. Toilets have historically been(and continue to be) shaped by our cultures, gender, social class and ethnicity with clear boundaries, distinctions and divisions imposed. This, in turn, shapes our social identities.

Toilets are a personal thing; a private side of life that is rarely discussed. If we do disclose our habits or toilet trips we do so with hesitation, euphemisms or a nervous giggle. However, toilets are a very public issue. They are in department stores, coffee shops, pubs, restaurants and on trains. There is a declining number of public toilets, now often vandalised and abandoned, perceived as unhygienic, or a place of illegal activity and other “hazards”.

Toilets are a source of interaction, of social structures, organisation, norms and values. So why aren’t sociologists discussing them more?

I have a bowel problem. I live with an unpredictable bowel, one that changes every day, with symptoms ranging from abdominal pain to bloating and urgency to find a toilet. Bowel conditions are not socially accepted and discussed conditions: a disclosure is often regarded as “too much information”. The anxiety of the symptoms and the urgent need to use toilets led me to toilet mapping: making mental notes of the nearest toilets, and the quickest way to get to them. Toilets became not just a functional space, but also a place of safety and relief, in more than one sense.

I am not alone. There are a variety of conditions for which knowledge of toilet locations are crucial for managing symptoms – conditions such as bladder incontinence, Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS), for example. My PhD research is focusing on the common condition of IBS. According to NHS Choices, 20% of the UK population lives with IBS – arguably more, given the concealment of the condition. Despite this, bowel conditions and the symptoms of constipation, diarrhoea, flatulence, (in)continence and other activities that take place in the “private” realm of the toilets remain heavily taboo topics in contemporary western society.

My research explores the lived experience of managing symptoms of IBS, particularly in the spaces where symptoms are mostly managed: the bathroom.

My research examines how places such as toilets can be reflective of our practices of privacy and containment of our bodily excretions. We may divide ourselves and our relations to each other in such a way that makes life with conditions such as IBS incredibly isolating. This means that the coping strategies and challenges faced in the day-to-day life of people who live with these conditions are underappreciated, hidden and, crucially, misunderstood.

Some would argue that bathrooms and toilets are the backstage of social life. However, there are many performances still going on within the toilet cubicle: the holding on until another person has left the toilet; waiting until the hand dryer goes on; blaming the time spent in the toilet on a fictional queue. Whilst this may seem an obvious behaviour of privacy and dignity, the strategies of toilet mapping and negotiating toilet spaces to keep one’s IBS identity private question the boundaries of society, the public and the private, the clean and the dirty, self and other.

In discussing my research, I often face a reception of pure horror, a nervous laugh or a joke, but very rarely an open, honest, discussion of our own bowel habits and toilet behaviours. The awkwardness around the topic creates greater challenges for those living with bowel conditions, and reinforces stigma. Some may laugh at the fact I talk about poo and toilets in my academic life. There may be banter about bowels, a joke that I need a colon in my future research papers or conference presentations. But is the difficulty of living with an unpredictable bowel in an unaccommodating society really that funny? It’s time to talk shit.

Source:/www.theguardian.com

How to Treat IBS (Irritable Bowel Syndrome) Naturally

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IBS or Irritable Bowel Syndrome can happen to anyone. Usually, people who suffer from IBS don’t have a healthy diet and/or are exposed to stressors regularly. Then, there are also those who have IBS due to food allergies that they are not aware of. And in extreme cases, people who have depression and/or anxiety disorder can also be victims of IBS.

image

Do note that IBS is different from LBM (Loose Bowel Movement or, in layman’s terms, diarrhea). While both are characterized by diarrhea and stomach cramps, IBS has other symptoms, such as bloating, constipation, gas, mucus in the stool, and irregular bowel movement.

It’s tempting to treat IBS using prescription drugs and over-the-counter medications since these can give you a quick fix — but why not go the natural route and leave those chemicals behind? Plus, you lower your chances of experiencing side effects from taking these pills.

Here are some suggestions on IBS natural treatment

1. Learn how to manage your stress better

When you are stressed out, your hormones not only go haywire; your stomach’s acidity will also shoot up. When that happens, your digestive system (particularly the small intestine) is affected negatively, thus leading to IBS.

Not everyone is equipped with the right disposition and mindset to deal with stress properly. Sometimes, you get so stressed that you fail to see how you can get out of that abyss you are in. The solution: Try meditation and other relaxing techniques to help you cope with stress better. Deep breathing exercises as soon as you wake up and before you go to sleep at night can help.

Changing your perspective is a great way to manage stress better, too. Instead of dwelling in negativity, keep telling yourself that you are stronger than you think — and therefore, you will be able to deal with stressful people and situations better.

Another IBS natural treatment is to anticipate which triggers stress. How do you do this? Start keeping a journal (it doesn’t matter if it’s a handwritten or “digital” one) and jot down the stressful incidents, events, and people that you face. Doing so will help you identify these IBS stress-related causes — and learn how to cope with them, if not avoid them completely.

2. Find out if you’re allergic to certain types of food

People have this preconceived notion that allergies appear as early as infancy or childhood. However, the truth is that some allergies develop over time. For example, you may have been fine eating seafood before, yet suddenly you’re breaking out in hives and experiencing IBS after consuming a seafood-laden pasta dish. If this occurs once or twice, that may be okay, but if it keeps recurring, then you may have to get tested for food allergies.

If you don’t have the budget — or time — to get yourself tested, try eliminating seafood, nuts, eggs and other dairy products, and other common food allergens (such as soy, yeast, dairy, and gluten) from your diet. Avoid these typical allergens for 12 weeks, then reintroduce them again one by one so you can narrow down which ones are causing the allergies.

3. Eat healthy

Making your diet more nutritious is an effective IBS natural treatment. Incorporate fiber-rich foods such as leafy greens and fruits into your diet, but don’t shock your system with too much of these if you’re not used to eating fruits and veggies on a regular basis. The best way is to increase the amount of fiber gradually.

Make it a point to regularly drink peppermint or ginger tea, which are both known to soothe stomach and digestive problems. IBS can also strip away good bacteria (which you need to keep IBS at bay) from your digestive system, so load up with foods that contain good bacteria, such as cultured (coconut) yogurt, miso, and sauerkraut.

Breath Test to Detect IBS Masqueraders

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Sometimes a ‘diagnosis of exclusion’ doesn’t exclude everything.

  • by Shawn Khodadadian MD

In my practice, I deal with many patients whose lives are affected on a daily basis by symptoms of functional bowel disorders. They suffer from gas, bloating, and other bothersome symptoms that interfere with everyday life.

They often undergo procedures to rule out conditions such as peptic ulcer disease, colitis, and other conditions. Many of them are diagnosed with irritable bowel syndrome (IBS).

These patients are placed on severely restrictive diets by healthcare professionals or even well-intentioned, but misinformed friends and family. For example, the common practice of restricting dairy products in nonlactose intolerant patients can be unnecessarily restrictive. These additional — and sometimes unwarranted — restrictions can make adequate diet selection difficult.

In patients who do not have celiac disease, sensitivity to gluten may still exist. But ruling out other testable and common intolerances (such as lactose or fructose) and small intestinal bacterial overgrowth may be a good idea before long-term gluten restriction in these patients.

I have found that offering my patients hydrogen breath testing can be valuable in helping us diagnose on two fronts: overlooked intolerances to lactose or fructose, as well as small intestinal bacterial overgrowth.

There is a growing body of literature highlighting symptoms that may be attributable to poor absorption of short chain sugars. Fermentable oligo-, di-, and monosaccharides, and polyols (FODMAPs) may trigger gastrointestinal symptoms in IBS patients, and adherence to these diets has been associated with symptoms improvement.

Small intestinal bacterial overgrowth is a condition characterized by excessive growth of small intestinal bacteria and can be associated with inflammation and nutrient malabsorption. Patients may have symptoms such as bloating, dyspepsia, abdominal discomfort, and diarrhea, which may be mistakenly labeled as irritable bowel syndrome. This is important for treatment: bacterial overgrowth may respond to a short course of antibiotics rather than long-term management of uncomfortable symptoms.

Breath testing measures the hydrogen and methane gas produced by bacteria in the small intestine that has diffused into the blood and then lungs for expiration. During a breath test, patients are asked to give a baseline breath sample and then ingest a substance such as lactose, fructose, or lactulose. Subsequent breath samples are then taken to determine if these substances were adequately digested or if there may be an overgrowth of small intestinal bacteria.

We have found these tests to be quite useful in treating patients with gas and bloating and IBS. They allow us to place patients on accurate and specific diet plans. Our patients are very appreciative of being able to identify which foods cause their adverse symptoms, which subsequently leads to a more free diet.

We have found that many of our patients who had previously been told to restrict lactose and fructose may in fact not have issues with digesting these substances and can expand their already restricted diets. This extra piece of information can make a difference for patients and can be as simple as taking a breath.

A role for the gut microbiota in IBS.

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The past decade has witnessed an explosion of knowledge regarding the vast microbial community that resides within our intestine—the gut microbiota. The topic has generated great expectations in terms of gaining a better understanding of disorders ranging from IBD to metabolic disorders and obesity. IBS is a condition for which investigators have long been in search of plausible underlying pathogeneses and it is inevitable that altered composition or function of the gut microbiota will be considered as a potential aetiological factor in at least a subset of patients with IBS. This Review describes the evidence implicating the gut microbiota in not only the expression of the intestinal manifestations of IBS, but also the psychiatric morbidity that coexists in up to 80% of patients with IBS. The evidence described herein ranges from proof-of-concept studies in animals to observational studies and clinical trials in humans. The gut microbiota is subject to influences from a diverse range of factors including diet, antibiotic usage, infection and stress. These factors have previously been implicated in the pathophysiology of IBS and further prompt consideration of a role for the gut microbiota in IBS.

Mechanisms and efficacy of dietary FODMAP restriction in IBS.

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IBS is a debilitating condition that markedly affects quality of life. The chronic nature, high prevalence and associated comorbidities contribute to the considerable economic burden of IBS. The pathophysiology of IBS is not completely understood and evidence to guide management is variable. Interest in dietary intervention continues to grow rapidly. Ileostomy and MRI studies have demonstrated that some fermentable carbohydrates increase ileal luminal water content and breath hydrogen testing studies have demonstrated that some carbohydrates also increase colonic hydrogen production. The effects of fermentable carbohydrates on gastrointestinal symptoms have also been well described in blinded, controlled trials. Dietary restriction of fermentable carbohydrates (popularly termed the ‘low FODMAP diet’) has received considerable attention. An emerging body of research now demonstrates the efficacy of fermentable carbohydrate restriction in IBS; however, limitations still exist with this approach owing to a limited number of randomized trials, in part due to the fundamental difficulty of placebo control in dietary trials. Evidence also indicates that the diet can influence the gut microbiota and nutrient intake. Fermentable carbohydrate restriction in people with IBS is promising, but the effects on gastrointestinal health require further investigation.

Mechanisms by which short-chain fermentable carbohydrates might induce symptoms in IBS.

Conclusions

Individuals with IBS or other functional bowel disorders have historically been difficult to treat by both medical and dietary means. Widespread progress in the dietary management of IBS has been of major interest and has helped to successfully manage symptoms in patients. However, further work is urgently needed both to confirm clinical efficacy of fermentable carbohydrate restriction in a variety of clinical subgroups and to fully characterize the effect on the gut microbiota and the colonic environment. Whether the effect on luminal bifidobacteria is clinically relevant, preventable, or long lasting, needs to be investigated. The influence on nutrient intake, dietary diversity, which might also affect the gut microbiota,137 and quality of life also requires further exploration as does the possible economic effects due to reduced physician contact and need for medication. Although further work is required to confirm its place in IBS and functional bowel disorder clinical pathways, fermentable carbohydrate restriction is an important consideration for future national and international IBS guidelines.

New finding could ease bowel trouble.

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http://m.timesofindia.com/life-style/health-fitness/health/New-finding-could-ease-bowel-trouble/articleshow/18429468.cms

Selective Serotonin Reuptake Inhibitors for the Treatment of Hypersensitive Esophagus: A Randomized, Double-Blind, Placebo-Controlled Study.

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Ambulatory 24-h pH–impedance monitoring can be used to assess the relationship of persistent symptoms and reflux episodes, despite proton pump inhibitor (PPI) therapy. Using this technique, we aimed to identify patients with hypersensitive esophagus and evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on their symptoms.

METHODS:

 

Patients with normal endoscopy and typical reflux symptoms (heartburn, chest pain, and regurgitation), despite PPI therapy twice daily, underwent 24-h pH–impedance monitoring. Distal esophageal acid exposure (% time pH <4) was measured and reflux episodes were classified into acid or non-acid. A positive symptom index (SI) was declared if at least half of the symptom events were preceded by reflux episodes. Patients with a normal distal esophageal acid exposure time, but with a positive SI were classified as having hypersensitive esophagus and were randomized to receive citalopram 20 mg or placebo once daily for 6 months.

RESULTS:

 

A total of 252 patients (150 females (59.5%); mean age 55 (range 18–75) years) underwent 24-h pH–impedance monitoring. Two hundred and nineteen patients (86.9%) recorded symptoms during the study day, while 105 (47.9%) of those had a positive SI (22 (20.95%) with acid, 5 (4.76%) with both acid and non-acid, and 78 (74.29%) with non-acid reflux). Among those 105 patients, 75 (71.4%) had normal distal esophageal acid exposure time and were randomized to receive citalopram 20 mg (group A, n=39) or placebo (group B, n=36). At the end of the follow-up period, 15 out of the 39 patients of group A (38.5%) and 24 out of the 36 patients of group B (66.7%) continue to report reflux symptoms (P=0.021).

CONCLUSIONS:

 

Treatment with SSRIs is effective in a select group of patients with hypersensitive esophagus.

Source: Nature Gut.

 

Irritable Bowel Syndrome in the Brain

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IBS Patients’ Brains on High Alert, With Less Control of Emotion and Pain

July 23, 2010 — Irritable bowel syndrome (IBS) may be in the brain, not in the mind.

IBS patients tend to suffer anxiety and depression, but they tire of being told their symptoms of diarrhea, constipation, and/or pain are all in their minds.

Now there’s evidence that their underlying problem may be due to the structure of their brains, says Emeran Mayer, MD, professor of medicine, physiology, and psychiatry at the University of California, Los Angeles.

“Discovering structural changes in the brain … demonstrates an ‘organic’ component to IBS and supports the concept of a brain-gut disorder,” Mayer says in a news release. “The finding removes the idea once and for all that IBS symptoms are not real and are ‘only psychological.’ The findings will give us more insight into better understanding IBS.”

Mayer, David A. Seminowicz, PhD, and colleagues at UCLA and Canada’s McGill University used sophisticated scans to compare the brain anatomy of 55 women with moderate IBS to 48 age-matched healthy women.

The finding: Thinning grey matter — the part of the brain rich in neurons — in specific areas of the brain. The affected areas involve:

  • Dampening the brain’s arousal system. IBS patients tend to be over-sensitive to (and hypervigilant for) bowel sensations.
  • Controlling emotion. Symptom-related worries and ineffective coping strategies play an important role in chronic pain syndromes.
  • Controlling pain. Brain thinning in this region was seen only in patients who listed pain as their most bothersome IBS symptom.

Importantly, brain areas linked to anxiety and depression were no different in IBS patients than in anxious or depressed people without IBS.

The findings, Seminowicz and colleagues suggest, point to a difference between IBS and chronic pain syndromes such as fibromyalgia.

In chronic pain syndromes, nerves constantly send increased pain signals to the brain. But in IBS, the brain itself seems to be amplifying pain signals it receives from the bowel.

The researchers say future studies should look at family members of IBS patients, to see if they inherited the same brain anatomy that may increase a person’s risk of IBS. If so, the studies may reveal genetic components of IBS and point the way to new treatments.

The study appears in the July issue of the journal Gastroenterology.