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Introduction
Every once in while I read a post on another blog that is so good that I don’t just sit back and think, “Now there’s a good post.” No, I sit back and think, “What an admirable, original post! I wish I had written something like that.” Sophie, who runs the IBS Tales blog, has just written that kind of post, on “Why self-diagnosis is so crazy.”
Listing Reasons
From time to time I see lists of IBS symptoms on web sites and blogs. Without giving it much thought, I say to myself “Perhaps For My Tummy should do something like that,” and then never write it. Of course I’m a procrastinator; that’s a perfectly good reason for not setting up a page with common symptoms of IBS. A second reason is wanting to think that readers come to this blog with some knowledge of what Irritable Bowel Syndrome is (or isn’t) and what the symptom picture is likely to be. A third rationale is not particularly wanting to specialize in either IBS-C (predominantly constipation) or IBS-D (predominantly diarrhea) or IBS-A (C and D are Alternating), nor discuss the specific forms that IBS takes–so I don’t discuss the typing of IBS according to current or historical symptom. It’s just IBS, and you know what kind you have, presumably.
Deepest Concern
AND the deep underlying ultimate reason is that I don’t want you, the reader, to diagnose yourself based on this web site. Use a lot of self-help measures, yes. Avoid things that don’t help, yes. Diagnose yourself, no. If that means you go get that colonoscopy your doctor says you need to have for a diagnosis, then this site will cheer you on and provide moral support–mostly metaphorical, it’s true. And for more encouragement on that path, of getting a real medical IBS diagnosis, read Sophie’s post.
Discuss
Do you have a strong reaction to this policy? See the “No Comment” link below–or if there’s been a comment, the link will have the number of comments? Click on that and a window will open that allows you to disguise your identity and tell us what you think.
January 17th, 2008
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Blog, Medical, general, IBS, Irritable Bowel Syndrome, IBS Symptoms |
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Digestive Advantage-IBS Probiotic
The week I chose to start Digestive Advantage–IBS turned out to be more stressful than I expected. This web site went down, for reasons that are not yet clear. I had meetings two days in a row in different parts of town, and transportation was disrupted by demonstrations. I promised two people copies of a report and wasn’t able to deliver them. Tuesday I had a tooth pulled, and had to take 4 amoxicillin capsules, against inflammation/infection. Amoxicillin always gives me diarrhea. You’ve all had weeks like this.
Symptoms
My changing probiotics from Align to Digestive Advantage-IBS meant that Monday and Tuesday nights were a little uncomfortable with gas pains. Wednesday morning, knowing I would have a stressful day, I took two Digestive Advantage-IBS caplets. I had no more pain, although sitting through a long meeting I was aware of silently passing gas.
By Thursday, I had dropped back to one caplet, and in a different meeting with different people I still silently passed gas a couple of times. (I don’t know about the “deadly” part because I do not have a well-developed sense of smell–makes for a certain amount of serenity!)
Thursday night, still another meeting, and then making one of those huge copies against a deadline, I had a very quiet tummy, and it is continuing today. No diarrhea from the Amoxicillin. That looks good for Digestive Advantage-IBS, so far.
Schedule
I’ll continue to report once a week, approximately on Friday.
September 21st, 2007
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Probiotics, Irritable Bowel Syndrome, Digestive Advantage - IBS, IBS Symptoms |
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I have been fixing up the inner workings of For My Tummy. This involved going back over two months of posts, and that gave me the chance to notice that I had posted once on two rules for IBS, here. And then, ten days or so before that, I had posted on the one rule for IBS.
The rules in reverse order are:
-
Never Drink Ice Water
- Never Eat on an Empty Stomach
- The Second-Day Rule<
“The Second-Day Rule” needs a little explaining. If you try a new food and have no problems with it on the first day, don’t scarf it up on the second day, thinking “Oh, boy. Now it’s okay to eat xyz!” It will come back to bite you. In other words, some foods–like the IBS triggers–are ok for one day at a time, but not for day-in, day-out use.
Taken together, the three rules make life sound like hard work for people with Irritable Bowel Syndrome. That’s true! I don’t want to coat it with Stevia to make it easier to swallow–actually Stevia would taste bitter if you used it in that way! What I want to do is to give you some sign posts so that what is happening in terms of Irritable Bowel Symptoms, whether constipation or diarrhea or cramps or alternating stuff–so that these symptoms make some kind of sense and potentially can be controlled.
September 12th, 2007
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Gastrocolic Reflex, IBS, Irritable Bowel Syndrome, IBS Triggers, IBS-C, IBS-D, IBS Diet, IBS Symptoms |
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̈ ܹNo matter how many times I see this very short paragraph by Sophie at ibstales.com, I chuckle. I tried writing “giggle,” but that sounds too undignified. She’s had a calm period, and writes:
No sooner had I written an entry saying I was so well I didn’t have anything to write about, my intestines gave me something to write about. They’ve very helpful like that. Sometimes they even make the bed.
September 3rd, 2007
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Blog, humor, IBS, Irritable Bowel Syndrome, IBS Symptoms |
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This recent post about IBS probiotic Align has a comment from David at Ganeden Biotech, makers of Digestive Advantage ™IBS. They would like me to repeat the review process that I did with Align, using their product for IBS. Their product is widely available in stores, and has one good clinical test of its efficacy.
I am going to respond and thank them. I will have to suggest that I do the review month with their product for Constipation, rather than the one labeled IBS. DA-IBS contains sucralose (Splenda), one of the IBS triggers — at least one of my triggers. Their http://www.ganedenbiotech.com/prod_constipation.html is labeled as using sugar, rather than sucralose.
So, we’ll see. Again, the only compensation is two months of free product. I will also ask for a discount specifically for readers of this blog. They already offer free samples on their web site, although I don’t know how many that would be sent to each customer.
There are some interesting and good reviews of Digestive Advantage ™- IBS on ePinions, which will server for starters.
September 1st, 2007
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Probiotics, IBS, Irritable Bowel Syndrome, IBS-C, IBS-D, Align, Digestive Advantage - IBS, Digestive Advantage - Constipation, IBS Symptoms |
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The Second Brain
There is an actual physical finding in Irritable Bowel Syndrome (IBS), that indicates that IBS is not “all in the head.” All in the nerves, maybe, but not all in the head.
The Three Nervous Systembs
To begin with, we need to understand that our bodies have three nervous systems:
- CNS - The Central Nervous System
- PNS - The Peripheral Nervous System
- ENS - The Enteric Nervous System, or the “second brain”
The CNS - Central Nervous System - consists of the brain and spinal column.
The PNS - Peripheral Nervous System - consists of the very long nerves that run along our arms and legs to our hands and feet.
The ENS - Enteric Nervous System - is the nerve tissue that lines our gut = the viscera = (mostly) small and large intestine.
And Serotonin
Serotonin is a neurotransmitter that plays an active role in the activity of neurons in the brain (CNS) and in the gut (ENS) . This activity, to simplify it all, either speeds impulses along the nerve pathways, or (as lack of activity) slows down nerve impulses.
Motility and Serotonin
What do you suppose that would do for motility–the ability of the gut to move its contents along easily, nicely, and calmly to the desired end. That’s right. The role of serotonin and the balanced action of serotonin affects both the speed of thought and the motility of the gut.
“Chemical Imbalance”
Depression is the major chemical imbalance in the brain that reflects an unbalanced serotonin activity. Not exactly similarly, just in somewhat the same fashion, IBS (IBS-C and IBS-D) are in part the result of a “chemical imbalance” of the Enteric Nervous System (ENS), the nerves that operate your gut, which rely on serotonin to transmit signals from one nerve ending to the next.
Balancing Serotonin
That’s why a gastroenterologist (gut doctor) may prescribe a tricyclic antidepressant, not because she or he is treating your head or thinks you are depressed. It is, rather, because he or she wants to give your Enteric Nervous System (ENS) more serotonin to work with for a better-balanced ENS.
August 27th, 2007
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Medical, IBS, Irritable Bowel Syndrome, IBS-C, IBS-D, Digesting Information, IBS Symptoms |
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The term Repressor-Sensitizer is a psychological term used to describe a certain kind of reaction to the discovery of symptoms or of illness. This kind of person, and I’m one, is accustomed to just keeping on keeping on, just hanging in there and getting it done. Until, that is, she or he notices signs of illness, or a usual test produces unusual results, or the doctor sends the person for a lot of dramatically invasive tests.
Then the ability to ignore small physical things that are not quite right goes out the window. Every shift and change in physical functioning gets noticed, felt strongly, and worried about. This is the shift from repressing bodily discomfort to becoming sensitized to every twinge–in your inner ear, in your kidney, and, of course, in your intestines.
I want to introduce the term ‘repressor-sensitizer’ in advance of a discussion next week of two very recent high-profile articles in the medical journal Gut. I think it helps to have the main term I’m going to use clearly in mind before reading my critiques of the Gut articles.
August 25th, 2007
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Medical, IBS, Irritable Bowel Syndrome, Digesting Information, IBS Symptoms |
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Terminology Problems
The discussion about appropriate types of fiber in the therapy of Irritable Bowel Syndrome is hampered by a number of misconceptions about fiber. What has been holding me up in writing a simple Fiber 101b post, the second part of the primer on fiber, has been the need to explain several distinctions among types of fiber, that is so much of what I mean when I say fiber.
These are some the terms used on this and other sites:
-
Dietary Fiber
- Insoluble Fiber (IF)
- Soluble Fiber (SF)
- Soluble Fiber Supplement (SFS)
- TV ads for “Fiber”
Putting the explanation of terms into an article, I think, will make your eyes glaze over. That will happen if what I say is in conflict with what you know. So, this is the fiber glossary, the words and terms for talking about fiber. Some of what is on this page will be new to your understanding of fiber.
Glossary
Fiber
Not a specific term. It doesn’t describe the food, or the supplements, that supply fiber. It may be used to describe a daily amount of fiber.
Dietary Fiber
This is more specific. It is part of the break down of the carbohydrates count in a nutrition label. The other part of the carbohydrate count is sugars. Dietary fiber contributes only a small amount of energy/calories, because it is the residue from plant foods. Recommended daily allowances are talking about measurable totals of different kinds of dietary fiber.
Soluble Fiber (SF)
Soluble Fiber comes from plants that are sources of gums used in the preparation of foods, as thickeners, for example. In Heather’s system of Eating for IBS, soluble fiber is also starches that are found in rice, potatoes, and sweet potatoes, and are useful to put the gastrocolic reflex to sleep before eating a (more-or-less) regular meal.
Soluble Fiber Supplements (SFS)
Soluble Fiber Supplements are commercially available varieties of the first kind of SF above, the plants that produce gums that dissolve completely in water. Some examples are guar gum used in the old Benefiber ™, acacia gum used in Heather’s Organic Acacia Tummy Fiber ™, and inulin from chicory root, sometimes used as a sweetener, and the only ingredient in FiberSure ™.
Insoluble Fiber (IF)
This is plant materials–fibers–that do not dissolve in water. Insoluble fiber is what used to be called “roughage.” It is usually what we understand doctors to be saying when they say “Increase fiber.” My bad example is Metamucil ™, which is made from psyllium (a kind of seed) husks. They add bulk to the stool, hastening its movement through the intestines. Bran and various crunchy, rough cereals are sources of insoluble fiber (IF); also raw vegetables such as carrots. The skins and seeds of fruit and vegetables are other sources, as are nuts. This is what doctors still give as the kind of stuff to eat as part of a “high fiber diet.”
None of these things is easily tolerated by a person with IBS.
TV Ads for “Fiber”
In the United States there is an ad for FiberCon caplets, ™ which are “Calcium polycarbophil 625 mg equivalent to 500 mg polycarbophil.” Their labeling suggests that the caplets should not be used more than 7 days without a doctor’s approval. The ingredient is the same as that in Equalactin ™. The interesting point is the way the ads play on the popular conception of a “high fiber diet,” and suggest that such a diet is impossible to follow because we’d be eating fiber all day. So, why not take their caplets? Well, because polycarbophil is a “bulk-forming” laxative–roughage, or IF–and may give some problems to people with IBS.
NOTE
In the past, in the archived posts on this blog, I have used SF and SFS interchangeably, meaning supplements. Heather’s site also has used the terms interchangeably in the past, in the meaning of both supplements and the soluble element of starches such as rice and potatoes, and bananas.
Neither of us is technically wrong, just different. SF, including both starches and SFS, is PREbiotic, a growing medium for the good bacteria that we call PRObiotics.
August 21st, 2007
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fiber, IBS therapy, FiberSure (tm), Heather's Organic Acacia Tummy Fiber (tm), Prebiotics, IBS Diet, IBS Symptoms |
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The following paragraph on Heather’s web site caught my eye:
Irritable Bowel Syndrome (IBS) Supplements
Supplements for the dietary management of IBS can be unbelievably helpful for stabilizing digestion. This is particularly true when they’re used as one of the five key strategies for controlling Irritable Bowel Syndrome (proper diet, stress management, alternative therapies, and prescription medications are the other four).
Soluble fiber supplements, herbs that have medicinal effects on the gastrointestinal tract, heat therapy, probiotics, calcium and/or magnesium, and digestive enzymes are all of proven benefit. Best of all, results are usually felt very quickly - sometimes even immediately (emphasis mine). ((1 from the Help for IBS Website
http://www.helpforibs.com/supplements/))
see also
http://www.helpforibs.com/footer/treatments.asp
Not to throw a wet blanket on your hopes of instant relief–well, yes, I’ll throw that wet blanket after all.
Starting diet change, discovering that indeed there are more triggers than you thought, finding the right supplements, all take time. It took me at least three months. Then, too, probiotics take at least three weeks before they begin to give relief. So IBS treatment in full does not produce rapid results. Yes, parts of a treatment regimen do, such as putting a heating pad on a painful tummy, or drinking fennel tea for gas and bloating. Getting IBS under control, though, takes time.
August 19th, 2007
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fiber, Probiotics, IBS, Irritable Bowel Syndrome, IBS therapy, IBS Triggers, Digesting Information, Prebiotics, Adjuncts, IBS Symptoms |
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One of what I call “adjuncts” to the therapy (not treatment, per se) of IBS is peppermint. Another is teas, which I’ve talked about before. This week’s Newsweek has a short article on the researched benefits of smelling peppermint, and, when it comes to IBS, ingesting peppermint. Here is the IBS part of the article:
One of the best uses of peppermint may be to help relieve the symptoms of irritable bowel syndrome, which can include abdominal cramping and pain and bloating. How does it work? Researchers say that menthol, the waxy, crystalline substance in peppermint oil, blocks calcium channels. This, in turn, helps relax muscles in the walls of the intestine. Sufferers can take the mint as a tea, or in peppermint capsules.
If you are taking guaifenisin for the therapy of Fibromyalgia, you should not take most forms of peppermint at the same time–this includes mint toothpaste, mint breath drops, mint lifesavers and other candies, and mint tea. The jury is still out on whether enteric-coated–that is, gets through your stomach and small intestine into your large intestine (bowel) before it opens–peppermint capsules can be used. The capsules I mean are Heather’s Tummy Tamers™ Peppermint Oil Caps, available from Heather’s web site, and from Amazon.com as well. I also checked Vitacost.com for peppermint capsules, but all I saw were soft gels, which would dissolve in your stomach and not reach your gut.
August 9th, 2007
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Teas, IBS, Irritable Bowel Syndrome, IBS therapy, Adjuncts, IBS Symptoms |
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The last two lines of a dense article on the effects of music on gastric motility (motion) are intriguing, yet raise many questions.
Listening to enjoyable music increases the amplitude of gastric myoelectrical activity in healthy humans.
Music therapy may improve gastric motility and may be used to stimulate gastric emptying.
This is the source for the statements above, accessed on the web on July 24, 2007.
The interesting implication is that listening to music that you like improves your intestines’ ability to move things along–great for people with IBS-C. Does that mean that people with IBS-D should not listen to music they like? Should listen to music they don’t like? This finding is based on testing with 17 normal subjects.
It is a simple thing to try, if you have IBS-C. I would be interested in getting a lot more experiential data from people with IBS. What do you think?
July 25th, 2007
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IBS, Irritable Bowel Syndrome, IBS therapy, IBS-C, Digesting Information, IBS Symptoms |
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There are two important rules to remember in the self-help approach to IBS. You have made the important decision to take charge of what’s going on with your body, now that, hooray! the doctors and technicians have found none of the majors. You don’t have cancer. You don’t have Crohn’s Disease. You don’t have gall bladder disease, or you don’t have a gall bladder. You don’t have liver disease. So you do sensible things: you stop drinking alcohol, you test whether milk makes things worse, you look at the authoritative list of triggers for IBS here, and begin to eliminate them.
Still, not everything seems right–or worse, nothing seems to be under control. So these are two rules you need to remember.
July 22nd, 2007
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fiber, IBS, Irritable Bowel Syndrome, IBS therapy, IBS Triggers, IBS-C, IBS-D, Digesting Information, IBS Diet, IBS Symptoms |
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