Benjamin H. Natelson, M.D.
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 While I don't have an answer to that question, it's clear that there is some overlap among CFS, FM, ibs, and MCS.
The Question of Syndromic Overlap
When people complain of severe fatigue, they usually have other symptoms as well. How does that affect the diagnoses of different medically unexplained syndromes? One group looked at that exact question when they compared twenty-five patients with CFS and twenty-two patients with FM. |
| Thus, although specific diagnostic lab tests do not yet exist to distinguish CFS, FM, and ibs from one another, their different symptoms strongly suggest to me the existence of various mechanisms within the body that cause each syndrome.
To sum up, following are the diagnostic rules for each of the syndromes I have detailed in this chapter:
• Chronic fatigue syndrome (CFS). |
| I have discussed serotonin before as a substance related to depressed mood and to pain. In ibs, the normal tone of the gut serotonin system is turned up, sometimes by stress and sometimes by infection, causing abdominal pain and diarrhea. Tegaserod and alosetron have exactly opposite effects on the serotonin system: tegaserod tends to turn it on and relieve constipation, while alosetron tends to block it and relieve diarrhea. |
Marshall Editions
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 Lycopodium: If symptoms of ibs are associated with anticipation about an upcoming event, and/or eating too much hard-to-digest, high-fiber foods, such as beans, sprouts, and lentils, try Lycopodium. Common symptoms include alternating bouts of diarrhea and constipation, coupled with a very noisy and distended digestive tract. There is rumbling and gurgling in the abdomen, heartburn, and a tendency for acid to wash up into the throat when belching. |
Andreas Moritz
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 Far from being a cure for ibs, the researchers found that it was the bran that was actually causing it! Bran also led to bowel disturbances, abdominal distension and pain. There is also a growing skepticism in the U.S. that lack of fiber causes cancer; some studies even suggest that a fiber-enhanced diet increases the risk of colon cancer.
Other Adverse Effects of Added Fiber
While fruit and vegetable fiber is quite harmless for the body, bran fiber from grain foods should be avoided as it poses a considerable health risk. |
Jacky Law
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 According to a leaked document from medical communications company, In Vivo, GlaxoSmithKline led a medical education programme in Australia as part of its marketing strategy for Lotronex, a drug designed to treat such a common dysfunction. 'IBS must be established in the minds of doctors as a significant and discrete disease state,' it said. Patients also 'need to be convinced that ibs is a common and recognized medical disorder.'33
The first step of the strategy was to set up an advisory board with one key opinion leader from each state of Australia. |
Andreas Moritz
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| Today over 20 percent of the British population suffers from ibs, and it is even more so in the United States. High fiber cereals cause loose stools, a major reason why people with constipation choose bran or bran-enriched foods as a method of producing regular bowel movements. Added bran, however, leaches minerals from the colon cells, weakens peristalsis, and causes chronic colon problems. If intake of bran is discontinued, constipation results.
Many health-conscious people follow a low fat diet—so highly recommended by nutritional experts. |
Jonny Bowden, Ph.D., C.N.S.
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 Food for Thought
The connection between food sensitivities and ibs is an important one, and most nutritionally minded health practitioners will recommend cutting out certain foods as a good starting place. Though trigger foods can be different for different people, some seem to crop up consistently and should be considered a good starting point. |
Jack Challem
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 Various pro-inflammatory cytokines are elevated in people with ibs. The combination can lead to a "leaky gut" in which undigested food proteins move into the blood, causing a broader immune response.
Standard Treatment
A variety of drugs, including corticosteroids, may be prescribed for ibs. The role of diet is often ignored.
Nutrients That Can Help
It should come as no surprise that anti-inflammatory omega-3 fatty acids are helpful in relieving ibs. |
Marshall Editions
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| Menthol is the primary component of ^ Y peppermint oil and produces many of the clinical effects. For ibs, it is best to use enteric-coated capsules so that the oil passes through to the intestines rather than being absorbed in the stomach, where it may contribute to heartburn. The daily dose is 0.6 ml of peppermint oil in enteric-coated tablets or capsules, often dosed as a 0.2 ml of peppermint oil in a capsule or tablet three times daily before food. |
Dr. Paula Baillie-Hamilton
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 Because this term is applied to a spectrum of complaints, there is no agreed precise definition of what ibs is. Because of this lack of clarity, this condition is often known by several other names, such as spastic colon, mucus colitis, or noninflammatory bowel disease.
Those affected by ibs usually have variable periods of relapse and remission. Common symptoms include bloating, abdominal pain, gas, alternating diarrhea and constipation, excess mucus, an urgency to defecate, and indigestion. |
| What he has discovered is that ibs appears to be particularly influenced by environmental triggers, such as toxic chemicals, and a range of allergens, such as pollen and certain foods. The good news is that symptoms can often be eliminated by removing these triggers and lowering the total body's chemical-pollutant load.
How Chemicals Affect IBS
The problem appears to lie in the makeup of our gastrointestinal system and its extreme vulnerability to the harmful effects of chemicals. It seems that chemicals can totally disrupt the smooth functioning of virtually every aspect of bowel activity. |
Leslie Taylor, ND
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 Of the ibs patients, 96 percent rated artichoke leaf extract as better than or at least equal to previous therapies administered for their ibs symptoms.
CURRENT PRACTICAL USES
The history of artichoke is a perfect example of science finally catching up to the longstanding traditional uses of a medicinal plant. |
Marshall Editions
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| Anxiety may trigger ibs in some people; this can be addressed by using many different plants (see Anxiety, p. 828).
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DIAGNOSIS
The cause of most kidney stones is unknown but they do tend to run in families. They generally start off as a minute crystal in the kidneys, usually caused by a high concentration of calcium in the urine. They can also be caused by dehydration, infection, and various kidney disorders. The condition is three times more common in men than women, and tends to be a recurrent problem.
Kidney stones vary greatly in size. |
| It is the most common condition seen by gastroenterologists and can occur at any age, but usually starts during the teenage years. ibs often results from a combination of physical and psychological factors. For example, there is evidence that patients with irritable bowel syndrome have increased sensitivity to stimuli within the gut. As well as the intestinal symptoms, stress seems to be one of the main triggers. Many people find that the onset of their symptoms is often due to a major life event. |
| There is no single blood test, X-ray, or scan that will diagnose ibs. Changes in diet, exercise, and stress management techniques can all help bring a reduction in distressing symptoms. and diarrhea
• Feeling full after small meals
• Abdominal bloating after meals
• Excessive gurgling noises in the stomach
"^xt^^ Diet: Add 2 tbsp of loose psyllium husk to food a day—it can be sprinkled vF* on cereal or salad. Introduce foods that are high in fiber into your diet.
The fiber should be mixed with, or followed by, about 8 oz of water to w prevent binding. |
| Arg nit: This remedy may be helpful if symptoms of ibs occur after ingesting too many sugary foods or drinks. Symptoms include passing gas and diarrhea that alternate with bouts of constipation, accompanied by severe bloating and swelling of the belly, which feels as though it's about to burst. High levels of anxiety and nervous tension will also aggravate digestive uneasiness.
Colocynthis: This remedy has a reputation for relieving colicky pains that come on in waves after eating and drinking. |
Dr. Edward F. Group III, DC, ND, DACBN
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| How Does Regular Colon Cleansing Help Relieve and Prevent ibs?
• Eliminates built up toxins and rids the intestinal walls of yeast and harmful bacteria (this sets the stage for rebalancing your intestinal flora with beneficial bacteria). |
Jack Challem
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| However, the fact that ibs affects the digestive tract strongly points to an interaction with food.
How Common Is Inflammatory Bowel Syndrome?
An estimated 500,000 to 1 million Americans have either ulcerative colitis or Crohn's disease. People of Jewish descent are more likely than Gentiles to develop ibs.
The Inflammation Syndrome Connection
The abdominal cramps, which may come on suddenly, are spasmodic responses to an irritant. Various pro-inflammatory cytokines are elevated in people with ibs. |
Bottom Line Health
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| HOW IT WORKS
Although experts are not sure just how cognitive therapy and hypnosis ease ibs symptoms, Lackner's and Simren's results are in line with other studies that have come to similar conclusions.
Dr. Emeran Mayer, a professor of medicine and physiology at the University of California at Los Angeles, believes that hypnotherapy works because it alters the way the brain reacts to stress, reducing levels of body arousal. "There's a very important role for these kinds of [mind-body] approaches," he says. |
Dr. Paula Baillie-Hamilton
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| Another way in which chemicals produce symptoms of ibs is by increasing or decreasing the levels of mucus secretion. Chemical damage done to the balance of intestinal bacteria or microflora results in excess wind. The range of symptoms experienced depends upon which part of the gut is affected, as well as the particular damage done.
Toxic chemicals induce a range of symptoms in those who suffer from ibs. |
Dr. Edward F. Group III, DC, ND, DACBN
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| The vital oxygen provided by these cleansers helps to purge garbage from the colon and it also serves as an excellent remedy for constipation and ibs as proven in human clinical trials.
As the years of waste melt away, the intestinal lining hidden beneath is revealed. In most cases, this lining is littered with microscopic holes due to years of abuse. In a toxic colon, these holes allow toxins to enter the bloodstream. After cleansing the colon, however, these same holes present a perfect opportunity for oxygen to work its way into the bloodstream where it can help detoxify the entire body. |
Bottom Line Health
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| To learn more about ibs, visit the Ameri-can Gastroenterological Association at www.gastro.org. Click on "Digestive Conditions" under the heading "Patient Center."
Herbs that Have Proven Power to Heal
Mark Blumenthal, founder and executive director of the American Botanical Council (ABC), www.herbalgram. org, and senior editor of both the English translation of The Complete German Commission EMonographs—Therapeutic Guide to Herbal Medicines (Integrative Medicine Communications) and of The ABC Clinical Guide to Herbs (ABC). |
Ann M. Coulston and Carol J. Boushey
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 Whereas healthy persons normally endure minor abdominal pains and changes in bowel habit with little thought, patients
TABLE 4 Concerns Expressed by Patients with Inflammatory Bowel Disease and persons with ibs in Internet Newsgroups, Crohn's Colitis Support Groups
?Need for procedures, surgery/ostomy/hospitalization
?Source or significance of pains and other symptoms
?Diarrhea, incontinence, embarrassment
?Occurrence of obstruction or fistulas
?The possibility that symptoms will lead to surgery
? |
Bottom Line Health
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| Helpful: ibs treatment typically includes stress reduction, a shift to a high-fiber diet and possibly medication.
Important MS Drug Back on the Market
Steven K. Galson, MD, MPH, director, Center for Drug Evaluation and Research, US Food and Drug Administration.
Patricia O'Looney, MD, director, biomedical research, National Multiple Sclerosis Society.
Russell Katz, MD, Office of Drug Evaluation 1, Division of Neurology Products, Center for Drug Evaluation and Research, US Food and Drug Administration. |
Jacky Law
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| Patients also 'need to be convinced that ibs is a common and recognized medical disorder.'33
The first step of the strategy was to set up an advisory board with one key opinion leader from each state of Australia. The job of this doctor would be to provide advice to the corporate sponsors on current opinion in gastroenterology and on 'opportunities for shaping it'. Further work included developing 'best practice guidelines' for diagnosing and managing ibs, and attending overseas meetings.
As it happens, Lotronex never made it onto the market. |
Bottom Line Health
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| Zelnorm has never been shown to be effective for men who have ibs, but it is used for chronic idiopathic (from an unknown cause) constipation in men and women younger than age 65. Also, it is not recommended for people who have a history of bowel obstruction and/or gallbladder disease because it can worsen both conditions.
Zelnorm is one of a new class of drugs called serotonin-4 receptor agonists, which activate receptors for serotonin, a relaxing neurotransmitter, in the digestive tract. This action is thought to normalize digestive tract movement. |
Brenda Watson and Leonard Smith
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 If you are personally familiar with ibs, then you know very well how much it can put a damper on quality of life. There are many studies that conclude that the constant intake of food additives and the ingestion of pesticides, chemicals, and dyes can cause irritation to the intestinal tract and/or an imbalance of the intestinal microflora, resulting in inflammation or symptoms of irritable bowel syndrome.
When I utter the world constipation in a roomful of people, it's always interesting to watch the response. Constipation is not something we usually like to talk about in public. |
H. Winter Griffith, M.D.
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 No Drug class: Gastrointestinal serotonin receptor agonist
Treatment for women with constipation-predominant irritable bowel syndrome (IBS or IBS-C). ibs is a common gastrointestinal disorder affecting women more often than men. Symptoms include abdominal pain and discomfort, bloating, constipation or diarrhea. May be used for treatment of other disorders as determined by your doctor.
DOSAGE & USAGE INFORMATION
How to take:
Tablet—Take with water on an empty stomach. When to use:
Twice daily just before a meal (usually morning and evening). Follow prescription instructions. |
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